Ryan, Una; Paparini, Andrea; Oskam, Charlotte
Enteric parasites are major contributors to the global diarrhoeal disease load, infecting >67.2 million people. Their prevalence and clinical impact, however, are underestimated due to lack of adequate detection, which is largely still based on microscopy, particularly in developing countries. New commercially available enteric panel assays, which detect parasites (as well as bacteria and/or viruses) using multiplex PCR, offer enhanced sensitivity and specificity as well as the ability to detect mixed infections, and will play an important role in epidemiological surveillance and outbreak investigations. A major limitation of these technologies, however, particularly for developing countries, is the costs involved. Emerging technologies for low-resource, point-of-care (POC) settings have the potential to dramatically improve the cost and accuracy of enteric parasite detection in the future. Copyright © 2017 Elsevier Ltd. All rights reserved.
Costantini, Verónica P.; Azevedo, Ana C.; Li, Xin; Williams, Mike C.; Michel, Frederick C.; Saif, Linda J.
Enteric pathogens in animal waste that is not properly processed can contaminate the environment and food. The persistence of pathogens in animal waste depends upon the waste treatment technology, but little is known about persistence of porcine viruses. Our objectives were to characterize the porcine enteric viruses (porcine noroviruses [PoNoVs], porcine sapoviruses [PoSaVs], rotavirus A [RV-A], RV-B, and RV-C) in fresh feces or manure and to evaluate the effects of different candidate environmentally superior technologies (ESTs) for animal waste treatment on the detection of these viruses. Untreated manure and samples collected at different stages during and after treatment were obtained from swine farms that used conventional waste management (CWM) and five different candidate ESTs. The RNA from porcine enteric viruses was detected by reverse transcription-PCR and/or seminested PCR; PoSaV and RV-A were also detected by enzyme-linked immunosorbent assay. Cell culture immunofluorescence (CCIF) and experimental inoculation of gnotobiotic (Gn) pigs were used to determine RV-A/C infectivity in posttreatment samples. The PoSaV and RV-A were detected in pretreatment samples from each farm, whereas PoNoV and RV-C were detected in pretreatment feces from three of five and four of five farms using the candidate ESTs, respectively. After treatment, PoSaV RNA was detected only in the samples from the farm using CWM and not from the farms using the candidate ESTs. RV-A and RV-C RNAs were detected in four of five and three of four candidate ESTs, respectively, after treatment, but infectious particles were not detected by CCIF, nor were clinical signs or seroconversion detected in inoculated Gn pigs. These results indicate that only RV-A/C RNA, but no viral infectivity, was detected after treatment. Our findings address a public health concern regarding environmental quality surrounding swine production units. PMID:17601821
Wu, Chunnuan; Sun, Le; Sun, Jin; Yang, Yajun; Ren, Congcong; Ai, Xiaoyu; Lian, He; He, Zhonggui
The aim of the present study was to correlate in vitro properties of drug formulation to its in vivo performance, and to elucidate the deciding properties of oral absorption. Gastrointestinal simulation technology (GST) was used to simulate the in vivo plasma concentration-time curve and was implemented by GastroPlus™ software. Lansoprazole, a typical BCS class II drug, was chosen as a model drug. Firstly, physicochemical and pharmacokinetic parameters of lansoprazole were determined or collected from literature to construct the model. Validation of the developed model was performed by comparison of the predicted and the experimental plasma concentration data. We found that the predicted curve was in a good agreement with the experimental data. Then, parameter sensitivity analysis (PSA) was performed to find the key parameters of oral absorption. The absorption was particularly sensitive to dose, solubility and particle size for lansoprazole enteric-coated tablets. With a single dose of 30 mg and the solubility of 0.04 mg/ml, the absorption was complete. A good absorption could be achieved with lansoprazole particle radius down to about 25 μm. In summary, GST is a useful tool for profiling biopharmaceutical deciding properties of absorption of lansoprazole enteric-coated tablets and guiding the formulation optimization. Crown Copyright © 2013. Published by Elsevier B.V. All rights reserved.
Patra, Amlan Kumar
Enteric methane (CH(4)) emission in ruminants, which is produced via fermentation of feeds in the rumen and lower digestive tract by methanogenic archaea, represents a loss of 2% to 12% of gross energy of feeds and contributes to global greenhouse effects. Globally, about 80 million tonnes of CH(4) is produced annually from enteric fermentation mainly from ruminants. Therefore, CH(4) mitigation strategies in ruminants have focused to obtain economic as well as environmental benefits. Some mitigation options such as chemical inhibitors, defaunation, and ionophores inhibit methanogenesis directly or indirectly in the rumen, but they have not confirmed consistent effects for practical use. A variety of nutritional amendments such as increasing the amount of grains, inclusion of some leguminous forages containing condensed tannins and ionophore compounds in diets, supplementation of low-quality roughages with protein and readily fermentable carbohydrates, and addition of fats show promise for CH(4) mitigation. These nutritional amendments also increase the efficiency of feed utilization and, therefore, are most likely to be adopted by farmers. Several new potential technologies such as use of plant secondary metabolites, probiotics and propionate enhancers, stimulation of acetogens, immunization, CH(4) oxidation by methylotrophs, and genetic selection of low CH(4)-producing animals have emerged to decrease CH(4) production, but these require extensive research before they can be recommended to livestock producers. The use of bacteriocins, bacteriophages, and development of recombinant vaccines targeting archaeal-specific genes and cell surface proteins may be areas worthy of investigation for CH(4) mitigation as well. A combination of different CH(4) mitigation strategies should be adopted in farm levels to substantially decrease methane emission from ruminants. Evidently, comprehensive research is needed to explore proven and reliable CH(4) mitigation technologies
Xu, Y; Wen, X; Feng, X; Liang, Z; Ye, X; Nie, H; Liao, X; Li, J; Zeng, Y; Tang, S; He, J
The objective of this work was to manufacture an enteric formulation of florfenicol (FF) using hot-melt extrusion (HME) technology and to evaluate its in vitro dissolution and in vivo pharmacokinetics. For the HME process, hypromellose acetate succinate LG (HPMCAS-LG) was the enteric polymer mixed with FF, and the two components were extruded with a standard screw configuration at a speed of 50 rpm. Differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), powder X-ray diffraction (PXRD), and Fourier transform infrared spectroscopy (FT-IR) were performed to characterize the HME extrudate. The release percentage of the enteric formulation in the acidic stage was 80%. Pharmacokinetic evaluations in swine revealed that the enteric formulation had a longer t 1/2λ and MRT than commercially available FF powder (FULAIKA ® ), indicating that the novel formulation exhibited enteric and sustained release properties. Compared with the commercial product, the relative bioavailability of the enteric formulation reached up to 117.2%. This study suggests that this formulation may have potential for future commercialization. © 2018 John Wiley & Sons Ltd.
Mawasha, P. Ruby; Lam, Paul C.; Vesalo, John; Leitch, Ronda; Rice, Stacey
In this article, it is postulated that the development of a successful training program for women in science, math, engineering, and technology (SMET) disciplines is dependent upon a combination of several factors, including (a) career orientation: commitment to SMET as a career, reasons for pursuing SMET as a career, and opportunity to pursue a SMET career; (b) knowledge of SMET: SMET courses completed, SMET achievement, and hands-on SMET activities; (c) academic and social support: diversity initiatives, role models, cooperative learning, and peer counseling; and (d) self-concept: program emphasis on competence and peer competition. The proposed model is based on the GET SMART (Girls Entering Technology, Science, Math and Research Training) workshop program to prepare and develop female high school students as competitive future SMET professionals. The proposed model is not intended to serve as an elaborate theory, but as a general guide in training females entering SMET disciplines.
Courtney-Pratt, Helen; Cummings, Elizabeth; Turner, Paul; Cameron-Tucker, Helen; Wood-Baker, Richard; Walters, Eugene Haydn; Robinson, Andrew Lyle
Achieving adoption, use, and integration of information and communication technology by healthcare clinicians in the workplace is recognized as a challenge that requires a multifaceted approach. This article explores community health nurses' engagement with information and communication technology as part of a larger research project that investigated the delivery of self-management support to people with chronic obstructive pulmonary disease. Following a survey of computer skills, participants were provided with computer training to support use of the project information system. Changes in practice were explored using action research meetings and individual semistructured interviews. Results highlight three domains that affected nurses' acceptance, utilization, and integration of information and communication technology into practice; environmental issues; factors in building capacity, confidence, and trust in the technology; and developing competence. Nurses face individual and practice challenges when attempting to integrate new processes into work activities, and the use of participatory models to support adoption is recommended.
Varadarajulu, Shyam; Banerjee, Subhas; Barth, Bradley; Desilets, David; Kaul, Vivek; Kethu, Sripathi; Pedrosa, Marcos; Pfau, Patrick; Tokar, Jeffrey; Wang, Amy; Song, Louis-Michel Wong Kee; Rodriguez, Sarah
The American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidence-based methodology is used, with a MEDLINE literature search to identify pertinent clinical studies on the topic and a MAUDE (U.S. Food and Drug Administration Center for Devices and Radiological Health) database search to identify the reported complications of a given technology. Both are supplemented by accessing the "related articles" feature of PubMed and by scrutinizing pertinent references cited by the identified studies. Controlled clinical trials are emphasized, but in many cases, data from randomized, controlled trials are lacking. In such cases, large case series, preliminary clinical studies, and expert opinions are used. Technical data are gathered from traditional and Web-based publications, proprietary publications, and informal communications with pertinent vendors. Technology Status Evaluation Reports are drafted by 1 or 2 members of the ASGE Technology Committee, reviewed and edited by the committee as a whole, and approved by the Governing Board of the ASGE. When financial guidance is indicated, the most recent coding data and list prices at the time of publication are provided. For this review, the MEDLINE database was searched through August 2010 for articles related to enteral, esophageal, duodenal, and colonic stents. Technology Status Evaluation Reports are scientific reviews provided solely for educational and informational purposes. Technology Status Evaluation Reports are not rules and should not be construed as establishing a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment or payment for such treatment. Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
Full Text Available In the absence of immortality, the human species has over the millennia developed rites and rituals to help in the passing of life to honor the person who is dying or has died or in some way demonstrate their “courage” and perseverance as well as duty even in the face of almost certain death. The centuries-old traditions of the gathering of loved ones, the chanting of prayers, the ritual religious blessings are in the process of being replaced by the “miracles” of modern medical technology.
In the absence of immortality, the human species has over the millennia developed rites and rituals to help in the passing of life to honor the person who is dying or has died or in some way demonstrate their “courage” and perseverance as well as duty even in the face of almost certain death. The centuries-old traditions of the gathering of loved ones, the chanting of prayers, the ritual religious blessings are in the process of being replaced by the “miracles” of modern medical technology. PMID:25717389
Corsi, Ilaria; Cherr, Gary N; Lenihan, Hunter S; Labille, Jerome; Hassellov, Martin; Canesi, Laura; Dondero, Francesco; Frenzilli, Giada; Hristozov, Danail; Puntes, Victor; Della Torre, Camilla; Pinsino, Annalisa; Libralato, Giovanni; Marcomini, Antonio; Sabbioni, Enrico; Matranga, Valeria
The widespread use of engineered nanomaterials (ENMs) in a variety of technologies and consumer products inevitably causes their release into aquatic environments and final deposition into the oceans. In addition, a growing number of ENM products are being developed specifically for marine applications, such as antifouling coatings and environmental remediation systems, thus increasing the need to address any potential risks for marine organisms and ecosystems. To safeguard the marine environment, major scientific gaps related to assessing and designing ecosafe ENMs need to be filled. In this Nano Focus, we examine key issues related to the state-of-the-art models and analytical tools being developed to understand ecological risks and to design safeguards for marine organisms.
Dishauzi, Karen M.
Extensive research exists on female, African American, and Hispanic students pursuing Science, Technology, Engineering and Mathematics (STEM) field disciplines. However, little research evaluates students with disabilities and career decision-making relating to STEM field disciplines. This study explored the career decision-making experiences and self-efficacy for students with disabilities. The purpose of this research study was to document experiences and perceptions of students with disabilities who pursue, and may consider pursuing, careers in the STEM field disciplines by exploring the career decision-making self-efficacy of students with disabilities. This study documented the level of influence that the students with disabilities had or may not have had encountered from parents, friends, advisors, counselors, and instructors as they managed their decision-making choice relating to their academic major/career in the STEM or non-STEM field disciplines. A total of 85 respondents of approximately 340 students with disabilities at one Midwestern public university completed a quantitatively designed survey instrument. The Career Decision-Making Self-Efficacy Scale-Short Form by Betz and Hackett was the instrument used, and additional questions were included in the survey. Data analysis included descriptive statistics and analysis of variance. Based upon the results, college students with disabilities are not currently being influenced by individuals and groups of individuals to pursue the STEM field disciplines. This is a cohort of individuals who can be marketed to increase enrollment in STEM programs at academic institutions. This research further found that gender differences at the institution under study did not affect the career decision-making self-efficacy scores. The men did not score any higher in confidence in career decision-making than the women. Disability type did not significantly affect the relationship between the Career Decision-Making Self
Rühl, A; Nasser, Y; Sharkey, K A
The enteric nervous system is composed of both enteric neurones and enteric glia. Enteric glial cells were first described by Dogiel and are now known to outnumber neurones approximately 4 : 1. In the past, these cells were assumed to subserve a largely supportive role; however, recent evidence indicates that enteric glial cells may play a more active role in the control of gut function. In transgenic mouse models, where enteric glial cells are selectively ablated, the loss of glia results in intestinal inflammation and disruption of the epithelial barrier. Enteric glia are activated specifically by inflammatory insults and may contribute actively to inflammatory pathology via antigen presentation and cytokine synthesis. Enteric glia also express receptors for neurotransmitters and so may serve as intermediaries in enteric neurotransmission. Thus, enteric glia may serve as a link between the nervous and immune systems of the gut and may also have an important role in maintaining the integrity of the mucosal barrier and in other aspects of intestinal homeostasis.
Radiation enteropathy; Radiation-induced small bowel injury; Post-radiation enteritis ... Radiation therapy uses high-powered x-rays, particles, or radioactive seeds to kill cancer cells. The therapy ...
Kwon, Richard S; Banerjee, Subhas; Desilets, David; Diehl, David L; Farraye, Francis A; Kaul, Vivek; Mamula, Petar; Pedrosa, Marcos C; Rodriguez, Sarah A; Varadarajulu, Shyam; Song, Louis-Michel Wong Kee; Tierney, William M
The ASGE Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidence-based methodology is used, performing a MEDLINE literature search to identify pertinent clinical studies on the topic and a MAUDE (U.S. Food and Drug Administration Center for Devices and Radiological Health) database search to identify the reported complications of a given technology. Both are supplemented by accessing the "related articles" feature of PubMed and by scrutinizing pertinent references cited by the identified studies. Controlled clinical trials are emphasized, but, in many cases, data from randomized, controlled trials are lacking. In such situations, large case series, preliminary clinical studies, and expert opinions are used. Technical data are gathered from traditional and Web-based publications, proprietary publications, and informal communications with pertinent vendors. Technology Status Evaluation Reports are drafted by 1 or 2 members of the ASGE Technology Committee, reviewed and edited by the committee as a whole, and approved by the ASGE Governing Board. When financial guidance is indicated, the most recent coding data and list prices at the time of publication are provided. For this review, the MEDLINE database was searched through August 2009 for articles related to endoscopy in patients requiring enteral feeding access by using the keywords "endoscopy," "percutaneous," "gastrostomy," "jejunostomy," "nasogastric," "nasoenteric," "nasojejunal," "transnasal," "feeding tube," "enteric," and "button." Technology Status Evaluation Reports are scientific reviews provided solely for educational and informational purposes. Technology Status Evaluation Reports are not rules and should not be construed as establishing a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment or payment for such treatment. Copyright 2010 American Society
Sucha, R.; Lichvarova, I.; Duchon, R.; Dolnik, J.; Pindak, D.
Enteral feeding provides physiologic, metabolic, safety, and cost benefits over parenteral nutrition. There are various ways enteral nutritional is administered and scheduled. The method of administration must be individualized to each patient's specific needs. Enteral nutrition is not only the supply of exogenous substrates and to prevent depletion of endogenous sources. Today the enteral nutrition becomes part of a therapeutic strategy to influence the severity of the disease to affect the function of GIT, and to modulate immune responses of the gut and the whole organism. Early enteral nutrition in the postoperative period reduces the risk of infectious complications. (author)
Derevitskay, O. K.; Dydykin, A. S.
Enteral nutrition is widely used in hospitals as a means of nutritional support and therapy for different diseases. Enteral nutrition must fulfil the energy needs of the body, be balanced by the nutrient composition and meet patient’s nutritional needs. Meat is a source of full-value animal protein, vitamins and minerals. On the basis of this research, recipes and technology for a meat-based enteral nutrition product were developed. The product is a ready-to-eat sterilised mixture in the form of a liquid homogeneous mass, which is of full value in terms of composition and enriched with vitamins and minerals, consists of particles with a size of not more than 0.3 mm and has the modified fat composition and rheological characteristics that are necessary for passage through enteral feeding tubes. The study presents experimental data on the content of the main macro- and micro-nutrients in the developed product. The new product is characterised by a balanced fatty acid composition, which plays an important role in correction of lipid metabolism disorders and protein-energy deficiency, and it is capable of satisfying patients’ daily requirements for vitamins and the main macro- and microelements when consuming 1500-2000 ml. Meat-based enteral nutrition can be used in diets as a standard mixture for effective correction of the energy and anabolic requirements of the body and support of the nutritional status of patients, including those with operated stomach syndrome.
Full Text Available Nutritional support of surgical patients is a necessary part of the treatment. It alone cannot cure the disease but it significantly affects the recovery of patients and supports surgical interventions. Patients in malnutrition have shown to have significantly more postoperative infectious and non-infectious complications. This significantly prolongs treatment time and increases costs. However, there is one fact that cannot be expressed in money, which is the patient's impression of the surgical intervention. Adequate preoperative patient support, based on the intake of liquid nutritive solutions, reduces preoperative stress and deflects the metabolic response. Now, it is recommended for adults and children older than one year to drink clear liquid up to 2 hours before induction in anesthesia. Appropriate enteral nutrition has a significant place in the postoperative recovery of patients. Enteral nutrition is reducing complications, mainly infectious complications because the function of the digestive system as one large immune system is preserved. Perioperative enteral nutrition is a necessary part of the modern treatment of surgical patients. In addition to the significant effect on the occurrence of postoperative complications, it is also important that this type of diet improves the psychological status of patients.
Camilleri, M; Cowen, T; Koch, T R
The objective of this article is to review the clinical presentation and neurobiology of degeneration of the enteric nervous system with emphasis on human data where available. Constipation, incontinence and evacuation disorders are frequently encountered in the ageing population. Healthy lower gastrointestinal function is essential for successful ageing as it is critical to maintaining independence and autonomy to pursue further activity. One clinical expression of enteric neurodegeneration is constipation. However, the aetiology may be multifactorial as disturbances of epithelial, muscle or neural function may all result from neurodegeneration. There is evidence of loss of excitatory (e.g. cholinergic) enteric neurons and interstitial cells of Cajal, whereas inhibitory (including nitrergic) neurons appear unaffected. Understanding neurodegeneration in the enteric nervous system is key to developing treatments to reverse it. Neurotrophins have been shown to accelerate colonic transit and relieve constipation in the medium term; they are also implicated in maintenance programmes in adult enteric neurons through a role in antioxidant defence. However, their effects in ageing colon require further study. There is evidence that 5-HT(2) and 5-HT(4) mechanisms are involved in development, maintenance and survival of enteric neurons. Further research is needed to understand and potentially reverse enteric neurodegeneration.
... types of feeding tubes. Enteral Nutrition Fact Sheet Twitter Tweets by ASPENWEB ASPEN 8401 Colesville Road, Suite ... Staff Find a Clinician Press Room Career Center Advertising and Sponsorship Related Websites BPS NBNSC NBPNS Connect ...
Fuhrmeister, Erica R; Schwab, Kellogg J; Julian, Timothy R
Understanding the excretion and treatment of human waste (feces and urine) in low and middle income countries (LMICs) is necessary to design appropriate waste management strategies. However, excretion and treatment are often difficult to quantify due to decentralization of excreta management. We address this gap by developing a mechanistic, stochastic model to characterize phosphorus, nitrogen, biochemical oxygen demand (BOD), and fecal coliform pollution from human excreta for 108 LMICs. The model estimates excretion and treatment given three scenarios: (1) use of existing sanitation systems, (2) use of World Health Organization-defined "improved sanitation", and (3) use of best available technologies. Our model estimates that more than 10(9) kg/yr each of phosphorus, nitrogen and BOD are produced. Of this, 22(19-27)%, 11(7-15)%, 17(10-23)%, and 35 (23-47)% (mean and 95% range) BOD, nitrogen, phosphorus, and fecal coliforms, respectively, are removed by existing sanitation systems. Our model estimates that upgrading to "improved sanitation" increases mean removal slightly to between 17 and 53%. Under the best available technology scenario, only approximately 60-80% of pollutants are treated. To reduce impact of nutrient and microbial pollution on human and environmental health, improvements in both access to adequate sanitation and sanitation treatment efficiency are needed.
... page: //medlineplus.gov/ency/patientinstructions/000164.htm Enteral nutrition - child - managing problems To use the sharing features ... trouble breathing, call 911. References Mcclave SA. Enteral nutrition. In: Goldman L, Schafer AI, eds. Goldman-Cecil ...
Sindbæk, Søren Michael
Innovations in culture or technology are moments, which offer extraordinary insights into the working of societies. The ways in which new practices or things are adopted by groups or individuals, or encounter resistance or rejection from the same, trace a section through the social topography...
Kurt, Cansu; Göy, Defne Flora; Özden, Gülşah; Barutçu, Öykü; Bozer, Cüneyt
Enteric nervous system directs and regulates the breakdown, absorption and elimination of food in our digestive system. However, alongside its digestive functions, enteric nervous system has also gained importance because of the discovery of its bidirectional link with intestinal flora, which has recently started to be considered as a separate organ in addiction to its digestive functions. Enteric nervous system contains approximately 100 million nerve cells, operates both independently and i...
Conventional wisdom has it that the best way to do business in China is through an equity joint venture (EJV) with a well-connected Chinese partner. But pioneering companies are starting a trend toward a new way to enter that market: as a wholly foreign-owned enterprise, or WFOE. Increasingly, says the author, joint ventures do not offer foreign companies what they need to succeed in China. For example, many companies want to do business nationally, but the prospects for finding a Chinese partner with national scope are poor. Moreover, there are often conflicting perceptions between partners about how to operate an EJV: Chinese companies, for example, typically have a more immediate interest in profits than foreign investors do. By contrast, the author asserts, WFOEs are faster to set up and easier to manage; and they allow managers to expand operations more rapidly. That makes them the perfect solution, right? The answer is a qualified yes. First, foreign companies will still need sources of guanxi, or social and political connections. Second, managers must take steps to avoid trampling on China's cultural or economic sovereignty. Third and perhaps most important, foreign companies must be prepared to bring something of value to China-usually in the form of jobs or new technology that can help the country develop. Companies willing to make the effort, says the author, can reap the rewards of China's burgeoning marketplace.
both the state and the Danish Red Cross, which operates the majority of the asylum centres. While these structures are in some ways reminiscent of Foucault's panopticon, I want to suggest a counterpoint to the panopticon, which I call the ‘myopticon’ to indicate the near-sightedness of the central...... of bureaucratic processing, but intrinsic to the operation of the myopticon. By drawing out points of distinction with Foucault's panopticon, I sketch the outlines of a new technology of power that has powerful consequences for the daily lives of asylum seekers in Denmark....
Kaushik, Neeraj; Pietraszewski, Marie; Holst, Jens Juul
OBJECTIVE: All forms of commonly practiced enteral feeding techniques stimulate pancreatic secretion, and only intravenous feeding avoids it. In this study, we explored the possibility of more distal enteral infusions of tube feeds to see whether activation of the ileal brake mechanism can result...... in plasma glucagon-like peptide-1 and peptide YY concentrations. CONCLUSIONS: Our results suggest that enteral feeding can be given without stimulating pancreatic trypsin secretion provided it is delivered into the mid-distal jejunum. The mechanism may involve activation of the ileal brake mechanism....
Jørgensen, Henry; Theil, Peter Kappel; Knudsen, Knud Erik Bach
per kg meat produced is increased (Fernández et al. 1983; Lekule et al. 1990). The present chapter will summarise our current knowledge concerning dietary and enteric fermentation that may influence the methane (CH4) emission in pigs. Enteric fermentation is the digestive process by which.......3 % of the worlds pig population. The main number of pigs is in Asia (59.6 %) where the main pig population stay in China (47.8 % of the worlds pig population). The objective of the chapter is therefore: To obtain a general overview of the pigs’ contribution to methane emission. Where is the pigs’ enteric gas...... produced and how is it measured. The variation in methane emission and factors affecting the emission. Possibility for reducing the enteric methane emission and the consequences....
Ojo, Omorogieva; Brooke, Joanne
There have been significant advances in the provision of enteral nutrition support in the acute and community healthcare settings. Enteral nutrition is beneficial to individuals who have functional guts but may not be able to meet their nutritional requirements via a normal diet. Most of these people have neurological conditions such as stroke, multiple sclerosis and dementia which could impact on swallowing reflexes, leading to dysphagia . Others may have cancer, intellectual disability o...
Full Text Available BACKGROUND Nutrients form the fuel for the body, which comes in the form of carbohydrates, proteins and lipids. The body is intended to burn fuels in order to perform work. Starvation with malnutrition affects the postoperative patients and patients with acute pancreatitis. There is an increased risk of nosocomial infections and a delay in the wound healing may be noted. They are more prone for respiratory tract infections. Enteral Nutrition (EN delivers nutrition to the body through gastrointestinal tract. This also includes the oral feeding. This study will review the administration, rationale and assess the pros and cons associated with the early initiation of enteral feeding. The aim of this study is to evaluate if early commencement of enteral nutrition compared to traditional management (delayed enteral feeding is associated with fewer complications and improved outcome- In patients undergoing elective/emergency gastrointestinal surgery. In patients with acute pancreatitis. It is also used to determine whether a period of starvation (nil by mouth after gastrointestinal surgery or in the early days of acute pancreatitis is beneficial in terms of specific outcomes. MATERIALS AND METHODS A prospective cohort interventional study was conducted using 100 patients from July 2012 to November 2012. Patients satisfying the inclusion and exclusion criteria were included in the study. Patients admitted in my unit for GIT surgeries or acute pancreatitis constituted the test group, while patients admitted in other units for similar disease processes constituted the control group. RESULTS Our study concluded that early enteral feeding resulted in reduced incidence of surgical site infections. When the decreased length of stay, shorter convalescent period and the lesser post-interventional fatigue were taken into account, early enteral feeding has a definite cost benefit.CONCLUSION Early enteral feeding was beneficial associated with fewer
... disease The inflammation can also involve the stomach ( gastritis ) and large intestine ( colitis ). Risk factors include: Recent ... a few days in otherwise healthy people. Possible Complications Complications may include: Dehydration Long-term diarrhea Note: ...
Wood, Jackie D
Discovery and documentation of noncholinergic-nonadrenergic neurotransmission in the enteric nervous system started a revolution in mechanisms of neural control of the digestive tract that continues into a twenty-first century era of translational gastroenterology, which is now firmly embedded in the term, neurogastroenterology. This chapter, on Enteric Neurobiology: Discoveries and Directions, tracks the step-by-step advances in enteric neuronal electrophysiology and synaptic behavior and progresses to the higher order functions of central pattern generators, hard wired synaptic circuits and libraries of neural programs in the brain-in-the-gut that underlie the several different patterns of motility and secretory behaviors that occur in the specialized, serially-connected compartments extending from the esophagus to the anus.
Weiner, R; Matkowitz, R; Hartig, W; Conradi, G; Laue, R
The rapid loss of the body weight of oncological patients in the advanced stage of the carcinomatous disease is caused by numerous pathophysiological mechanisms. With the help of the modified D-xylose absorption test was investigated which value have disturbances of the enteral absorption in the complex of causes for the development of a tumour cachexia. For the patients in the stage of generalisation of the carcinomatous disease clear disturbances in the enteral food intake could be proved in contrast to patients with carcinoma without general tumour symptomatology and healthy persons. The influence of chemo- and radio-therapy on the enteral absorption of patients with carcinoma was discussed. The forced alimentation of oncological patients with unspezific tumour symptoms must be regarded as a firm constituent in the treatment of patients with carcinoma.
Shakeer, V K; Devi, Sobhana R; Chettupuzha, Antony Paul; Mustafa, C P; Sandesh, K; Kumar, Sunil K; Thomas, Varghese; Ashraf, A Syed
We describe a 15-year-old boy who was on carbamazepine for the past 8 years for seizure disorder, who developed recurrent episodes of small bowel obstruction. Full-thickness small bowel biopsy obtained at laparotomy was consistent with eosinophilic enteritis. He improved clinically after tapering the drug.
Ventriculoperitoneal 78. Point of View: Exit ventriculoperitoneal shunt; enter endoscopic third ventriculostomy (ETV): contemporary views on hydrocephalus and their implications on management. Abstract. Hydrocephalus has been known to affect humans since the birth of human medicine as it is described by Hippocrates.
Barrachina Bellés, Lidón; García Hernández, Misericordia; Oto Cavero, Isabel
Este trabajo nos introduce en la administración de la nutrición enteral, haciendo una revisión de los aspectos a tener en cuenta tanto en sus indicaciones, vias, tipos, métodos, cuidados y complicaciones más importantes.
Full Text Available A one month old male child presented with respiratory distress since day 10 of life. There was intercostal retraction and decreased air entry on the right side. Investigations revealed a well defined cystic mass in the posterior mediastinum with vertebral anomalies, the cyst was excised by posterolateral thoracotomy. Histopathology revealed it to be an enteric foregut duplication cyst.
Kaushik, Neeraj; Pietraszewski, Marie; Holst, Jens Juul
.5 g protein/kg ideal body weight/d. Plasma gut peptide responses were monitored in 15 subjects. RESULTS: In comparison with basal fasting trypsin secretion rates (mean = 134 [standard error = 22] U/h), duodenal feeding with the polymeric and elemental formulae stimulated trypsin secretion (mean = 408...... in enteral feeding without pancreatic stimulation, with particular reference to trypsin, because the avoidance of trypsin stimulation may optimize enteral feeding in acute pancreatitis. METHODS: The pancreatic secretory responses to feeding were studied in 36 healthy volunteers by standard double...... [standard error = 51] U/h; P standard error = 34] U/h) and mid-distal jejunal (mean = 119 [standard error = 16] U/h) did not. Stimulation was associated with an increase in plasma cholecystokinin, whereas distal jejunal feeding resulted in an increase...
CERN openlab is a unique public-private partnership between CERN and leading ICT companies. At the start of this year, openlab officially entered its fifth phase, which will run until the end of 2017. For the first time in its history, it has extended beyond the CERN community to include other major European and international research laboratories. Founded in 2001 to develop the innovative ICT systems needed to cope with the unprecedented computing challenges of the LHC, CERN openlab unites science and industry at the cutting edge of research and innovation. In a white paper published last year, CERN openlab set out the main ICT challenges it will tackle during its fifth phase, namely data acquisition, computing platforms, data storage architectures, computer management and provisioning, networks and connectivity, and data analytics. As it enters its fifth phase, CERN openlab is expanding to include other research laboratories. "Today, research centres in other disciplines are also st...
Benya, R; Mobarhan, S
Tube feeding is commonly used for providing essential calories and nutrients to the patient otherwise unable to eat. In the last two decades there has been significant expansion in the number and quality of enteral formulas. In this review, we evaluate the indications for each major class of formula, and survey complications associated with formulas and devices that deliver formula. Recommendations for future research are listed.
Bida, S A; Schillhorn van Veen, T
An outbreak of acute enteric paramphistomiasis was observed among Yankasa (indigenous) sheep that were herded with cattle on the University farm at Samaru in February 1973. Mortality was approximately thirty to forty per cent. The most important clinical signs were anorexia, unthriftiness and profuse foetid diarrhoea soiling the perianal region and hind legs. Diagnosis was based on the post-mortem findings, clinical signs and presence of conical flukes identified as Paramphistomum microbothrium.
Cross, M.J.; Frazee, R.C. (Department of General Surgery, Scott and White Memorial Hospital, Temple TX (United States))
Radiation enteritis is a progressive, disease process that causes intestinal fibrosis and obliterative endarteritis, which results in significant morbidity and mortality. The authors' clinical experience involving 20 patients over a 22-year period from 1967 through 1989 who underwent various surgical procedures to alleviate chronic symptoms secondary to radiation enteritis is described. Eight men and 12 women with a mean age of 52 years (24 to 81 years) underwent a total of 27 procedures for complications of radiation enteritis. Radiation therapy was delivered for treatment of gynecologic malignancies (55%), colorectal cancer (20%), prostate malignancies (10%), and others (15%). The mean average dose of radiation delivered was 5,514 rads with a range of 2,613 to 7,000 rads. The interval from radiation treatment to time of surgery averaged 9 years. Operative procedures consisted of 12 resection and primary anastomosis procedures and 15 resections with stoma creation. Formation of a stoma was used in patients with more severe disease. The 30-day operative mortality was 0% and morbidity was 55%. There were no anastomotic leaks or intra-abdominal abscesses. The authors conclude that resection and primary anastomosis can safely be performed in selected patients but that judicious use of stoma formation can avoid major mortality and morbidity associated with surgery in this setting.
Cross, M.J.; Frazee, R.C.
Radiation enteritis is a progressive, disease process that causes intestinal fibrosis and obliterative endarteritis, which results in significant morbidity and mortality. The authors' clinical experience involving 20 patients over a 22-year period from 1967 through 1989 who underwent various surgical procedures to alleviate chronic symptoms secondary to radiation enteritis is described. Eight men and 12 women with a mean age of 52 years (24 to 81 years) underwent a total of 27 procedures for complications of radiation enteritis. Radiation therapy was delivered for treatment of gynecologic malignancies (55%), colorectal cancer (20%), prostate malignancies (10%), and others (15%). The mean average dose of radiation delivered was 5,514 rads with a range of 2,613 to 7,000 rads. The interval from radiation treatment to time of surgery averaged 9 years. Operative procedures consisted of 12 resection and primary anastomosis procedures and 15 resections with stoma creation. Formation of a stoma was used in patients with more severe disease. The 30-day operative mortality was 0% and morbidity was 55%. There were no anastomotic leaks or intra-abdominal abscesses. The authors conclude that resection and primary anastomosis can safely be performed in selected patients but that judicious use of stoma formation can avoid major mortality and morbidity associated with surgery in this setting
Ponsky, J L
Nutrition has become a cornerstone of surgical patient care. With better understanding of metabolic and compositional requirements, great advances have been made in the area of total parenteral nutrition. Recent attention to full utilization of alimentary tract function has prompted a resurgence of interest in dietary formulas and methods of delivery. Three new approaches to the alimentary tract provide better access for feeding. Needle catheter jejunostomy allows early alimentary tract utilization following operations, while percutaneous endoscopic gastrostomy and jejunostomy provide long-term solutions to the provision of enteral alimentation. Future utilization of these techniques will certainly lead to better patient care.
Munk, Anders Kristian
'modes of mattering'. In this paper I explore what difference digital cartography can make to STS practice. I draw on three examples from my own work where digitally mediated maps have entered the conversation and made critical, often surprising, differences to the research process. In my first example...... the map is brought along as an ethnographic device on a piece of fieldwork, in my second example it serves as the central collaborative object in a participatory design project, and in my third example the map becomes the object of contestation as it finds itself centre stage in the controversy...
As display technologies prepare to welcome 3-D, the 21st-century classroom will soon bear little resemblance to anything students and teachers have ever seen. In this article, the author presents the latest innovations in the world of digital display technology. These include: (1) Touchlight, an interactive touch screen program that takes a normal…
The newest phase of CERN’s openlab framework was inaugurated this week during a meeting of the openlab partners. This phase will last three years and will bring together existing openlab partners and a new contributor: Huawei. Group picture taken at the first CERN openlab IV annual Board of Sponsors meeting, in the presence of the CERN Director-General, the partners and the openlab team members. © Fons Rademakers (CERN Photo Club). Eleven years ago, the creation of the CERN openlab created a long-term link between industrial partners and the Organization. Its framework has allowed industry to carry out large-scale IT research and development in an open atmosphere – an “Open Lab”, if you will. For CERN, openlab has contributed to giving the computing centre and, more broadly, the LHC community, the opportunity to ensure that the next generation of services and products is suitable to their needs. Now entering its fourth phase, openlab will ...
Sbarbati, Andrea; Osculati, Francesco
The work reviews the evidence suggesting that lingual components of the autonomic system may be considered the most rostral portion of the enteric nervous system (ENS) defining the concept of lingual ENS (LENS). The LENS is not dissimilar from the more distally located portions of the ENS, however, it is characterized by a massive sensory input generated by collaterals of gustatory and trigeminal fibers. The different neuronal subpopulations that compose the LENS operate reflexes involved in regulation of secretion and vasomotility. Systemic reflexes on the digestive and respiratory apparatus are operated by means of neural connections through the pharynx or larynx. The LENS can modulate the activity of distally located organs by means of the annexed glands.The LENS seems therefore to be a "chemical eye" located at the beginning of the digestive apparatus which analyses the foods before their ingestion and diffuses this information distally. The definition of the LENS supports the concept of an elevated degree of autonomy in the ENS and puts in a new light the role of the gustatory system in modulation of the digestive functions. For its characteristics, the LENS appears to be an ideal model to study the elementary connectivity of the ENS.
Nuclear plant simulation continues to evolve rapidly as ever increasing computer power becomes available at ever decreasing prices. S3 Technologies while still dedicated to designing the full-scope control room simulators that make training so realistic, are now extending training beyond the control room with small, powerful computers and innovative graphics. The small graphics-driven simulators can supplement the traditional training with a more personal and flexible approach by exploiting existing models in different environments. We are also capitalising on the same technologies and trends that permit us to change the methods of training to simplify our approach to engineering by combining small, powerful computers, graphics-based model creation and automatic code generators. (Author)
Focuses on technology, on advances in such areas as aeronautics, electronics, physics, the space sciences, as well as computers and the attendant progress in medicine, robotics, and artificial intelligence. Describes educational resources for elementary and middle school students, including Web sites, CD-ROMs and software, videotapes, books,…
Sejian, Veerasamy; Lal, Rattan; Lakritz, Jeffrey; Ezeji, Thaddeus
The greenhouse gas (GHG) emissions from the agricultural sector account for about 25.5% of total global anthropogenic emission. While CO2 receives the most attention as a factor relative to global warming, CH4, N2O and chlorofluorocarbons (CFCs) also cause significant radiative forcing. With the relative global warming potential of 25 compared with CO2, CH4 is one of the most important GHGs. This article reviews the prediction models, estimation methodology and strategies for reducing enteric CH4 emissions. Emission of CH4 in ruminants differs among developed and developing countries, depending on factors like animal species, breed, pH of rumen fluid, ratio of acetate:propionate, methanogen population, composition of diet and amount of concentrate fed. Among the ruminant animals, cattle contribute the most towards the greenhouse effect through methane emission followed by sheep, goats and buffalos, respectively. The estimated CH4 emission rate per cattle, buffaloe, sheep and goat in developed countries are 150.7, 137, 21.9 and 13.7 (g/animal/day) respectively. However, the estimated rates in developing countries are significantly lower at 95.9 and 13.7 (g/animal/day) per cattle and sheep, respectively. There exists a strong interest in developing new and improving the existing CH4 prediction models to identify mitigation strategies for reducing the overall CH4 emissions. A synthesis of the available literature suggests that the mechanistic models are superior to empirical models in accurately predicting the CH4 emission from dairy farms. The latest development in prediction model is the integrated farm system model which is a process-based whole-farm simulation technique. Several techniques are used to quantify enteric CH4 emissions starting from whole animal chambers to sulfur hexafluoride (SF6) tracer techniques. The latest technology developed to estimate CH4 more accurately is the micrometeorological mass difference technique. Because the conditions under which
However, there is limited published data focused on effect of enteral glutamine on infection rate in patients with severe burns. Results from recently published RCT on effects of enteral glutamine, show a trend of an overall reduction in incidence of bacteraemia, lower antibiotic usage and lower mortality rates in patients with ...
Noncommunicating isolated enteric duplications in the abdomen are an extremely rare variant of enteric duplications with their own blood supply. We report a case of a noncommunicating isolated ileal duplication in a 10-month-old boy. He was admitted because of severe abdominal distension and developed irritability ...
Spanier, B. W. M.; Bruno, M. J.; Mathus-Vliegen, E. M. H.
Introduction. In patients with acute pancreatitis (AP), nutritional support is required if normal food cannot be tolerated within several days. Enteral nutrition is preferred over parenteral nutrition. We reviewed the literature about enteral nutrition in AP. Methods. A MEDLINE search of the English
Boeckxstaens, G. E.
The enteric nervous system or the `Little Brain' of the gut controls gastrointestinal motility and secretion, and is involved in visceral sensation. In this chapter, new developments in understanding the function of the enteric nervous system are described. In particular, the interaction of this
Coehoorn, M.; Sinke, W.C.
Everybody agrees that there is a bright future for solar energy. After two decades of research and development, the market introduction of solar hot water systems is now taking off. In several countries, including the Netherlands, preparations are also underway for the large-scale introduction of photovoltaic systems. Although the share of thermal and photovoltaic solar energy in the energy supply sector in the Netherlands is very small (0.1 PJ) there are signs of imminent change. According to the Follow-up Policy Document on Energy Conservation, the share of solar energy should increase to 7 PJ by the year 2010. After years of concentrating on research and development, it is now generally recognised that it is time to introduce these technologies onto the market in order to realize the long-term objectives. In this respect, thermal solar energy is ahead of photovoltaics. 4 ills
Full Text Available The traditional answer card reading method using OMR (Optical Mark Reader, most commonly, OMR special card special use, less versatile, high cost, aiming at the existing problems proposed a method based on pattern recognition of the answer card identification method. Using the method based on Line Segment Detector to detect the tilt of the image, the existence of tilt image rotation correction, and eventually achieve positioning and detection of answers to the answer sheet .Pattern recognition technology for automatic reading, high accuracy, detect faster
Pietroletti, R.; Blaauwgeers, J.L.; Taat, C.W.; Simi, M.; Brummelkamp, W.H.; Becker, A.E.
In this study, the intestinal endocrine cells were investigated in 13 surgical specimens affected by radiation enteritis. Endocrine cells were studied by means of Grimelius' silver staining and immunostaining for chromogranin, a general marker of endocrine cells. Positively stained cells were quantified by counting their number per unit length of muscularis mucosa. Results in radiation enteritis were compared with matched control specimens by using Student's t test. Chromogranin immunostaining showed a statistically significant increase of endocrine cells in radiation enteritis specimens compared with controls both in small and large intestine (ileum, 67.5 +/- 23.5 cells per unit length of muscularis mucosa in radiation enteritis versus 17.0 +/- 6.1 in controls; colon, 40.9 +/- 13.7 cells per unit length of muscularis mucosa in radiation enteritis versus 9.5 +/- 4.1 in controls--p less than 0.005 in both instances). Increase of endocrine cells was demonstrated also by Grimelius' staining; however, without reaching statistical significance. It is not clear whether or not the increase of endocrine cells in radiation enteritis reported in this study is caused by a hyperplastic response or by a sparing phenomenon. We should consider that increased endocrine cells, when abnormally secreting their products, may be involved in some of the clinical features of radiation enteropathy. In addition, as intestinal endocrine cells produce trophic substances to the intestine, their increase could be responsible for the raised risk of developing carcinoma of the intestine in long standing radiation enteritis
calculations (I can legally buy this music or I can get it for free online with very little risk of getting punished). In the case of P2P file sharing...battle by MGM to stop illegal music sharing, the danger of making a moral issue into a market issue means that legal measures, especially measures...Desai and Magliocca, “Patents, Meet Napster”; Samuelson, “Three Reactions”; Waldefogel, “Evidence from Recorded Music .” 52 legal means would
Clements, Abigail; Young, Joanna C; Constantinou, Nicholas; Frankel, Gad
Enteric Escherichia coli (E. coli) are both natural flora of humans and important pathogens causing significant morbidity and mortality worldwide. Traditionally enteric E. coli have been divided into 6 pathotypes, with further pathotypes often proposed. In this review we suggest expansion of the enteric E. coli into 8 pathotypes to include the emerging pathotypes of adherent invasive E. coli (AIEC) and Shiga-toxin producing enteroaggregative E. coli (STEAEC). The molecular mechanisms that allow enteric E. coli to colonize and cause disease in the human host are examined and for two of the pathotypes that express a type 3 secretion system (T3SS) we discuss the complex interplay between translocated effectors and manipulation of host cell signaling pathways that occurs during infection.
Baumann, Christian R.; Clark, Erika L.; Pedersen, Nigel P.; Hecht, Jonathan L.; Scammell, Thomas E.
Hypocretins (orexins) are wake-promoting neuropeptides produced by hypothalamic neurons. These hypocretin-producing cells are lost in people with narcolepsy, possibly due to an autoimmune attack. Prior studies described hypocretin neurons in the enteric nervous system, and these cells could be an additional target of an autoimmune process. We sought to determine whether enteric hypocretin neurons are lost in narcoleptic subjects. Even though we tried several methods (including whole mounts, sectioned tissue, pre-treatment of mice with colchicine, and the use of various primary antisera), we could not identify hypocretin-producing cells in enteric nervous tissue collected from mice or normal human subjects. These results raise doubts about whether enteric neurons produce hypocretin. PMID:18191238
A number of different types of human enteric viruses cause waterborne outbreaks when individuals are exposed to contaminated drinking and recreational waters. Vaccination against poliovirus has virtually eliminated poliomyelitis from the planet, but other members of the enterovi...
Hallay, Judit; Nagy, Dániel; Fülesdi, Béla
Malnutrition in hospitalised patients has a significant and disadvantageous impact on treatment outcome. If possible, enteral nutrition with an energy/protein-balanced nutrient should be preferred depending on the patient's condition, type of illness and risk factors. The aim of the nutrition therapy is to increase the efficacy of treatment and shorten the length of hospital stay in order to ensure rapid rehabilitation. In the present review the authors summarize the most important clinical and practical aspects of enteral nutrition therapy.
Baumann, Christian R.; Clark, Erika L.; Pedersen, Nigel P.; Hecht, Jonathan L.; Scammell, Thomas E.
Hypocretins (orexins) are wake-promoting neuropeptides produced by hypothalamic neurons. These hypocretin-producing cells are lost in people with narcolepsy, possibly due to an autoimmune attack. Prior studies described hypocretin neurons in the enteric nervous system, and these cells could be an additional target of an autoimmune process. We sought to determine whether enteric hypocretin neurons are lost in narcoleptic subjects. Even though we tried several methods (including whole mounts, s...
Greiner, Mary V; Beal, Sarah J; Nause, Katie; Staat, Mary Allen; Dexheimer, Judith W; Scribano, Philip V
To determine the prevalence of medical illness detected by laboratory screening in children entering foster care in a single, urban county. All children entering foster care in a single county in Ohio were seen at a consultation foster care clinic and had laboratory screening, including testing for infectious diseases such as HIV, hepatitis B, hepatitis C, syphilis, and tuberculosis as well as for hemoglobin and lead levels. Over a 3-year period (2012-2015), laboratory screening was performed on 1977 subjects entering foster care in a consultative foster care clinic. The prevalence of hepatitis B, hepatitis C, syphilis, and tuberculosis were all found to be <1%. There were no cases of HIV. Seven percent of teenagers entering foster care tested positive for Chlamydia . A secondary finding was that 54% of subjects were hepatitis B surface antibody-negative, indicating an absence of detected immunity to the hepatitis B virus. Routine laboratory screening for children entering foster care resulted in a low yield. Targeted, rather than routine, laboratory screening may be a more clinically meaningful approach for children entering foster care. Copyright © 2017 by the American Academy of Pediatrics.
Alidjinou, Enagnon Kazali; Sane, Famara; Firquet, Swan; Lobert, Pierre-Emmanuel; Hober, Didier
Human enteric viruses are associated with several clinical features, especially gastroenteritis. Large amounts of these viruses can be released in the environment and spread to people. Enteric viruses are nonenveloped viruses and have displayed good survival in the environment. They can be significantly resistant in food and water but also on fomites, and this is thought to play a role in transmission, leading to sporadic cases or outbreaks. The survival of enteric viruses on fomites relies on many factors including the virus itself, fomite properties, and extrinsic environmental factors such as temperature or relative humidity. Several reports in the literature have found an association with gastroenteritis cases or outbreaks and fomites naturally contaminated by enteric viruses. However, the study of virus survival following natural contamination is challenging, and most published studies are laboratory based, using experimental contamination. In addition, recent and detailed data on the resistance of each of the main enteric viruses on fomites are scarce. Many approaches, both physical and chemical, can be used to inactivate enteric viruses, the efficacy of which depends on the virus and the disinfection conditions. © 2017 S. Karger AG, Basel.
Holmgren, Jan; Parashar, Umesh D; Plotkin, Stanley; Louis, Jacques; Ng, Su-Peing; Desauziers, Eric; Picot, Valentina; Saadatian-Elahi, Mitra
An immunological Correlate of Protection (CoP) is an immune response that is statistically interrelated with protection. Identification of CoPs for enteric vaccines would help design studies to improve vaccine performance of licensed vaccines in low income settings, and would facilitate the testing of future vaccines in development that might be more affordable. CoPs are lacking today for most existing and investigational enteric vaccines. In order to share the latest information on CoPs for enteric vaccines and to discuss novel approaches to correlate mucosal immune responses in humans with protection, the Foundation Mérieux organized an international conference of experts where potential CoPs for vaccines were examined using case-studies for both bacterial and viral enteric pathogens. Experts on the panel concluded that to date, all established enteric vaccine CoPs, such as those for hepatitis A, Vi typhoid and poliovirus vaccines, are based on serological immune responses even though these may poorly reflect the relevant gut immune responses or predict protective efficacy. Known CoPs for cholera, norovirus and rotavirus could be considered as acceptable for comparisons of similarly composed vaccines while more work is still needed to establish CoPs for the remaining enteric pathogens and their candidate vaccines. Novel approaches to correlate human mucosal immune responses with protection include the investigation of gut-originating antibody-secreting cells (ASCs), B memory cells and follicular helper T cells from samples of peripheral blood during their recirculation. Copyright © 2017.
Full Text Available The aim of this review is to provide a global perspective of Home Enteral Tube Feeding (HETF and to outline some of the challenges of home enteral nutrition (HEN provisions. It is well established that the number of patients on HETF is on the increase worldwide due to advances in technology, development of percutaneous endoscopic gastrostomy techniques, and the shift in care provisions from acute to community settings. While the significance of home enteral nutrition in meeting the nutritional requirements of patients with poor swallowing reflexes and those with poor nutritional status is not in doubt, differences exist in terms of funding, standards, management approaches and the level of infrastructural development across the world. Strategies for alleviating some of the challenges militating against the effective delivery of HETF including the development of national and international standards, guidelines and policies for HETF, increased awareness and funding by government at all levels were discussed. Others, including development of HEN services, which should create the enabling environment for multidisciplinary team work, clinical audit and research, recruitment and retention of specialist staff, and improvement in patient outcomes have been outlined. However, more research is required to fully establish the cost effectiveness of the HEN service especially in developing countries and to compare the organization of HEN service between developing and developed countries.
Haddad, G.K.; Grodsinsky, C.; Allen, H.
Radiation therapy, often used to treat gynecologic and urologic pelvic malignancies, has varying, adverse effects on the bowel. Radiation enteritis may occur from one month to 20 years after irradiation, and disabling symptoms may require surgery in 10 to 20 per cent of patients. From our experience with 20 patients who required surgery for radiation enteritis and who were followed for up to 20 years, we were able to identify three clinical groups. Patients in the first group need only medical treatment for their symptoms, and observation, whereas patients in the second group may present with acute, debilitating, life-threatening symptoms that may require emergency surgery. Patients in the third group have a long-standing history of intermittent bowel obstruction and/or enteric fistulas that are best treated with adequate nutritional support followed by timely surgical intervention
Morton, Alison; Wolfe, Susan
Enteral tube feeding is routinely used in many cystic fibrosis centres when oral dietary and supplement intake has failed to achieve an adequate nutritional status. The use of this method of feeding is assessed on an individual basis taking into consideration the patients age and clinical status. To examine the evidence that in people with cystic fibrosis, supplemental enteral tube feeding improves nutritional status, respiratory function, and quality of life without significant adverse effects. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register which comprises references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. We also contacted the companies that market enteral feeds and reviewed their databases.Date of the most recent search of the Group's Cystic Fibrosis Trials Register: 13 February 2015.Date of the most recent hand search of PubMed and conference abstract books: 13 February 2015. All randomised controlled trials comparing supplemental enteral tube feeding for one month or longer with no specific intervention in people with cystic fibrosis. The searches identified 38 trials; however, none were eligible for inclusion in this review. There are no trials included in this review. Supplemental enteral tube feeding is widely used throughout the world to improve nutritional status in people with cystic fibrosis. The methods mostly used, nasogastric or gastrostomy feeding, are expensive and may have a negative effect on self-esteem and body image. Reported use of enteral tube feeding suggests that it results in nutritional and respiratory improvement; but, efficacy has not been fully assessed by randomised controlled trials. It is acknowledged, however, that performing a randomised controlled trial would be difficult due to the ethics of withholding an intervention in a group of patients whose nutritional status necessitates it.
Appropriate nutritional support is crucial in the therapeutic approach of multiple conditions, which justifies the frequent and increasing use of specific access routes for enteral and parenteral nutrition. This article reviews the relevant literature concerning indications, procedures, effectiveness and complications of enteral access routes in children. The decision between gastric and postpyloric access, and between nasogastric tube and gastrostomy is thoroughly discussed. Percutaneous endoscopic gastrostomy is the most commonly used technique when a long-term gastric access is required, given its efficacy and safety although the associated morbidity is not negligible;laparoscopic gastrostomy emerges as a potentially advantageous alternative.
Lisitsyn Nikolai A
Full Text Available Abstract Microbes living in the mammalian gut exist in constant contact with immunity system that prevents infection and maintains homeostasis. Enteric alpha defensins play an important role in regulation of bacterial colonization of the gut, as well as in activation of pro- and anti-inflammatory responses of the adaptive immune system cells in lamina propria. This review summarizes currently available data on functions of mammalian enteric alpha defensins in the immune defense and changes in their secretion in intestinal inflammatory diseases and cancer.
Kermarrec, Laetitia; Durand, Tony; Neunlist, Michel; Naveilhan, Philippe; Neveu, Isabelle
Enteric glial cells (EGC) have trophic and neuroregulatory functions in the enteric nervous system, but whether they exert a direct effect on immune cells is unknown. Here, we used co-cultures to show that human EGC can inhibit the proliferation of activated T lymphocytes. Interestingly, EGC from Crohn's patients were effective at one EGC for two T cells whereas EGC from control patients required a ratio of 1:1. These data suggest that EGC contribute to local immune homeostasis in the gastrointestinal wall. They also raise the possibility that EGC have particular immunosuppressive properties in inflammatory bowel diseases such as Crohn's disease. Copyright © 2016. Published by Elsevier B.V.
Radiotherapy of abdominal and pelvic tumours is frequently associated with acute radiation enteritis. Predominant symptoms include diarrhea, watery stools, abdominal pain, nausea and vomiting. There are very few effective interventions available for this condition. Enteral oligomeric nutrition has been used in bowel diseases with functional failure similar to radiation enteritis. The aim of presented work was to observe occurrence of symptoms of radiation enteritis in patients undergoing abdominal or pelvic radiotherapy. Apart from diet and pharmacological therapy, oral oligomeric enteral nutrition (Peptisorb Powder Nutricia) at the dose of 1000 - 2000 ml per day was administered for minimum of 4 days. Planned period of administration was 14 days and longer. Symptoms of radiation enteritis were evaluated at the beginning and in the end of administration. Prevalence of all evaluated symptoms of radiation enteritis was decreased and difference was statistically significant for diarrhea, watery stools, abdominal pain, nausea and vomiting. The use of evaluated oligomeric nutritional support might, in conjunction with pharmacotherapy and diet, alleviate symptoms of acute radiation enteritis and maintain nutritional status of patients. (author)
In this paper, I enter a crack to think otherwise about the concept "gossip". Drawing on previous scholarship engaging with Deleuzian concepts to inform research methodologies, this paper builds on this body of work. Following Deleuze and Guattari, the paper undertakes a mapping of gossip, subsequent to an encounter with a crack.…
Hobolth, Lise; Bendtsen, Flemming
and a pill cam capsule endoscopy were normal. In all cases the condition normalized spontaneously. A thorough interview revealed a recreational use of cocaine, and diary recordings confirmed the association between her abdominal pain and cocaine use. Ischaemic enteritis has previously been described...... in cocaine users. Udgivelsesdato: 2009-Sep...
Justin, R B; Hohenhaus, A E
Hypophosphatemia is uncommon in cats, but it has been reported in association with diabetes mellitus and hepatic lipidosis, where it can cause hemolysis, rhabdomyopathy, depression, seizures, and coma. The purpose of this article is to describe 9 cats that developed low serum phosphorus concentrations (alimentation. Serum biochemical analyses from more than 6,000 cats were reviewed. The medical records of all cats with hypophosphatemia were examined for history of enteral alimentation; diabetic cats were excluded from the study. Nine cats, ranging in age from 3 to 17 years, were identified. All cats had normal serum phosphorus concentrations before tube feeding began. Onset of hypophosphatemia occurred 12 to 72 hours after initiation of enteral alimentation, and the nadir for phosphorus concentrations ranged from 0.4 to 2.4 mg/dL. Hemolysis occurred in 6 of the 9 cats. Hypophosphatemia secondary to enteral alimentation is an uncommon clinical finding in cats. Cats with high alanine aminotransferase activity, hyperbilirubinemia, and weight loss should be closely monitored for hypophosphatemia during the first 72 hours of enteral alimentation.
Suzuki, Y; Hanyu, N; Kashiwagi, H; Kubo, T; Aoki, T
The history of percutaneous endoscopic gastrostomy (PEG) is relatively short. In 1980, a report entitled "Gastrostomy without laparotomy: A percutaneous endoscopic technique" by Ponsky and Gaudere was first published in the Journal of Pediatric Surgery. Thereafter, PEG soon saw widespread use in Western countries because of its clinical efficacy and economy. It has been performed in about 170,000 cases annually in the US. In contrast, its spread in Japan has been extremely slow: only about 10,000 cases have undergone this procedure annually, and this number accounted for less than 5% of patients receiving enteral alimentation. The reason why PEG has not spread may be the medical insurance system in Japan and the local distaste for operation scarring. However, in consideration of the unprecedented ageing of society that is surely coming in the near future, the role of PEG in Japan must be reexamined. In this report, we presented the methodology of enteral alimentation at home by means of PEG, giving special consideration to: (1) "What points are improved by using enteral alimentation at home by means of PEG in various diseases; (2) dysphagia due to cerebral angiopathy; (3) terminal cancer; (4) otolaryngological diseases; and (5) Crohn disease. We also discussed "Why PEG is important now?" in performing enteral alimentation at home.
Objective: To estimate the magnitude of Campylobacter enteritis in children below fifteen years of age. Design: A cross-sectional survey. Setting: Seven villages found in the outskirts of Kolla Diba town were covered. The town is located 35 kilometres away from Gondar teaching hospital. Participants: Stool specimens were ...
Dec 12, 2000 ... Objective: To estimate the magnitude of Campylobacter enteritis in children below fifteen years of age. Design: A cross-sectional survey. Setting: Seven villages found in the outskirts of Kolla Diba town were covered. The town is located 35 kilometres away from Gondar teaching hospital. Participants: Stool ...
Astronaut John Glenn enters the Mercury spacecraft, Friendship 7, prior to the launch of MA-6 on February 20, 1961 and became the first American who orbited the Earth. The MA-6 mission was the first manned orbital flight boosted by the Mercury-Atlas vehicle, a modified Atlas ICBM (Intercontinental Ballistic Missile), lasted for five hours, and orbited the Earth three times.
Smit, Jitske Martha
This thesis deals with several aspects of the influences of intensive cancer chemotherapy on the nutritional status, the metabolism, and the gastrointestinal tract of the host and describes whether these results can be influenced by enteral hyperalimentation, We studied these aspects in patients
This article discuses the problems faced by West African and particularly Ghanaian female popular performers and the various factors that have, since the 1960's led to increasing numbers of women entering the professional theatre and the commercial entertainment industry. The study examines the upsurge of female ...
and guinea pigs. Animals orally fed with clean water showed no symptoms of yersiniosis. Rabbits infected with Y. pseudotuberculosis showed signs of illness while guinea pigs did not show any clinical sign. Visceral organs of infected rabbits showed enteritis with necrotic lesions but no pathological changes were observed ...
Full Text Available We report an extremely rare case of isolated enteric cyst in the neck region which was diagnosed on the histopathological examination. It was suspected to be duplication cyst on radiology. We have also evaluated the differential diagnosis and management issues.
Sánchez-Izquierdo Riera, J A; Montejo González, J C
The hypermetabolism that develops in patients with severe polytraumatism has led to the need for an aggressive metabolic-nutritional support from the start. Parenteral Nutrition is the preferred technique in many instances, due to the doubts on the effectiveness of enteral nutrition in the control of the metabolic response and to problems of gastrointestinal tolerance derived from its administration. However, the role of enteral nutrition as an important factor which limits the development of bacterial translocation and the chain of events leading to multiorganic failure appears to be more and more well-established and is an important argument for justifying the early administration of enteral nutrition in these patients. In accordance with the accumulated experience of several authors over the past few years, enteral nutrition may be administered early in polytraumatized patients. This is not only accompanied by the evidence of acceptable gastrointestinal tolerance to the diet, but also by additional advantages compared to parenteral nutrition, such as the maintenance of trophism and immunocompetence of the digestive mucosa, the reduction of septic complications and also greater nutritional effectiveness which can be evaluated by the behaviour of the seric proteins used as nutritional evolution markers. The interest of the different diet formulae which exist at present, for example diets enriched with branched-chain amino acids, diets with added fibre, peptidic diets, specific pulmonary diets or "euglycaemic diets" is evaluated in this review. All these diets may mean an increase in the effectiveness and/or tolerance of enteral nutrition in polytraumatized patients, and also contribute to the handling of specific problems such as "stress" hyperglycaemia or the withdrawal of mechanical ventilation support. The use of specific nutrients for the digestive mucosa, such as glutamine or short chain fatty acids seems to be an important factor in the reduction of
Mukai, Junji; Miyanaga, Yohko; Ishizaka, Toshihiko; Asaka, Kiyokazu; Nakai, Yuka; Tsuji, Eriko; Uchida, Takahiro
The purpose of this study was to evaluate quantitatively the taste of the various total enteral nutrients marketed in Japan using human gustatory sensation tests and an artificial taste sensor. In the human gustatory sensation test, four basic taste intensities (sweetness, saltiness, sourness, and bitterness), as well as 15 kinds of palatability scales, were evaluated according to the semantic differential (SD) method. Among 15 palatability items, the item; difficult to drink/easy to drink, was adopted as an overall palatability since it shows the highest factor loading by factor analysis. The overall palatability was found to be highly positively correlated with sweetness and sourness, but negatively correlated with bitterness and saltiness. Addition of a flavour to the amino acid-based enteral nutrient AminolebanEN significantly improved its palatability. This effect is presumably due to sour components of the flavour, such as citric acid, which reduce the bitterness intensity of branched-chain amino acids in the product. The sweetness and sourness intensities predicted by the taste sensor showed a high correlation with the results obtained in the human gustatory sensation tests. The taste sensor was able to predict the overall palatability of the total enteral nutrients with high accuracy. The products could be classified into three groups (peptide-based, amino-acid-based, and protein-based) by principal component analysis using sensor output of 8 channels. The products could be also classified into four groups; peptide-based, amino-acid-based, and protein-based and flavor addition group by principal component analysis using sensor output of channels 1, 3, 4 and 7, which are specific to basic tastes. The taste sensor could therefore be useful in predicting the taste or palatability of total enteral nutrients, and could contribute to attempts to improve compliance for such products and for enteral nutrients.
EPA's Federal Technology Transfer Act (FTTA) is a mechanism with which EPA can patent its inventions and license them to companies, through which innovative technologies can enter the marketplace to improve the environment and human health.
Dämmgen, Ulrich; Schulz, Joachim; Klausing, Heinrich Kleine
Methane emissions from enteric fermentation of pigs are object of emission reporting. Hitherto they were treated as part of the energy balance of pigs, in accordance with IPCC guidance documents. They were calculated from the gross energy intake rate and a constant methane conversion ratio....... Meanwhile numerous experimental data on methane emissions from enteric fermentation is available in Germany and abroad; the results are compiled in this work. These results also allow for a description of transformation processes in the hind gut and a subsequent establishment of models that relate emissions...... to feed and performance data. The model by Kirchgeßner et al. (1995) is based on German experimental data and reflects typical national diet compositions. It is used to quantify typical emissions and methane conversion ratios. The results agree with other experimental findings at home and abroad...
Beer, W.H.; Fan, A.; Halsted, C.H.
The clinical and nutritional significance of radiation enteritis was assessed in eight patients with chronic diarrhea which followed curative doses of radiotherapy for pelvic malignancies. Steatorrhea, found in seven malnourished patients, was ascribed to ileal disease or previous surgery, or to bacterial contamination of the small intestine. Lactose intolerance, assessed by breath hydrogen excretion after oral lactose and by jejunal lactase levels, was found in six patients. In a subgroup of five patients, the administration of two different defined formula liquid diets by nasoduodenal infusion decreased fecal fluid and energy losses by about one-half. Compared to Vivonex-HN, the infusion of Criticare-HN was associated with greater likelihood of intestinal gas production but a three-fold greater utilization of protein. Intestinal malabsorption and malnutrition in radiation enteritis has diverse etiologies. Whereas nutritional support by liquid diet limits fecal fluid and energy losses, these diets differ significantly in clinical tolerance and biologic value.
Galligan, J J
Human immune deficient virus (HIV) is an immunosuppressive virus that targets CD4(+) T-lymphocytes. HIV infections cause increased susceptibility to opportunistic infections and cancer. HIV infection can also alter central nervous system (CNS) function causing cognitive impairment. HIV does not infect neurons but it does infect astrocytes and microglia in the CNS. HIV can also infect enteric glia initiating an intestinal inflammatory response which causes enteric neural injury and gut dysfunction. Part of the inflammatory response is HIV induced production of proteins including, Transactivator of transcription (Tat) which contribute to neuronal injury after release from HIV infected glial cells. A risk factor for HIV infection is intravenous drug use with contaminated needles and chronic opiate use can exacerbate neural injury in the nervous system. While most research focuses on the actions of Tat and other HIV related proteins and opiates on the brain, recent data indicate that Tat can cause intestinal inflammation and disruption of enteric neuron function, including alteration of Na(+) channel activity and action potential generation. A paper published in this issue of Neurogastroenterology and Motility extends these findings by identifying an interaction between Tat and morphine on enteric neuron Na(+) channels and on intestinal motility in vivo using a Tat expressing transgenic mouse model. These new data show that Tat protein can enhance the inhibitory actions of morphine on action potential generation and propulsive motility. These findings are important to our understanding of how HIV causes diarrhea in infected patients and for the use of opioid drugs to treat HIV-induced diarrhea. © 2015 John Wiley & Sons Ltd.
Brooke, Joanne; Ojo, Omorogieva
The aim of this systematic review is to evaluate the role of enteral nutrition in dementia. The prevalence of dementia is predicted to rise worldwide partly due to an aging population. People with dementia may experience both cognitive and physical complications that impact on their nutritional intake. Malnutrition and weight loss in dementia correlates with cognitive decline and the progress of the disease. An intervention for long term eating difficulties is the provision of enteral nutrition through a Percutaneous Endoscopic Gastrostomy tube to improve both nutritional parameters and quality of life. Enteral nutrition in dementia has traditionally been discouraged, although further understanding of physical, nutritional and quality of life outcomes are required. The following electronic databases were searched: EBSCO Host, MEDLINE, PubMed, Cochrane Database of Systematic Reviews and Google Scholar for publications from 1st January 2008 and up to and including 1st January 2014. Inclusion criteria included the following outcomes: mortality, aspiration pneumonia, pressure sores, nutritional parameters and quality of life. Each study included separate analysis for patients with a diagnosis of dementia and/or neurological disease. Retrospective and prospective observational studies were included. No differences in mortality were found for patients with dementia, without dementia or other neurological disorders. Risk factors for poor survival included decreased or decreasing serum albumin levels, increasing age or over 80 years and male gender. Evidence regarding pneumonia was limited, although did not impact on mortality. No studies explored pressure sores or quality of life. PMID:25854831
Full Text Available The aim of this systematic review is to evaluate the role of enteral nutrition in dementia. The prevalence of dementia is predicted to rise worldwide partly due to an aging population. People with dementia may experience both cognitive and physical complications that impact on their nutritional intake. Malnutrition and weight loss in dementia correlates with cognitive decline and the progress of the disease. An intervention for long term eating difficulties is the provision of enteral nutrition through a Percutaneous Endoscopic Gastrostomy tube to improve both nutritional parameters and quality of life. Enteral nutrition in dementia has traditionally been discouraged, although further understanding of physical, nutritional and quality of life outcomes are required. The following electronic databases were searched: EBSCO Host, MEDLINE, PubMed, Cochrane Database of Systematic Reviews and Google Scholar for publications from 1st January 2008 and up to and including 1st January 2014. Inclusion criteria included the following outcomes: mortality, aspiration pneumonia, pressure sores, nutritional parameters and quality of life. Each study included separate analysis for patients with a diagnosis of dementia and/or neurological disease. Retrospective and prospective observational studies were included. No differences in mortality were found for patients with dementia, without dementia or other neurological disorders. Risk factors for poor survival included decreased or decreasing serum albumin levels, increasing age or over 80 years and male gender. Evidence regarding pneumonia was limited, although did not impact on mortality. No studies explored pressure sores or quality of life.
Full Text Available This review summarizes the importance of enteric methane (CH4 emission in ruminants and relevant to the current on knowledge relevant to genetic aspects of enteric CH4 production, highlighting future research needs and directions. Global average temperature has increased by about 0.7°C in the last century. The Intergovernmental Panel on Climate Change (IPCC reported that anthropogenic greenhouse gases (GHG, including carbon dioxide (CO2, CH4, nitrous oxide (N2O and halocarbons, have been responsible for most of the observed temperature increase since the middle of the twentieth century. Agriculture, particularly livestock, is increasingly being recognized as both a contributor to the process and a potential victim of it. Policy interventions and technical solutions are required to address both the impact of livestock production on climate change and the effects of climate change on livestock production. Food and Agriculture Organization (FAO, declared that in the next 50 years, the world’s farmers will be called upon to produce more food than has been produced in the past 10,000 years, and to do so in environmentally sustainable ways. Therefore, the GHG reduction should be treated as a public good. The United States congress is prospecting to define a price on GHG emissions. Limiting the concentration of CO2 and other GHG in Earth’s atmosphere requires a technological and economic revolution. A cost-effective way could be the genetic improvement of livestock, which produces permanent and cumulative changes in performance. Animal variation in enteric CH4 emission has been reported in the literature, providing potential for improvement through genetic selection.
Moraes, Luis E; Strathe, Anders B; Fadel, James G; Casper, David P; Kebreab, Ermias
Agriculture has a key role in food production worldwide and it is a major component of the gross domestic product of several countries. Livestock production is essential for the generation of high quality protein foods and the delivery of foods in regions where animal products are the main food source. Environmental impacts of livestock production have been examined for decades, but recently emission of methane from enteric fermentation has been targeted as a substantial greenhouse gas source. The quantification of methane emissions from livestock on a global scale relies on prediction models because measurements require specialized equipment and may be expensive. The predictive ability of current methane emission models remains poor. Moreover, the availability of information on livestock production systems has increased substantially over the years enabling the development of more detailed methane prediction models. In this study, we have developed and evaluated prediction models based on a large database of enteric methane emissions from North American dairy and beef cattle. Most probable models of various complexity levels were identified using a Bayesian model selection procedure and were fitted under a hierarchical setting. Energy intake, dietary fiber and lipid proportions, animal body weight and milk fat proportion were identified as key explanatory variables for predicting emissions. Models here developed substantially outperformed models currently used in national greenhouse gas inventories. Additionally, estimates of repeatability of methane emissions were lower than the ones from the literature and multicollinearity diagnostics suggested that prediction models are stable. In this context, we propose various enteric methane prediction models which require different levels of information availability and can be readily implemented in national greenhouse gas inventories of different complexity levels. The utilization of such models may reduce errors
McLean, G K; Rombeau, J L; Caldwell, M D; Ring, E J; Freiman, D B
Malnourished patients who cannot maintain an adequate oral intake but have normal intestinal absorption and motility are candidates for enteric alimentation. When impaired gastric peristalsis or an increased risk for aspiration makes gastrostomy feeding unsafe, direct jejunal infusion is the preferred route of alimentation. Angiographic techniques were used to convert previously placed, simple gastrostomies to combined gastrostomy-jejunostomies in 14 patients. In 17 additional patients, a combined gastrostomy-jejunal tube was placed under local anesthesia; angiographic techniques assisted in the placement of 11 of these tubes.
Full Text Available In this review, diagnostic techniques and viral agents involved in enteric diseases affecting turkeys are described. Data from field observations and laboratory researches have been reported in turkey flocks for over 70 years, and several viruses have been identified. After a period of 30 years of inoculation experiments and neutralization studies, adequate visualization of the viruses was achieved using electronic microscopy. During the following years, several studies were then conducted to isolate and classify those viruses using cell-culture, embryo-propagation, serological tests, genome electropherotyping by polyacrylamide gel electrophoresis of double-stranded RNA viruses, and recently, nucleic acid studies. Thus, since the 1990s, the nucleic-acid technology has focused on genomic surveys and on the detection of specific segments of the genome of each virus using the polymerase-chain reaction, resulting in several prevalence studies and phylogenetic analyses of different isolates and proper classification of the viruses.
Anholt, R M; Berezowski, J; Jamal, I; Ribble, C; Stephen, C
Large amounts of animal health care data are present in veterinary electronic medical records (EMR) and they present an opportunity for companion animal disease surveillance. Veterinary patient records are largely in free-text without clinical coding or fixed vocabulary. Text-mining, a computer and information technology application, is needed to identify cases of interest and to add structure to the otherwise unstructured data. In this study EMR's were extracted from veterinary management programs of 12 participating veterinary practices and stored in a data warehouse. Using commercially available text-mining software (WordStat™), we developed a categorization dictionary that could be used to automatically classify and extract enteric syndrome cases from the warehoused electronic medical records. The diagnostic accuracy of the text-miner for retrieving cases of enteric syndrome was measured against human reviewers who independently categorized a random sample of 2500 cases as enteric syndrome positive or negative. Compared to the reviewers, the text-miner retrieved cases with enteric signs with a sensitivity of 87.6% (95%CI, 80.4-92.9%) and a specificity of 99.3% (95%CI, 98.9-99.6%). Automatic and accurate detection of enteric syndrome cases provides an opportunity for community surveillance of enteric pathogens in companion animals. Copyright © 2014 Elsevier B.V. All rights reserved.
and affecting encounters between human (patients, healthcare providers) and nonhuman (technology, algorithms, software) actors. I illustrate that even though responsibility is delegated to the technology, it is unable to make bodies move by itself. Rather, what determines what ‘it’ becomes and how ‘it’ comes...... rehabilitation in Denmark, and the kind of relationships patients and healthcare providers establish with and through this technology, I illustrate how a new geography of responsibility is constituted, where responsibility for professional guidance is delegated to the technology and patients are expected...
Luesma, Ma José; Cantarero, Irene; Castiella, Tomás; Soriano, Mario; Garcia-Verdugo, José Manuel; Junquera, Concepción
The primary cilium is a non-motile cilium whose structure is 9+0. It is involved in co-ordinating cellular signal transduction pathways, developmental processes and tissue homeostasis. Defects in the structure or function of the primary cilium underlie numerous human diseases, collectively termed ciliopathies. The presence of single cilia in the central nervous system (CNS) is well documented, including some choroid plexus cells, neural stem cells, neurons and astrocytes, but the presence of primary cilia in differentiated neurons of the enteric nervous system (ENS) has not yet been described in mammals to the best of our knowledge. The enteric nervous system closely resembles the central nervous system. In fact, the ultrastructure of the ENS is more similar to the CNS ultrastructure than to the rest of the peripheral nervous system. This research work describes for the first time the ultrastructural characteristics of the single cilium in neurons of rat duodenum myenteric plexus, and reviews the cilium function in the CNS to propose the possible role of cilia in the ENS cells. © 2012 The Authors. Published by Foundation for Cellular and Molecular Medicine/Blackwell Publishing Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Rossman, Jeremy S.; Leser, George P.
Influenza virus is pleiomorphic, producing both spherical (100-nm-diameter) and filamentous (100-nm by 20-μm) virions. While the spherical virions are known to enter host cells through exploitation of clathrin-mediated endocytosis, the entry pathway for filamentous virions has not been determined, though the existence of an alternative, non-clathrin-, non-caveolin-mediated entry pathway for influenza virus has been known for many years. In this study, we confirm recent results showing that influenza virus utilizes macropinocytosis as an alternate entry pathway. Furthermore, we find that filamentous influenza viruses use macropinocytosis as the primary entry mechanism. Virions enter cells as intact filaments within macropinosomes and are trafficked to the acidic late-endosomal compartment. Low pH triggers a conformational change in the M2 ion channel protein, altering membrane curvature and leading to a fragmentation of the filamentous virions. This fragmentation may enable more-efficient fusion between the viral and endosomal membranes. PMID:22875971
Orduña, R M; Giménez Martínez, R; Valdivia Garvayo, M; Ruiz Santa-Olalla, A T; Roca Fernández-Castanys, E; Pérez de la Cruz, A
Enteral nutrition in the home of the patient, has gained interest in recent years. In our health care area, we do not have a Unit of at Home Hospitalization, which has not prevented the implementation of this therapeutic modality in certain types of patients. 89 cases who have undergone enteral Nutrition in their home after the last hospital admission, were reviewed. According to the basic pathology, 41.6% (37 patients) correspond to neurological patients; 51.7% correspond to neoplasmic patients, and 6.7% are classified as miscellaneous. The average age is 64 years (18 months-92 years); the mean caloric ingestion is 1,520 Kcal/day (500-2,500), and the duration is a mean of 315 days (7-1,560). The complications observed through ambulatory visits of the patient and/or the family, accounted for a total of 36, of which 30 (83%) were digestive, and were corrected with the usual methods. In 8 cases (22%), it involved mechanical complications, and only 2 cases involved metabolic complications. Only 1 serious complication (massive bronchoaspiration) could have been avoided. The results indicate a good degree of acceptance, with similar results to those described by other authors, and with a low incidence of severe complications.
Ghesquière, F; Olivero de Rubiana, J P; Mourot, N; Garen, C; Wulverick, M; Viars, P
In a series of twenty similar patients, having a healthy small intestine and having undergone elective surgery, two protocols of alimentation were studied. Beginning from the 8th post-operative hour, enteral alimentation is carried out by means of access to the jejunum and continued for ten days. The volume of liquid in the alimentary canal is progressively increased allowing the intravenous route to be stopped on average after 3,9 days. The high amount of the nitrogen and calory supply limits the post-operative nitrogen catabolism and rapidly restores a positive nitrogen balance. In other respects the weight loss is less than 2%, the biological constants are stable and no serious complications are linked with this technique. The early use of GI tract deals with the alimentational and electrolyte needs of the post-operative patient and diminishes the risks of iatrogenic complications of long term intravenous infusions. Relying on experimental data proving the absence of cessation of peristalsis of the small intestine in the immediate post-operative period and also the continuation of its capacity for absorption, this work demonstrates the possibility of early enteral alimentation. A better knowledge of the indications and contra-indications of this technique of feeding, of its methods of administration, and of the capabilities of absorption of the alimentary canal, must extend its indications to the high risk operative patients.
Sharkey, Keith A.
Enteric glia are important components of the enteric nervous system (ENS) and also form an extensive network in the mucosa of the gastrointestinal (GI) tract. Initially regarded as passive support cells, it is now clear that they are actively involved as cellular integrators in the control of motility and epithelial barrier function. Enteric glia form a cellular and molecular bridge between enteric nerves, enteroendocrine cells, immune cells, and epithelial cells, depending on their location....
Callahan, Michael J; Talmadge, Jennifer M; MacDougall, Robert; Buonomo, Carlo; Taylor, George A
Enteric contrast media are commonly administered for diagnostic cross-sectional imaging studies in the pediatric population. The purpose of this manuscript is to review the use of enteric contrast media for CT, MRI, and ultrasound in infants, children, and adolescents and to share our experiences at a large tertiary care pediatric teaching hospital. The use of enteric contrast material for diagnostic imaging in infants and children continues to evolve with advances in imaging technology and available enteric contrast media. Many principles of enteric contrast use in pediatric imaging are similar to those in adult imaging, but important differences must be kept in mind when imaging the gastrointestinal tract in infants and children, and practical ways to optimize the imaging examination and the patient experience should be employed where possible.
... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Mink Enteritis Vaccine, Killed Virus..., DEPARTMENT OF AGRICULTURE VIRUSES, SERUMS, TOXINS, AND ANALOGOUS PRODUCTS; ORGANISMS AND VECTORS STANDARD REQUIREMENTS Killed Virus Vaccines § 113.204 Mink Enteritis Vaccine, Killed Virus. Mink Enteritis Vaccine...
Noncommunicating isolated enteric duplication cyst in the abdomen in children: report of one case and review of the literature. Hyun-Young Kim, Soo-Hong Kim, Kwi-Won Park and Sung-Eun Jung. Noncommunicating isolated enteric duplications in the abdomen are an extremely rare variant of enteric duplications with their ...
Objectives: The benefit of an early enteral nutrition start in critical ill patients is widely accepted. However, limited published data focus on trauma patients. This study aimed to investigate the effect of early enteral nutrition initiation on length of stay and mortality in an intensive care unit (ICU), as well as explore if enteral ...
Mitrova, Tatiana; Molnar, Gergely
After a period of extensive growth in the 2000's, the Russian gas industry is now facing numerous challenges. Mounting competition by independent producers and the development of new production by Gazprom, combined with stagnating domestic demand and weakening export markets, have created a situation of overproduction, made worse by western sanctions and low oil and gas prices. Expansion to the East thanks to the recent China deal is not expected to provide much relief before 2024. The coming decade will be critical for the industry and its outcome will largely depend on the government's pricing and institutional policies but the role of the state should remain essential. This document presents the key findings of the New CEDIGAZ report 'Russian Gas Market: Entering New Era'. The report analyses the ongoing changes in the Russian industry and the challenges to be met
Dammgen, U; Rosemann, C; Haenel, H D
Up to now, the German agricultural emission inventory used a model for the assessment of methane emissions from enteric fermentation that combined an estimate of the energy and feed requirements as a function of performance parameters and diet composition, with the constant methane conversion rate......, as stated by IPCC. A methane emission model was selected here that is based on German feed data. It was combined with the hitherto applied model describing energy requirements. The emission rates thus calculated deviate from those previously obtained. In the new model, the methane conversion rate is back......-calculated from emission rates and gross energy intake rates. For German conditions of animal performance and diet composition, the national means of methane conversion rates range between 71 kJ MJ(-1) and 61 kJ MJ(-1) for low and high performances (4700 kg animal(-1) a(-1) in 1990 to 7200 kg animal(-1) a(-1...
Full Text Available We consider the financial planning problem of a retiree wishing to enter a retirement village at a future uncertain date. The date of entry is determined by the retiree’s utility and bequest maximisation problem within the context of uncertain future health states. In addition, the retiree must choose optimal consumption, investment, bequest and purchase of insurance products prior to their full annuitisation on entry to the retirement village. A hyperbolic absolute risk-aversion (HARA utility function is used to allow necessary consumption for basic living and medical costs. The retirement village will typically require an initial deposit upon entry. This threshold wealth requirement leads to exercising the replication of an American put option at the uncertain stopping time. From our numerical results, active insurance and annuity markets are shown to be a critical aspect in retirement planning.
Park, H.M.; Chernish, S.M.; Rosenek, B.D.; Brunelle, R.L.; Hargrove, B.; Wellman, H.N.
To evaluate the gastric emptying time of pharmaceutical dosage forms in a clinical setting, a relatively simple dual-radionuclide technique was developed. Placebo tablets of six different combinations of shape and size were labeled with indium-111 DTPA and enteric coated. Six volunteers participated in a single-blind and crossover study. Tablets were given in the morning of a fasting stomach with 6 oz of water containing /sup 99m/Tc pertechnetate and continuously observed with a gamma camera. A scintigraph was obtained each minute. The results suggested that the size, shape, or volume of the tablet used in this study had no significant effect in the rate of gastric emptying. The tablets emptied erratically and unpredictably, depending upon their time of arrival in the stomach in relation to the occurrence of interdigestive myoelectric contractions. The method described is a relatively simple and accurate technique to allow one to follow the gastric emptying of tablets
Honda, Kazuya; Iwanaga, Nozomi; Izumi, Yasumori; Tsuji, Yoshika; Kawahara, Chieko; Michitsuji, Toru; Higashi, Shuntaro; Kawakami, Atsushi; Migita, Kiyoshi
We report a case of reactive arthritis (ReA) triggered by Yersinia enterocolitica enteritis. A 24-year-old Japanese man developed polyarthritis in the lower limbs. Two weeks prior to these symptoms, he noted diarrhea, right lower abdominal pain and a fever. Y. enterocolitica was not isolated from a stool culture; however, he was diagnosed with ReA based on the colonoscopic findings of a high anti-Y. enterocolitica antibody titer and HLA-B27 antigen positivity. Following treatment with methotrexate and steroids, his arthritis improved. This is the first reported Japanese case of ReA in the English literature after a gastrointestinal infection caused by Y. enterocolitica.
Full Text Available The enteric nervous system (ENS autonomously controls gut muscle activity. Mechanosensitive enteric neurons (MEN initiate reflex activity by responding to mechanical deformation of the gastrointestinal wall. MEN throughout the gut primarily respond to compression or stretch rather than to shear force. Some MEN are multimodal as they respond to compression and stretch. Depending on the region up to 60% of the entire ENS population responds to mechanical stress. MEN fire action potentials after mechanical stimulation of processes or soma although they are more sensitive to process deformation. There are at least two populations of MEN based on their sensitivity to different modalities of mechanical stress and on their firing pattern. 1 Rapidly, slowly and ultra-slowly adapting neurons which encode compressive forces. 2 Ultra-slowly adapting stretch-sensitive neurons encoding tensile forces. Rapid adaptation of firing is typically observed after compressive force while slow adaptation or ongoing spike discharge occurs often during tensile stress (stretch. All MEN have some common properties: they receive synaptic input, are low fidelity mechanoreceptors and are multifunctional in that some serve interneuronal others even motor functions. Consequently, MEN possess processes with mechanosensitive as well as efferent functions. This raises the intriguing hypothesis that MEN sense and control muscle activity at the same time as servo-feedback loop. The mechanosensitive channel(s or receptor(s expressed by the different MEN populations are unknown. Future concepts have to incorporate compressive and tensile-sensitive MEN into neural circuits that controls muscle activity. They may interact to control various forms of a particular motor pattern or regulate different motor patterns independently from each other.
Caraballo, Maria L; Donmez, Seda; Nathan, Kobi; Zhao, Fang
Objective: There is limited information on compounded apixaban formulations for administration via enteral feeding tubes. This study was designed to identify a suitable apixaban suspension formulation that is easy to prepare in a pharmacy setting, is compatible with commonly used feeding tubes, and has a beyond-use date of 7 days. Methods: Apixaban suspensions were prepared from commercially available 5-mg Eliquis tablets. Several vehicles and compounding methods were screened for ease of preparation, dosage accuracy, and tube compatibility. Two tubing types, polyurethane and polyvinyl chloride, with varying lengths and diameters, were included in the study. They were mounted on a peg board during evaluation to mimic the patient body position. A 7-day stability study of the selected formulation was also conducted. Results: Vehicles containing 40% to 60% Ora-Plus in water all exhibited satisfactory flowability through the tubes. The mortar/pestle compounding method was found to produce more accurate and consistent apixaban suspensions than the pill crusher or crushing syringe method. The selected formulation, 0.25 mg/mL apixaban in 50:50 Ora-Plus:water, was compatible with both tubing types, retaining >98% drug in posttube samples. The stability study also confirmed that this formulation was stable physically and chemically over 7 days of storage at room temperature. Conclusions: A suitable apixaban suspension formulation was identified for administration via enteral feeding tubes. The formulation consisted of 0.25 mg/mL apixaban in 50:50 Ora-Plus:water. The stability study results supported a beyond-use date of 7 days at room temperature.
Ye. V Grigoryev
Full Text Available Objective: to substantiate the choice of a gastrointestinal tract (GIT function support regimen as a mode for correction of the abdominal compartment syndrome (ACS. Subjects and methods. Forty-three patients with different causes of inadequate GIT function of various origin and ACS (disseminated peritonitis (45%, pancreatitis (24%, and severe concomitant injury (31% were examined. Group 1 (control received complete parenteral nutritional feeding (n=23; APACHE II scores, 21±4; calculated probability of fatal outcome, 33.5%. In Group II (study, complete parenteral feeding in the first 24 hours after stabilization was supplemented with GIT function support with Pepsisorb (Nutricia in doses of 500, 1000, and 1500 ml on days 1, 2, and 3, respectively (n=20; APACHE II scores, 20±6; calculated probability of fatal outcome, 37.1%. During early enteral nutritional support, the SOFA score was significantly less than that in Group 1 on days 2—3; the oxygenation index significantly increased on day 3; the value of intra-abdominal hypertension decreased to the control values. The positive effect of the GIT function support regimen on regression of the multiple organ dysfunction syndrome (MODS was confirmed by the lowered levels of biological markers (von Willebrand factor (WF and endothelin-1 as markers of endothelial damage of MODS. Correlation analysis showed a direct correlation between the markers of endothelial damage and the SOFA scores (r=0.34; p=0.05 for WF and r=0.49;p=0.03 for endothelin. Conclusion. The GIT function support regimen via early enteral alimentation with Peptisorb, which was initiated in the first 24 hours after admission, is able to level off the manifestations of the early stages of the abdominal compartment syndrome, with the acceptable values of oxygen balance and water-electrolyte and osmotic homeostasis being achieved. Key words: abdominal compartment syndrome, nutritional support, biological markers, oxygenation index
technologies and in this article these processes will be investigated from three different perspectives: an historical perspective of how new technologies have entered homes, a consumer perspective of how both houses and new technologies are purchased and finally, as the primary part of the article, a user...... perspective of how routines develop while these technologies are being used. In the conclusion these insights are discussed in relation to possible ways of influencing routines....
Clairembault, Thomas; Leclair-Visonneau, Laurène; Neunlist, Michel; Derkinderen, Pascal
Lewy pathology has been described in neurons of the enteric nervous system in nearly all Parkinson's disease (PD) patients at autopsy. The enteric nervous system not only contains a variety of functionally distinct enteric neurons but also harbors a prominent component of glial cells, the so-called enteric glial cells, which, like astrocytes of the central nervous system, contribute to support, protect, and maintain the neural network. A growing body of evidence supports a role for enteric glial cells in the pathophysiology of gastrointestinal disorders such as inflammatory bowel disease and chronic constipation. We have recently shown that enteric glial cell dysfunction occurs in PD. In the present review, we discuss the possible implications of enteric glia in PD-related gut dysfunction as well as in disease initiation and development. © 2014 International Parkinson and Movement Disorder Society.
Staritz, Cornelia; Whitfield, Lindsay; Melese, Ayelech Tiruwha
Capitalist transformation is composed of many multifaceted processes, but growth in the size and capabilities of locally owned firms is essential. The AfriCap research project aims to understand how African-owned firms learn and build their technological capabilities in order to enter and remain...... competitive in new export sectors. The purpose of this first working paper is to advance our conceptualization of what it means to build capabilities within globalized industries. The paper draws on the conception of technological capabilities from the Technological Capabilities literature, but adapts...
Burns, Alan J.; Goldstein, Allan M.; Newgreen, Donald F.; Stamp, Lincon; Schäfer, Karl-Herbert; Metzger, Marco; Hotta, Ryo; Young, Heather M.; Andrews, Peter W.; Thapar, Nikhil; Belkind-Gerson, Jaime; Bondurand, Nadege; Bornstein, Joel C.; Chan, Wood Yee; Cheah, Kathryn; Gershon, Michael D.; Heuckeroth, Robert O.; Hofstra, Robert M.W.; Just, Lothar; Kapur, Raj P.; King, Sebastian K.; McCann, Conor J.; Nagy, Nandor; Ngan, Elly; Obermayr, Florian; Pachnis, Vassilis; Pasricha, Pankaj J.; Sham, Mai Har; Tam, Paul; Berghe, Pieter Vanden
Over the last 20 years, there has been increasing focus on the development of novel stem cell based therapies for the treatment of disorders and diseases affecting the enteric nervous system (ENS) of the gastrointestinal tract (so-called enteric neuropathies). Here, the idea is that ENS progenitor/stem cells could be transplanted into the gut wall to replace the damaged or absent neurons and glia of the ENS. This White Paper sets out experts’ views on the commonly used methods and approaches to identify, isolate, purify, expand and optimize ENS stem cells, transplant them into the bowel, and assess transplant success, including restoration of gut function. We also highlight obstacles that must be overcome in order to progress from successful preclinical studies in animal models to ENS stem cell therapies in the clinic. PMID:27059883
Gago Sánchez, A I; Garzas Martín de Almagro, C; Cárdenas Aranzana, M; Calañas Continente, A; Calleja Hernández, M A
To detect potential complications and interactions between drugs and enteral nutrition (EN) as to describe the interventions carried out by the pharmacist in those circumstances and to propose strategies of improvement. Prospective assessment of patients admitted to hospital candidates to receive EN. The pharmacist worked as part of the team of Endocrinology and Nutrition for one month. A data collection form was designed for the study in which the following information had to be recorded: NE indications, nutrition characteristics (type, route of administration, infusion rate), pharmacological therapy, drug/EN interaction and complications. The study included 14 patients (mean age of 50 +/- 13 years) in which digestive (35.7%) and neurological (28.6%) complications were the most frequent indications for EN. Eleven patients (78.57%) reported complications associated to EN, mostly digestive (57.14%). The main cause for consultation was related to the administration of drugs via NGT (nasogastric tube). A total of 77 drugs were prescribed, 23 of which were administered in this way, so a guidelines for the administration of drugs via nasogastric tube was prepared. The hospital pharmacist can actively cooperate with nutritional support units, given the need to assess the nutritional support administered and to manage potential complications and interactions between nutritional status, drugs and artificial nutrition. The pharmacist also plays a significant role in the prevention and identification of problems related to the administration of drugs via NGT.
Clabby, John F
The concept of cultural humility acknowledges the enormous task of becoming culturally competent by encouraging curiosity about the context within which others live. For physicians, this includes curiosity about the organizations in which they work as Outsiders in settings such as a new hospital or patients' homes. However, efforts to train healthcare professionals in cultural competence are often de-emphasized due to the pressure learners feel to acquire Medical Knowledge and clinical skills. Little time is devoted to address the significance of cultural humility for fully appreciating the experiences of others. Efforts to educate physicians-in-training about the cultural aspects of care require innovative approaches that help them recognize bias without provoking defensiveness. Enter as an Outsider is a highly focused activity which fosters a culturally humble approach to an often neglected problem, organizational bias. This article describes how cultural humility is explained to learners and small group activities are used to explore the thoughts and feelings of an organization's Insiders and Outsiders. This program relies on instructor self-disclosure to facilitate learning and on a video vignette from popular-culture media to illustrate being an Outsider in a healthcare setting. Participants in this training have improved their ability to recognize when they are Outsiders where they provide care. They have developed a better understanding that cultural humility in organizations is a gateway to providing quality care. They have begun the process of committing to respectfully learn from the organization's Insiders.
Onodera, Hisashi; Park, Tae Bun; Hasegawa, Masato
We analyzed 23 patients (5 males and 18 females, mean age 60) who had been operated on in our department for radiation enteritis. 1) These patients were divided into two types according to the time of surgery. Sixteen of 23 (79%) patients were operated on a median of 12 months after radiotherapy, while 7 (30%) underwent surgery more than 10 years later. 2) They were also divided according to the dominant symptoms. Fourteen of 23 (60%) complained of nausea and abdominal distension suggestive of small bowel injury, whereas 7 (30%) had tenesmus and anal bleeding indicating proctitis. Two patients developed perforative peritonitis. 3) The operations performed were as follows: extensive intestinal resection and anastomosis (13), pull-through procedure (3), rectal excision (2), ileostomy (3), by-pass operation (2). Two patients with peritonitis died despite open drainage. Nineteen intestinal anastomoses were all successfully performed. Patients who underwent extensive small bowel resection could resume ordinary daily life without symptoms. Our analysis showed that small bowel injury should be treated by generous resection of the affected bowels followed by anastomosis of the disease-free ends, while rectal lesions are best dealt with by restorative proctectomy. This may provide a good quality of life and minimize major postoperative complications such as leakage. (author)
Onodera, Hisashi; Park, Tae Bun; Hasegawa, Masato (Kyoto Univ. (Japan). Faculty of Medicine) (and others)
We analyzed 23 patients (5 males and 18 females, mean age 60) who had been operated on in our department for radiation enteritis. (1) These patients were divided into two types according to the time of surgery. Sixteen of 23 (79%) patients were operated on a median of 12 months after radiotherapy, while 7 (30%) underwent surgery more than 10 years later. (2) They were also divided according to the dominant symptoms. Fourteen of 23 (60%) complained of nausea and abdominal distension suggestive of small bowel injury, whereas 7 (30%) had tenesmus and anal bleeding indicating proctitis. Two patients developed perforative peritonitis. (3) The operations performed were as follows: extensive intestinal resection and anastomosis (13), pull-through procedure (3), rectal excision (2), ileostomy (3), by-pass operation (2). Two patients with peritonitis died despite open drainage. Nineteen intestinal anastomoses were all successfully performed. Patients who underwent extensive small bowel resection could resume ordinary daily life without symptoms. Our analysis showed that small bowel injury should be treated by generous resection of the affected bowels followed by anastomosis of the disease-free ends, while rectal lesions are best dealt with by restorative proctectomy. This may provide a good quality of life and minimize major postoperative complications such as leakage. (author).
Volkert, D; Berner, Y N; Berry, E; Cederholm, T; Coti Bertrand, P; Milne, A; Palmblad, J; Schneider, St; Sobotka, L; Stanga, Z; Lenzen-Grossimlinghaus, R; Krys, U; Pirlich, M; Herbst, B; Schütz, T; Schröer, W; Weinrebe, W; Ockenga, J; Lochs, H
Nutritional intake is often compromised in elderly, multimorbid patients. Enteral nutrition (EN) by means of oral nutritional supplements (ONS) and tube feeding (TF) offers the possibility to increase or to insure nutrient intake in case of insufficient oral food intake. The present guideline is intended to give evidence-based recommendations for the use of ONS and TF in geriatric patients. It was developed by an interdisciplinary expert group in accordance with officially accepted standards and is based on all relevant publications since 1985. The guideline was discussed and accepted in a consensus conference. EN by means of ONS is recommended for geriatric patients at nutritional risk, in case of multimorbidity and frailty, and following orthopaedic-surgical procedures. In elderly people at risk of undernutrition ONS improve nutritional status and reduce mortality. After orthopaedic-surgery ONS reduce unfavourable outcome. TF is clearly indicated in patients with neurologic dysphagia. In contrast, TF is not indicated in final disease states, including final dementia, and in order to facilitate patient care. Altogether, it is strongly recommended not to wait until severe undernutrition has developed, but to start EN therapy early, as soon as a nutritional risk becomes apparent.
Full Text Available Giardia is the most prevalent human intestinal parasitic protist in the world, and one of the most common parasite of companion animals and young livestock. Giardia is a major cause of diarrhea in children and in travelers. The host-microbial interactions that govern the outcome of infection remain incompletely understood. Findings available to date indicate that the infection causes diarrhea via a combination of intestinal malabsorption and hypersecretion. Malabsorption and maldigestion mainly result from a diffuse shortening of epithelial microvilli. This enterocytic injury is mediated by activated host T lymphocytes. Pathophysiological activation of lymphocytes is secondary to Giardia-induced disruption of epithelial tight junctions, which in turn increases intestinal permeability. Loss of epithelial barrier function is a result of Giardia-induced enterocyte apoptosis. Recent findings suggest that these effects may facilitate the development of chronic enteric disorders, including inflammatory bowel disease, irritable bowel syndrome, and allergies, via mechanisms that remain poorly understood. A newly discovered SGLT-1 glucose uptake-mediated host cytoprotective mechanism may represent an effective modulator of the epithelial apoptosis induced by this parasite, and, possibly, by other enteropathogens. A better understanding of the pathogenesis of giardiasis will shed light on new potential therapeutic targets.
Loiudice, T.A.; Lang, J.A.
Twenty-four patients with severe radiation injury to the small bowel seen over a 4-year period were randomized to four treatment groups: 1) methylprednisolone 80 mg intravenously plus Vivonex-HN, 2 L/day po, 2) methylprednisolone 80 mg intravenously plus total parenteral nutrition, 2.5 L/day, 3) total parenteral nutrition, 2.5 L/day, and 4) Vivonex-HN, 2 L/day po. Patients received nothing by mouth except water in groups II and III, and only Vivonex-HN in groups I and IV. Patients were treated for 8-wk periods. Improvement was gauged by overall nutritional assessment measurements, nitrogen balance data and by radiological and clinical parameters. No significant difference between groups I, II, III, and IV could be found for age, sex, mean radiation dosage, time of onset after radiation therapy, or initial nutritional assessment data. Differences statistically could be found between groups II and III and I and IV regarding nutritional assessment data, nitrogen balance, radiographic and clinical parameters after therapy, with marked improvement noted in groups II and III. We conclude that a treatment regimen consisting of total parenteral nutrition and bowel rest is beneficial in the treatment of radiation enteritis. Methylprednisolone appears to enhance this effect and indeed, may be responsible for a longer lasting response
Full Text Available Pancreaticoduodenectomy (PD is considered the gold standard treatment for periampullory carcinomas. This procedure presents 30%–40% of morbidity. Patients who have undergone pancreaticoduodenectomy often present perioperative malnutrition that is worse in the early postoperative days, affects the process of healing, the intestinal barrier function and the number of postoperative complications. Few studies focus on the relation between enteral nutrition (EN and postoperative complications. Our aim was to perform a review, including only randomized controlled trial meta-analyses or well-designed studies, of evidence regarding the correlation between EN and main complications and outcomes after pancreaticoduodenectomy, as delayed gastric emptying (DGE, postoperative pancreatic fistula (POPF, postpancreatectomy hemorrhage (PPH, length of stay and infectious complications. Several studies, especially randomized controlled trial have shown that EN does not increase the rate of DGE. EN appeared safe and tolerated for patients after PD, even if it did not reveal any advantages in terms of POPF, PPH, length of stay and infectious complications.
Gilberto Simeone HENRIQUES
Full Text Available Abstract Patients who need prolonged domiciliary enteral nutritional therapy may benefit from handmade diets. However, the preparation of such diets might cause insecurity with regard to their nutritional composition and physical-chemical properties. Current study analyzes the osmolality and Hydrogen-Ion concentration (pH on handmade enteral diets. To this purpose, six formulas and two juices, prescribed on discharge from hospital, were analyzed physically and chemically. Osmolality and pH were respectively determined by cryoscopy and potentiometry. Most formulations were classified as isosmolar (with less than 400 mOsm/kg solvent, and only one was classified as slightly hyperosmolar, with rates ranging from 356.7 to 403.5 mOsm/kg solvent. On average, the standard formula presented higher osmolality than similar ones prepared for hyperglycemia. Among the juices, only one registered hyperosmolar concentration of 595.54 mOsm/kg solvent. All formulas presented pH rates classified as low acidity, ranging between 6.1 and 6.6, while the two juices had the lowest results, 4.73 and 4.66 each. The blend of ingredients used in handmade formulas and juices studied presented acceptable osmolality and pH rates for a safe administration and absence of gastrointestinal complications. Data showed here are consistent with an appropriate and healthy diet and contributed towards success in domiciliary enteral nutritional therapy.
Chang, Sue-Joan; Huang, Hsiu-Hua
Diarrhea has great impact on enteral nutrition. The purpose of this review is to identify the factors leading to diarrhea during enteral nutrition and to provide the published updates on diarrhea prevention through nutritional intervention. Diarrhea in enteral fed patients is attributed to multiple factors, including medications (major contributor), infections, bacterial contamination, underlying disease, and enteral feeding. Diet management can alleviate diarrhea in enteral feeding. High content of fermentable oligosaccharides, disaccharides, and monosaccharides and polyols (FODMAPs) in enteral formula is postulated to induce diarrhea and lower FODMAPs formula may reduce the likelihood of diarrhea in enterally fed patients. Fiber-enriched formula can reduce the incidence of diarrhea and produce short-chain fatty acids for colonocytes. Ingesting prebiotics, nonviable probiotics or probiotic derivatives, and human lactoferrin may provide alternatives for reducing/preventing diarrhea. Enteral feeding is not generally considered the primary cause of diarrhea, which is frequently linked to prescribed medications. When diarrhea is apparent, healthcare members should evaluate the possible risk factors and systematically attempt to eliminate the underlying causes of diarrhea before reducing or suspending enteral feeding. Lower FODMAPs formula, prebiotics, probiotic derivatives, and lactoferrin may be used to manage enteral feeding-related diarrhea.
Granell Vidal, Lina; Sánchez Juan, Carlos; Alfonso García, Antonio
Enteral nutrition (EN) is indicated in patients who, although they may not eat enough food, maintain a sufficient function to receive, digest and absorb nutrients digestive system. Oral Nutritional Supplements (SON) are nutritionally complete or incomplete formulas (depending on whether or not provide all the nutrients needed to serve as the sole source of nutrients), which supplement inadequate oral diet. This study aims to evaluate the organoleptic characteristics of hyperproteic, normoproteic and fiber-enriched oral SON. SON test, carried out at the Department of Endocrinology and Nutrition Consortium Hospital General Universitario de Valencia from October 2012 to February 2013. 137 SON were evaluated in total, of which 47 were hyperproteic, 46 normoproteic and 44 enriched in fiber. Of the SON evaluated in the group of hyperproteic the following 3 SON obtained the best scores: Fresenius Prot Energy Drink® (21,27, vanilla flavor), Avant Standard Nut® (20.3 , strawberry flavor) and Resource® Protein (20.01, chocolate flavor) In the group of normoproteic SON the 3 best rated were: Ensure Plus® (22.3, banana flavor), Ensure Plus® (21.9, peach flavor) and Fresubin Energy Drink® (21, strawberry flavor) In the group of fiber-enriched the 3 SON most appreciated were: 2 Kcal Fresubin Fibre Drink® (23.78, vanilla flavor), Ensure Plus® TwoCal (22.9, banana flavor) and Fortimel Compact® (21.5, strawberry flavor) The study aims to guide clinicians on what SON may be more acceptable to the patient, so that the SON serve their purpose and restore or improve nutritional status, as the SON intervention is safe and cost - effective, since they improve both the functionality and quality of life. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Investigates Japanese efforts to enter a new phase of its postwar technological period with a focus on internationalization of its economy and industry. Analyzes which technologies will dominate the early 21st century and their relationships to each other. (MVL)
Sharkey, Keith A
Enteric glia are important components of the enteric nervous system (ENS) and also form an extensive network in the mucosa of the gastrointestinal (GI) tract. Initially regarded as passive support cells, it is now clear that they are actively involved as cellular integrators in the control of motility and epithelial barrier function. Enteric glia form a cellular and molecular bridge between enteric nerves, enteroendocrine cells, immune cells, and epithelial cells, depending on their location. This Review highlights the role of enteric glia in GI motility disorders and in barrier and defense functions of the gut, notably in states of inflammation. It also discusses the involvement of enteric glia in neurological diseases that involve the GI tract.
Full Text Available An enteric syndrome observed in semi-intensively reared quails is described. The affected birds showed depression, severe diarrhoea and dehydration. The mortality occurred particularly in young birds. At necropsy, the prominent lesion was catarrhal enteritis. Laboratory investigations demonstrated the presence of coronavirus in the gut of dead animals. No additional pathogens were detected. To our knowledge, this is the first evidence for the presence of CoVs in quail with enteritis.
Gulbransen, Brian D; Sharkey, Keith A
Enteric glia are a unique class of peripheral glial cells within the gastrointestinal tract. Major populations of enteric glia are found in enteric ganglia in the myenteric and submucosal plexuses of the enteric nervous system (ENS); these cells are also found outside of the ENS, within the circular muscle and in the lamina propria of the mucosa. These different populations of cells probably represent unique classes of glial cells with differing functions. In the past few years, enteric glia have been found to be involved in almost every gut function including motility, mucosal secretion and host defence. Subepithelial glia seem to have a trophic and supporting relationship with intestinal epithelial cells, but the necessity of these roles in the maintenance of normal epithelial functions remains to be shown. Likewise, glia within enteric ganglia are activated by synaptic stimulation, suggesting an active role in synaptic transmission, but the precise role of glial activation in normal enteric network activity is unclear. Excitingly, enteric glia can also give rise to new neurons, but seemingly only under limited circumstances. In this Review, we discuss the current body of evidence supporting functional roles of enteric glia and identify key gaps in our understanding of the physiology of these unique cells.
Full Text Available Helen White, Linsey King Nutrition and Dietetic Group, School of Health and Wellbeing, Faculty Health and Social Science, Leeds Metropolitan University, Leeds, United Kingdom Abstract: Enteral feeding is a long established practice across pediatric and adult populations, to enhance nutritional intake and prevent malnutrition. Despite recognition of the importance of nutrition within the modern health agenda, evaluation of the efficacy of how such feeds are delivered is more limited. The accuracy, safety, and consistency with which enteral feed pump systems dispense nutritional formulae are important determinants of their use and acceptability. Enteral feed pump safety has received increased interest in recent years as enteral pumps are used across hospital and home settings. Four areas of enteral feed pump safety have emerged: the consistent and accurate delivery of formula; the minimization of errors associated with tube misconnection; the impact of continuous feed delivery itself (via an enteral feed pump; and the chemical composition of the casing used in enteral feed pump manufacture. The daily use of pumps in delivery of enteral feeds in a home setting predominantly falls to the hands of parents and caregivers. Their understanding of the use and function of their pump is necessary to ensure appropriate, safe, and accurate delivery of enteral nutrition; their experience with this is important in informing clinicians and manufacturers of the emerging needs and requirements of this diverse patient population. The review highlights current practice and areas of concern and establishes our current knowledge in this field. Keywords: nutrition, perceptions, experience
Full Text Available Abstract Syndromic diarrhea/Tricho-hepato-enteric syndrome (SD/THE is a rare and severe bowel disorder caused by mutation in SKIV2L or in TTC37, 2 genes encoding subunits of the putative human SKI complex. The estimated prevalence is 1/1,000,000 births and the transmission is autosomal recessive. The classical form is characterized by 5 clinical signs: intractable diarrhea of infancy beginning in the first month of life, usually leading to failure to thrive and requiring parenteral nutrition; facial dysmorphism characterised by prominent forehead and cheeks, broad nasal root and hypertelorism; hair abnormalities described as woolly and easily removable; immune disorders resulting from defective antibody production; intrauterine growth restriction. The aetiology is a defect in TTC37, a TPR containing protein, or in the RNA helicase SKIV2L, both constituting the putative human ski complex. The ski complex is a heterotetrameric cofactor of the cytoplasmic RNA exosome which ensures aberrants mRNAs decay. The diagnosis SD/THE is initially based on clinical findings and confirmed by direct sequencing of TTC37 and SKIV2L. Differential diagnosis with the other causes of intractable diarrhea is easily performed by pathologic investigations. During their clinical course, most of the children require parenteral nutrition and often immunoglobulin supplementation. With time, some of them can be weaned off parenteral nutrition and immunoglobulin supplementation. The prognosis depends on the management and is largely related to the occurrence of parenteral nutrition complications or infections. Even with optimal management, most of the children seem to experience failure to thrive and final short stature. Mild mental retardation is observed in half of the cases. Abstract in French Les diarrhées syndromiques ou syndrome tricho-hepato-enterique (SD/THE sont un syndrome rare et sévère dont l’incidence est estimée à 1 cas pour 1 million de naissances et la
Martínez Augustin, O; Martínez de Victoria Muñoz, E
A protein is an essential macronutrient for the growth and maintenance of corporal structures. An important concept in proteic nutrition is the protein's quality, mainly determined by the profile and proportion of the amino acids making up the protein, although other factors such as solubility and degree of glycosylation may be involved. There are different ways to evaluate protein quality that can be classified as chemical, biological and microbiological. Currently Protein Digestibility-Corrected Amino Acid Score (PDCAAS) is routinely used. Protein quality can be altered by the technological and culinary processes to which food is subjected and also by the presence in food of anti-nutritional factors affecting the bioavailability of amino acids. Protein complementation through the formulation of low-quality protein mixtures lets us improve bioavailability, and therefore the quality of this protein mix. In the past few years, nutrition and food technology are undergoing a profound transformation due to the development of the concept of functional and nutraceutic foods. Functional proteins and bioactive peptides are gaining in importance since, in addition to their nutritional role as a source of amino acids, they are capable of exerting different biological effects on the immune system, the cardiovascular system or the gastrointestinal tract. In addition, these peptides and proteins have been described as having anticancer, antibacterial or antiviral effects. This paper reviews the most relevant functional proteins and bioactive peptides from a functional standpoint, with special emphasis on those coming from milk, eggs and soy.
... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Entering into an agreement. 228.100 Section 228... MANAGEMENT COOPERATIVE ACTIVITIES WITH STATES AND INDIAN TRIBES Oil and Gas, Onshore § 228.100 Entering into... proposing to undertake activities on Indian lands located within the State, a resolution from the...
... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Products entering inspected plants... Products entering inspected plants. All products of a kind certified under this part or materials to be used in the preparation of such products when brought into an inspected plant shall be identified and...
Maunula, L.; Kaupke, A.; Vasickova, P.; Soderberg, K.; Kozyra, I.; Lazic, S.; Poel, van der W.H.M.; Bouwknegt, M.; Rutjes, S.; Willems, K.A.; Moloney, R.; Agostino, D' M.; Husman, A.M.D.; Bonsdorff, C.H.; Rzezutka, A.; Pavlik, I.; Petrovic, T.; Cook, N.
In recent years, numerous foodborne outbreaks due to consumption of berry fruit contaminated by human enteric viruses have been reported. This European multinational study investigated possible contamination routes by monitoring the entire food chain for a panel of human and animal enteric viruses.
The biosolids from municipal wastewater treatment plant contains several enteric microbial pathogens, predominantly Salmonella and Escherichia species in the range of 15-18 x 104 CFU/g and 11-12 x 104 CFU/g respectively. The present study investigates the influence of earthworm, Lampito mauritii on enteric pathogen ...
2016;30(3):118-128]. Key words: Contamination, drinking water, households, enteric bacteria, Jigjiga. Introduction ... High enteric bacterial contamination of drinking of water in Jigjiga city, Eastern Ethiopia 119. Ethiop. J. Health Dev. 2016 ..... people's tendency to fetch water for toilet services with contaminated toilet articles ...
Thapa, Rajoo; Banerjee, Pritam; Akhtar, Nishar; Jain, Trilochan S
A case of childhood enteric fever complicated by transient dysautonomia and cerebellitis is reported. The child was treated with intravenous antibiotics, and the complications were managed conservatively. Dysautonomia and cerebellitis resolved by day 5 and day 8 after admission, respectively. Results of a neurologic examination at the end of 6 months were normal. Dysautonomia complicating the course of childhood enteric fever is previously unreported.
Lochs, H.; Allison, S.P.; Meier, R.
The ESPEN guidelines on enteral nutrition are the first evidence-based European recommendations for enteral nutrition. They were established by European experts for a variety of disease groups. During guideline development it became evident that terms and definitions in clinical nutrition have been...
Objectives: The aim of the study was to compare the incidence of complications in patients receiving enteral and parenteral nutrition (PN), and review how the early initiation of enteral feeding and early achievement of caloric goal would affect the incidence of complications. Design: The design was a retrospective audit of ...
Problems experienced by women re-entering the education profession: a South African case study. Melanie Kok, Van der Westhuizen C. Philip. Abstract. The problems experienced by women re-entering the education profession in South Africa were focused on. A review of the literature revealed that problems are ...
Pingleton, S K; Hadzima, S K
The incidence of upper gastrointestinal (GI) bleeding in mechanically ventilated ICU patients receiving enteral alimentation was reviewed and compared to bleeding occurring in ventilated patients receiving prophylactic antacids or cimetidine. Of 250 patients admitted to our ICU during a 1-yr time period, 43 ventilated patients were studied. Patients in each group were comparable with respect to age, respiratory diagnosis, number of GI hemorrhage risk factors, and number of ventilator, ICU, and hospital days. Twenty-one patients had evidence of GI bleeding. Fourteen of 20 patients receiving antacids and 7 of 9 patients receiving cimetidine had evidence of GI bleeding. No bleeding occurred in 14 patients receiving enteral alimentation. Complications of enteral alimentation were few and none required discontinuation of enteral alimentation. Our preliminary data suggest the role of enteral alimentation in critically ill patients may include not only protection against malnutrition but also protection against GI bleeding.
Full Text Available Enteric fever is a common infectious disease of the tropical world, about 80% of these cases occur in Asian countries. Enteric fever presenting with isolated cerebellar ataxia or nephritis is rare. We report three cases of enteric fever that presented with these complications. Isolated cerebellar ataxia usually occurs in the second week, whereas in our cases it presented within first four days of fever. The common complications of enteric fever related to the urinary tract are cystitis, pyelitis, and pyelonephritis. Glomerulonephritis is uncommon. Most patients with enteric glomerulonephritis present with acute renal failure, hypertensive encephalopathy, or nephritic syndrome. In comparison, our case had milder manifestations. All three patients were treated with parenteral ceftriaxone and showed a prompt recovery.
Vasile, I; Mirea, C; Vîlcea, I D; Calotă, F; Paşalega, M; Meşină, C; Cheie, M; Mogoanţă, S; Dumitrescu, T; Grecu, C; Radu, V; Moraru, E
This paper aim is to discuss the advantages of enteral postoperative feeding on patients submitted to surgery finalized through an eso-digestive anastomosis; in these cases enteral feeding is often delayed 5-8 days after the surgery, and in case of an anastomotic dehiscence may be even impossible. Also, the paper promotes duodenostomy as an important enteral feeding way, and discusses the indications and contraindications of different enteral nutrition pathways in such cases. There were studied 230 cases, 149 cases submitted to cancer surgery and 81 cases with benign condition surgery followed by an eso-digestive anastomosis, in which the following enteral nutrition pathways was practiced: nasogastric or naso-esojejunal feeding tube (55 cases); Witzel jejunostomy (28 cases); gastrostomy (79 cases); duodenostomy (68 cases). Postoperative morbidity induced exclusively by the enteral nutrition pathway was encountered in 36% of patients. On patients with an eso-gastric cervical anastomosis or esogastric thoracic anastomosis we used jejunostomy as enteral feeding path and a gastric tube passed by pyloric canal for gastric decompression. In cases of esophageal reconstruction for benign esophageal strictures gastrostomy remains the best feeding method. Duodenostomy was practiced as a feeding pathway in cases of total gastrectomy with esojejunal anastomosis, with closure of the duodenal stump.
Nijs, Els L. F.; Cahill, Anne Marie
Enteral feeding is considered a widespread, well-accepted means of delivering nutrition to adults and children who are unable to consume food by mouth or who need support in maintaining adequate nutrition for a variety of reasons, including acute and chronic disease states. Delivery of enteral feeding to nutritionally deprived patients may be achieved by several means. In this article, the indications and insertion of enteral access in children will be reviewed. In addition, common complications and management of problems will be discussed.
Alsulays, Bader B; Kulkarni, Vijay; Alshehri, Sultan M; Almutairy, Bjad K; Ashour, Eman A; Morott, Joseph T; Alshetaili, Abdullah S; Park, Jun-Bom; Tiwari, Roshan V; Repka, Michael A
The objective of this work was to use hot-melt extrusion (HME) technology to improve the physiochemical properties of lansoprazole (LNS) to prepare stable enteric coated LNS tablets. For the extrusion process, we chose Kollidon ® 12 PF (K12) polymeric matrix. Lutrol ® F 68 was selected as the plasticizer and magnesium oxide (MgO) as the alkalizer. With or without the alkalizer, LNS at 10% drug load was extruded with K12 and F68. LNS changed to the amorphous phase and showed better release compared to that of the pure crystalline drug. Inclusion of MgO improved LNS extrudability and release and resulted in over 80% drug release in the buffer stage. Hot-melt extruded LNS was physically and chemically stable after 12 months of storage. Both formulations were studied for compatibility with Eudragit ® L100-55. The optimized formulation was compressed into a tablet followed by coating process utilizing a pan coater using L100-55 as an enteric coating polymer. In a two-step dissolution study, the release profile of the enteric coated LNS tablets in the acidic stage was less than 10% of the LNS, while that in the buffer stage was more than 80%. Drug content analysis revealed the LNS content to be 97%, indicating the chemical stability of the enteric coated tablet after storage for six months. HME, which has not been previously used for LNS, is a valuable technique to reduce processing time in the manufacture of enteric coated formulations of an acid-sensitive active pharmaceutical ingredient as compared to the existing methods.
textabstractIn this thesis clinical aspects of perioperative feeding in gastrointestinal surgery are discussed in several clinical studies. The main goal is to obtain insight in the influence of enteral feeding and
Factors associated with acquisition of enteric episodes in cattle waste handlers in Morogoro, Tanzania. Balichene P Madoshi, Athuman M Lupindu, Madundo M A Mtambo, Amandus P Muhairwa, John E Olsen ...
Wahyuni, L. M.; Masih, I. K.; Rejeki, I. N. Mei
Communication skills are generic skills which need to be developed for success in the vocational education entering the workforce. This study aimed to discover the attributes of communication skill considered important in entering the workforce as perceived by vocational education students. The research was conducted by survey method using questionnaire as data collecting tool. The research population is final year student of D3 Vocational education Program and D4 Managerial Vocational education in academic year 2016/2017 who have completed field work practice in industry. The sampling technique was proportional random sampling. Data were analyzed with descriptive statistics and independent sampel t-test. Have ten communication skills attributes with the highest important level required to enter the workplace as perceived by the vocational education diploma. These results indicate that there was the same need related communication skills to enter the workforce
Douard, H; Cosnes, J; Sebag, A; Evard, D; Le Quintrec, Y
Total parenteral nutrition may be responsible for gallbladder sludge and lithiasis which might possibly be related to gallbladder bile stasis. Gallbladder motility has not yet been studied during constant-rate enteral nutrition. We performed serial ultrasonographic studies of gallbladder volume and contents in ten patients receiving constant-rate enteral nutrition during 35 +/- 17 days. Each patient had two weekly examinations at 9 AM and 2 PM on the same day. None of the patients developed gallbladder sludge or lithiasis. The gallbladder was frequently seen to be contracted. Mean gallbladder volume during constant-rate enteral nutrition was not significantly different from mean gallbladder volume after Bladex. Individual gallbladder volume changed significantly from one measurement to another. This study showed that gallbladder motility is preserved during constant-rate enteral nutrition. The persistence of gallbladder contractions may prevent the development of biliary sludge ad lithiasis.
Muller, Paul Andrew; Koscsó, Balázs; Rajani, Gaurav Manohar; Stevanovic, Korey; Berres, Marie-Luise; Hashimoto, Daigo; Mortha, Arthur; Leboeuf, Marylene; Li, Xiu-Min; Mucida, Daniel; Stanley, E Richard; Dahan, Stephanie; Margolis, Kara Gross; Gershon, Michael David; Merad, Miriam; Bogunovic, Milena
Intestinal peristalsis is a dynamic physiologic process influenced by dietary and microbial changes. It is tightly regulated by complex cellular interactions; however, our understanding of these controls is incomplete. A distinct population of macrophages is distributed in the intestinal muscularis externa. We demonstrate that, in the steady state, muscularis macrophages regulate peristaltic activity of the colon. They change the pattern of smooth muscle contractions by secreting bone morphogenetic protein 2 (BMP2), which activates BMP receptor (BMPR) expressed by enteric neurons. Enteric neurons, in turn, secrete colony stimulatory factor 1 (CSF1), a growth factor required for macrophage development. Finally, stimuli from microbial commensals regulate BMP2 expression by macrophages and CSF1 expression by enteric neurons. Our findings identify a plastic, microbiota-driven crosstalk between muscularis macrophages and enteric neurons that controls gastrointestinal motility. PAPERFLICK: Copyright © 2014 Elsevier Inc. All rights reserved.
Muller, Paul Andrew; Koscsó, Balázs; Rajani, Gaurav Manohar; Stevanovic, Korey; Berres, Marie-Luise; Hashimoto, Daigo; Mortha, Arthur; Leboeuf, Marylene; Li, Xiu-Min; Mucida, Daniel; Stanley, E. Richard; Dahan, Stephanie; Margolis, Kara Gross; Gershon, Michael David; Merad, Miriam; Bogunovic, Milena
SUMMARY Intestinal peristalsis is a dynamic physiologic process influenced by dietary and microbial changes. It is tightly regulated by complex cellular interactions; however, our understanding of these controls is incomplete. A distinct population of macrophages is distributed in the intestinal muscularis externa. We demonstrate that in the steady state muscularis macrophages regulate peristaltic activity of the colon. They change the pattern of smooth muscle contractions by secreting bone morphogenetic protein 2 (BMP2), which activates BMP receptor (BMPR) expressed by enteric neurons. Enteric neurons, in turn, secrete colony stimulatory factor 1 (CSF1), a growth factor required for macrophage development. Finally, stimuli from microbial commensals regulate BMP2 expression by macrophages and CSF1 expression by enteric neurons. Our findings identify a plastic, microbiota-driven, crosstalk between muscularis macrophages and enteric neurons, which controls gastrointestinal motility. PMID:25036630
INTRODUCTION. Molluscan shellfish include oysters, clams, mussels, and cockles, which can cause illnesses from a variety of human pathogens. Enteric viruses, like norovirus and hepatitis A virus, are generally transmitted to shellfish through fecal contamination of shellfish harvesting areas, alth...
Haren, F.M. van; Oudemans-van Straaten, H.M.; Mathus-Vliegen, E.M.H.; Tepaske, R.; Hoeven, J.G. van der
Nutritional therapy in the intensive care unit exerts favourable effects on morbidity and mortality. Enteral nutrition is preferable to parenteral nutrition. Only perforation or total obstruction of the gastrointestinal tract, proven mesenteric ischaemia and toxic megacolon are absolute
O. A. Malkov
Full Text Available Objective: to provide evidence whether it is expedient to use an early enteral feeding protocol in patients with colonic malignancies in the postoperative period to prevent and to correct hemodynamic disorders, oxygen imbalance, and malnutrition. Subjects and methods. A hundred patients (61 males and 39 females aged 66.2±5.0 years, who had Stages 2—3 colonic malignancies, were examined. Two algorithms of postoperative management were analyzed using the traditional diet and early enteral feeding. Results. The early enteral feeding protocol improves central hemodynamics and oxygen and nutritional status, prevents moderate protein-energy deficiency in the early postoperative period and reduces the number of complications and fatal outcomes in patients with colonic malignancies. Key words: malignancies, malnutrition, hemo-dynamics, oxygen status, enteral feeding.
Antibiotic resistance profiles and relatedness of enteric bacterial pathogens isolated from HIV/AIDS patients with and without diarrhoea and their household drinking water in rural communities in Limpopo Province South Africa.
Chattha, Kuldeep S; Roth, James A; Saif, Linda J
Enteric viral infections in domestic animals cause significant economic losses. The recent emergence of virulent enteric coronaviruses [porcine epidemic diarrhea virus (PEDV)] in North America and Asia, for which no vaccines are available, remains a challenge for the global swine industry. Vaccination strategies against rotavirus and coronavirus (transmissible gastroenteritis virus) infections are reviewed. These vaccination principles are applicable against emerging enteric infections such as PEDV. Maternal vaccines to induce lactogenic immunity, and their transmission to suckling neonates via colostrum and milk, are critical for early passive protection. Subsequently, in weaned animals, oral vaccines incorporating novel mucosal adjuvants (e.g., vitamin A, probiotics) may provide active protection when maternal immunity wanes. Understanding intestinal and systemic immune responses to experimental rotavirus and transmissible gastroenteritis virus vaccines and infection in pigs provides a basis and model for the development of safe and effective vaccines for young animals and children against established and emerging enteric infections.
Wentling, Rose Mary; Thomas, Steven P.
There is a major concern about the drop of young women entering Computer Science degree programs and a drop in the participation of women in these information technology occupations. In all levels of educational institutions across the nation, girls and women remain under-represented in computer and information science studies and subsequently,…
Luengo Pérez, L M; Chicharro, M L; Cuerda, C; García Luna, P P; Rabassa Soler, A; Romero, A; Irles, J A; Penacho, M A; Camarero, E; Martínez Olmos, M A; Calañas, A; Parés, R M; Lecha, M; Gómez Candela, C; Zapata, A; Pérez de la Cruz, A; Luis, D de; Wanden-Berghe, C; Cantón, A; Laborda, L; Matía, P; Martí, E
To communicate the results from the registry of Home-Based Enteral Nutrition of the NADYASENPE group in 2007. We included every patient in the registry with home enteral nutrition any time from January 1st to December 31st of 2007. The number of patients with home enteral nutrition in 2007 was 5,107 (52% male) from 28 different hospitals. 95.4% of them were 15 yr or older, with a mean age of 67.96 +/- 18.12, and 4.2 +/- 3.38 among patients aged 14 yr or less. The most common underlying diseases were neurological (37.8%) and neoplastic diseases (29.3%). Enteral nutrition was administered p.o. in most patients (63.5%), followed by nasogastric tube (25.9%), while gastrostomy was only used in 9.2%. The mean time in enteral nutrition support was 9.4 months and the most common reasons for withdrawal were death (58.7%) and switching to oral intake (32%). Activity was limited in 31.4% of patients and 36.01% were house-bound. Most patients needed partial (26.51%) or total (37.68%) care assistance. Enteral formula was provided by hospitals to 69.14% of patients and by pharmacies to 30.17% of them, while disposable material was provided by hospitals to 81.63% and by Primary Care to the remaining patients. In 2007, there has been an increase of more than 30% of patients registered with home enteral nutrition comparing with 2006, without any big difference in other data, but a higher proportion of patients with enteral nutrition p.o.
Conclusions: Garlic had excellent antimicrobial effects against enteric bacteria and was recommended to be given to patients with gastroenteritis. The other vegetables (pennywort, mint, parsley and celery showed no inhibitory effects on enteric bacteria but still can be used for its richness in vitamins and fibers. The performance of the well diffusion method was better than that of the disc diffusion method in detecting the antibacterial effects of green vegetables.
Smith, Tricia H.; Grider, John R.; Dewey, William L.; Akbarali, Hamid I.
Gastrointestinal peristalsis is significantly dependent on the enteric nervous system. Constipation due to reduced peristalsis is a major side-effect of morphine, which limits the chronic usefulness of this excellent pain reliever in man. The ionic basis for the inhibition of enteric neuron excitability by morphine is not well characterized as previous studies have mainly utilized microelectrode recordings from whole mount myenteric plexus preparations in guinea pigs. Here we have developed a...
Abstract Glia (from Greek γλοία meaning ‘glue’) pertains to non‐neuronal cells in the central (CNS) and peripheral nervous system (PNS) that nourish neurons and maintain homeostasis. In addition, glia are now increasingly appreciated as active regulators of numerous physiological processes initially considered exclusively under neuronal regulation. For instance, enteric glia, a collection of glial cells residing within the walls of the intestinal tract, regulate intestinal motility, a well‐characterized reflex controlled by enteric neurons. Enteric glia also interact with various non‐neuronal cell types in the gut wall such as enterocytes, enteroendocrine and immune cells and are therefore emerging as important local regulators of diverse gut functions. The intricate molecular mechanisms that govern glia‐mediated regulation are beginning to be discovered, but much remains unknown about the functions of enteric glia in health and disease. Here we present a current view of the enteric glia and their regulatory roles in gastrointestinal (GI) (patho)physiology; from GI motility and epithelial barrier function to enteric neuroinflammation. PMID:27106597
Sayyed Mohammad Ali Alamolhodaei
Full Text Available The internationalization of small and medium size businesses is regarded as one of the most leading general policies in many of the world’s countries. The reason is that it is often the small and medium size companies which have a vital role in industrial innovation and gain profit for their societies through economic development. This research has investigated and identified the effective factors (organizational factors and business etiquette in Islam on entering into international markets by presenting local Islamic model in the companies of incubator of Science and Technology Park. The statistical population of the research includes the existing companies of Incubator of Mashhad Science and Technology Park. The statistical sample was investigated through simple random sampling from managers of active companies in export in Science and Technology Park. AMOS and SPSS software were applied for data analysis to identify the effects among variables survey research methodology and questionnaire tools were used.
Cheng, Ying; Zhang, Junfeng; Zhang, Liwei; Wu, Juan; Zhan, Zhen
Background Nutrition support is a common means for patients with gastric cancer, especially for those undergoing elective surgery. Recently, enteral immunonutrition (EIN) was increasingly found to be more effective than enteral nutrition (EN) in enhancing the host immunity and eventually improving the prognosis of gastric cancer patients undergoing gastrectomy. However, the results reported were not consistent. This meta-analysis aimed to assess the impact of EIN for patients with GC on bioch...
Halmos, Emma P
Gastrointestinal symptoms including diarrhea are common complications of enteral nutrition (EN); however, the cause is unclear. Mode of EN delivery that alters digestion and possibly absorption is suggested to contribute to the high incidence of diarrhea; however, enteral formula is frequently blamed. Most research has focused on fiber-supplemented EN, with a meta-analysis showing that fiber reduces the incidence of diarrhea in non-intensive care unit studies. Other hypotheses include formula osmolality and FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) content. FODMAPs are poorly absorbed short-chain carbohydrates that exert an osmotic effect. Dietary FODMAPs have been shown to reduce gastrointestinal symptoms, including diarrhea, in those with irritable bowel syndrome and, given a high-enough dose, will induce a laxative effect in most people. As FODMAPs are commonly added to enteral formula and EN is frequently used as the main source of nutrition, it is reasonable to hypothesize that EN provides more FODMAPs than usual dietary intake and increases risk for developing diarrhea. This hypothesis was assessed through a retrospective study showing that the standard-use enteral formula Isosource 1.5 had a protective effect of developing diarrhea. The only characteristic unique to Isosource 1.5 was the lower FODMAP content as determined through methodologies previously validated for food analysis. Methodologies for application to enteral formulas are currently undergoing formal validation. Once confirmed for application in enteral formula, future directions include FODMAP analysis of specific ingredients to increase understanding of potential problems associated with enteral formula and a randomized, controlled trial investigating the role of formula FODMAP content. © 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.
Romero Jiménez, Rosa Mª; Ortega Navarro, Cristina; Cuerda Compés, Cristina
Oral medications are often administered through enteral feeding tubes in patients with complex chronic diseases. It is important to consider possible interactions between drugs and enteral nutrition that might lead to unsuccessful treatment or tube occlusion. These patients become subjects for higher risk of problems and errors such as drug incompatibility with enteral nutrition and inappropriate dosage form selection. It is possible to minimize the risk of tube occlusion and incompatibilities problems by recognizing potential medication errors, selecting the most appropriate drug and dosage form and using appropriate administration techniques. In this context, high-alert medications for patients with chronic diseases deserve special attention. Furthermore, risk exposure should be considered among healthcare professionals and patient caregivers handling hazardous drugs. Therefore, main incompatibility problems between drugs and enteral nutrition have been reviewed, including general recommendations for administration of oral medications through enteral feeding tubes and safe handling of hazardous drugs. Specific recommendations for administration of high-alert medications for patients with chronic diseases are also included.
Full Text Available Objective: This systematic literature review aims to clarify indications for the use of enteral feeding in patients with dementia. Difficulties in feeding patients with dementia may arise at any stage of the disease and may include malnutrition, weight loss, decreased quality of life, among others. Enteral tube feeding by tube may be a way of mitigating the effects, but its benefits are under discussion. Methods: Eight qualitative studies were included: 5 primary sources, 3 systematic literature reviews, published in the 2008-2013 period. Results: Enteral tube feeding in patients with dementia may affect survival/mortality rate (no evidence of benefit, nutritional status (no improvement, functional status and cognitive development (no improvement, aspiration (does not reduce the risk of aspiration, pressure ulcers (no evidence of benefit in ulcers incidence and progression, and quality of life (without hard data in most studies. Conclusion: Evidence on benefits of enteral tube feeding in patients with dementia was not conclusive and may even have the opposite effect. We lack data on the adverse effects of these interventions. Keywords: Palliative care; Dementia; Enteral feeding; Therapeutic use.
Full Text Available This article discusses the use of enteral nutrition in the management of stroke. Stroke is a major source of disability, including dysphagia. The clinical manifestation of swallowing difficulties in stroke patients may lead to malnutrition which has implications for health status and clinical outcomes including morbidity, mortality and cost to the health service. The prevalence of malnutrition following an acute stroke could range from 8% to 34%. Therefore, the need to develop and implement the use of enteral nutrition support in stroke patients becomes pertinent. A range of enteral feeding tubes and feeding methods may be used to support stroke patients who are unable to meet their nutritional requirements through oral intake alone, although each of these approaches has its merits and limitations. Based on this review, there is evidence that enteral nutrition support is a useful method of providing nutrition for patients with dysphagia following a stroke in order to enhance their nutritional status and promote their health. However, there are challenges in the use of enteral tube feeding in these patients.
Ochoa-Cortes, Fernando; Turco, Fabio; Linan-Rico, Andromeda; Soghomonyan, Suren; Whitaker, Emmett; Wehner, Sven; Cuomo, Rosario; Christofi, Fievos L
The word "glia" is derived from the Greek word "γλoια," glue of the enteric nervous system, and for many years, enteric glial cells (EGCs) were believed to provide mainly structural support. However, EGCs as astrocytes in the central nervous system may serve a much more vital and active role in the enteric nervous system, and in homeostatic regulation of gastrointestinal functions. The emphasis of this review will be on emerging concepts supported by basic, translational, and/or clinical studies, implicating EGCs in neuron-to-glial (neuroglial) communication, motility, interactions with other cells in the gut microenvironment, infection, and inflammatory bowel diseases. The concept of the "reactive glial phenotype" is explored as it relates to inflammatory bowel diseases, bacterial and viral infections, postoperative ileus, functional gastrointestinal disorders, and motility disorders. The main theme of this review is that EGCs are emerging as a new frontier in neurogastroenterology and a potential therapeutic target. New technological innovations in neuroimaging techniques are facilitating progress in the field, and an update is provided on exciting new translational studies. Gaps in our knowledge are discussed for further research. Restoring normal EGC function may prove to be an efficient strategy to dampen inflammation. Probiotics, palmitoylethanolamide (peroxisome proliferator-activated receptor-α), interleukin-1 antagonists (anakinra), and interventions acting on nitric oxide, receptor for advanced glycation end products, S100B, or purinergic signaling pathways are relevant clinical targets on EGCs with therapeutic potential.
Ochoa-Cortes, Fernando; Turco, Fabio; Linan-Rico, Andromeda; Soghomonyan, Suren; Whitaker, Emmett; Wehner, Sven; Cuomo, Rosario
Abstract: The word “glia” is derived from the Greek word “γλοια,” glue of the enteric nervous system, and for many years, enteric glial cells (EGCs) were believed to provide mainly structural support. However, EGCs as astrocytes in the central nervous system may serve a much more vital and active role in the enteric nervous system, and in homeostatic regulation of gastrointestinal functions. The emphasis of this review will be on emerging concepts supported by basic, translational, and/or clinical studies, implicating EGCs in neuron-to-glial (neuroglial) communication, motility, interactions with other cells in the gut microenvironment, infection, and inflammatory bowel diseases. The concept of the “reactive glial phenotype” is explored as it relates to inflammatory bowel diseases, bacterial and viral infections, postoperative ileus, functional gastrointestinal disorders, and motility disorders. The main theme of this review is that EGCs are emerging as a new frontier in neurogastroenterology and a potential therapeutic target. New technological innovations in neuroimaging techniques are facilitating progress in the field, and an update is provided on exciting new translational studies. Gaps in our knowledge are discussed for further research. Restoring normal EGC function may prove to be an efficient strategy to dampen inflammation. Probiotics, palmitoylethanolamide (peroxisome proliferator-activated receptor–α), interleukin-1 antagonists (anakinra), and interventions acting on nitric oxide, receptor for advanced glycation end products, S100B, or purinergic signaling pathways are relevant clinical targets on EGCs with therapeutic potential. PMID:26689598
Richards, G P
Hepatitis A and E viruses, rotaviruses, Norwalk-like caliciviruses, and astroviruses are among the enteric viruses known to cause food- and waterborne illness. These viruses are spread by the fecal-oral route and are a major cause of morbidity and mortality worldwide. Foods may be contaminated at any time pre- or post-harvest; however, many outbreaks are associated with foods handled by infected restaurant workers. Produce may be contaminated by improper irrigation or fertilization practices, by the hands of infected pickers or processors, or as the result of adulteration during any stage of handling. Outbreaks have been commonly associated with foods which are served raw or only lightly cooked, such as molluscan shellfish, fruits and vegetables, and salads or products contaminated after cooking like frosted bakery products. The farming, shellfish, processing, transportation, and restaurant industries must maintain vigilance to reduce outbreaks of enteric virus illness. Intervention strategies to enhance product safety include increased industry and consumer education; changes in industrial practices, product management, and processing technologies; worker immunizations; and the development of improved monitoring tools for the detection of enteric viruses in foods.
Lima, Ana Raquel da Costa; Barros, Luciana Machado; Rosa, Monique Silveira; Cardonha, Angela Maria Soares; Dantas, Maria Amélia Marques
To evaluate the microbiological quality of open enteral feeding system manipulated in a specialized hospital in oncology in the city of Natal-RN. 20 samples of industrialized enteral feeding in open system had been analyzed. The searched microrganisms had been: Bacillus cereus, total coliforms, Escherichia coli, Salmonella sp, Clostridium sulfite reducer, mesophilic aerobic bacteria and coagulase positive Staphylococci. The methodology used for accomplishment of the microbiological analyses was the praised one for the Food and Drug Administration--FDA. It was evidenced total coliforms, Escherichia coli and mesophilic aerobic bacteria contamination in 25%, 10% and 20% of the analyzed samples, respectively. It was not identified the presence of Bacillus cereus, Salmonella sp, Clostridium sulfite reducer, and coagulase positive Staphylococci in none of the analyzed samples. The gotten results show that the enteral feedings are in unsatisfactory hygienic-sanitary conditions, evidencing the necessity of a bigger control in the manipulation of the same ones.
Herbivorous surgeonfishes are an ecologically successful group of reef fish that rely on marine algae as their principal food source. Here, we elucidated the significance of giant enteric symbionts colonizing these fishes regarding their roles in the digestive processes of hosts feeding predominantly on polysiphonous red algae and brown Turbinaria algae, which contain different polysaccharide constituents. Using metagenomics, single-cell genomics, and metatranscriptomic analyses, we provide evidence of metabolic diversification of enteric microbiota involved in the degradation of algal biomass in these fishes. The enteric microbiota is also phylogenetically and functionally simple relative to the complex lignocellulose-degrading microbiota of terrestrial herbivores. Over 90% of the enzymes for deconstructing algal polysaccharides emanate from members of a single bacterial lineage,
Padar, Martin; Uusvel, Gerli; Starkopf, Liis
AIM: To determine the effects of implementing an enteral feeding protocol on the nutritional delivery and outcomes of intensive care patients. METHODS: An uncontrolled, observational before-and-after study was performed in a tertiary mixed medical-surgical intensive care unit (ICU). In 2013......, a nurse-driven enteral feeding protocol was developed and implemented in the ICU. Nutrition and outcome-related data from patients who were treated in the study unit from 2011-2012 (the Before group) and 2014-2015 (the After group) were obtained from a local electronic database, the national Population...... the groups. Patients in the After group had a lower 90-d (P = 0.026) and 120-d (P = 0.033) mortality. In the After group, enteral nutrition was prescribed less frequently (P = 0.039) on day 1 but significantly more frequently on all days from day 3. Implementation of the feeding protocol resulted in a higher...
Cutie, A J; Altman, E; Lenkel, L
Although drugs are routinely administered through gavage feedings set along with enteral products, there is little scientific data available to the physician, pharmacist, nurse, and dietician concerning the physical and chemical compatibility of drugs with enteral formulations. This study assesses the compatibility of Ensure (Ross Laboratories, Columbus, OH), Ensure Plus (Ross Laboratories, Columbus, OH), Osmolite (Ross Laboratories, Columbus, OH) with antibiotics, gastrointestinal agents, antipsychotic agents, urinary antiseptics cough and cold medications, and other commonly used additives. All enteral formulations were examined immediately after mixing for phase changes, creaming, and particle growth using a contrast light and a rotation viscometer. Results are presented in a tabular format. Guidelines and recommendations concerning how the addition of troublesome drug additives can be added are also presented.
Hafez Mohamed Hafez
Full Text Available The enteric heath of growing poultry is imperative to success of the production. The basic role of poultry production is turning feed stuffs into meat. Any changes in this turning process, due to mechanical, chemical or biological disturbance of digestive system (enteric disorders is mostly accompanied with high economic losses due to poor performance, increased mortality rates and increased medication costs. The severity of clinical signs and course of the disorders are influenced several factors such as management, nutrition and the involved agent(s. Several pathogens (viruses, bacteria and parasites are incriminated as possible cause of enteric disorders either alone (mono-causal, in synergy with other micro-organisms (multi-causal, or with non-infectious causes such as feed and /or management related factors. In addition, excessive levels of mycotoxins and biogenic amines in feed lead to enteric disorders. Also factors such as high stocking density, poor litter conditions, poor hygiene and high ammonia level and other stressful situation may reduce the resistance of the birds and increases their susceptibility to infections. Under field conditions, however, under filed conditions it is difficult to determine whether the true cause of enteric disorders, is of infectious or non-infectious origin. In recent years and since the ban of use of antimicrobial growth promoters in several countries the incidence of intestinal disorders especially those caused by clostridial infection was drastically increased. The present review described in general the several factors involved in enteric disorders and summarized the available literatures about Clostridium perfringens infection in poultry.
This paper considers the potential impact of medical school indebtedness and other variables on the propensity of US doctors to enter academic medicine. Probit models provide some evidence that indebtedness reduces the likelihood that physicians will choose academic medicine as their primary activity. Nevertheless, the magnitude of this effect is not large. As indebtedness may be endogenous, the probits are rerun using an instrumental variables approach. These estimates imply that over time indebtedness may have an important impact on the propensity of physicians to enter academic medicine. Copyright 2002 John Wiley & Sons, Ltd.
Mcguire, Robyn Lynette; Ojo, Jane Oshuwa
Finding new territories to expand a business is a common goal for many. Many markets are flooded with such a variety of products it is sometimes hard for an entering business to be noticed. Entering a virgin market that is not yet saturated with the mass companies is an ideal situation for a business. They would be new, fresh and desired. There are many countries that are considered to be up and coming economies. The factors in making these countries virtually untouched are many, some in...
Divyashree, S; Nabarro, L E B; Veeraraghavan, B; Rupali, P
Enteric fever is a major cause of morbidity and mortality in tropical areas worldwide. The Indian subcontinent bears the brunt of the disease, both in terms of absolute case numbers and drug-resistant strains. Recent phylogenetic studies suggest that the multidrug-resistant clade H58 originated in India and subsequently expanded through Asia and Africa. In Africa, it caused unrecognised outbreaks in areas previously considered free of the disease. In this study, we discuss the current status of enteric fever in India, the factors preventing its control and its future directions in this rapidly developing nation. © 2016 John Wiley & Sons Ltd.
Davies, Clive; Hopkins, DW; Owen, WS
Calculations in Furnace Technology presents the theoretical and practical aspects of furnace technology. This book provides information pertinent to the development, application, and efficiency of furnace technology. Organized into eight chapters, this book begins with an overview of the exothermic reactions that occur when carbon, hydrogen, and sulfur are burned to release the energy available in the fuel. This text then evaluates the efficiencies to measure the quantity of fuel used, of flue gases leaving the plant, of air entering, and the heat lost to the surroundings. Other chapters consi
The globalization of the economy and the end of the Cold War have triggered many changes in the traditional practices of U.S. industry. To effectively apply the resources available to the United States, the federal government has firmly advocated a policy of technology transfer between private industry and government labs, in this case the National Aeronautics and Space Administration (NASA). NASA Administrator Daniel Goldin is a strong proponent of this policy and has organized technology transfer or commercialization programs at each of the NASA field centers. Here at Langley Research Center, the Technology Applications Group (TAG) is responsible for facilitating the transfer of Langley developed research and technology to U.S. industry. Entering the program, I had many objectives for my summer research with TAG. Certainly, I wanted to gain a more thorough understanding of the concept of technology transfer and Langley's implementation of a system to promote it to both the Langley community and the community at large. Also, I hoped to become more familiar with Langley's research capabilities and technology inventory available to the public. More specifically, I wanted to learn about the technology transfer process at Langley. Because my mentor is a member of Materials and Manufacturing marketing sector of the Technology Transfer Team, another overriding objective for my research was to take advantage of his work and experience in materials research to learn about the Advanced Materials Research agency wide and help market these developments to private industry. Through the various projects I have been assigned to work on in TAG, I have successfully satisfied the majority of these objectives. Work on the Problem Statement Process for TAG as well as the development of the Advanced Materials Research Brochure have provided me with the opportunity to learn about the technology transfer process from the outside looking in and the inside looking out. Because TAG covers
The EntericBio system uses a multiplex PCR assay for the simultaneous detection of Campylobacter spp., Salmonella enterica, Shigella spp., and Escherichia coli O157 from feces. It combines overnight broth enrichment with PCR amplification and detection by hybridization. An evaluation of this system was conducted by comparing the results obtained with the system with those obtained by routine culture, supplemented with alternative PCR detection methods. In a study of 773 samples, routine culture and the EntericBio system yielded 94.6 and 92.4% negative results, respectively. Forty-two samples had positive results by culture, and all of these were positive with the EntericBio system. This system detected an additional 17 positive samples (Campylobacter spp., n = 12; Shigella spp., n = 1; E. coli O157, n = 4), but the results for 5 samples (Campylobacter spp., n = 2; Shigella spp., n = 1; E. coli O157, n = 2) could not be confirmed. The target for Shigella spp. detected by the EntericBio system is the ipaH gene, and the molecular indication of the presence of Shigella spp. was investigated by sequence analysis, which confirmed that the ipaH gene was present in a Klebsiella pneumoniae isolate from the patient. The sensitivity, specificity, positive predictive value, and negative predictive value were 100%, 99.3%, 91.5%, and 100%, respectively. Turnaround times were significantly reduced with the EntericBio system, and a result was available between 24 and 32 h after receipt of the sample in the laboratory. In addition, the amount of laboratory waste was significantly reduced by use of this system. In summary, the EntericBio system proved convenient to use, more sensitive than the conventional culture used in this study, and highly specific; and it generated results significantly faster than routine culture for the pathogens tested.
With an increasing number of outbreaks and illnesses associated with pre-harvest contaminated produce, understanding the potential and mechanisms of produce contamination by enteric pathogens can aid in the development of preventative measures and post-harvest processing to reduce microbial populati...
Apr 16, 2007 ... Antibiotic resistance profiles and the correlation of enteric bacterial pathogens from HIV positive indivi- duals with and ... from the various study cohorts showed multiple antibiotic resistance to penicillin, amoxicillin, ampicillin, erythromycin .... chose to work closely with support groups, NGOs and HIV care-.
Bacterial resistance to antibiotic in food animals is an emerging public health concern as a result of increasing multi-resistant bacteria found in Abeokuta. Therefore, occurrence rate and resistant profile of the emerging enteric pathogens were determined in food animals in Abeokuta, Nigeria. Fecal and rectal samples of 82 ...
... the enteric neural crest-derived cells (ENCCs), and many molecules and biochemical processes may be involved in its development. This study examined the effects of modulating embryonic nitric oxide (NO) activity on the intestinal motility induced by ENS. One-hundred-and-twenty fertilized chicken eggs were assigned ...
Kamp, L.M.; Ortt, J.R.; Harahap, B.
Companies that bring a new product to the market or enter a new market with an existing product, come across a number of barriers that prevent large?scale diffusion. In order to circumvent or remove these barriers, they can adopt alternative strategies. This paper looks into these barriers and
Griffith, Annette K.; Ingram, Stephanie D.; Barth, Richard P.; Trout, Alexandra L.; Hurley, Kristin Duppong; Thompson, Ronald W.; Epstein, Michael H.
Although much is known about the mental health and behavioral functioning of youth who enter residential care programs, very little research has focused on examining the family characteristics of this population. Knowledge about family characteristics is important, however, as it can aid in tailoring programs to meet the needs of families who are…
The goal of this diploma paper is to present Business Consulting, describe characteristics of european and global consultancy market, give detailed description of the Ukrainian consultancy market and finally to propose the strategic steps necessary for the Czech consultancy company with intention to enter the Ukrainian market.
Objective: To determine the effect of enteral glutamine in reducing the incidence of post burn infections in patients with severe burns. Design: A double blind randomised clinical trial. Setting: Burns unit and ward 4D of Kenyatta National Hospital, Kenya Subjects: Sixty patients with severe burns who were randomised to two ...
Risk Factors Associated With Canine Parvovirus Enteritis In Vom And Environs. J G Mohammed, AO Ogbe, NJ Zwandor, JU Umoh. Abstract. No Abstract. Animal Research International Vol. 2 (3) 2005 pp. 366-368. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.
B.E. Carlier (Bouwine)
markdownabstractUnemployed persons have poorer health compared to employed persons. Also, persons with a poor health are less likely to enter the workforce than healthy persons. So, more insight is needed in determinants of re-employment and effective re-employment programs for unemployed persons
Freedman, Joanne; Lighton, Lorraine; Jones, Jane
There is no internationally recognized case-definition for travel-associated enteric fever in non-endemic countries. This study describes the patterns of case reporting between 2007 and 2011 as travel-associated or not from the surveillance data in England, Wales and Northern Ireland (EWNI), before and after a change in the time component of the case-definition in January 2011. It examines in particular the role of a time frame based on the reported typical incubation period in defining a case of travel-associated enteric fever. The results showed no significant differences in the distribution of cases of enteric fever in regards to the interval between the onset and UK arrival in 2011 compared to 2007-2010 (p=0.98 for typhoid and paratyphoid A); the distribution for paratyphoid B was also similar in both time periods. During 2007-2010, 93% (1730/1853) of all of the cases were classified as travel-associated compared to 94% (448/477) in 2011. This difference was not statistically significant. Changing the time component of the definition of travel-associated enteric fever did not make a significant difference to the proportion of travel-associated cases reported by investigators. Our analysis suggests that time might be subordinate to other considerations when investigators classify a case as travel-associated. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.
Escortell Sánchez, Raquel; Reig García-Galbis, Manuel
to identify what effect causes enteral nutrition on nutritional status of cancer. a search was performed using the keywords "Cancer" AND "Enteral Nutrition" AND "Supplementation" in four document databases: Pubmed, EBSCO, ProQuest, and Web of Science. age of the sample, major than 18 years; submitted to surgery for cancer; that the intervention program was including diet and employment or not of nutritional Supplementation; clinical trials published between January 2004 and December 2014, in scientific journals indexed. we analyzed 660 articles, of which only 2% has been included. 58% of intervention programs are applied outside Spain; 84% of the interventions was carried out in a hospitable ambient; 58% of the sample is formed by adults older than 54 years; 33% of the interventions were multidisciplinary and its duration ranges between 1 and 4 years. we found just a few national interventions in cancer participants and there two types of interventions: by exclusive polymeric enteral formula or mixed with immunonutrition. enteral nutrition shows against the parenteral and its introduction at an early stage, it helps to improve nutritional status of the patient; polymeric formulas next immunonutrition, it helps to reduce the time of hospitalization; the analytical parameters are shown as a measurement pattern when assessing the improvement in nutritional status in cancer. It is recommended to increase the research in this field, especially in children. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
This study was an attempt to measure the Van Hiele levels of geometric thought attained by SHS 1 students on entering Senior High School in Ghana. In all, 188 SHS Form 1 students from two schools were involved in this study. These students were given the Van Hiele Geometry Test adapted from the 'Cognitive ...
Introduction: The objective of the study was to present our last 5-years experience of peritonitis and validate POSSUM score in predicting mortality and morbidity in patients of enteric perforation (EP) peritonitis. Methods: Data was collected prospectively for all peritonitis cases admitted in single surgical unit from January ...
Bacteriophages are an attractive alternative to fecal indicator bacteria (FIB), particularly as surrogates of enteric virus fate and transport due to their closer morphological and biological properties compared to FIB. Based on a meta-analysis of published data, we summarize con...
Hodgson, Kate R; Torok, Valeria A; Turnbull, Alison R
Human enteric viruses, such as norovirus and hepatitis A virus, are spread by a variety of routes including faecal-oral transmission. Contaminated bivalve shellfish are regularly implicated in foodborne viral disease outbreaks internationally. Traditionally indicator bacteria, the coliforms and Escherichia coli, have been used to detect faecal pollution in growing waters and shellfish. However, studies have established that they are inadequate as indicators of the risk of human enteric viruses. Bacteriophages have been identified as potential indicators or surrogates for human enteric viruses due to their similarities in morphology, behaviour in water environments and resistance to disinfectant treatments. The somatic coliphages, male-specific RNA coliphages (FRNA coliphages) and the bacteriophages of Bacteroides are the groups recognised as most suitable for water and shellfish testing. In this review, we discuss the rationale and supporting evidence for the application of bacteriophages as surrogates for human enteric viruses in shellfish under a variety of conditions. There is some evidence to support the validity of using bacteriophage levels to indicate viral risk in shellfish in highly contaminated sites and following adverse sewage events. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.
Mar 23, 2016 ... Plant part Yield (%). Citrus aurantifolia (Christm). Swing Lime. AP 2086 HNB. Fruit peel. 0.8. Eucalyptus citriodora Hook. Lemon scent. AAC 181 HNB. Leaves. 2.57 ... enteric methane production owing to their antimicrobial activity (Bodas et al., 2012). Antimicrobial properties of EO depend on their chemical.
Merwe, Christiaan Frederik van der
The purpose of this clinical study was to determine whether the use of a gluten-free diet influenced the course and prognosis of regional enteritis. Following a few clinical communications in the Dutch medical literature reporting favourable results obtained with the gluten-free diet in the
Materials and Methods: We retrospectively studied the effects of single versus double layer intestinal closure after typhoid enteric perforation with peritonitis in 902 pediatric patients from September 2007 to April 2012. All the patients underwent laparotomy after resuscitation and antibiotic cover. The patients were divided ...
as Parkinson's syndrome, motor neuron disease, transient amnesia, symmetrical sensory-motor neuropathy, schizophreniform psychosis and cerebellar involvement, have also been reported in various journals.5. Aphasia as a complication of enteric fever has been described in 2 - 7.4% of studies in an adult population3 but ...
This article critically discusses the necessity for (practical) theology to transform. Taking as a point of departure church historian Andrew Walls' remark: 'Christian faith must go on being translated, must continuously enter into the vernacular culture and interact with it, or it withers and fades', examples from ministry are ...
Mar 23, 2016 ... Enteric methane production lowers the efficiency of feed utilization in ruminants and contributes to greenhouse gas emissions which are responsible for global climate change. This study examined the effects of nine essential oils (EO) from Citrus aurantifolia, Cymbopogon citratus, Eucalyptus citriodora,.
A wide range of organisms was encountered in the 24 sampled sites of the Lagos Lagoon. The enteric gram-negative shortrods, Lactose fermenting organisms such as Klebsiella spp, Enterobacter spp and Escherichia coli were prevalent in most of the Lagoon sites studied. The in vitro antibiotic sensitivity profile of the ...
Full Text Available Diarrhea is a major clinical problem affecting foals up to 3 months of age. The aim of this study was to identify enteric microorganisms involved in monoinfections and coinfections and the associated virulence factors in healthy and diarrheic foals. Diarrheic (D (n=56 and nondiarrheic (ND foals (n=60 up to three months of age were studied. Fecal samples were analyzed for identification of infectious agents (microbiological culturing, molecular techniques, and microscopic analyses. Escherichia coli fimH (30% versus 25%, Salmonella spp. (25% versus 7%, Strongyloides westeri (25% versus 25%, Clostridium perfringens type A (21% versus 10%, E. coli ag43 (20% versus 35%, Strongylus (11% versus 18%, and vapA-positive Rhodococcus equi (5% versus 2% were the most frequent enteric pathogens detected in D and ND foals, respectively. The frequency of toxin A-positive C. perfringens was significantly increased in the D (p=0.033 compared with the ND animals. R. equi strains harboring virulent plasmids were also identified (VapA 85-kb type I and VapA 87-kb type I in D and ND foals. Coinfections were observed in 46% of the D and 33% of the ND foals. Our results demonstrate the great diversity of enteric pathogens, virulence factors, and coinfections involved in enteric infections of foals.
Clostridium perfringens type A strains are the main etiological factors for necrotic enteritis (NE), one of the economically important gastrointestinal diseases in poultry responsible for the annual loss of 2 billion dollars in US poultry industry. NE has gained worldwide importance during the last...
Environmental enteric dysfunction (EED) is often measured with a dual sugar absorption test and implicated as a causative factor in childhood stunting. Disturbances in the gut microbiota are hypothesized to be a mechanism by which EED is exacerbated, although this supposition lacks support. We perfo...
Influence of enteric bacteria and parasite infection and nutritional status on diarrhoea occurrence in six to 60 month old children admitted at Morogoro ... Other factors found to significantly (p<0.05) influence diarrhoea occurrence included age when breastfeeding stopped, food(s) given, feeding utensils and the child´s toilet.
Hoffman, C H; Dietrich, R B; Pais, M J; Demos, D S; Pribram, H F
Split notochord syndrome with dorsal enteric fistula is an extremely rare congenital anomaly that may be associated with meningomyelocele or meningocele, and genitourinary anomalies. This case presented with an additional finding of bladder exstrophy, raising the possibility of a relationship between this syndrome and the OEIS complex.
Arribas, Lorena; Frías, Laura; Creus, Gloria; Parejo, Juana; Urzola, Carmen; Ashbaugh, Rosana; Pérez-Portabella, Cleofé; Cuerda, Cristina
The group of standardization and protocols of the Spanish Society of Parenteral and Enteral Nutrition (SENPE) published in 2011 a consensus document SENPE/SEGHNP/ANECIPN/SECP on enteral access for paediatric nutritional support. Along the lines of this document, we have developed another document on adult patients to homogenize the clinical practice and improve the quality of care in enteral access in this age group. The working group included health professionals (nurses, dietitians and doctor) with extensive experience in enteral nutrition and access. We tried to find scientific evidence through a literature review and we used the criteria of the Agency for Health-care Research and Quality (AHRQ) to classify the evidence (Grade of Recommendation A, B or C). Later the document was reviewed by external experts to the group and requested the endorsement of the Scientific and Educational Committee (CCE) and the group of home artificial nutrition (NADYA) of the SENPE. The full text will be published as a monograph number in this journal. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
E. histolytica, G. lamblia, A. lumbricoides, H. nana, and Taenia species were the parasites recovered with E. histolytica and A. lumbricoides as the most prevalent enteric parasites recovered. A. lumbricoides was the most prevalent parasite across the age groups, male, married participants and those who are anaemic.
Child malnutrition is a complex global problem, of which lack of food is only one component. Enteric pathogens and malnutrition work in a cyclic manner to depress a child’s intestinal immunity, while decreasing nutrient absorption. This cycle leads to stunting, wasting, and death. Often malnourished...
Bowden, Mark P.; Abhayawansa, Subhash; Bahtsevanoglou, John
Purpose: There is evidence that students who attend Technical and Further Education (TAFE) prior to entering higher education underperform in their first year of study. The purpose of this paper is to examine the role of self-efficacy in understanding the performance of students who completed TAFE in the previous year in a first year subject of…
Oct 20, 2014 ... inhibition of NO caused a deficient development of the ENS, leading to a decrease in the frequency and amplitude of the intestinal contractions ... development of enteric nervous system mediated gut motility in chick embryo model. J. Biosci. ... oncogene tyrosine-protein kinase receptor Ret (GDNF–. RET) is ...
Tsiouris, V; Georgopoulou, I; Batzios, Chr; Pappaioannou, N; Ducatelle, R; Fortomaris, P
The objective of this study was to investigate the effect of feed restriction on the intestinal ecosystem and on the pathogenesis of experimental necrotic enteritis in broiler chicks. To induce subclinical necrotic enteritis, an experimental challenge model using a specific diet formulation, Gumboro vaccination, oral inoculation of broilers with a 10-fold dose of attenuated anticoccidial vaccine and multiple oral inoculations with a specific strain of Clostridium perfringens was adopted. Two hundred and forty 1-day-old Cobb 500 broilers were randomly allocated to four groups: feed restricted, challenged, both feed restricted and challenged, and negative control. At 21, 22, 23 and 24 days of age, the intestines, gizzard and liver were collected from 15 birds in each group and scored for gross lesions. The intestinal digesta was collected for pH and viscosity determination. One caecum from each bird was taken for microbiological analysis. The application of feed restriction in birds challenged with C. perfringens reduced the necrotic enteritis lesion score significantly (P ≤ 0.05) and feed restriction significantly reduced (P ≤ 0.05) pH in the small intestine, the viscosity of the jejunum digesta as well as the C. perfringens counts in the caeca compared with the controls. In conclusion, feed restriction of broilers has a positive effect on the intestinal ecosystem and a significant protective effect against necrotic enteritis in the subclinical experimental model.
Enteric fever is caused by Salmonella enterica serotype typhi, Salmonella paratyphi A, B, C, and Salmonella typhimurium respectively. Of the 2818 blood cultures reviewed, only 90 (3.2%) had positive cultures for Salmonella species while the 10,007 faecal samples cultured, 159 (1.6%) were positive for Salmonella species.
Schaefer, Karl-Herbert; Van Ginneken, Chris; Copray, Sjef
The enteric nervous system (ENS) is a highly organized part of the autonomic nervous system, which innervates the whole gastrointestinal tract by several interconnected neuronal networks. The ENS changes during development and keeps throughout its lifespan a significant capacity to adapt to
Nurses' Competency and Challenges in Enteral feeding in the Intensive Care Unit (ICU) and High Dependency ... the American Association of Critical Care Nurses (AACN). Synergy Model for Patient Care. This model .... shortage as a common challenge, followed by patients'/guardians' refusal of tube feeding (18, 35.3%).
management level, within their career, and within society. These findings and the extent to which re-entering women experience these problems at different life stages were subsequently empirically tested by means of a structured questionnaire. The empirical research design. In order to test the validity of the observations in ...
Oct 20, 2014 ... J. Biosci. 39 835–848] DOI 10.1007/s12038-014-9474-4. 1. Introduction. The enteric nervous system (ENS) is a network of sensory neurons, interneurons, supporting (glia) and motor neurons with different neurotransmitters polypeptide mediators that enable it to act independently (Goyal and Hirano 1996;.
Background. Optimal feeding regimens in babies weighing <1 000 g have not been established, and wide variations occur. In South Africa. (SA) this situation is complicated by varied resource constraints. Objective. To determine the preterm enteral feeding practices of paediatricians in SA. Methods. We invited 288 ...
J.H.C. Meijers (Johan)
textabstractTo clarify pathogenetic mechanisms of congenital malformations of the ENS, the formation of the ENS was investigated in chicken and murine embryos. The experimental work was concentrated on several aspects of the interaction between neural crest cells and the enteric microenvironment.
The nervous system is emerging as a regulator of malignancy. In this issue of Cancer Cell, Hayakawa et al. demonstrate a feedforward signaling loop in which tumor-derived nerve growth factor promotes enteric tumor innervation, and recruited nerves drive cancer growth through acetylcholine-regulated Wnt signaling and stimulation of further NGF release. Copyright © 2017 Elsevier Inc. All rights reserved.
It may mimic peptic ulcer, subacute (or chronic) intestinal obstruction, gastroenteritis, irritable bowel syndrome, and inflammatory bowel disease. The diagnosis is often ... Finalement laparotomy a revele des segments enflames de petit intestin, une biopsie de qui a montré Eosinophilic enteritis. Le malade a été traite par la ...
Abstract Salmonella typhimurium was isolated from the feces of an alpaca suffering anorexia and weight loss. Multifocal necrotizing and suppurative hepatitis consistent with bacterial infection was found in the liver biopsies. Enteric salmonellosis may be associated with milder physical and clinicopathological changes in camelids than in other large animal species. PMID:15144106
Reilly, Elizabeth C.
To enter a future that waits to be born, educational leaders must continually assess their own ethical stance as well as that of the organizations they serve. Three frames form a model for examining the ethics of both individual and organization, with internal monologue and engaged conversation as the means for reflection and action.
Willard, Devina L; Young, Lorraine S; He, Xuemei; Braverman, Lewis E; Pearce, Elizabeth N
Iodine is essential for thyroid hormone synthesis, and iodine deficiency may result in thyroid disorders including goiter and hypothyroidism. Patients on long-term enteral nutrition (EN) or parenteral nutrition (PN) may be at risk for micronutrient deficiencies. The recommended daily allowance for iodine intake is 150 μg for nonpregnant adults. However, there is no current consensus among scientific societies regarding the quantity of iodine to be added in adult EN and PN formulations. The objective of this study was to determine the iodine content of U.S. adult enteral and parenteral nutrition solutions. This study also aimed to determine whether adult patients in the United States who are receiving long-term artificial nutrition may be at risk for iodine deficiency. Ten enteral nutrition solutions and 4 parenteral nutrition solutions were evaluated. The iodine contents of these solutions were measured spectrophotometrically and compared to the labeled contents. Measured and labeled EN iodine contents were similar (range 131-176 μg/L and 106-160 μg/L, respectively). In contrast, PN formulas were found to contain small, unlabeled amounts of iodine, averaging 27 μg/L. Typical fluid requirements are 30 to 40 mL/kg/day for adults receiving either total EN (TEN) or total PN (TPN). Adults on long-term TEN likely consume enough servings to meet their daily iodine requirements. However, patients on long-term TPN would require on average 5.6 L PN/day to meet the recommended daily allowance of iodine. This volume of PN is far in excess of typical consumption. Thus, U.S. patients requiring long-term TPN may be at risk for iodine deficiency. EN = enteral nutrition; PN = parenteral nutrition; TEN = total enteral nutrition; TPN = total parenteral nutrition; UIC = urinary iodine concentration.
Reindel, Kristin; Zhao, Fang; Hughes, Susan; Dave, Vivek S
Purpose: The feasibility of preparing an eslicarbazepine acetate suspension using Aptiom tablets for administration via enteral feeding tubes was evaluated. Methods: Eslicarbazepine acetate suspension (40 mg/mL) was prepared using Aptiom tablets after optimizing the tablet crushing methods and the vehicle composition. A stability-indicating high-performance liquid chromatography (HPLC) method was developed to monitor the eslicarbazepine stability in the prepared suspension. Three enteric feeding tubes of various composition and dimensions were evaluated for the delivery of the suspensions. The suspension was evaluated for the physical and chemical stability for 48 hours. Results: The reproducibility and consistency of particle size reduction was found to be best with standard mortar/pestle. The viscosity analysis and physical stability studies showed that ORA-Plus:water (50:50 v/v) was optimal for suspending ability and flowability of suspension through the tubes. The developed HPLC method was found to be stability indicating and suitable for the assay of eslicarbazepine acetate in the prepared suspension. The eslicarbazepine concentrations in separately prepared suspensions were within acceptable range (±3%), indicating accuracy and reproducibility of the procedure. The eslicarbazepine concentrations in suspensions before and after delivery through the enteric feeding tubes were within acceptable range (±4%), indicating absence of any physical/chemical interactions of eslicarbazepine with the tubes and a successful delivery of eslicarbazepine dosage via enteric feeding tubes. The stability study results showed that eslicarbazepine concentration in the suspension remained unchanged when stored at room temperature for 48 hours. Conclusion: The study presents a convenient procedure for the preparation of a stable suspension of eslicarbazepine acetate (40 mg/mL) using Aptiom tablets, for administration via enteral feeding tubes.
Victoria A Keegan
Full Text Available OBJECTIVE: The objective of the present study was to describe the epidemiology of reportable enteric illness in Ontario’s Waterloo region, including comparing calculated incidence rates with published rates, and adjusting for under-reporting to determine the number of community cases, where published data were available.
Buster, Marcel C. A.; van Brussel, Giel H. A.; van den Brink, Wim
AIMS: It has been suggested that starting and temporarily discontinuing methadone treatment is related to an increased risk in overdose mortality. This study describes the incidence of overdose mortality in relation to time after (re)entering or leaving treatment. DESIGN: A dynamic cohort of 5200
This study investigated the surface properties of the semi-synthetic enteric coating materials for potential colon- targeted bioactive delivery. The enteric coating materials were produced by combining nanoscale resistant starch, pectin, and carboxymethylcellulose. The surface properties of the co...
Lim, Mei Ling; Yong, Bei Yi Paulynn; Mar, Mei Qi Maggie; Ang, Shin Yuh; Chan, Mei Mei; Lam, Madeleine; Chong, Ngian Choo Janet; Lopez, Violeta
To explore the experiences of community nurses and home carers, in caring for patients on home enteral nutrition. The number of patients on home enteral nutrition is on the increase due to advancement in technology and shift in focus of providing care from acute to community care settings. A mixed-method approach was adopted. (i) A face-to-face survey design was used to elicit experience of carers of patients on home enteral nutrition. (ii) Focus group interviews were conducted with community nurses. Ninety-nine carers (n = 99) were recruited. Patient's mean age that they cared for was aged 77.7 years (SD = 11.2), and they had been on enteral feeding for a mean of 29 months (SD = 23.0). Most were bed-bound (90%) and required full assistance with their feeding (99%). Most were not on follow-up with dietitians (91%) and dentists (96%). The three most common reported gastrointestinal complications were constipation (31%), abdominal distension (28%) and vomiting (22%). Twenty community nurses (n = 20) were recruited for the focus group interviews. Four main themes emerged from the analysis: (i) challenge of accessing allied health services in the community; (ii) shorter length of stay in the acute care setting led to challenges in carers' learning and adaptation; (iii) transition gaps between hospital and home care services; and (iv) managing expectations of family. To facilitate a better transition of care for patients, adequate training for carers, standardising clinical practice in managing patients with home enteral nutrition and improving communication between home care services and the acute care hospitals are needed. This study highlighted the challenges faced by community home care nurses and carers. Results of this study would help to inform future policies and practice changes that would improve the quality of care received by patients on home enteral nutrition. © 2018 John Wiley & Sons Ltd.
Simeone, D M; Romanchuk, G; Mulholland, M W
Primary cultures of guinea pig myenteric plexus ganglia were used to examine the ability of agents that activate adenylate cyclase or mimic intracellular adenosine 3',5'-cyclic monophosphate (cAMP) to stimulate morphological growth. Dose-dependent increases in neurite length and density were produced in enteric neuronal cultures by forskolin (212% of control), cholera toxin (356% of control), or the permeant cAMP analogues 8-bromoadenosine 3',5'-cyclic monophosphate and dibutyryl cAMP. (R)-p-adenosine 3',5'-cyclic monophosphorothioate, an inhibitor of cAMP-dependent kinases, blocked the growth-promoting effects of cAMP analogues but not of nerve growth factor (NGF). Activation of cAMP-dependent signaling pathways also increased production of mRNA for alpha-tubulin and microtubule-associated protein 2. Dual pathways, regulated by NGF and cAMP-dependent protein kinases, influence growth signaling in enteric ganglia.
Bianchi, Emily C
Despite widespread interest in narcissism, relatively little is known about the conditions that encourage or dampen it. Drawing on research showing that macroenvironmental conditions in emerging adulthood can leave a lasting imprint on attitudes and behaviors, I argue that people who enter adulthood during recessions are less likely to be narcissistic later in life than those who come of age in more prosperous times. Using large samples of American adults, Studies 1 and 2 showed that people who entered adulthood during worse economic times endorsed fewer narcissistic items as older adults. Study 3 extended these findings to a behavioral manifestation of narcissism: the relative pay of CEOs. CEOs who came of age in worse economic times paid themselves less relative to other top executives in their firms. These findings suggest that macroenvironmental experiences at a critical life stage can have lasting implications for how unique, special, and deserving people believe themselves to be. © The Author(s) 2014.
A quantum algorithm provides for the encoding of an exponentially large number of classical data bits by use of a smaller (polynomially large) number of quantum bits (qubits). The development of this algorithm was prompted by the need, heretofore not satisfied, for a means of entering real-world binary data into a quantum computer. The data format provided by this algorithm is suitable for subsequent ultrafast quantum processing of the entered data. Potential applications lie in disciplines (e.g., genomics) in which one needs to search for matches between parts of very long sequences of data. For example, the algorithm could be used to encode the N-bit-long human genome in only log2N qubits. The resulting log2N-qubit state could then be used for subsequent quantum data processing - for example, to perform rapid comparisons of sequences.
Erzo G. J. Luttmer
Suppose firms are subject to decreasing returns and permanent idiosyncratic productivity shocks. Suppose also firms can only stay in business by continuously paying a fixed cost. New firms can enter. Firms with a history of relatively good productivity shocks tend to survive and others are forced to exit. This paper identifies assumptions about entry that guarantee a stationary firm size distribution and lead to balanced growth. The range of technology diffusion mechanisms that can be conside...
Akashi, Tetsuro; Muto, Ayano; Takahashi, Yayoi; Nishiyama, Hiroshi
Diarrhea often occurs during enteral nutrition. Recently, several reports showed that diarrhea improves by adding egg yolk lecithin, an emulsifier, in an enteral formula. Therefore, we evaluated if this combination could improve diarrhea outcomes. We retrospectively investigated the inhibitory effects on watery stools by replacing a polymeric fomula with that containing egg yolk lecithin. Then, we investigated the emulsion stability in vitro. Next, we examined the lipid absorption using different emulsifiers among bile duct-ligated rats and assessed whether egg yolk lecithin, medium-chain triglyceride, and dietary fiber can improve diarrhea outcomes in a rat model of short bowel syndrome. Stool consistency or frequency improved on the day after using the aforementioned combination in 13/14 patients. Average particle size of the egg yolk lecithin emulsifier did not change by adding artificial gastric juice, whereas that of soy lecithin and synthetic emulsifiers increased. Serum triglyceride concentrations were significantly higher in the egg yolk lecithin group compared with the soybean lecithin and synthetic emulsifier groups in bile duct-ligated rats. In rats with short bowels, the fecal consistency was a significant looser the dietary fiber (+) group than the egg yolk lecithin (+) groups from day 6 of test meal feedings. The fecal consistency was also a significant looser the egg yolk lecithin (-) group than the egg yolk lecithin (+) groups from day 4 of test meal feeding. The fecal consistency was no significant difference between the medium-chain triglycerides (-) and egg yolk lecithin (+) groups. Enteral formula emulsified with egg yolk lecithin promotes lipid absorption by preventing the destruction of emulsified substances by gastric acid. This enteral formula improved diarrhea and should reduce the burden on patients and healthcare workers.
The main objective of this thesis was to identify which marketing strategy is most effective for wine producing companies to enter and compete on the Australian wine market with excessive supply and diminishing demand. The purpose of the thesis was to create a marketing strategy for the commissioner, a case company, referred to as Company X for confidential reasons. Secondary research, predominantly based on marketing literature and governmental statistics, was conducted to create the th...
Migoha, C. O.; Ratansi, M.; Kaale, E.; Kagashe, G.
Preformulation is an important step in the rational formulation of an active pharmaceutical ingredient (API). Micromeritics properties: bulk density (BD) and tapped density (TD), compressibility index (Carr’s index), Hauser’s ratio (H), and sieve analysis were performed in order to determine the best excipients to be used in the formulation development of omeprazole magnesium enteric coated tablets. Results show that omeprazole magnesium has fair flow and compressibility properties (BD 0.4 g/...
Full Text Available BACKGROUND: Although seasonality is a defining characteristic of many infectious diseases, few studies have described and compared seasonal patterns across diseases globally, impeding our understanding of putative mechanisms. Here, we review seasonal patterns across five enteric zoonotic diseases: campylobacteriosis, salmonellosis, vero-cytotoxigenic Escherichia coli (VTEC, cryptosporidiosis and giardiasis in the context of two primary drivers of seasonality: (i environmental effects on pathogen occurrence and pathogen-host associations and (ii population characteristics/behaviour. METHODOLOGY/PRINCIPAL FINDINGS: We systematically reviewed published literature from 1960-2010, resulting in the review of 86 studies across the five diseases. The Gini coefficient compared temporal variations in incidence across diseases and the monthly seasonality index characterised timing of seasonal peaks. Consistent seasonal patterns across transnational boundaries, albeit with regional variations was observed. The bacterial diseases all had a distinct summer peak, with identical Gini values for campylobacteriosis and salmonellosis (0.22 and a higher index for VTEC (Gini 0.36. Cryptosporidiosis displayed a bi-modal peak with spring and summer highs and the most marked temporal variation (Gini = 0.39. Giardiasis showed a relatively small summer increase and was the least variable (Gini = 0.18. CONCLUSIONS/SIGNIFICANCE: Seasonal variation in enteric zoonotic diseases is ubiquitous, with regional variations highlighting complex environment-pathogen-host interactions. Results suggest that proximal environmental influences and host population dynamics, together with distal, longer-term climatic variability could have important direct and indirect consequences for future enteric disease risk. Additional understanding of the concerted influence of these factors on disease patterns may improve assessment and prediction of enteric disease burden in temperate
Maria Gabriella Gentile
Full Text Available Severe undernutrition nearly always leads to marked changes in body spaces (e.g., alterations of intra-extracellular water and in body masses and composition (e.g., overall and compartmental stores of phosphate, potassium, and magnesium. In patients with severe undernutrition it is almost always necessary to use oral nutrition support and/or artificial nutrition, besides ordinary food; enteral nutrition should be a preferred route of feeding if there is a functional accessible gastrointestinal tract. Refeeding of severely malnourished patients represents two very complex and conflicting tasks: (1 to avoid “refeeding syndrome” caused by a too fast correction of malnutrition; (2 to avoid “underfeeding” caused by a too cautious rate of refeeding. The aim of this paper is to discuss the modality of refeeding severely underfed patients and to present our experience with the use of enteral tube feeding for gradual correction of very severe undernutrition whilst avoiding refeeding syndrome, in 10 patients aged 22 ± 11.4 years and with mean initial body mass index (BMI of 11.2 ± 0.7 kg/m2. The mean BMI increased from 11.2 ± 0.7 kg/m2 to 17.3 ± 1.6 kg/m2 and the mean body weight from 27.9 ± 3.3 to 43.0 ± 5.7 kg after 90 days of intensive in-patient treatment (p < 0.0001. Caloric intake levels were established after measuring resting energy expenditure by indirect calorimetry, and nutritional support was performed with enteral feeding. Vitamins, phosphate, and potassium supplements were administered during refeeding. All patients achieved a significant modification of BMI; none developed refeeding syndrome. In conclusion, our findings show that, even in cases of extreme undernutrition, enteral feeding may be a well-tolerated way of feeding.
The majority of enteral nutrition products for diabetes mellitus have a carbohydrate content of 30–45% and fat between 40–49%, mainly monounsaturated fat, with a mix of soluble and insoluble fibre (total of 14–24 g/l). Does this have short- and long-term benefits and which component(s) is/are crucial for the outcome or is it ...
The undergraduate thesis focuses on students’ social network and lifestyle changes after engaging in a new partnership. Theoretical framework about the young adulthood era, social relationship, social network and support was in the empirical part upgraded with an overview of changes in diversification and composition of students’ social network after engaging in a new partnership and their satisfaction with these changes. I was researching also lifestyle changes that occur after entering a...
Greig, J D; Lee, M B; Harris, J E
To identify documented outbreaks, worldwide, of enteric illness in correctional facilities over the last 10 years to understand the epidemiology of the outbreaks and explicitly identify effective infection control measures. Review of literature and outbreak investigation reports. Computer-aided searches of literature databases and systematic searches of government websites were completed to identify relevant outbreak reports. Reference lists were hand-searched to validate the electronic search methodology. Reports identified through personal communications with public health officials were also included. Of the 72 outbreaks meeting the inclusion criteria, 76% and 21% were associated with bacterial agents and viral agents, respectively. The majority of outbreaks were associated with Salmonella (n=20), Clostridium perfringens (n=14), norovirus (n=14), pathogenic Escherichia coli (n=10) and Campylobacter spp. (n=5). Transmission was primarily foodborne (67%). During an outbreak, the most common control measures included limiting movements of ill inmates and staff, and their exclusion from kitchen duty. The most common retrospectively reported preventative recommendations included monitoring food temperatures and effective infection control procedures. It is essential to monitor food temperatures to prevent enteric outbreaks in prisons. Training in safe food handling should be offered to inmates who work in the kitchen. Enteric outbreaks are best controlled by effective infection control practices, while active surveillance and early diagnosis may prevent further spread of illness. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.
Nam, Jae-Hui; Yun, Yeojun; Kim, Han-Saem; Kim, Han-Na; Jung, Ho Joo; Chang, Yoosoo; Ryu, Seungho; Shin, Hocheol; Kim, Hyung-Lae; Kim, Won-Serk
Rosacea is a chronic inflammatory dermatosis affecting the face and eyes. An association between systemic comorbidities and rosacea has been reported, but the link to enteral microbiota is uncertain. We aimed to investigate the link between rosacea and enteral microbiota. A cross-sectional study was performed in a sample of Korean women who participated in a health check-up programme at the Kangbuk Samsung Hospital Health Screening Center between 23 June 2014 and 5 September 2014. The gut microbiome was evaluated by 16S rRNA gene and metagenome sequence analyses. A total of 12 rosacea patients and 251 controls were enrolled. We identified links between rosacea and several changes in gut microbiota: reduced abundance of Peptococcaceae family unknown genus, Methanobrevibacter (genus), Slackia (genus), Coprobacillus (genus), Citrobacter (genus), and Desulfovibrio (genus), and increased abundance of Acidaminococcus (genus), Megasphaera (genus), and Lactobacillales order unknown family unknown genus. A link between rosacea and enteral microbiota was observed in this metagenomic study. A large and elaborate study is needed to confirm these findings and to elucidate the mechanisms involved. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Ngugi, David Kamanda; Miyake, Sou; Cahill, Matt; Vinu, Manikandan; Hackmann, Timothy J; Blom, Jochen; Tietbohl, Matthew D; Berumen, Michael L; Stingl, Ulrich
Herbivorous surgeonfishes are an ecologically successful group of reef fish that rely on marine algae as their principal food source. Here, we elucidated the significance of giant enteric symbionts colonizing these fishes regarding their roles in the digestive processes of hosts feeding predominantly on polysiphonous red algae and brown Turbinaria algae, which contain different polysaccharide constituents. Using metagenomics, single-cell genomics, and metatranscriptomic analyses, we provide evidence of metabolic diversification of enteric microbiota involved in the degradation of algal biomass in these fishes. The enteric microbiota is also phylogenetically and functionally simple relative to the complex lignocellulose-degrading microbiota of terrestrial herbivores. Over 90% of the enzymes for deconstructing algal polysaccharides emanate from members of a single bacterial lineage, " Candidatus Epulopiscium" and related giant bacteria. These symbionts lack cellulases but encode a distinctive and lineage-specific array of mostly intracellular carbohydrases concurrent with the unique and tractable dietary resources of their hosts. Importantly, enzymes initiating the breakdown of the abundant and complex algal polysaccharides also originate from these symbionts. These are also highly transcribed and peak according to the diel lifestyle of their host, further supporting their importance and host-symbiont cospeciation. Because of their distinctive genomic blueprint, we propose the classification of these giant bacteria into three candidate genera. Collectively, our findings show that the acquisition of metabolically distinct " Epulopiscium " symbionts in hosts feeding on compositionally varied algal diets is a key niche-partitioning driver in the nutritional ecology of herbivorous surgeonfishes.
Czerkinsky, Cecil; Holmgren, Jan
Since the first licensure of the Sabin oral polio vaccine more than 50 years ago, only eight enteric vaccines have been licensed for four disease indications, and all are given orally. While mucosal vaccines offer programmatically attractive tools for facilitating vaccine deployment, their development remains hampered by several factors: —limited knowledge regarding the properties of the gut immune system during early life;—lack of mucosal adjuvants, limiting mucosal vaccine development to live-attenuated or killed whole virus and bacterial vaccines;—lack of correlates/surrogates of mucosal immune protection; and—limited knowledge of the factors contributing to oral vaccine underperformance in children from developing countries.There are now reasons to believe that the development of safe and effective mucosal adjuvants and of programmatically sound intervention strategies could enhance the efficacy of current and next-generation enteric vaccines, especially in lesser developed countries which are often co-endemic for enteric infections and malnutrition. These vaccines must be safe and affordable for the world's poorest, confer long-term protection and herd immunity, and must be able to contain epidemics. PMID:25964464
Full Text Available In the present study, a capsule formulation composed of enteric coated granules of Lactobacillus acidophilus ATCC 4962 was developed using Eudragit L30D-55 as enteric polymer. Optimization of the capsule formulation was achieved with a maximum viable cell count after 2 h of incubation in acid medium and disintegration time of 1 h in buffer pH 6.8. The amount of Eudragit L30D-55 in the capsules correlated with gastric juice resistance. The best protective qualities against artificial gastric juice were observed when capsules were prepared from granules composed of L. acidophilus, corn starch, lactose monohydrate, polyvinylpyrrolidone and coated with 12.5 % (m/V of Eudragit L30D-55. Capsule formulation of L. acidophilus in edible broth medium suspension serves as a cheap alternative to the expensive freeze-drying procedure for preparing L. acidophilus. In addition, the enteric coating using Eudragit L30D-55 could protect probiotics from the acidic gastric environment and enhance the bioactivity of probiotics along with replacement of pathogenic microbes in human intestine
Pyar, Hassan; Peh, Kok-Khiang
In the present study, a capsule formulation composed of enteric coated granules of Lactobacillus acidophilus ATCC 4962 was developed using Eudragit L30D-55 as enteric polymer. Optimization of the capsule formulation was achieved with a maximum viable cell count after 2 h of incubation in acid medium and disintegration time of 1 h in buffer pH 6.8. The amount of Eudragit L30D-55 in the capsules correlated with gastric juice resistance. The best protective qualities against artificial gastric juice were observed when capsules were prepared from granules composed of L. acidophilus, corn starch, lactose monohydrate, polyvinylpyrrolidone and coated with 12.5 % (m/V) of Eudragit L30D-55. Capsule formulation of L. acidophilus in edible broth medium suspension serves as a cheap alternative to the expensive freeze-drying procedure for preparing L. acidophilus. In addition, the enteric coating using Eudragit L30D-55 could protect probiotics from the acidic gastric environment and enhance the bioactivity of probiotics along with replacement of pathogenic microbes in human intestine.
Henna, Nausheen; Nagi, Abdul H; Sheikh, Muhammad A; Shaukat, Mahmood
Hirschsprung's Disease (HD) is a developmental disorder of enteric nervous system characterised by the absence of ganglion cells in submucosal (Meissner's) and myenteric (Aurbach's) plexuses of distal bowel. The purpose of the present study was to observe and report the morphological patterns of ganglion related enteric neuronal abnormalities in children presented with clinical features of (HD) in a Pakistani population. A total of 92 patients with clinical presentation of HD were enrolled between March 2009 and October 2009. Among them, 8 were excluded according to the exclusion criteria. After detailed history and physical examination, paraffin embedded H and E stained sections were prepared from the serial open biopsies from colorectum. The data was analysed using SPSS-17. Frequencies and percentages are given for qualitative variables. Non-parametric Binomial Chi-Square test was applied to observe within group associations and pganglionic whereas 71 (84.5%) showed ganglion related enteric neuronal abnormalities namely isolated hypoganglionosis 9 (12.7%), immaturity of ganglion cells 9 (12.7%), isolated hyperganglionosis (IND Type B) 2 (2.8%) and Hirschsprung's disease 51 (71.8%). Among HD group, 34 (66.7%) belonged to isolated form and 17 (33.3%) showed combined ganglion related abnormalities. Hirschsprung's disease is common in Pakistani population, followed by hypoganglionosis, immaturity of ganglion cells and IND type B. The presence of hypertrophic nerve fibres was significant in HD, hyperganglionosis and hypoganglionosis, whereas, no hypertrophic nerve fibres were appreciated in immaturity of ganglion cell group.
Martínez-Ubieto, Fernando; Bueno-Delgado, Alvaro; Jiménez-Bernadó, Teresa; Santero Ramírez, María Pilar; Arribas-Del Amo, Dolores; Martínez-Ubieto, Javier
Eosinophilic enteritis is a rather rare condition characterized by infiltration of the gastrointestinal tract by eosinophils; as a casue of acute abdomen it is really exceptional. The etiology is unclear and its description in the literature is sparse, but associations have been made with collagen vascular disease, inflammatory bowel disease, food allergy and parasitic infections as it was confirmed in one of our pathologic studies. From 1997 to 2011 six cases of eosinophilic enteritis that involved a small bowel segment were diagnosed. A partial resection by an irreversible necrosis was necessary in three of them; in the other three only a biopsy was necessary due to the inflammatory aspect of the affected loop causing the acute abdomen. Eosinophilic enteritis can originate acute abdomen processes where an urgent surgical treatment is necessary. The intraoperative aspect can be from a segment of small bowel with inflammatory signs up to a completely irrecoverable loop, where removing of the affected segment is the correct treatment, which can be done laparoscopically.
Bacteriophages are an attractive alternative to fecal indicator bacteria (FIB), particularly as surrogates of enteric virus fate and transport due to their closer morphological and biological properties compared to FIB. Based on a meta-analysis of published data, we summarize concentrations of coliphages (F+ and somatic), Bacteroides spp. and enterococci bacteriophages (phages) in human waste, non-human waste, fresh and marine waters as well as removal through wastewater treatment processes. We also provide comparisons with FIB and enteric viruses whenever possible. Lastly, we examine fate and transport characteristics in the environment and provide an overview of the methods available for detection and enumeration of bacteriophages. In summary, concentrations of FIB bacteriophages in various sources were consistently lower than FIB, but more reflective of infectious enteric virus levels. Our investigation supports use of bacteriophages as viral surrogates especially for wastewater treatment processes, while additional research is needed to clarify their utility as indicators of viral fate and transport in the ambient water. Describes concentrations and removal through environmental and engineered systems of bacteriophages, fecal indicator bacteria and viral pathogens.
Gupta, A.; Chaudhuri, M. [Indian Institute of Technology, Kanpur (India). Dept. of Civil Engineering
Four coal-based media, viz. alum-pretreated or ferric hydroxide-impregnated Giridih bituminous coal and lignite (alum-GBC, Fe-GBC; alum-lignite and Fe-Lignite) were laboratory tested to assess their potential in removing/inactivating enteric viruses in water. Batch-sorption screening tests, employing a poliovirus-spiked canal water, indicated high poliovirus sorption by Fe-GBC and alum-GBC in a short contact time of 5 min. Based on the results of further batch-sorption tests, using silver incorporated media (alum/Ag-GBC, alum-GBC-Ag and Fe-GBC-Ag), as well as aesthetic water quality consideration and previous findings on removal of coliforms and turbidity, alum/Ag-GBC, alum-GBC and alum-GBC-AG were included in downflow column studies employing poliovirus-spiked canal water. All three media showed potential in removing/inactivating enteric viruses. In a separate column study employing a joint challenge of poliovirus and rotavirus, alum/Ag-GBC removed 59.3-86.5% of the viruses along with more than 99% reduction in indigenous heterotrophic bacteria. Alum/silver-pretreated bituminous coal medium appears promising for use in household water filters in rural areas of the developing world. However, improved medium preparation to further enhance its efficiency is needed; also, its efficacy in removing/inactivating indigenous enteric bacteria, viruses and protozoa has to be ensured and practicalities or economics of application need to be considered.
Costanzo, Simon D; Murby, John; Bates, John
Awareness of antibiotics in wastewaters and aquatic ecosystems is growing as investigations into alternate pollutants increase and analytical techniques for detecting these chemicals improve. The presence of three antibiotics (ciprofloxacin, norfloxacin and cephalexin) was evaluated in both sewage effluent and environmental waters downstream from a sewage discharge. Bacteria cultured from the sewage bioreactor and receiving waters were tested for resistance against six antibiotics (ciprofloxacin, tetracycline, ampicillin, trimethoprim, erythromycin and trimethoprim/sulphamethoxazole) and effects of short term exposure (24 h) to antibiotics on bacterial denitrification rates were examined. Antibiotics were detected entering the sewage treatment plant with varying levels of removal during the treatment process. Antibiotics were also detected in effluent entering receiving waters and detectable 500 m from the source. Among the bacteria cultured from the sewage bioreactor, resistance was displayed against all six antibiotics tested and bacteria cultured from receiving waters were resistant against two of the antibiotics tested. Rates of denitrification were observed to decrease in response to some antibiotics and not to others, though this was only observed at concentrations exceeding those likely to be found in the environment. Findings from this preliminary research have indicated that antibiotics are entering our aquatic systems and pose a potential threat to ecosystem function and potentially human health.
Schemann, Michael; Mazzuoli, Gemma
One of the most intriguing abilities of the gut is to function in isolation. This is possible because the gut's own nervous system, the enteric nervous system, contains the necessary elements to control reflex behaviors. Much progress has been made in identifying those neurons that encode mechanical or chemical stimuli. Thus, muscle behaviors in the small and large intestines depend on mechanosensitive neurons which encode a variety of mechanical stimuli, ranging from brief deformation of the neurons soma or processes to sustained tissue stretch. Mechanosensitivity has been recorded in a wide variety of neurons which behave like rapid or slowly adapting mechanosensors. Strikingly, mechanosensitive neurons do not appear to belong to a distinct class of highly specialised neurons but rather differ in their electrophysiology, neurochemistry and morphology. While some mechanosensitive neurons may respond to one stimulus type others appear to be polymodal. Available data would suggest that mechanosensitive enteric neurons are multitasking and hence belong to multifunctional circuits. This review summarises the main arguments in favour of this concept, discusses the stimulus modalities, the response patterns and the functional role of mechanosensitive enteric neurons and concludes with identifying future challenges. Copyright 2009 Elsevier B.V. All rights reserved.
Piotrow, P T; Rimon, J G
Messages about sexual relationships, the prevention of pregnancy and disease, education, the empowerment of women, and concern for the environment are increasingly being disseminated to audiences of all ages through the use of entertainment. Ideas are presented in this Enter-Educate approach through popular, enjoyable entertainment in the form of songs, dramas, soap operas, variety shows, and other folk media. This approach can be adapted to be acceptable and effective in all cultures. Yafaman is one such example. It is a drama written and acted by high school students in Cote d'Ivoire which depicts the story of a school girl who learns that her older, married boyfriend is no longer interested in her when she becomes pregnant. After winning the annual national drama contest, Yafaman was televised and broadcast widely in schools and on national networks in francophone Africa. The video has also been dubbed in English for wider use. Popular music has delivered effective messages of sexual responsibility to young adults in Latin America and the Philippines. The US Agency for International Development-funded Population Communication Services project at the Johns Hopkins University supports 36 major Enter-Educate television series and specials, nine radio dramas, three songs, and nine music videos. Other organizations are expanding or experimenting with work in this area. The authors discuss the theoretical basis for Enter-Educate projects and explain that the approach works because it is pervasive, popular, personal, passionate, persuasive, practical, profitable, and proven effective.
Full Text Available Introduction: Ipilimumab is an immune checkpoint inhibitor targeting cytotoxic T-lymphocyte associated antigen 4 (CTLA4, approved to treat metastatic melanoma. It was the first therapy shown to prolong survival in a large, randomized clinical trial. However, immune-related adverse events are common and can be severe. Enterocolitis is a common adverse event with ipilimumab, but enteritis without colitis has not been previously described. Case Report: An 83-year-old man presented to our hospital with grade 3 diarrhea for 5 days. One month prior, he had started treatment with ipilimumab for metastatic melanoma. On presentation, he was found to have severe electrolyte disturbances, including hyponatremia, hypokalemia, and acute kidney injury. Causes of infectious diarrhea were excluded, and he was treated with corticosteroids for presumed ipilimumab-associated enterocolitis. However, colonoscopy revealed normal mucosa, both grossly and on pathology of random biopsies. Steroids were weaned but his symptoms recurred. He then underwent upper endoscopy with enteroscopy. Biopsy of the duodenum was notable for acute inflammation, villous blunting, and other changes consistent with ipilimumab-associated injury. He was restarted on high-dose steroids and his symptoms resolved. Discussion: Ipilimumab-induced enteritis is a serious and potentially life-threatening immune related adverse event that warrants prompt recognition and aggressive management. As in cases of ipilimumab-associated enterocolitis, steroids are an effective therapy. Enteritis without colitis should be suspected in patients on ipilimumab who present with severe diarrhea but have a normal colonoscopy.
Czerkinsky, Cecil; Holmgren, Jan
Since the first licensure of the Sabin oral polio vaccine more than 50 years ago, only eight enteric vaccines have been licensed for four disease indications, and all are given orally. While mucosal vaccines offer programmatically attractive tools for facilitating vaccine deployment, their development remains hampered by several factors: -limited knowledge regarding the properties of the gut immune system during early life; -lack of mucosal adjuvants, limiting mucosal vaccine development to live-attenuated or killed whole virus and bacterial vaccines; -lack of correlates/surrogates of mucosal immune protection; and -limited knowledge of the factors contributing to oral vaccine underperformance in children from developing countries. There are now reasons to believe that the development of safe and effective mucosal adjuvants and of programmatically sound intervention strategies could enhance the efficacy of current and next-generation enteric vaccines, especially in lesser developed countries which are often co-endemic for enteric infections and malnutrition. These vaccines must be safe and affordable for the world's poorest, confer long-term protection and herd immunity, and must be able to contain epidemics. © 2015 The Author(s) Published by the Royal Society. All rights reserved.
Fletcher, Stephanie M.; Stark, Damien; Harkness, John
Summary: Several enteric protozoa cause severe morbidity and mortality in both humans and animals worldwide. In developed settings, enteric protozoa are often ignored as a cause of diarrheal illness due to better hygiene conditions, and as such, very little effort is used toward laboratory diagnosis. Although these protozoa contribute to the high burden of infectious diseases, estimates of their true prevalence are sometimes affected by the lack of sensitive diagnostic techniques to detect them in clinical and environmental specimens. Despite recent advances in the epidemiology, molecular biology, and treatment of protozoan illnesses, gaps in knowledge still exist, requiring further research. There is evidence that climate-related changes will contribute to their burden due to displacement of ecosystems and human and animal populations, increases in atmospheric temperature, flooding and other environmental conditions suitable for transmission, and the need for the reuse of alternative water sources to meet growing population needs. This review discusses the common enteric protozoa from a public health perspective, highlighting their epidemiology, modes of transmission, prevention, and control. It also discusses the potential impact of climate changes on their epidemiology and the issues surrounding waterborne transmission and suggests a multidisciplinary approach to their prevention and control. PMID:22763633
Full Text Available Entrepreneurs typically have limited resources during the start-up phase of a business. Business ecosystems are a strategy for entrepreneurs to access and exchange many different aspects of value, resources, and benefits. However, there may be business risks for entering a particular type of ecosystem, and further risks may be encountered after entering and participating in a business ecosystem. These risks are significant and can inhibit a startup's growth. In this article, the literature on business ecosystems is reviewed as it relates to risk to discover insights of relevance to entrepreneurs, top management teams, and business-ecosystem operators. First, the published research is organized into two streams: i risks relating to categories of business ecosystems, and ii risks relating to participating in business ecosystems. Then, the problem is abstracted to develop a potential strategy for managing these risks, which features a pre-entry inspection followed by real-time resource management. Finally, five recommendations are offered for entrepreneurs seeking to enter and participate in business ecosystems.
Wijedoru, Lalith; Mallett, Sue; Parry, Christopher M
Differentiating both typhoid (Salmonella Typhi) and paratyphoid (Salmonella Paratyphi A) infection from other causes of fever in endemic areas is a diagnostic challenge. Although commercial point-of-care rapid diagnostic tests (RDTs) for enteric fever are available as alternatives to the current reference standard test of blood or bone marrow culture, or to the widely used Widal Test, their diagnostic accuracy is unclear. If accurate, they could potentially replace blood culture as the World Health Organization (WHO)-recommended main diagnostic test for enteric fever. To assess the diagnostic accuracy of commercially available rapid diagnostic tests (RDTs) and prototypes for detecting Salmonella Typhi or Paratyphi A infection in symptomatic persons living in endemic areas. We searched the Cochrane Infectious Diseases Group Specialized Register, MEDLINE, Embase, Science Citation Index, IndMED, African Index Medicus, LILACS, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) up to 4 March 2016. We manually searched WHO reports, and papers from international conferences on Salmonella infections. We also contacted test manufacturers to identify studies. We included diagnostic accuracy studies of enteric fever RDTs in patients with fever or with symptoms suggestive of enteric fever living in endemic areas. We classified the reference standard used as either Grade 1 (result from a blood culture and a bone marrow culture) or Grade 2 (result from blood culture and blood polymerase chain reaction, or from blood culture alone). Two review authors independently extracted the test result data. We used a modified QUADAS-2 extraction form to assess methodological quality. We performed a meta-analysis when there were sufficient studies for the test and heterogeneity was reasonable. Thirty-seven studies met the inclusion criteria and included a total of 5080 participants (range 50 to 1732). Enteric fever prevalence
B. García Vila; T. Grau
La nutrición enteral se ha demostrado como un método eficaz y seguro de nutrir a los enfermos graves ingresados en una Unidad de Cuidados Intensivos. Aunque se desconoce cuánto tiempo puede estar un enfermo grave sin nutrición, el catabolismo acelerado y el ayuno pueden ser deletéreos en el enfermo grave y la recomendación más frecuente es la de empezar la nutrición artificial cuando se prevea un período de ayuno superior a los siete días. Las ventajas de la nutrición enteral sobre la nutrici...
Keegan, Victoria A; Majowicz, Shannon E; Pearl, David L; Marshall, Barbara J; Sittler, Nancy; Knowles, Lewinda; Wilson, Jeffery B
The objective of the present study was to describe the epidemiology of reportable enteric illness in Ontario's Waterloo region, including comparing calculated incidence rates with published rates, and adjusting for under-reporting to determine the number of community cases, where published data were available. Descriptive analyses were performed on reportable disease data for 13 enteric diseases collected in the Waterloo region from 1990 to 2004. Poisson and negative binomial regression analyses were used to investigate differences in incidence rates among age, sex, the 15 years of data and seasons. Disease-specific incidence rates were calculated and compared with the literature, where possible. Under-reporting ratios from the literature were applied to estimate the number of cases of campylobacteriosis, nontyphoidal salmonellosis and verotoxigenic Escherichia coli infection at the community level. Over the study period, the average annual age- and sex-adjusted incidence rates per 100,000 population were highest for campylobacteriosis (49.69 cases), followed by giardiasis (31.87 cases) and nontyphoidal salmonellosis (25.97 cases). The incidence of most enteric illnesses peaked in the summer. The highest incidence occurred in young children, followed by adults in their 20s. Diarrhea (85.4%) was the most frequently reported symptom, food (57.4%) was the most commonly reported probable source, and home (41.7%) and travel (37.0%) were the two most frequently reported risk settings. Enteric illness was a significant health burden in the Waterloo region from 1990 to 2004. Because reportable disease data are subject to under-reporting, it is likely that the true burden is greater than estimated in the present study.
Owino, Victor; Ahmed, Tahmeed; Freemark, Michael; Kelly, Paul; Loy, Alexander; Manary, Mark; Loechl, Cornelia
Approximately 25% of the world's children aged global target for 2030. The pathogenesis of stunting is poorly understood. Prenatal and postnatal nutritional deficits and enteric and systemic infections clearly contribute, but recent findings implicate a central role for environmental enteric dysfunction (EED), a generalized disturbance of small intestinal structure and function found at a high prevalence in children living under unsanitary conditions. Mechanisms contributing to growth failure in EED include intestinal leakiness and heightened permeability, gut inflammation, dysbiosis and bacterial translocation, systemic inflammation, and nutrient malabsorption. Because EED has multiple causal pathways, approaches to manage it need to be multifaceted. Potential interventions to tackle EED include: (1) reduction of exposure to feces and contact with animals through programs such as improved water, sanitation, and hygiene; (2) breastfeeding and enhanced dietary diversity; (3) probiotics and prebiotics; (4) nutrient supplements, including zinc, polyunsaturated fatty acids, and amino acids; (5) antiinflammatory agents such as 5-aminosalicyclic acid; and (6) antibiotics in the context of acute malnutrition and infection. Better understanding of the underlying causes of EED and development of noninvasive, practical, simple, and affordable point-of-care diagnostic tools remain key gaps. "Omics" technologies (genomics, epigenomics, transcriptomics, proteomics, and metabolomics) and stable isotope techniques (eg, 13 C breath tests) targeted at children and their intestinal microbiota will enhance our ability to successfully identify, manage, and prevent this disorder. Copyright © 2016 by the American Academy of Pediatrics.
Full Text Available Market environment is currently characterised by a constant dynamic development and changing conditions. The wine sector in the Czech Republic has passed and still passes through a number of changes which affect the decisions of business entities that are considering whether to enter the industry or not. The importance of strategic management is on the rise in this area as well as the significance of a company strategies creation which give the company the instructions how to use their distinctive ability and transform it into a competitive advantage. With regard to the distribution of market shares of each of the companies in the market, it is considered that the market will enter two different size firms, i.e. company A and B, in which the fundamental assumptions have been chosen so that they simulate two extreme examples of enterprises that might emerge in the market. The two chosen types of businesses are proposed recommendations focused on the most effective entry with the use of a methodological tool – GE Matrix (General Electric. For the micro-enterprise (company B it was a careful entry with minimising the entry investment, differentiation of production and subsequent gradual increase of the market share. For medium-sized enterprise (company A it means the need of high investments, primarily to the purchase of technology and marketing.
Yadgir, Sheri A.
Technology is advancing more rapidly than at any time in history since the beginning of the Industrial Revolution. In fact, experts say that the world is leaving the Industrial Age of the 20th century and entering an Information Age that will lead into the future. These advances mean that important changes are being made in all areas of life--and…
Knapp, J R; Laur, G L; Vadas, P A; Weiss, W P; Tricarico, J M
-enhancing technologies, and facility design to increase feed efficiency and life-time productivity of individual animals and herds. Many of the approaches discussed are only partially additive, and all approaches to reducing enteric CH4 emissions should consider the economic impacts on farm profitability and the relationships between enteric CH4 and other GHG. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.
Dokkum, W. van; Guéronnière, V. dela; Schaafsma, G.; Bouley, C.; Luten, J.; Latgé, C.
True fractional Ca absorption from six foods was measured in twelve normal healthy women, aged 20-29 years. The tested foods were commercially available fresh cheese, fresh cheese prepared by new technology and rich in Ca, similar cheese with added Fe, enteral food, mineral water alone and combined
Kliegman, R.M.; Miettinen, E.L.; Kalhan, S.C.; Adam, P.A.
Newborn pups were assigned to a fasting group or to a group receiving intravenous glucose alimentation. Glucose turnover was determined during steady state equilibration of simultaneously infused [6- 3 H] glucose. Thereafter, pups from each group received 0.625 g/Kg of either oral [U- 14 C] galactose or [U- 14 C] glucose. In fasted or intravenously alimented pups enteric glucose resulted in a rapid and sustained elevation of blood glucose concentrations. Systemic appearance of 14 C label from enteric glucose increased rapidly as did the enrichment of blood [ 14 C] glucose specific activity. In those pups given enteric galactose, blood glucose values were equivalent to that in the glucose fed groups, however 14 C appearing in blood glucose and blood glucose specific activity was significantly lower. The peak values for rates of appearance and disappearance of systemic glucose were significantly lower in pups fed galactose than among pups fed glucose. Glucose clearance was also significantly lower in these pups despite equivalent plasma insulin responses. Among fasting pups hepatic glycogen content was significantly higher in those given either oral glucose or galactose when compared to a completely starved control group. In contrast, among alimented pups galactose administration significantly enhanced hepatic glycogen content compared to those fed glucose. In addition, hepatic glycogen synthase (glucose-6-phosphate independent) activity was increased only among alimented pups fed galactose when compared to completely fasted pups. In conclusion these data suggest that following gastrointestinal galactose administration, hepatic carbohydrate uptake is augmented while glycogen synthesis may be enhanced. Augmented glycogen synthesis following galactose administration may reflect alterations in hepatic glycogen synthase activity or enhanced hepatic carbohydrate uptake
Tricia H Smith
Full Text Available Gastrointestinal peristalsis is significantly dependent on the enteric nervous system. Constipation due to reduced peristalsis is a major side-effect of morphine, which limits the chronic usefulness of this excellent pain reliever in man. The ionic basis for the inhibition of enteric neuron excitability by morphine is not well characterized as previous studies have mainly utilized microelectrode recordings from whole mount myenteric plexus preparations in guinea pigs. Here we have developed a Swiss-Webster mouse myenteric neuron culture and examined their electrophysiological properties by patch-clamp techniques and determined the mechanism for morphine-induced decrease in neuronal excitability. Isolated neurons in culture were confirmed by immunostaining with pan-neuronal marker, β-III tubulin and two populations were identified by calbindin and calretinin staining. Distinct neuronal populations were further identified based on the presence and absence of an afterhyperpolarization (AHP. Cells with AHP expressed greater density of sodium currents. Morphine (3 µM significantly reduced the amplitude of the action potential, increased the threshold for spike generation but did not alter the resting membrane potential. The decrease in excitability resulted from inhibition of sodium currents. In the presence of morphine, the steady-state voltage dependence of Na channels was shifted to the left with almost 50% of channels unavailable for activation from hyperpolarized potentials. During prolonged exposure to morphine (two hours, action potentials recovered, indicative of the development of tolerance in single enteric neurons. These results demonstrate the feasibility of isolating mouse myenteric neurons and establish sodium channel inhibition as a mechanism for morphine-induced decrease in neuronal excitability.
Full Text Available Clostridium perfringens (C. perfringens is a normal inhabitant of the intestinal tract of chickens as well as a potential pathogen causing necrotic enteritis. C. perfringens only causes necrotic enteritis when it transforms from non-toxin producing type to toxin producing type. The alpha toxin, (phospholipase C is believed to be a key to the occurrence of Clostridial necrotic enteritis (CNE. The best known predisposing factor is mucosal damage, caused by coccidiosis that damages the intestinal lining, making the gut susceptible to infections including C. perfringens. The purpose of this study was to observe the chicken performance in experimental CNE and field cases of CNE. Diagnosis of CNE were made by latex agglutination test, isolation and identification of the agent. Pathological and histopathological changes were also observed. Experimentally, NE could be reproduced when Eimeria sp and C. perfringens spores are inoculated in chicken. Signs of an NE are wet litter and diarrhea, and an increase in mortality is not often obvious. The depression of growth rate and feed efficiency of chicken become noticeable by week 5 because of damage to the intestine and the subsequent reduction in digestion and absorption of food. Subclinical form of CNE was also frequently found in the field, leading to significant decreases in performance. Chicken gut samples examinations revealed that subclinical form of CNE causes damage to the intestinal mucosa caused by C. perfringens leads to decreased digestion and absorption, increased feed conversion ratio and reduced weight gain. Dual infection with C. perfringens and Eimeria sp. was frequently found in field. The results of these studies provide evidence for C. perfringens as a causative bacteria for growth depression.
Rachmadi, Andri T; Kitajima, Masaaki; Pepper, Ian L; Gerba, Charles P
We investigated the occurrence and attenuation of several human enteric viruses (i.e., norovirus, adenovirus, Aichi virus 1, polyomaviruses, and enterovirus) as well as a plant virus, pepper mild mottle virus (PMMoV), at two surface flow wetlands in Arizona. The retention time in one of the wetlands was seven days, whereas in the other wetland it could not be defined. Water samples were collected at the inlet and outlet from the wetlands over nine months, and concentration of viral genomes was determined by quantitative polymerase chain reaction (qPCR). Of the human enteric viruses tested, adenovirus and Aichi virus 1 were found in the greatest prevalence in treated wastewater (i.e., inlet of the wetlands). Reduction efficiencies of enteric viruses by the wetlands ranged from 1 to 3 log10. Polyomaviruses were generally removed to below detection limit, indicating at least 2 to 4 log10 removal. PMMoV was detected in a greater concentration in the inlet of both wetlands for all the viruses tested (10(4) to 10(7) genome copies/L), but exhibited little or no removal (1 log10 or less). To determine the factors associated with virus genome attenuation (as determined by qPCR), the persistence of PMMoV and poliovirus type 1 (an enterovirus) was studied in autoclaved and natural wetland water, and deionized water incubated under three different temperatures for 21 days. A combination of elevated water temperature and biological activities reduced poliovirus by 1 to 4 log10, while PMMoV was not significantly reduced during this time period. Overall, PMMoV showed much greater persistence than human viruses in the wetland treatment. Copyright © 2015 Elsevier B.V. All rights reserved.
Davison, S.; Converse, K.A.; Hamir, A.N.; Eckroade, R.J.
Duck viral enteritis (DVE) outbreaks occurred at two different locations in Pennsylvania in 1991 and 1992. In the first outbreak, four ducks died out of a group of 30 domestic ducks; in the second outbreak, 65 ducks died out of a group of 114 domestic ducks, and 15 domestic geese died as well. A variety of species of ducks were present on both premises, but only muscovy ducks (Cairina moschata) died from the disease. On necropsy, gross lesions included hepatomegaly with petechial hemorrhages, petechial hemorrhages in the abdominal fat, petechial hemorrhages on the epicardial surface of the heart, and multifocal to coalescing areas of fibrinonecrotic material over the mucosal surface of the trachea, esophagus, intestine, and cloaca. Histologically, the liver had random multifocal areas of necrosis and eosinophilic intranuclear inclusion bodies in hepatocytes. DVE virus was isolated and identified using muscovy duck embryo fibroblast inoculation and virus neutralization. /// En dos sitios diferentes se presentaron brotes de enteritis viral de los patos en el estados de Pensilvania en los a??os 1991 y 1992. En el primer brote, cuatro de un lote de 30 patos murieron mientras que en el segundo brote murieron 65 patos de un lote de 114 patos y 15 gansos. En ambas localidades exist?-a una variedad de especies de patos, sin embargo, s??lamente los patos almizcleros (Cairina moschata) murieron. A la necropsia, las lesiones macrosc??picas incluyeron hepatomegalia con hemorragias petequiales, hemorragias petequiales en la grasa abdominal y en la superficie del epicardio, y ?!reas multifocales o coalescentes de material fibrinonecr??tico sobre la superficie de la mucosa de la tr?!quea, es??fago, intestino y cloaca. Histol??gicamente, el h?-gado mostraba ?!reas multifocales de necrosis y cuerpos de inclusi??n intranucleares eosinof?-licos en los hepatocitos. El virus de la enteritis viral de los patos fue aislado e identificado usando fibroblasto de embriones de pato almizclero
Lupus enteritis is a rare and poorly understood cause of abdominal pain in patients with systemic lupus erythematosus (SLE). In this study, we report a series of 7 new patients with this rare condition who were referred to French tertiary care centers and perform a systematic literature review of SLE cases fulfilling the revised ACR criteria, with evidence for small bowel involvement, excluding those with infectious enteritis. We describe the characteristics of 143 previously published and 7 new cases. Clinical symptoms mostly included abdominal pain (97%), vomiting (42%), diarrhea (32%) and fever (20%). Laboratory features mostly reflected lupus activity: low complement levels (88%), anemia (52%), leukocytopenia or lymphocytopenia (40%) and thrombocytopenia (21%). Median CRP level was 2.0 mg/dL (range 0–8.2 mg/dL). Proteinuria was present in 47% of cases. Imaging studies revealed bowel wall edema (95%), ascites (78%), the characteristic target sign (71%), mesenteric abnormalities (71%) and bowel dilatation (24%). Only 9 patients (6%) had histologically confirmed vasculitis. All patients received corticosteroids as a first-line therapy, with additional immunosuppressants administered either from the initial episode or only in case of relapse (recurrence rate: 25%). Seven percent developed intestinal necrosis or perforation, yielding a mortality rate of 2.7%. Altogether, lupus enteritis is a poorly known cause of abdominal pain in SLE patients, with distinct clinical and therapeutic features. The disease may evolve to intestinal necrosis and perforation if untreated. Adding with this an excellent steroid responsiveness, timely diagnosis becomes primordial for the adequate management of this rare entity. PMID:23642042
Berry, Donagh P; Lassen, Jan; de Hass, Y
no explicit inclusion of environmental load (and in most instances, even feed efficiency) in these goals. Heritability of feed intake-related traits in cattle is moderate to high, implying that relatively high accuracy of selection can be achieved with relatively low information content per animal; however...... in cattle are rare. No estimate of the genetic variation in enteric CH4 emissions independent of animal performance exists; it is the parameters for this trait that depict the scope for genetic improvement. The approach to the inclusion of feed intake or CH4 emissions in cattle breeding goals is not clear...
A blended diet for enteral nutrition is defined as home-made everyday food blended to a smooth 'single cream' consistency. At present, blended food is not recommended as a first choice. However, the wishes of parents who prefer to use blended food for their child need to be respected, and hospice policy for Children's Hospice South West is to replicate home conditions as far as possible. Therefore guidelines have been created for use of a blended diet. However, benefits in physical and emotional health need to be balanced against risks of tube blockage, contamination and digestive upsets.
Chattaway, Marie Anne; Kamara, Abdul; Rhodes, Fay; Kaffeta, Konneh; Jambai, Amara; Alemu, Wondimagegnehu; Islam, Mohammed Sirajul; Freeman, Molly M; Welfare, William; Harding, Doris; Samba, Ahmed F; Abu, Musu; Kamanda, Sylvester; Grant, Kathie; Jenkins, Claire; Nair, Satheesh; Connell, Steve; Siorvanes, Lisa; Desai, Sarika; Allen, Collette; Frost, Margaret; Hughes, Daniel; Jeffrey, Zonya; Gill, Noel; Salter, Mark
In 2012, Sierra Leone experienced its worst cholera outbreak in over 15 years affecting 12 of the country's 13 districts. With limited diagnostic capability, particularly in bacterial culture, the cholera outbreak was initially confirmed by microbiological testing of clinical specimens outside of Sierra Leone. During 2012 - 2013, in direct response to the lack of diagnostic microbiology facilities, and to assist in investigating and monitoring the cholera outbreak, diagnostic and reference services were established in Sierra Leone at the Central Public Health Reference Laboratory focusing specifically on isolating and identifying Vibrio cholerae and other enteric bacterial pathogens. Sierra Leone is now capable of confirming cholera cases by reference laboratory testing.
Vetto, J.T.; Culp, S.C.; Smythe, T.B.; Chang, A.E.; Sindelar, W.F.; Sugarbaker, P.H.; Heit, H.A.; Giordano, J.M.; Kozloff, L.
Fistulas from the iliac artery to the bowel constitute a condition that is often lethal. Excluding fistulas related to vascular grafts, a review of previously reported cases shows that they are most often due to atherosclerotic iliac aneurysms. Three unusual cases of this condition that occurred after high-dose pelvic irradiation for treatment of cancer are presented; in no case was recurrent tumor evident. These cases suggest that high-dose pelvic irradiation can predispose to the formation of iliac arterial-enteric fistulas, particularly if sepsis or inflammation develops. The definitive surgical management of these fistulas entails bowel resection, arterial ligation, and extra-anatomic bypass
Meitin, Catherine A.; Bender, Bradley S.; Small, Parker A., Jr.
Intrajejunal administration to mice of a recombinant vaccinia virus containing the influenza virus hemagglutinin gene induced IgA antibody in nasal, gut, and vaginal secretions. It also induced IgG antibody in serum and cell-mediated immunity. The immunization provided significant protection against an influenza virus challenge. This work suggests that enteric-coated recombinant vaccinia could be an orally administered, inexpensive, multivalent, temperature-stable, safe, and effective vaccine for children that could be particularly useful in developing nations, where multiple injections are not easily administered. Oral administration of vaccines should also reduce children's fear of shots at the doctor's office.
Aflitto, Nicholas C; Hofstetter, Richard W
Acoustic technology is a potential tool to protect wood materials and eventually live trees from colonization by bark beetles. Bark beetles such as the southern pine beetle Dendroctonus frontalis, western pine beetle D. brevicomis and pine engraver Ips pini (Coleoptera: Curculionidae) use chemical and acoustic cues to communicate and to locate potential mates and host trees. In this study, the efficacy of sound treatments on D. frontalis, D. brevicomis and I. pini entry into tree materials was tested. Acoustic treatments significantly influenced whether beetles entered pine logs in the laboratory. Playback of artificial sounds reduced D. brevicomis entry into logs, and playback of stress call sounds reduced D. frontalis entry into logs. Sound treatments had no effect on I. pini entry into logs. The reduction in bark beetle entry into logs using particular acoustic treatments indicates that sound could be used as a viable management tool. © 2013 Society of Chemical Industry.
Konecny, Tomas; DeSimone, Christopher V.; Friedman, Paul A.; Bruce, Charles [Department of Medicine, Cardiovascular Diseases, Mayo Clinic, Rochester, MN (United States); Asirvatham, Samuel J., E-mail: email@example.com [Department of Medicine, Cardiovascular Diseases, Mayo Clinic, Rochester, MN (United States); Department of Pediatric and Adolescent Medicine, Pediatric Cardiology, Mayo Clinic, Rochester, MN (United States)
Ventricular pacing is most commonly performed at the right ventricular (RV) apex. This is not without risk as placement requires crossing the tricuspid valve (TV) and may cause valvular dysfunction and dyssynchronous activation of the ventricles. The fact that the tricuspid valve lies more apically than the mitral valve allows for the possibility of pacing the ventricles from the right atrium (RA) via the “atrio-ventricular septum” without crossing the TV or entering the coronary sinus (CS). In order to mitigate far field activation inherent to current pacing technology, we constructed a novel lead in which the cathode and anode are both intra-myocardial. We demonstrate safety and efficacy of this novel lead for ventricular pacing at the atrio-ventricular septum in canines, including improved synchronous activation of both ventricles, improved differentiation in ventricular versus atrial sensing, while providing reliable ventricular capture, opening novel and a potentially safer alternative to human cardiac resynchronization therapy.
Morgenstern, John; Norstrud, Nicole; Sokhey, Jack; Martens, Steve; Alonso, Juan J.
Lockheed Martin Aeronautics Company (LM), working in conjunction with General Electric Global Research (GE GR), Rolls-Royce Liberty Works (RRLW), and Stanford University, herein presents results from the "N+2 Supersonic Validations" contract s initial 22 month phase, addressing the NASA solicitation "Advanced Concept Studies for Supersonic Commercial Transports Entering Service in the 2018 to 2020 Period." This report version adds documentation of an additional three month low boom test task. The key technical objective of this effort was to validate integrated airframe and propulsion technologies and design methodologies. These capabilities aspired to produce a viable supersonic vehicle design with environmental and performance characteristics. Supersonic testing of both airframe and propulsion technologies (including LM3: 97-023 low boom testing and April-June nozzle acoustic testing) verified LM s supersonic low-boom design methodologies and both GE and RRLW's nozzle technologies for future implementation. The N+2 program is aligned with NASA s Supersonic Project and is focused on providing system-level solutions capable of overcoming the environmental and performance/efficiency barriers to practical supersonic flight. NASA proposed "Initial Environmental Targets and Performance Goals for Future Supersonic Civil Aircraft". The LM N+2 studies are built upon LM s prior N+3 100 passenger design studies. The LM N+2 program addresses low boom design and methodology validations with wind tunnel testing, performance and efficiency goals with system level analysis, and low noise validations with two nozzle (GE and RRLW) acoustic tests.
Morgan, K J; Alley, M R; Pomroy, W E; Castro, I; Howe, L
Enteric coccidiosis may cause significant morbidity and mortality in juvenile brown kiwi (Apteryx mantelli). Morphology of sporulated oocysts indicates that at least two Eimeria species are able to infect the brown kiwi. A histological study of the endogenous stages of coccidia was undertaken in the intestinal tracts of ten naturally infected young kiwi. Sequential sectioning of the entire intestinal tract allowed identification and recording of the distribution of the various coccidial life stages. Macromeronts measuring 268 × 162 μm when mature were found mainly within the lamina propria of the proximal one third of the small intestine. A smaller form of lamina propria meront was also identified (8.7 × 6.4 μm) with a similar distribution to the macromeronts. Small meronts (4.4 × 3.8 μm) were also identified in mucosal epithelial cells, with the overall peak in distribution within the intestinal tract being distal to the lamina propria meronts. Three morphologically distinctive gametocytes were identified. Type A gametocytes contained within epithelial cells shared the same distribution as the epithelial meronts. Polyps containing large numbers of type B gametocytes within the distal intestinal tract were found in two cases, and type C gametocytes were identified throughout the entire intestinal tract in one case only. The observational nature of this study precludes complete knowledge of the parasite life cycles using histology alone. However, it is likely that each of the three morphologically distinct gametocytes represents a separate species of enteric coccidia.
Christian Diamant Mossoro-Kpinde
Full Text Available Introduction. The number of Salmonella isolated from clinical samples that are resistant to multiple antibiotics has increased worldwide. The aim of this study was to determine the prevalence of resistant Salmonella enterica isolated in Bangui. Methods. All enteric Salmonella strains isolated from patients in 2008 were identified and serotyped, and the phenotypes of resistance were determined by using the disk diffusion method. Nine resistance-associated genes, blaTEM, blaOXA, blaSHV, tetA, aadA1, catA1, dhfrA1, sul I, and sul II, were sought by genic amplification in seven S.e. Typhimurium strains. Results. The 94 strains isolated consisted of 47 S.e. Typhimurium (50%, 21 S.e. Stanleyville (22%, 18 S.e. Enteritidis (19%, 4 S.e. Dublin (4%, 4 S.e. Hadar (4%, and 1 S.e. Papuana (1%. Twenty-five (28% were multiresistant, including 20 of the Typhimurium serovar (80%. Two main phenotypes of resistance were found: four antibiotics (56% and to five antibiotics (40%. One S.e. Typhimurium isolate produced an extended-spectrum β-lactamase (ESBL. Only seven strains of S.e. Typhimurium could be amplified genically. Only phenotypic resistance to tetracycline and aminosides was found. Conclusion. S. Typhimurium is the predominant serovar of enteric S. enterica and is the most widely resistant. The search for resistance genes showed heterogeneity of the circulating strains.
Full Text Available In today’s globalized world, businesses look to expand to have a global presence. Restaurant businesses have expanded internationally using franchising. This study sought to determine the critical success factors (CSFs of a franchised restaurant system entering the Kenyan market from the franchisors’ perspective. It sought to establish how franchisors define, identify, and evaluate success. This study provides a theoretical framework that helps to understand the background of why organizations seek to expand using franchising method and consequently the CSFs of franchised restaurants entering the Kenyan market. The study used qualitative methodology with the use of in-depth interviews for collecting data. The results yielded CSFs from the franchisors’ perspective. As revealed by the study, the CSFs include brand power/concept, competitive environment, government policies, distance management, cultural appeal, excellent selection of franchisees, good site/location selection, good relationship with the franchisees, and proper contract management. These findings can be used by restaurant franchises that seek to establish successful businesses in the Kenyan market and other similar regional markets. The Africa franchise partners may also find some useful information from this article as they seek to set up the Franchise Association of Kenya. Other franchise businesses may also benefit from some aspects of the study.
Full Text Available The organisation of services to support the increasing number of people receiving enteral tube feeding (ETF at home varies across regions. There is evidence that multi-disciplinary primary care teams focussed on home enteral nutrition (HEN can provide cost-effective care. This paper describes the development and evaluation of a HEN Team in one UK city. A HEN Team comprising dietetians, nurses and a speech and language therapist was developed with the aim of delivering a quality service for people with gastrostomy tubes living at home. Team objectives were set and an underpinning framework of organisation developed including a care pathway and a schedule of training. Impact on patient outcomes was assessed in a pre-post test evaluation design. Patients and carers reported improved support in managing their ETF. Cost savings were realised through: (1 prevention of hospital admission and related transport for ETF related issues; (2 effective management and reduction of waste of feed and thickener; (3 balloon gastrostomy tube replacement by the HEN Team in the patient’s home, and optimisation of nutritional status. This service evaluation demonstrated that the establishment of a dedicated multi-professional HEN Team focussed on achievement of key objectives improved patient experience and, although calculation of cost savings were estimates, provided evidence of cost-effectiveness.
Kumar, Koshila; Roberts, Chris; Thistlethwaite, Jill
Despite a recognised need for richer narratives about academic medicine, much of the literature is limited to an analysis of the enablers and barriers associated with recruitment and retention, and focuses on analysing the development of research career pathways. We explored academic clinician-educators' experiences of entering into and navigating academic medicine, with a particular focus on those who privilege teaching above research. Data were collected through interviews and focus groups conducted across a medical school at one Australian university. We used socio-cognitive career theory to provide theoretical insight into the factors that influence academic clinician-educators' interests, choice and motivations regarding entering and pursuing a teaching pathway within academic medicine. Framework analysis was used to illustrate key themes in the data. We identified a number of themes related to academic clinician-educators' engagement and performance within an academic medicine career focused on teaching. These include contextual factors associated with how academic medicine is structured as a discipline, cultural perceptions regarding what constitutes legitimate practice in academia, experiential factors associated with the opportunity to develop a professional identity commensurate with being an educator, and socialisation practices. The emphasis on research in academia can engender feelings of marginalisation and lack of credibility for those clinicians who favour teaching over research. The prevailing focus on supporting and socialising clinicians in research will need to change substantially to facilitate the rise of the academic clinician-educator. © Blackwell Publishing Ltd 2011.
Sorteni, C; Clavenzani, P; De Giorgio, R; Portnoy, O; Sirri, R; Mordenti, O; Di Biase, A; Parmeggiani, A; Menconi, V; Chiocchetti, R
European eels live most of their lives in freshwater until spawning migration to the Sargasso Sea. During seawater adaptation, eels modify their physiology, and their digestive system adapts to the new environment, drinking salt water to compensate for the continuous water loss. In that period, eels stop feeding until spawning. Thus, the eel represents a unique model to understand the adaptive changes of the enteric nervous system (ENS) to modified salinity and starvation. To this purpose, we assessed and compared the enteric neuronal density in the cranial portion of the intestine of freshwater eels (control), lagoon eels captured in brackish water before their migration to the Sargasso Sea (T0), and starved seawater eels hormonally induced to sexual maturity (T18; 18 weeks of starvation and treatment with standardized carp pituitary extract). Furthermore, we analyzed the modification of intestinal neuronal density of hormonally untreated eels during prolonged starvation (10 weeks) in seawater and freshwater. The density of myenteric (MP) and submucosal plexus (SMP) HuC/D-immunoreactive (Hu-IR) neurons was assessed in wholemount preparations and cryosections. The number of MP and SMP HuC/D-IR neurons progressively increased from the freshwater to the salty water habitat (control > T0 > T18; P neuroplasticity as indicated by the increasing number of HuC/D-IR MP and SMP neurons, a mechanism likely contributing to maintaining the body homeostasis of this fish in extreme conditions. PMID:24433383
Psáder, Roland; Sterczer, Agnes; Pápa, Kinga; Harnos, Andrea; Szilvási, Viktória; Pap, Akos
Nutritional support in critically ill patients is a fundamental principle of patient care. Little is known about gallbladder motility during the interdigestive phase and in response to enteral feeding. The objective of this study was to investigate the effect of enteral feeding on gallbladder function in dogs. The cholagogue meal (Lipofundin infusion) was applied in four anatomical positions (jejunum, duodenojejunal junction, descending duodenum, stomach) in five healthy Beagle dogs. Gallbladder volume (GBV) was monitored by ultrasonography. Lipofundin infusion given through the feeding tube caused a maximal gallbladder contraction of 9.2% (range 3.7-13.9%) in the jejunum, 16.5% (9.1-22.1%) at the duodenojejunal junction and 26.3% (22.8-29.5%) in the descending duodenum. When the cholagogue meal was given through the mouth, it caused a mean 33.8% (28.6-46.5%) maximum gallbladder contraction in the same animals. In conclusion, we can establish that the ultrasound-guided gallbladder emptying method proved to be a useful technique for monitoring the cholagogue effect of Lipofundin meal applied in different anatomical positions of the intestine. The deeper the position of application, the smaller and shorter gallbladder contraction was evoked.
Lopez de Cardona, I.; Bermudez, M.; Billmire, E.; Hazen, T.C. [Univ. of Puerto Rico, Rio Piedras (Puerto Rico)
Mangrove oysters (Crassostrea rhizophorae) were screened for enteric viruses. For 18 months oysters were collected from Cano Boqueron, a tropical mangrove lagoon on the southwest coast of Puerto Rico. This popular tourist resort has two primary sewage treatment plants which service 158 single family cabanas. In spite of the heavy seasonal input of sewage to Cano Boqueron and high densities of fecal coliform bacteria, enteric viruses were not detected in shellfish meat. Because no viruses were detected in the oysters, a virus survival study was performed. Poliovirus type 1 was placed in diffusion chambers in situ at two sites in Cano Boqueron. More than 95% of the poliovirus inactivation occurred within 24 h. Virus inactivation was significantly different by site, indicating different inactivation rates within the lagoon. Chamber studies done simultaneously with Escherichia coli did not reveal differences between sites. It is suggested that the sewage effluent had an antiviral effect in the absence of an antibacterial effect. This study demonstrates the importance for establishing microbial contamination standards for shellfish growing waters in the tropics based upon in situ studies with tropical species, e.g. mangrove oyster.
Full Text Available Enteroaggregative Escherichia coli (EAEC are quite heterogeneous category of an emerging enteric pathogen associated with cases of acute or persistent diarrhea worldwide in children and adults, and over the past decade has received increasing attention as a cause of watery diarrhea, which is often persistent. EAEC infection is an important cause of diarrhea in outbreak and non-outbreak settings in developing and developed countries. Recently, EAEC has been implicated in the development of irritable bowel syndrome, but this remains to be confirmed. EAEC is defined as a diarrheal pathogen based on its characteristic aggregative adherence (AA to HEp-2 cells in culture and its biofilm formation on the intestinal mucosa with a “stacked-brick” adherence phenotype, which is related to the presence of a 60 MDa plasmid (pAA. At the molecular level, strains demonstrating the aggregative phenotype are quite heterogeneous; several virulence factors are detected by polymerase chain reaction; however, none exhibited 100% specificity. Although several studies have identified specific virulence factor(s unique to EAEC, the mechanism by which EAEC exerts its pathogenesis is, thus, far unknown. The present review updates the current knowledge on the epidemiology, chronic complications, detection, virulence factors, and treatment of EAEC, an emerging enteric food borne pathogen.
The purpose of this study was to determine the parameters of leadership of students entering one optometry school, assess the relation between personality types and leadership during optometry school, and forecast potential for leadership beyond school. Personality inventories of 269 students entering University of Houston College of Optometry (UHCO) from 1988 through 1990 were analyzed for personality type according to Gough's two-vector system (V1 = extroversion/introversion; V2 = norm-favoring/norm-doubting) which results in four types or life styles: Alpha, Beta, Gamma, and Delta. Although some sex and ethnic differences were found, most (71%) optometry students were Alphas (extroverted/norm-favoring), accepted leaders who strive to maintain and advance consensual values. Alphas achieved well in classroom and clinic and were student leaders. A lesser number (10%), mostly women, were Gammas; extroverted but norm-questioning, Gammas can provide creative and progressive leadership. Remaining types were Betas (15%) and Deltas (4%), both introverted types who avoid leadership positions. In sum, traditional and, to a lesser degree, innovative leadership potential appears strong among optometry students; they should serve the profession well.
Savigny, Michelle R; Macintire, Douglass K
To determine if oseltamivir with standard therapy for canine parvoviral enteritis ameliorates disease morbidity, mortality, or both; to document significant adverse effects associated with its use. Prospective, randomized, blinded, placebo-controlled clinical trial. University veterinary teaching hospital. Thirty-five dogs. Standard therapy was administered to all dogs. Treatment dogs also received oseltamivir, while control dogs received an equivalent volume of placebo. Dogs were monitored daily according to a clinical scoring system, physical parameters, and diagnostic evaluations. Dogs in the treatment group gained a significant percentage of weight during hospitalization (mean, +2.6%; SD, 7.1%) versus the control dogs (mean, -4.5%; SD, 6.9%) (P=0.006). Treatment dogs did not have any significant changes in their white blood cell (WBC) count, while control dogs experienced a significant drop in their WBC counts during their initial stay. In addition, it did not appear that oseltamivir use was associated with any major adverse clinical effects. While a clear advantage to the use of oseltamivir was not established, a significant weight loss during hospitalization, as well as a significant decrease in WBC count were documented in the control group. No major adverse effects were identified that could be associated with oseltamivir administration. Based on these results, the true role of oseltamivir in the treatment of parvoviral enteritis remains speculative, although it is believed that further investigation is warranted.
Full Text Available Wana Manitpisitkul1, Sabrina Lee2, Matthew Cooper31Department of Pharmacy, University of Maryland Medical Center, Baltimore, MD, USA; 2Solid Organ Transplant Program, University of Utah Health Care, Salt Lake City, UT, USA; 3Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USAAbstract: Addition of mycophenolate mofetil (MMF to calcineurin-based immunosuppressive therapy has led to a significant improvement in graft survival and reduction of acute rejection in renal transplant recipients. However, in clinical practice, MMF dose reduction, interruption, or discontinuation due to hematological and gastrointestinal (GI side-effects occurred in up to 50% of the patients. Large retrospective analyses have demonstrated that patients requiring MMF dose manipulation due to adverse events experienced a higher rate of rejection and graft loss. Enteric-coated mycophenolate sodium (EC-MPS was developed with the goal of improving upper GI side-effects. Here, we review the efficacy and safety of EC-MPS in de novo kidney transplant recipient, and in stable renal transplant patients who were converted from MMF. The changes in GI-related adverse events using patient-reported outcome instruments are also reviewed.Keywords: enteric-coated mycophenolate sodium, mycophenolate mofetil, kidney transplant, efficacy, gastrointestinal tolerability
Dinenage, Sarah; Gower, Morwenna; Van Wyk, Joanna; Blamey, Anne; Ashbolt, Karen; Sutcliffe, Michelle; Green, Sue M
The organisation of services to support the increasing number of people receiving enteral tube feeding (ETF) at home varies across regions. There is evidence that multi-disciplinary primary care teams focussed on home enteral nutrition (HEN) can provide cost-effective care. This paper describes the development and evaluation of a HEN Team in one UK city. A HEN Team comprising dietetians, nurses and a speech and language therapist was developed with the aim of delivering a quality service for people with gastrostomy tubes living at home. Team objectives were set and an underpinning framework of organisation developed including a care pathway and a schedule of training. Impact on patient outcomes was assessed in a pre-post test evaluation design. Patients and carers reported improved support in managing their ETF. Cost savings were realised through: (1) prevention of hospital admission and related transport for ETF related issues; (2) effective management and reduction of waste of feed and thickener; (3) balloon gastrostomy tube replacement by the HEN Team in the patient's home, and optimisation of nutritional status. This service evaluation demonstrated that the establishment of a dedicated multi-professional HEN Team focussed on achievement of key objectives improved patient experience and, although calculation of cost savings were estimates, provided evidence of cost-effectiveness.
PEGGS,S.; SATOGATA, T.; FLANZ, J.
Hadron therapy has entered a new age . The number of facilities grows steadily, and 'consumer' interest is high. Some groups are working on new accelerator technology, while others optimize existing designs by reducing capital and operating costs, and improving performance. This paper surveys the current requirements and directions in accelerator technology for hadron therapy.
Kuiken, Nicoline S. S.; Rings, Edmond H. H. M.; Havinga, Rick; Groen, Albert K.; Tissing, Wim J. E.
Patients suffering from gastrointestinal mucositis often receive parenteral nutrition as nutritional support. However, the absence of enteral nutrition might not be beneficial for the intestine. We aimed to determine the feasibility of minimal enteral feeding (MEF) administration in a methotrexate
Kuiken, Nicoline S. S.; Rings, Edmond H. H. M.; Havinga, Rick; Groen, Albert K.; Tissing, Wim J. E.
Patients suffering from gastrointestinal mucositis often receive parenteral nutrition as nutritional support. However, the absence of enteral nutrition might not be beneficial for the intestine. We aimed to determine the feasibility of minimal enteral feeding (MEF) administration in a methotrexate
serological) test in the diagnosis of enteric fevers, blood specimens from101 patients suspected of having enteric fevers were collected. 54.5% (55) of the patients were significantly seropositive. Fifteen urine specimens from these 55 seropositive ...
... techniques or other forms of information. Title: Documentation Requirements for Articles Entered Under... DEPARTMENT OF HOMELAND SECURITY U.S. Customs And Border Protection Agency Information Collection Activities: Documentation Requirements for Articles Entered Under Various Special Tariff Treatment Provisions...
Vermeulen, Mechteld A. R.; Brinkmann, Saskia J. H.; Buijs, Nikki; Beishuizen, Albertus; Bet, Pierre M.; Houdijk, Alexander P. J.; van Goudoever, Johannes B.; van Leeuwen, Paul A. M.
Glutamine supplementation in specific groups of critically ill patients results in favourable clinical outcome. Enhancement of citrulline and arginine synthesis by glutamine could serve as a potential mechanism. However, while receiving optimal enteral nutrition, uptake and enteral metabolism of
Costantini, Todd W.; Bansal, Vishal; Krzyzaniak, Michael; Putnam, James G.; Peterson, Carrie Y.; Loomis, William H.; Wolf, Paul; Baird, Andrew; Eliceiri, Brian P.; Coimbra, Raul
The enteric nervous system may have an important role in modulating gastrointestinal barrier response to disease through activation of enteric glia cells. In vitro studies have shown that enteric glia activation improves intestinal epithelial barrier function by altering the expression of tight junction proteins. We hypothesized that severe injury would increase expression of glial fibrillary acidic protein (GFAP), a marker of enteric glial activation. We also sought to define the effects of ...
Full Text Available For long it was believed that a particular population of enteric neurons, referred to as intrinsic primary afferent neuron (IPANs, encodes mechanical stimulation. We recently proposed a new concept suggesting that there are in addition mechanosensitive enteric neurons (MEN that are multifunctional. Based on firing pattern MEN behaved as rapidly, slowly or ultra-slowly adapting RAMEN, SAMEN or USAMEN, respectively. We aimed to validate this concept in the myenteric plexus of the gastric corpus, a region where IPANs were not identified and existence of enteric sensory neurons was even questioned. The gastric corpus is characterized by a particularly dense extrinsic sensory innervation. Neuronal activity was recorded with voltage sensitive dye imaging after deformation of ganglia by compression (intraganglionic volume injection or von Fry hair or tension (ganglionic stretch. We demonstrated that 27% of the gastric neurons were MEN and responded to intraganglionic volume injection. Of these 73% were RAMEN, 25% SAMEN and 2% USAMEN with a firing frequency of 1.7 (1.1/ 2.2 Hz, 5.1 (2.2/7.7 Hz and of 5.4 (5.0/15.5 Hz, respectively. The responses were reproducible and stronger with increased stimulus strength. Even after adaptation another deformation evoked spike discharge again suggesting a resetting mode of the mechanoreceptors. All MEN received fast synaptic input. 55% of all MEN were cholinergic and 45% nitrergic. Responses in some MEN significantly decreased after perfusion of TTX, low Ca++/high Mg++ Krebs solution, capsaicin induced nerve defunctionalization and capsazepine indicating the involvement of TRPV1 expressing extrinsic mechanosensitive nerves. Half of gastric MEN responded to intraganglionic volume injection as well as to ganglionic stretch and 23% responded to stretch only. Tension-sensitive MEN were to a large proportion USAMEN (44%. In summary, we demonstrated for the first time compression and tension-sensitive MEN in the stomach
Fettucciari, Katia; Ponsini, Pamela; Gioè, Davide; Macchioni, Lara; Palumbo, Camilla; Antonelli, Elisabetta; Coaccioli, Stefano; Villanacci, Vincenzo; Corazzi, Lanfranco; Marconi, Pierfrancesco; Bassotti, Gabrio
Clostridium difficile causes nosocomial/antibiotic-associated diarrhoea and pseudomembranous colitis. The major virulence factors are toxin A and toxin B (TcdB), which inactivate GTPases by monoglucosylation, leading to cytopathic (cytoskeleton alteration, cell rounding) and cytotoxic effects (cell-cycle arrest, apoptosis). C. difficile toxins breaching the intestinal epithelial barrier can act on underlying cells, enterocytes, colonocytes, and enteric neurons, as described in vitro and in vivo, but until now no data have been available on enteric glial cell (EGC) susceptibility. EGCs are crucial for regulating the enteric nervous system, gut homeostasis, the immune and inflammatory responses, and digestive and extradigestive diseases. Therefore, we evaluated the effects of C. difficile TcdB in EGCs. Rat-transformed EGCs were treated with TcdB at 0.1-10 ng/ml for 1.5-48 h, and several parameters were analysed. TcdB induces the following in EGCs: (1) early cell rounding with Rac1 glucosylation; (2) early G2/M cell-cycle arrest by cyclin B1/Cdc2 complex inactivation caused by p27 upregulation, the downregulation of cyclin B1 and Cdc2 phosphorylated at Thr161 and Tyr15; and (3) apoptosis by a caspase-dependent but mitochondria-independent pathway. Most importantly, the stimulation of EGCs with TNF-α plus IFN-γ before, concomitantly or after TcdB treatment strongly increased TcdB-induced apoptosis. Furthermore, EGCs that survived the cytotoxic effect of TcdB did not recover completely and showed not only persistent Rac1 glucosylation, cell-cycle arrest and low apoptosis but also increased production of glial cell-derived neurotrophic factor, suggesting self-rescuing mechanisms. In conclusion, the high susceptibility of EGCs to TcdB in vitro, the increased sensitivity to inflammatory cytokines related to apoptosis and the persistence of altered functions in surviving cells suggest an important in vivo role of EGCs in the pathogenesis of C. difficile infection.
... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Lightning arresters; wires entering buildings... buildings. Lightning arresters protecting exposed telephone wires entering buildings shall be provided at the point where each such telephone wire enters the building. ...
Cromartie, T.H.; Swain, C.G.
Chlorine kinetic isotope effects for the reaction of ethylene oxide and chloride ion are normal ( 35 Cl/ 37 Cl greater than unity) in protic solvents and in acetone and dimethylformamide (DMF) in the presence of 1 equiv of 2,6-lutidinium ion. In the presence of 0.1 equiv of this cation (and 0.9 of Li + ) the isotope effect in DMF is inverse (0.9922). This is the first observation of an inverse entering-group heavy-atom isotope effect. The reaction of chloride ion with dimethyl sulfate is normal in water but inverse in DMF. The ''normal'' isotope effects are shown to be due in large measure to the dominance of changes in hydrogen bonding to chlorine over changes in carbon--chlorine bonding
Reynolds, Lisa A; Redpath, Stephen A; Yurist-Doutsch, Sophie; Gill, Navkiran; Brown, Eric M; van der Heijden, Joris; Brosschot, Tara P; Han, Jun; Marshall, Natalie C; Woodward, Sarah E; Valdez, Yanet; Borchers, Christoph H; Perona-Wright, Georgia; Finlay, B Brett
Intestinal helminth infections occur predominantly in regions where exposure to enteric bacterial pathogens is also common. Helminth infections inhibit host immunity against microbial pathogens, which has largely been attributed to the induction of regulatory or type 2 (Th2) immune responses. Here we demonstrate an additional 3-way interaction in which helminth infection alters the metabolic environment of the host intestine to enhance bacterial pathogenicity. We show that an ongoing helminth infection increased colonization by Salmonella independently of T regulatory or Th2 cells. Instead, helminth infection altered the metabolic profile of the intestine, which directly enhanced bacterial expression of Salmonella pathogenicity island 1 (SPI-1) genes and increased intracellular invasion. These data reveal a novel mechanism by which a helminth-modified metabolome promotes susceptibility to bacterial coinfection. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: firstname.lastname@example.org.
Krogdahl, Åshild; Gajardo, Karina; Kortner, Trond M; Penn, Michael; Gu, Min; Berge, Gerd Marit; Bakke, Anne Marie
Soybean meal-induced enteritis (SBMIE) is a well-described condition in the distal intestine of salmonids, and saponins have been implicated as the causal agent. However, the question remains whether saponins alone cause SBMIE. Moreover, the dose-response relationship has not been described. In a 10 week feeding trial with Atlantic salmon, a highly purified (95%) soya saponin preparation was supplemented (0, 2, 4, 6, or 10 g/kg) to two basal diets, one containing fishmeal as the major protein source (FM) and the other 25% lupin meal (LP). Saponins caused dose-dependent increases in the severity of inflammation independent of the basal diet, with concomitant alterations in digestive functions and immunological marker expression. Thus, saponins induced inflammation whether the diet contained other legume components or not. However, responses were often the same or stronger in fish fed the corresponding saponin-supplemented LP diets despite lower saponin exposure, suggesting potentiation by other legume component(s).
Given, M F; Lyon, S M; Lee, M J
The provision of enteral nutrition through the placement of gastrostomy/gastrojejunostomy tubes is a well-established procedure. Traditionally, these catheters have been placed either surgically or endoscopically; however, over the past two decades interventional radiologists have increasingly performed these procedures successfully. The perceived advantages of this route lie in the reported lower morbidity and mortality rates. In addition, percutaneous radiologically guided (PRG) catheters may be placed in certain subgroups of patients in whom it would be technically difficult or impossible by other routes, e.g., patients with head and neck or oesophageal tumours. The aim of this review is to describe the techniques of radiologically placed gastrostomy/gastrojejunostomy, discuss its indications and contraindications, describe any associated potential complications and compare PRG results with the more established techniques of open surgical and endoscopic placement. We also describe some recent procedural and catheter modifications.
Matthew D. Phillips
Full Text Available 'Cooperation and imitation among crime and terror groups in recent years has given rise to a crime-terror nexus. A linear conceptualisation of a crime-terror spectrum, suggests that complete convergence of crime and terror in a failed state can give rise to a ‘black hole.’ Theoretical models of the crime-terror nexus, however, do not specify the means by which a crime-terror group enters this black hole state, yet others do not. Using the Taliban movement as a case study, this article presents a theoretical extension of black hole theory, using organisation-level characteristics to merge black hole theory with the crime-terror continuum.'
Sayar, Ersin; Islek, Ali; Yilmaz, Aygen; Akcam, Mustafa; Flanagan, Sarah E; Artan, Reha
Congenital diarrheal disorders consist of a variety of chronic enteropathies. There are approximately 30 different diseases that can be classified into four groups according to the mechanisms involved in pathogenesis: (i) absorption and transport of nutrients and electrolytes; (ii) enterocyte differentiation and polarization; (iii) enteroendocrine cell differentiation; and (iv) modulation of the intestinal immune response. Affected patients often present with life-threatening diarrhea, in the first few weeks of life. A new disorder, enteric anendocrinosis, which is characterized by severe malabsorptive diarrhea and a lack of intestinal enteroendocrine cells has recently been described in six patients with recessively inherited mutations in the Neurogenin-3 gene. In this report we describe a seventh case with a review of the literature. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.
Mills, Ryan John; Davies, Mark W
Preterm infants are at risk of exhausting their body iron stores much earlier than healthy term newborns. It is widespread practice to give enteral iron supplementation to preterm and low birth weight infants to prevent iron deficiency anaemia. However, it is unclear whether supplementing preterm and low birth weight infants with iron improves growth and neurodevelopment. It is suspected that excess exogenous iron can contribute to oxidative injury in preterm babies, causing or exacerbating conditions such as necrotising enterocolitis and retinopathy of prematurity. Additionally, the optimal dose and timing of commencement and cessation of iron supplementation are uncertain. To evaluate the effect of prophylactic enteral iron supplementation on growth and neurodevelopmental outcomes in preterm and low birth weight infants. The secondary objectives were to determine whether iron supplementation results in improved haematological parameters and prevents other causes of morbidity and mortality. We used the standard search strategy of the Cochrane Neonatal Review Group. We searched Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 8), MEDLINE (1951 to August 2011), CINAHL (1982 to August 2011) and conference proceedings and previous reviews. Randomised controlled trials (RCTs) and quasi-randomised trials that compared enteral iron supplementation with no iron supplementation, or different regimens of enteral iron supplementation in preterm or low birth weight infants or both. We extracted data using the standard methods of the Cochrane Neonatal Review Group. Both review authors separately evaluated trial quality and data extraction. We synthesised data using risk ratios (RRs), risk differences (RDs) and weighted mean differences (WMDs). Where data about the methodology and results or both were lacking, we made an attempt to contact the study authors for further information. We included twenty-six studies (2726 infants) in the
Full Text Available Classic grounded theory methodology is a much-debated topic in research, especially when novice researchers are selecting classic grounded theory for their research or theses. There is a constant need to justify and defend certain processes of grounded theory, which often challenge other research methods. As a novice researcher, I have often found myself juggling between the need to follow specific procedures and regulations of the university while opting to support the views of Glaser and the application of classic grounded theory for my research. To tackle such difficulties, specific decisions were used to support and justify key choices that favoured classic grounded theory and the requirements of the research institute and my research process. This article provides a reflection on the decisions taken at different stages of the research process to help readers make informed decisions before entering the field.
Full Text Available The pigeon squabs, aged 5-26 day-old, showed clinical signs of dullness, anorexia, indigestion, reten-tion of feed in crop, progressive emaciation then died. The morbidity rate and mortality rate were 7.14% (50/700. The adult pigeons did not show any signs of disease. From pathological finding, pharyngitis, esophagitis were found with diphtheritic membrane covering necrotic ulcers on the mucosa of pharynx, esophagus and crop. From histopathological findings, esophagitis with epithelial hyperplasia and sloughed, lamina propria mucosa edema with lymphoid cells infiltration were found in duodenum and jejunum. The intranuclear inclusion body, Cowdry type A, was found in epithelial mucosa of esophagus, enterocyte of jejunum and lymphoid cells in spleen. FA test to duck virus enteritis and inoculation to ducklings showed negative results. Electron microscopic study revealed electron dense core sized 146-167 nm., which was identified as herpesvirus.
Full Text Available Gastrointestinal involvement is frequent in patients with systemic lupus erythematosus (SLE. Eosinophilic gastroenteritis, however, has only rarely been described in rheumatological conditions, despite its reported connection to autoimmune diseases, such as hypereosinophilic syndrome, vasculitides, and systemic mastoidosis. It presents typically with abdominal pain and diarrhea and is only exceptionally associated with ascites. Diagnosis can be problematic, as several other clinical conditions (malignancies, infection/tuberculosis, and inflammatory bowel diseases have to be ruled out. It is basically a nonsurgical disease, with excellent recovery on conservative treatment. We report the rare case of a young woman with overlap syndrome who presented with abdominal pain and ascites. The diagnosis of eosinophilic enteritis was made based on clinical, radiological, and laboratory criteria. The patient was treated with corticosteroids with excellent response.
This study assessed the provision of education and support to parents of children on home enteral nutrition (HEN), current dietetic support available and perceived challenges facing parents and carers. From the 39 responses (13%), 29 (83%, n = 35) parents suggested services for HEN need improvement. 29 (74%, n = 39) parents wanted more structured follow up and 22 (56%) would like one person to co-ordinate HEN, education and discharge. 7 parents (18%) reported a need for further education of health care professionals (HCP). Hospital dietitians were the most common HCPs reported to provide support to patients following discharge. Specialist paediatric HEN dietetic services working in a dedicated HEN team, who would provide accurate training and education and liaise with both parents and community care services post discharge should be in place. This would facilitate transfer to community care, reduce hospital re-admissions, outpatient department attendances and costs.
Given, M.F.; Lyon, S.M.; Lee, M.J. [Department of Academic Radiology, Beaumont Hospital, Dublin 9 (Ireland); Royal College of Surgeons in Ireland, St. Stephen' s Green, Dublin 2 (Ireland)
The provision of enteral nutrition through the placement of gastrostomy/gastrojejunostomy tubes is a well-established procedure. Traditionally, these catheters have been placed either surgically or endoscopically; however, over the past two decades interventional radiologists have increasingly performed these procedures successfully. The perceived advantages of this route lie in the reported lower morbidity and mortality rates. In addition, percutaneous radiologically guided (PRG) catheters may be placed in certain subgroups of patients in whom it would be technically difficult or impossible by other routes, e.g., patients with head and neck or oesophageal tumours. The aim of this review is to describe the techniques of radiologically placed gastrostomy/gastrojejunostomy, discuss its indications and contraindications, describe any associated potential complications and compare PRG results with the more established techniques of open surgical and endoscopic placement. We also describe some recent procedural and catheter modifications. (orig.)
Derkinderen, P; Rouaud, T; Lebouvier, T; Bruley des Varannes, S; Neunlist, M; De Giorgio, R
Lewy pathology in Parkinson disease (PD) extends well beyond the CNS, also affecting peripheral autonomic neuronal circuits, especially the enteric nervous system (ENS). The ENS is an integrative neuronal network also referred to as "the brain in the gut" because of its similarities to the CNS. We have recently shown that the ENS can be readily analyzed using routine colonic biopsies. This led us to propose that the ENS could represent a unique window to assess the neuropathology in living patients with PD. In this perspective, we discuss current evidence which indicates that the presence of ENS pathology may by exploited to improve our understanding and management of PD and likely other neurodegenerative disorders.
Waywa, D; Kongkriengdaj, S; Chaidatch, S; Tiengrim, S; Kowadisaiburana, B; Chaikachonpat, S; Suwanagool, S; Chaiprasert, A; Curry, A; Bailey, W; Suputtamongkol, Y; Beeching, N J
The aim of this study was to determine the prevalence of enteric protozoa and other pathogens in AIDS patients with diarrhea in Bangkok, Thailand. Of 288 consecutive patients screened in the 10 month period between November 1999-August 2000 inclusive, 55 (19.2%) had Cryptosporidium spp, 13 (4.5%) had Isospora oocyst, 11 (3.8%) had Giardia lamblia, 3 (0.9%) had Entamoeba histolytica, and 1 (0.3%) had Iodamoeba butschlii infection. The prevalence of microsporidia was 11% in this study. Of 251 patients for whom stool culture for bacteria was performed, enteric bacterial pathogens isolated were Campylobacter spp in 18 (7.1%), Salmonella spp in 11 (4.3%), and Shigella spp in 1 (0.5%). Other pathogens found in these patients were Clostridium difficile in 16/102 (15.6%). Mycobacterium spp in 18/287 (6.2%), and Strongyloides stercoralis in 23/288 (8.0%). Overall, parasitic and bacterial pathogens were identified in 140 (48.6%) patients. These pathogens were identified by the routine simple wet smear technique in 32, formalin-ether concentration method in 46, culture for S. stercoralis in 5, and culture for bacteria in 30. Additional test, using modified Ziehl-Neelsen staining, identified cryptosporidial oocyst, isospora oocyst, and Mycobacterium spp in 72. The microsporidia, initially identified by modified trichrome blue staining, all were then determined to be Enterocytozoon bieneusi by thin sectioning electron microscopy. Protozoan and bacterial pathogens were confirmed to be important etiologic agents in diarrhea in AIDS in Thailand. They were all associated with increased mortality. Routine stool examination by simple wet smear detected only one-fourth of these pathogens. Therefore all diagnostic techniques for these organisms should be made more widely available in Thailand.
Su, Xiaowei; D'Souza, Doris H
Grape seed extract (GSE) is reported to have many pharmacological benefits, including antioxidant, anti-inflammatory, anticarcinogenic, and antimicrobial properties. However, the effect of this inexpensive rich source of natural phenolic compounds on human enteric viruses has not been well documented. In the present study, the effect of commercial GSE, Gravinol-S, on the infectivity of human enteric virus surrogates (feline calicivirus, FCV-F9; murine norovirus, MNV-1; and bacteriophage MS2) and hepatitis A virus (HAV; strain HM175) was evaluated. GSE at concentrations of 0.5, 1, and 2 mg/ml was individually mixed with equal volumes of each virus at titers of ∼7 log(10) PFU/ml or ∼5 log(10) PFU/ml and incubated for 2 h at room temperature or 37°C. The infectivity of the recovered viruses after triplicate treatments was evaluated by standardized plaque assays. At high titers (∼7 log(10) PFU/ml), FCV-F9 was significantly reduced by 3.64, 4.10, and 4.61 log(10) PFU/ml; MNV-1 by 0.82, 1.35, and 1.73 log(10) PFU/ml; MS2 by 1.13, 1.43, and 1.60 log(10) PFU/ml; and HAV by 1.81, 2.66, and 3.20 log(10) PFU/ml after treatment at 37°C with 0.25, 0.50, and 1 mg/ml GSE, respectively (P PFU/ml) at 37°C also showed viral reductions. Room-temperature treatments with GSE caused significant reduction of the four viruses, with higher reduction for low-titer FCV-F9, MNV-1, and HAV compared to high titers. Our results indicate that GSE shows promise for application in the food industry as an inexpensive novel natural alternative to reduce viral contamination and enhance food safety.
Full Text Available The purpose of this study is to examine the comparative advantage of Indonesian commodities in order to enter the ASEAN Economic Community (AEC. This study uses the export data during the period of 2003-2013 among five ASEAN countries participating in the AEC, including Indonesia, Malaysia, The Philippines, Singapore, and Thailand. All data obtained from the UN Comtrade database following the Harmonized System (HS at the two-digit classification level. This study applies dynamic revealed comparative advantage (DRCA index developed by Edwards and Schoer (2001 which is the development of revealed comparative advantage (RCA index by Balassa (1965. The results show that Indonesia is ready to enter the AEC. From this research, there are several Indonesian main commodities which have comparative advantage in ASEAN, including fish, crustaceans, molluscs, aquatic invertebrates ones (HS-03, edible fruit, nuts, peel of citrus fruit, melons (HS-08, oil seed, oleagic fruits, grain, seed, fruit, etc, nes (HS-12, lac, gums, resins, vegetable saps and extracts nes (HS-13, rubber and articles thereof (HS-40, paper & paperboard, articles of pulp, paper and board (HS-48, special woven or tufted fabric, lace, tapestry etc (HS-58, articles apparel, accessories, not knit or crochet (HS-62, and vehicles other than railway, tramway (HS-87. Those commodities are in line with Indonesian government export's strategy direction which mainly focuses on several sectors, including fishery, vegetable products, rubber, wood and wood products, textiles, and transportation. Therefore, Indonesian government should focus to improve those commodities in AEC. Keywords: Indonesian Comparative Advantage, Main Export Commodities, Export Strategy Direction, ASEAN Economic Community
Sullivan, Mary M; Sorreda-Esguerra, Pearl; Platon, Maria Bernadette; Castro, Cynthia G; Chou, Nancy R; Shott, Susan; Comer, Gail M; Alarcon, Pedro
The objective of this study was to analyze the nutritional quality and viscosity of blenderized enteral tube feedings (BTFs) from four hospitals in the Philippines. Samples of two different BTFs (one standard and one modified) were collected from each hospital on three separate occasions and analyzed for macronutrients, micronutrients, and viscosity. There was considerable variation among the BTFs for the concentrations of most nutrients measured. For standard BTF samples, the caloric density ranged from 66-123 kcal/100g and the percentages of total weight for protein, carbohydrate, and fat ranged from 1.5-4.0%, 8.6-21.4%, and 0.27-3.40%, respectively. Levels of specific vitamins were undetectable in 10 standard and 15 modified BTF samples. In samples where vitamin levels were detectable, results were: vitamin A, 625-8850 IU/kg; riboflavin, 0.40-5.00 mg/kg; and pyridoxine, 0.14-3.00 mg/kg. Mineral concentrations also varied greatly (eg calcium, 64-524 mg/kg; sodium, 148-886 mg/kg; iron, 3.0-13.7 mg/kg; and zinc, 1.8- 11.5 mg/kg). Correlation coefficients were statistically significant only for carbohydrate (r = 0.48, P = 0.017). Measured values tended to be lower than expected values for all nutrients, although the difference was statistically significant only for calories (P = 0.023). The viscosity of BTF samples ranged from 2.3-45,060 centipoise, excluding three samples that were too viscous for analysis. This study demonstrates that hospital prepared blenderized enteral tube feedings render unpredictable levels of micronutrients and macronutrients and appear likely to deliver less than the desired amounts of nutrients. Additionally, the viscosity of these feedings may be unsuitable for infusion through feeding tubes.
Francisco Bustos N.
Full Text Available Se describe por primera vez en Colombia la enteritis hemorrágica (EH, en pavos de 4 a 11 semanas de edad, mediante estudios macroscópicos, hislológicos y de microscopía electrónica. Se demostró una enteritis hemorrágica severa, y esplenomegalia con inclusiones intranucleares en la mayoría de las células de la pulpa blanca esplénica y en algunos mononucleares en el intestino delgado. Las inclusiones son características; consisten de un centro eosinófilico, rodeado de cromatina densa y condensada sobre la membrana nuclear y de una estructura muy basófila y densa sobre un polo nuclear que parece corresponder a un nucleolo. Al microscopio electrónico se aprecian fases del desarrollo viral, desde un material filamentoso y amorfo hasta la formación de grandes acúmulos de viriones y cápsides de 70-80 nm de diámetro con morfología típica de adenovirus. Los viriones se demostraron fácilmente en macerados de bazo fijado en formol, teñidos negativamente con fosfotungstato de potasio; no se visualizaron en el contenido intestinal hemorrágico estudiado con el mismo método. El estudio de microscopía de luz de bazo e intestino es suficiente para establecer el diagnóstico de esta entidad.
Ndetan, Harrison T; Rupert, Ronald L; Bae, Sejong; Singh, Karan P
The purpose of this study was to report the prevalence, distribution, and severity of injuries to students before entering chiropractic college and to explore the possible demographic risk factors to these injuries. A cross-sectional survey was administered to first-year chiropractic students (n = 255) of one chiropractic college. Survey questions were adopted from the Standardized Nordic and Outcome Assessment Health Status Questionnaires. Data were collected on severity and period of last perception of low back, hand/wrist (HW), and neck/shoulder (NS) injuries of the students before attending chiropractic college. The response rate was 98.8% (N = 252), among which 66.7% were males. Injury prevalence to low back, HW, and NS before attending chiropractic college was 50.4%, 40.1%, and 53.2%, respectively. Of the respondents, 48.8% were overweight/obese and they were more likely to report injuries to HW (odds ratio, 2.10; 95% confidence interval, 1.25-3.51) and NS (odds ratio, 1.70; 95% confidence interval, 1.04-2.73) compared with those with normal weight. Among those with injuries, the mean body mass index for the females was significantly greater than for the males. This study identified a high prevalence of musculoskeletal injuries among students before attending this particular chiropractic college. Only a small percentage of those injuries were severe enough to impede normal daily work. From this study sample, it seems that males entering this chiropractic college tend to report more injuries than females. However, females with high BMI seemed to report more previous injuries.
Faure, Sandrine; McKey, Jennifer; Sagnol, Sébastien; de Santa Barbara, Pascal
In vertebrates, the digestive tract develops from a uniform structure where reciprocal epithelial-mesenchymal interactions pattern this complex organ into regions with specific morphologies and functions. Concomitant with these early patterning events, the primitive GI tract is colonized by the vagal enteric neural crest cells (vENCCs), a population of cells that will give rise to the enteric nervous system (ENS), the intrinsic innervation of the GI tract. The influence of vENCCs on early patterning and differentiation of the GI tract has never been evaluated. In this study, we report that a crucial number of vENCCs is required for proper chick stomach development, patterning and differentiation. We show that reducing the number of vENCCs by performing vENCC ablations induces sustained activation of the BMP and Notch pathways in the stomach mesenchyme and impairs smooth muscle development. A reduction in vENCCs also leads to the transdifferentiation of the stomach into a stomach-intestinal mixed phenotype. In addition, sustained Notch signaling activity in the stomach mesenchyme phenocopies the defects observed in vENCC-ablated stomachs, indicating that inhibition of the Notch signaling pathway is essential for stomach patterning and differentiation. Finally, we report that a crucial number of vENCCs is also required for maintenance of stomach identity and differentiation through inhibition of the Notch signaling pathway. Altogether, our data reveal that, through the regulation of mesenchyme identity, vENCCs act as a new mediator in the mesenchymal-epithelial interactions that control stomach development. © 2015. Published by The Company of Biologists Ltd.
Fumian, T M; Victoria, M; Vieira, C B; Fioretti, J M; Rocha, M S; Prado, T; Guimarães, F R; da Gama, N P; de Oliveira, J M; Mendes, A C O; Gaspar, A M C; Santos, J D O; Chame, M; Leite, J P G; Miagostovich, M P
This study aimed to assess anthropogenic impact of surrounding population in the Private Reserve of Natural Heritage at Pantanal, the world's largest freshwater wetland ecosystem located in the centre of South America. Viral aetiological agents of acute gastroenteritis as rotavirus A (RVA), noroviruses, human adenoviruses, klassevirus and of hepatitis, as hepatitis A virus, were investigated in different aquatic matrices. Annual collection campaigns were carried out from 2009 to 2012, alternating dry and rainy seasons. Viral particles present in the samples were concentrated by the adsorption-elution method, with negatively charged membranes, and detected by qualitative and quantitative PCR. From a total of 43 samples at least one virus was detected in 65% (28) of them. Viruses were detected in all matrices with concentrations ranging from 2 × 10 2 to 8·3 × 10 4 genome copies per litre. A significant higher RVA frequency was observed in the dry season. Our data revealing dissemination of human enteric viruses in water matrices both inside and outside the reserve could be useful to trace faecal contamination in the environment and to minimize the risk of infection by exposure of susceptible individuals. This study is part of a collaborative project designed to investigate the environmental and health conditions of the Private Reserve of Natural Heritage at Pantanal, the largest seasonally flooded wetland in the world. The project aimed to promote health and quality of human and wildlife extending technical-scientific knowledge about pathogens present in the region. By assessing the occurrence of human enteric viruses in different water matrices we demonstrated the anthropogenic impact of surrounding population and pointed out the potential risk of infection by exposure of susceptible individuals. © 2018 The Society for Applied Microbiology.
Full Text Available Background: Patterns of enteric infections in HIV in developing countries may differ in several important ways from developed countries, the knowledge of which can often guide therapy when resource limitations hamper the exact diagnosis of the etiological agent in HIV-associated diarrhea. Objectives: The primary objective of this study was to define and compare the microbial etiologies of diarrhea in HIV-1 infected and non infected patients and in HIV infected non diarrheal patients. Materials and Methods: This study was conducted between April 2007 and July 2007 at the Department of Microbiology, Maulana Azad Medical College, New Delhi. Stool samples from 50 HIV seropositive cases with diarrhea (study group, 50 HIV seropositive cases without diarrhea (control group I, and 50 HIV seronegative cases with diarrhea (control group II were examined. After the diagnosis of HIV infection was made, routine parasitological and bacteriological detection was done. An ELISA was used for the detection of Clostridium difficile toxin and Cryptosporidium antigen in stool samples. Results: The overall prevalence of enteric parasitosis in the study group was 20% and the bacteria identified were Escherischia coli in 24% of the case, Clostridium difficile in 10% of the cases, Salmonella species and Vibrio cholerae in 4% of the cases, and Shigella species in 2% of the cases. Candida species was identified in 36% of the cases. Conclusions: Identification of the etiological agent of diarrhea in a patient with AIDS is very important as it can help in the institution of appropriate therapy and the reduction of morbidity and mortality in these patients.
Martignoni, M E; Friess, H; Sell, F; Ricken, L; Shrikhande, S; Kulli, C; Büchler, M W
Delayed gastric emptying is one of the most frequent postoperative complications after Whipple resection. In the present study we evaluated the role of enteral nutrition in the development of delayed gastric emptying after Whipple resection. Between January 1996 and June 1998, 64 patients (30 female, 34 male) underwent a classic (n = 27) or pylorus-preserving (n = 37) Whipple resection. Two patients were excluded; 30 patients received enteral and 32 patients received no-enteral nutrition. Delayed gastric emptying occurred significantly more in patients with enteral (17 of 30, 57%) than in patients with no-enteral nutrition (5 of 32, 16%) (P nasogastric tube for a significantly (Pindications.
Le Péchon, J Cl; Gourdon, G
Since 1850, compressed-air work has been used to prevent shafts or tunnels under construction from flooding. Until the 1980s, workers were digging in compressed-air environments. Since the introduction of tunnel boring machines (TBMs), very little digging under pressure is needed. However, the wearing out of cutter-head tools requires inspection and repair. Compressed-air workers enter the pressurized working chamber only occasionally to perform such repairs. Pressures between 3.5 and 4.5 bar, that stand outside a reasonable range for air breathing, were reached by 2002. Offshore deep diving technology had to be adapted to TBM work. Several sites have used mixed gases: in Japan for deep shaft sinking (4.8 bar), in The Netherlands at Western Scheldt Tunnels (6.9 bar), in Russia for St. Petersburg Metro (5.8 bar) and in the United States at Seattle (5.8 bar). Several tunnel projects are in progress that may involve higher pressures: Hallandsås (Sweden) interventions in heliox saturation up to 13 bar, and Lake Mead (U.S.) interventions to about 12 bar (2010). Research on TBMs and grouting technologies tries to reduce the requirements for hyperbaric works. Adapted international rules, expertise and services for saturation work, shuttles and trained personnel matching industrial requirements are the challenges.
The DynaWave family of scrubbers was developed and patented by DuPont in the 1970's and is used extensively within the company. Because the technology was treated as confidential, information about the scrubbers was not published outside of DuPont. In 1986 Monsanto Enviro-Chem was asked to install a Reverse Jet scrubber at DuPont's Burnside spent acid recovery pant to replace an aging spray humidifying tower. Enviro-Chem was impressed with the technology and entered into a licensing agreement with DuPont in late 1987. This paper addresses the application of DynaWave froth scrubbing technology to metallurgical plant process and effluent gas streams. Froth scrubber design principles an sampling results from pilot plant trails on fluid bed roaster off-gas are presented
Effa, Emmanuel E; Lassi, Zohra S; Critchley, Julia A; Garner, Paul; Sinclair, David; Olliaro, Piero L; Bhutta, Zulfiqar A
Typhoid and paratyphoid are febrile illnesses, due to a bacterial infection, which remain common in many low- and middle-income countries. The World Health Organization (WHO) currently recommends the fluoroquinolone antibiotics in areas with known resistance to the older first-line antibiotics. To evaluate fluoroquinolone antibiotics for treating children and adults with enteric fever. We searched The Cochrane Infectious Disease Group Specialized Register (February 2011); Cochrane Central Register of Controlled Trials (CENTRAL), published in The Cochrane Library (2011, Issue 2); MEDLINE (1966 to February 2011); EMBASE (1974 to February 2011); and LILACS (1982 to February 2011). We also searched the metaRegister of Controlled Trials (mRCT) in February 2011. Randomized controlled trials examining fluoroquinolone antibiotics, in people with blood, stool or bone marrow culture-confirmed enteric fever. Two authors independently assessed the trial's methodological quality and extracted data. We calculated risk ratios (RR) for dichotomous data and mean difference for continuous data with 95% confidence intervals (CI).Comparative effectiveness has been interpreted in the context of; length of treatment, dose, year of study, known levels of antibiotic resistance, or proxy measures of resistance such as the failure rate in the comparator arm. Twenty-six studies, involving 3033 patients, are included in this review.Fluoroquinolones versus older antibiotics (chloramphenicol, co-trimoxazole, amoxicillin and ampicillin)In one study from Pakistan in 2003-04, high clinical failure rates were seen with both chloramphenicol and co-trimoxazole, although resistance was not confirmed microbiologically. A seven-day course of either ciprofloxacin or ofloxacin were found to be superior. Older studies of these comparisons failed to show a difference (six trials, 361 participants).In small studies conducted almost two decades ago, the fluoroquinolones were demonstrated to have fewer
Gómez Candela, C; Cos Blanco, A I; Iglesias Rosado, C; Planas Vilá, M; Castellá, M; García Luna, P P; Parejo, J; Chamorro Quirós, J; Irles Rocamora, J A; Pérez de la Cruz, A; Carbonell, M D; Parés Marimón, R M; Gómez Enterría, P; Salas, J; Mancha, A; Ferrón Vidán, F; Celador Almaraz, A; Bobis, M A; Martín Peña, G; Martí Bonmatí, E; Morejón, E; Jiménez Sanz, M; Martínez, I; Muñoz, A; de la Rubia Nieto, A; Ordóñez González, J; Tusón Rovira, C; Carrera Macazaga, J A
During 1999, as in previous years, the NADYA-SENPE Group has maintained an annual register of patients with Artificial Nutrition at Home in order to keep up to date our available knowledge of this therapy. The present paper analyzes the results of the sixth National Register of patients under treatment with Enteral Nutrition at Home corresponding to 1999, produced with the co-operation of twenty-three centres in the Spanish national health network. The data were collected through a closed questionnaire included on our web site (www.nadya-senpe.com). Apart from epidemiological information, the form includes the indication that led to the prescription of nutrition, nutritional treatment, access path, complications and admissions to hospital, follow-up of the treatment, patients' quality of life and progress. All of the data are processed by the co-ordinating team. The Nutrition Unit at La Paz Teaching Hospital in Madrid has acted as the group co-ordinator. During 1999, a total of 2,262 patients at the twenty-three collaborating centres followed treatment with Home Enteral Nutrition (NED in its Spanish acronym). The mean age was 63.6 (19.67 years (males: 57.6%; females: 42.3%). The mean time with nutritional treatment is 5.89 (4.25 months. The neurological alterations (37.5%) and neoplasias (36.8%) were the most frequent indications for NED. Most patients used oral administration (50.7%), the use of artificial routes is less frequent, with 5NG being used on 27.9% and PEG on 12.7%. The polymeric formulas are the ones most commonly used (87.7%). The number of complications recorded amounted to 1,403 episodes, representing 0.62 complications per patient per year, of which 40.8% were gastro-intestinal (0.26 complications per patient per year) and 18.7% were mechanical complications, with only 9 recorded cases of bronchoaspiration. It was necessary to admit patients to hospital on 836 occasions (0.38 admissions per patient), albeit generally for causes not associated with
Mohammad Hameed GHH
Full Text Available Abstract Background There is paucity of published data on human immunodeficiency virus (HIV seroprevalence among migrant workers entering Middle-East particularly Kuwait. We took advantage of the routine screening of migrants for HIV infection, upon arrival in Kuwait from the areas with high HIV prevalence, to 1 estimate the HIV seroprevalence among migrant workers entering Kuwait and to 2 ascertain if any significant time trend or changes had occurred in HIV seroprevalence among these migrants over the study period. Methods The monthly aggregates of daily number of migrant workers tested and number of HIV seropositive were used to generate the monthly series of proportions of HIV seropositive (per 100,000 migrants over a period of 120 months from January 1, 1997 to December 31, 2006. We carried out spectral analysis of these time series data on monthly proportions (per 100,000 of HIV seropositive migrants. Results Overall HIV seroprevalence (per 100,000 among the migrants was 21 (494/2328582 (95% CI: 19 -23, ranging from 11 (95% CI: 8 – 16 in 2003 to 31 (95% CI: 24 -41 in 1998. There was no discernable pattern in the year-specific proportions of HIV seropositive migrants up to 2003; in subsequent years there was a slight but consistent increase in the proportions of HIV seropositive migrants. However, the Mann-Kendall test showed non-significant (P = 0.741 trend in de-seasonalized data series of proportions of HIV seropositive migrants. The spectral density had a statistically significant (P = 0.03 peak located at a frequency (radians 2.4, which corresponds to a regular cycle of three-month duration in this study. Auto-correlation function did not show any significant seasonality (correlation coefficient at lag 12 = – 0.025, P = 0.575. Conclusion During the study period, overall a low HIV seroprevalence (0.021% was recorded. Towards the end of the study, a slight but non-significant upward trend in the proportions of HIV seropositive
White, Billy; Doyle, Jacqueline; Matschull, Kirsten; Adamo, Marco; Christie, Deborah; Nicholls, Dasha; Kinra, Sanjay; Wong, Ian Chi Kei; Viner, Russell M
Bariatric surgery is the most effective intervention for weight loss and obesity-related comorbidities currently available. Little is known about adolescents entering National Health Service (NHS) bariatric programmes. We aimed to characterise those entering a pathway and report their outcomes. Prospective service evaluation of patients assessed within a single NHS adolescent bariatric service. 50 patients assessed between 26 July 2007 and 27 January 2014; 6 (12%) were not eligible for surgery, 7 (14%) actively opted out, 8 (16%) were lost to follow-up and 29 (58%) underwent surgery (18 sleeve gastrectomy (SG) 11 Roux-en-y gastric bypass (RYGB) and 0 adjustable gastric band). Mean (SD) age at initial assessment was 16.0 (1.3) years and 18.3 (1.3) at surgery (youngest 15.7 years). Mean time taken to surgery was 1.8 years; longer in those with higher body mass index (BMI) and aged below 14 at first assessment. Mean (SD) BMI at surgery was 53.1 (8.3) kg/m 2 , lower in those undergoing RYGB (-5.2, 95% CI -11.6 to 1.13). Follow-up was inconsistent and challenging; 1/29 (3.5%) was transferred to a regional centre, 10/29 (34.5%) attended ongoing follow-up within our protocol, 6/29 (20.7%) had intermittent monitoring and 12/29 (41.4%) were lost to follow-up. Mean BMI change at 1 year (-14.0 kg/m 2 ) and complications were similar to published cohorts. Data from 11 lost to follow-up were obtained and outcomes appeared similar to those who actively followed up. Adolescent bariatric surgery in the NHS appears effective, with outcomes similar to those reported internationally. Further work is needed to optimise postsurgical surveillance and reduce age at surgery. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Full Text Available David M Barrus1, Joann Romano-Keeler2, Christopher Carr3, Kira Segebarth4, Betty Claxton2, William F Walsh2, Paul J Flakoll51Department of Neonatology, Saint Francis Hospital–Bartlett, Memphis, TN, 2Department of Pediatrics, Vanderbilt Medical Center, Nashville, TN, 3Department of Surgery, Naval Hospital Bremerton, Bremerton, WA, 4Pediatric and Diabetes Specialists, Carolinas Medical Center, Charlotte, NC, 5Department of Surgery, Vanderbilt Medical Center, Nashville, TN, USAObjective: The quantity of enteral protein supplementation required by premature infants to optimize growth has not been determined. This study compares the growth of premature infants fed the current standard intake of protein (3.5 g/kg/day with the growth of those fed a higher amount (4.0 g/kg/day.Study design: Fifty-two infants <1500 g and <33 weeks gestational age participated in a blinded, single-center, prospective randomized control trial to compare growth between two groups of different protein-intake levels. Primary outcomes were average daily weight gain (g/kg/day, head-circumference (cm/kg/week and linear growth velocity (cm/kg/week. Secondary outcomes were serum indices of protein tolerance and plasma amino acid concentrations.Results: Infants receiving higher amounts of protein had higher rates of growth for body weight (18.2 ± 0.7 versus 16.2 ± 1.0 g/kg/day; P < 0.05 and head circumference (0.87 ± 0.08 versus 0.62 ± 0.07 cm/kg/week; P < 0.05, with no differences in blood protein or plasma amino acid concentrations. Length of hospital stay was 14 days shorter for the higher-protein group (51.4 ± 4.0 versus 65.9 ± 6.3 days.Conclusion: Increasing premature infant enteral protein supplementation from a calculated intake of 3.5–4.0 g/kg/day improved growth in a safe manner.Keywords: human milk, human milk fortifier, growth, low birth weight
Gupta, Adit; Fisher, Darrell
The adoption of technology has created a major impact in the field of education at all levels. Technology-supported classroom learning environments, involving modern information and communication technologies, are also entering the Indian educational system in general and the schools in Jammu region (Jammu & Kashmir State, India) in…
Balty, Cédric; Gayrard, Jean-Didier; Agnieray, Patrick
To cope with the economical and technical evolutions of the communication market and to better compete with or complement terrestrial networks, satellite operators are requiring more flexible satellites. It allows a better fleet planning potential and back-up policy, a more standardized and efficient procurement process, mission adaptation to market evolution and the possibility of early entry in new markets. New technologies that are developed either for terrestrial networks or for space defense applications would become soon available to satellite and equipment manufacturers. A skilful mix of these new technologies with the older and more mature ones should boost satellite performances and bring flexibility to the new generation of communication satellites. This paper reviews the economical and technical environment of the space communication business for the next decade. It identifies the needs and levels of flexibility that are required by the market but also allowed by technologies, in both a top-down and bottom-up approach.
Arco Chemical (Newtown Square, PA) will enter production of propylene glycol ethers (PGEs) in Europe by building a 70,000-m.t./year plant at its Rotterdam site. Arco's board has approved the project, with construction to begin this year and completion expected in mid-1995. 'This new plant supports the company's long-standing strategy to increase its downstream integration in value-added derivatives of propylene oxide,' says Jack Oppasser, president of Arco Chemical Europe (Maidenhead, U.K.). 'It allows the company to sustain its strong position in the growing European glycol ether market.' Arco's move represents a challenge to Dow Europe (Horgen, Switzerland), which dominates the European PGE market. Dow is Europe's biggest producer of PGEs, with its Dowanol brands commanding a share greater than 50% of the estimated 90,000-m.t./year methyl-based PGE market. This was recently boosted by completion of the expansion of its plant at Stade, Germany, from 60,000 m.t./year to 110,000 m.t./year. While Arco does not currently make PGEs in Europe, it is the second-largest supplier, with about 15,000 m.t.-20,000 m.t./year, via 'third-party manufacturing arrangements' with European producers, including BP Chemicals, and imports from its 90-million lbs/year plant at Bayport, TX. However, Arco refuses to comment on this because of 'antitrust aspects.'
Wobbes, T.; Verschueren, R.C.; Lubbers, E.J.; Jansen, W.; Paping, R.H.
Injury to the small bowel is one of the tragic complications of radiotherapy. We performed a retrospective analysis of patients operated upon for stenosis, perforation, fistulization, and chronic blood loss of the small bowel after radiotherapy for multiple malignant diseases. In the period 1970 to 1982 in the Department of General Surgery of the St. Radboud University Hospital, Nijmegen, and the Department of Surgical Oncology of the State University, Groningen, 27 patients were treated surgically. Twenty patients presented with obstruction. In 17 patients a side-to-side ileotransversostomy was performed; in three the injured bowel was resected. Of the five patients with fistulization, three underwent a bypass procedure; in two cases the affected bowel was resected. In one patient with perforation, a resection was performed, as in a patient with chronic blood loss. Two of the 20 patients (10 per cent) in whom the diseased bowel was bypassed died postoperatively. Of the seven patients whose affected bowel was resected four (57 per cent) died of intra-abdominal sepsis. Management of the patient with chronic radiation enteritis is discussed. We conclude, on the basis of our experience, that in patients with obstruction and fistulization, a bypass procedure of the affected bowel is a safe method of treatment. In case of resection, the anastomosis should be performed during a second operation.
Wobbes, T.; Verschueren, R.C.; Lubbers, E.J.; Jansen, W.; Paping, R.H.
Injury to the small bowel is one of the tragic complications of radiotherapy. We performed a retrospective analysis of patients operated upon for stenosis, perforation, fistulization, and chronic blood loss of the small bowel after radiotherapy for multiple malignant diseases. In the period 1970 to 1982 in the Department of General Surgery of the St. Radboud University Hospital, Nijmegen, and the Department of Surgical Oncology of the State University, Groningen, 27 patients were treated surgically. Twenty patients presented with obstruction. In 17 patients a side-to-side ileotransversostomy was performed; in three the injured bowel was resected. Of the five patients with fistulization, three underwent a bypass procedure; in two cases the affected bowel was resected. In one patient with perforation, a resection was performed, as in a patient with chronic blood loss. Two of the 20 patients (10 per cent) in whom the diseased bowel was bypassed died postoperatively. Of the seven patients whose affected bowel was resected four (57 per cent) died of intra-abdominal sepsis. Management of the patient with chronic radiation enteritis is discussed. We conclude, on the basis of our experience, that in patients with obstruction and fistulization, a bypass procedure of the affected bowel is a safe method of treatment. In case of resection, the anastomosis should be performed during a second operation
Heck, Nicholas C.; Sorensen, James L.
Little is known about the needs or characteristics of transgender individuals in substance abuse treatment settings. Transgender (n=199) and non-transgender (cisgender, n=13440) individuals were compared on psychosocial factors related to treatment, health risk behaviors, medical and mental health status and utilization, and substance use behaviors within a database that documented individuals entering substance abuse treatment in San Francisco, CA from 2007–2009 using logistic and linear regression analyses (run separately by identified gender). Transgender men (assigned birth sex of female) differed from cisgender men across many psychosocial factors, including having more recent employment, less legal system involvement, greater incidence of living with a substance abuser, and greater family conflict, while transgender women (assigned birth sex of male) were less likely to have minor children than cisgender women. Transgender women reported greater needle use and HIV testing rates were greater among transgender women. Transgender men and women reported higher rates of physical health problems, mental health diagnoses, and psychiatric medications but there were no differences in service utilization. There were no differences in substance use behaviors except that transgender women were more likely to endorse primary methamphetamine use. Transgender individuals evidence unique strengths and challenges that could inform targeted services in substance abuse treatment. PMID:24561017
Full Text Available Today we are faced with an aging society that may develop malnutrition because of dysphagia related to dementia, stroke, and malignancy seen often in the elderly. The preferred form of nutritional supplementation for this group is enteral nutrition, and the most appropriate long-term method is by use of a gastrostomy. Percutaneous endoscopic gastrostomy (PEG was first introduced in 1980 as an alternative to the traditional operative procedure and rapidly became the preferred procedure. In geriatric patients, the principal indications are neurological dysphagia and malnutrition, related to an underlying disease or anorexia-cachexia in very elderly. PEG is contraindicated in the presence of respiratory distress, previous gastric resection, total esophageal obstruction, coagulation disorders and sepsis in the elderly. Common complications include wound infection, leakage, hemorrhage, and fistula in the general population, but aspiration pneumonia is the major case of death in this group. Risks and complications of PEG must be discussed with patients and their families; and the decision for percutaneous endoscopic gastrostomy insertion should only be made after careful consideration and discussion between managing physicians, allied health professionals, and the patient and/or family. Four ethical principles may help make feeding decisions: beneficence, non-maleficence, autonomy and justice. Attentive long-term care after tube replacement is mandatory. Acceptance of percutaneous endoscopic gastrostomy placement by patients and their families tends to increase once favorable outcomes are offered.
Lu, Lei; Madugula, Viswanadh
Primary cilium is a rod-like plasma membrane protrusion that plays important roles in sensing the cellular environment and initiating corresponding signaling pathways. The sensory functions of the cilium critically depend on the unique enrichment of ciliary residents, which is maintained by the ciliary diffusion barrier. It is still unclear how ciliary cargoes specifically enter the diffusion barrier and accumulate within the cilium. In this review, the organization and trafficking mechanism of the cilium are compared to those of the nucleus, which are much better understood at the moment. Though the cilium differs significantly from the nucleus in terms of molecular and cellular functions, analogous themes and principles in the membrane organization and cargo trafficking are notable between them. Therefore, knowledge in the nuclear trafficking can likely shed light on our understanding of the ciliary trafficking. Here, with a focus on membrane cargoes in mammalian cells, we briefly review various ciliary trafficking pathways from the Golgi to the periciliary membrane. Models for the subsequent import translocation across the diffusion barrier and the enrichment of cargoes within the ciliary membrane are discussed in detail. Based on recent discoveries, we propose a Rab-importin-based model in an attempt to accommodate various observations on ciliary targeting.
C. O. Migoha
Full Text Available Preformulation is an important step in the rational formulation of an active pharmaceutical ingredient (API. Micromeritics properties: bulk density (BD and tapped density (TD, compressibility index (Carr’s index, Hauser’s ratio (H, and sieve analysis were performed in order to determine the best excipients to be used in the formulation development of omeprazole magnesium enteric coated tablets. Results show that omeprazole magnesium has fair flow and compressibility properties (BD 0.4 g/mL, TD 0.485 g/mL, Carr’s index 17.5%, Hauser’s ratio 1.2, and sieve analysis time 5 minutes. There were no significant drug excipient interactions except change in colour in all three conditions in the mixture of omeprazole and aerosil 200. Moisture content loss on drying in all three conditions was not constant and the changes were attributed to surrounding environment during the test time. Changes in the absorption spectra were noted in the mixture of omeprazole and water aerosil only in the visible region of 350–2500 nm. Omeprazole magnesium alone and with all excipients showed no significant changes in omeprazole concentration for a 30-day period. Omeprazole magnesium formulation complies with USP standards with regards to the fineness, flowability, and compressibility of which other excipients can be used in the formulation.
Chevalier, N. R.; Gazguez, E.; Bidault, L.; Guilbert, T.; Vias, C.; Vian, E.; Watanabe, Y.; Muller, L.; Germain, S.; Bondurand, N.; Dufour, S.; Fleury, V.
Neural crest cells (NCCs) are a population of multipotent cells that migrate extensively during vertebrate development. Alterations to neural crest ontogenesis cause several diseases, including cancers and congenital defects, such as Hirschprung disease, which results from incomplete colonization of the colon by enteric NCCs (ENCCs). We investigated the influence of the stiffness and structure of the environment on ENCC migration in vitro and during colonization of the gastrointestinal tract in chicken and mouse embryos. We showed using tensile stretching and atomic force microscopy (AFM) that the mesenchyme of the gut was initially soft but gradually stiffened during the period of ENCC colonization. Second-harmonic generation (SHG) microscopy revealed that this stiffening was associated with a gradual organization and enrichment of collagen fibers in the developing gut. Ex-vivo 2D cell migration assays showed that ENCCs migrated on substrates with very low levels of stiffness. In 3D collagen gels, the speed of the ENCC migratory front decreased with increasing gel stiffness, whereas no correlation was found between porosity and ENCC migration behavior. Metalloprotease inhibition experiments showed that ENCCs actively degraded collagen in order to progress. These results shed light on the role of the mechanical properties of tissues in ENCC migration during development.
Migoha, C O; Ratansi, M; Kaale, E; Kagashe, G
Preformulation is an important step in the rational formulation of an active pharmaceutical ingredient (API). Micromeritics properties: bulk density (BD) and tapped density (TD), compressibility index (Carr's index), Hauser's ratio (H), and sieve analysis were performed in order to determine the best excipients to be used in the formulation development of omeprazole magnesium enteric coated tablets. Results show that omeprazole magnesium has fair flow and compressibility properties (BD 0.4 g/mL, TD 0.485 g/mL, Carr's index 17.5%, Hauser's ratio 1.2, and sieve analysis time 5 minutes). There were no significant drug excipient interactions except change in colour in all three conditions in the mixture of omeprazole and aerosil 200. Moisture content loss on drying in all three conditions was not constant and the changes were attributed to surrounding environment during the test time. Changes in the absorption spectra were noted in the mixture of omeprazole and water aerosil only in the visible region of 350-2500 nm. Omeprazole magnesium alone and with all excipients showed no significant changes in omeprazole concentration for a 30-day period. Omeprazole magnesium formulation complies with USP standards with regards to the fineness, flowability, and compressibility of which other excipients can be used in the formulation.
Stanley, W; Borthwick, A M
Role flexibility is considered central to a health policy agenda stressing workforce redesign measures and professional role boundary change. Extensions in health professionals' role boundaries may involve the incorporation of new or 'vacant' roles, as well as the competitive acquisition of others. In the present study, the experiences of dietitians with extended roles in home enteral tube feeding (HETF) were explored and considered within the context of workforce role transition. Six semi-structured interviews conducted with dietitians specialising in HETF were undertaken and the emergent role development for dietitians in HETF was explored. Dietetic HETF roles emerged as a form of diversification, occupying a task 'vacancy', commonly on an opportunistic basis. Role overlap in these community based tasks was negotiated with community nurses, privately funded industry nurses and other medical staff. Notably, role conflict was encountered only with nutrition nurse specialists. To date, a lack of role exclusivity in a small and confined speciality field with multiple potential competitors has resulted in surprisingly little role conflict. Financial constraints within the National Health Service are considered likely to favour a privately funded service model of delivery, and this may have implications for dietitians specialising in this field. Dietitians also perceived an increase in professional status as a result of extended roles. © 2012 The Authors Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.
Kammerer, S; Höink, A J; Wessling, J; Heinzow, H; Koch, R; Schuelke, C; Heindel, W; Buerke, B
Evaluation of diagnostic accuracy of abdominal CT depending on the type of enteric contrast agent. Multislice CTs of 2,008 patients with different types of oral preparation (positive with barium, n = 576; neutral with water, n = 716; and no enteric contrast, n = 716) were retrospectively evaluated by two radiologists including delineation of intestinal segments and influence on diagnosis and diagnostic reliability exerted by the enteric contrast, using a three-point scale. Furthermore, diagnostic reliability of the delineation of selected enteric pathologies was noted. CT data were assigned into groups: oncology, inflammation, vascular, pathology, trauma and gastrointestinal pathology. Delineation of the bowel was clearly practicable across all segments irrespective of the type of enteric contrast, though a slight impairment was observed without enteric contrast. Although delineation of intestinal pathologies was mostly classified "clearly delimitable" more difficulties occurred without oral contrast (neutral/positive/no contrast, 0.8 %/3.8 %/6.5 %). Compared to examinations without enteric contrast, there was a significant improvement in diagnosis that was even increased regarding the reader's diagnostic reliability. Positive opacification impaired detection of mucosal enhancement or intestinal bleeding. Water can replace positive enteric contrast agents in abdominal CTs. However, selected clinical questions require individual enteric contrast preparations. Pathology detection is noticeably impaired without any enteric contrast.
Describes lasers and indicates that learning about laser technology and creating laser technology activities are among the teacher enhancement processes needed to strengthen technology education. (JOW)
Jan 20, 2017 ... In Peru, a pilot project that aims to improve maternal health by using technology to improve the health-care system's efficiency could one day have an impact on the entire country. This article is part of an ongoing series of stories about innovative projects in the developing world, a partnership between IDRC ...
Duijsters, G.M.; Zhang, Y.; Filippov, S.
Purpose – The purpose of this study is to examine specific use of strategic alliances and acquisitions for Chinese firms to catch‐up technologically and to enhance their internationalization competence. Design/methodology/approach – The paper offers a conceptual analysis of internationalization
Cheng, Ying; Zhang, Junfeng; Zhang, Liwei; Wu, Juan; Zhan, Zhen
Nutrition support is a common means for patients with gastric cancer, especially for those undergoing elective surgery. Recently, enteral immunonutrition (EIN) was increasingly found to be more effective than enteral nutrition (EN) in enhancing the host immunity and eventually improving the prognosis of gastric cancer patients undergoing gastrectomy. However, the results reported were not consistent. This meta-analysis aimed to assess the impact of EIN for patients with GC on biochemical, immune indices and clinical outcomes. Four electronical databases (Medline, EMBASE, Scopus and Cochrane library) were used to search articles in peer-reviewed, English-language journals. Mean difference (MD), Relative risk (RR), or standard mean difference (SMD) with 95% confidence interval (CI) were calculated. Heterogeneity was assessed by Cochrane Q and I 2 statistic combined with corresponding P-value. The analysis was carried out with RevMan 5.3. Seven studies involving 583 patients were eligible for the pooled analysis. EIN, when beyond a 7-day time-frame post-operatively (D ≥ 7), increased level of CD4 + (SMD = 0.99; 95% CI, 0.65-1.33; P SMD = 0.34; 95% CI, 0.02-0.67; P = 0.04), the IgM (SMD = 1.15; 95% CI, 0.11-2.20; P = 0.03), the IgG (SMD = 0.98; 95% CI, 0.55-1.42; P SMD = 0.69; 95% CI, 0.32-1.06; P = 0.0003), and the proalbumin (SMD = 0.73; 95% CI, 0.33-1.14; P = 0.0004). However, those increased effects were not obvious within a 7-day time-frame post-operatively (D infection and length of hospitalization (LHS) were not improved no matter what time after surgery. EIN was found to improve the cellular immunity, modulate inflammatory reaction and reduce postoperative complication for GC patients undergoing radical gastrointestinal surgery. Exclusion of grey literature and non-English language studies was the key limitation in this study.
Daly, D.J.; Erickson, T.A.; Groenewold, G.H.
The Energy ampersand Environmental Research Center (EERC), a contract-supported organization focused on technology research, development, demonstration, and commercialization (RDD ampersand C), is entering its second year of a Cooperative Agreement with the U.S. Department of Energy (DOE) Morgantown Energy Technology Center (METC) to facilitate the development, demonstration, and commercialization of innovative environmental management (EM) technologies in support of the activities of DOE's Office of Environmental Science and Technology (EM-50) under DOE's EM Program. This paper reviews the concept and approach of the program under the METC-EERC EM Cooperative Agreement and profiles the role the program is playing in the commercialization of five EM technologies
Tacchini, Simona; Nicoletti, Roberto; Ghio, Domenica; Martinenghi, Carlo Maria Andrea; Del Maschio, Alessandro; Chiesa, Roberto
Purpose. The aim of our study was to review CT finding concerning secondary aorto-enteric fistulae (AEF). In particular, we aimed to evaluate signs of contrast medium extravasation from the aortic graft into the bowel (active bleeding), in correlation with clinical and surgical reports. Materials and methods. Clinical and CT findings were retrospectively evaluated in 13 surgically proven cases of AEF. All patients underwent spiral CT examination with biphasic contrast technique, before and 30 and 80 seconds after intravenous injection of 120-150 ml of contrast medium (Ultravist 370; flow rate 2.5-3 ml/sec). Late scans (240 seconds) were also acquired on surgical anastomoses. We used 3 mm (arterial phase) and 5 mm (venous phase slices. Results. At surgery, all patients presented a communication between the bowel and the aortic graft. At CT examination, all 13 patients presented one or more CT signs indicating AEF (perigraft soft tissue, perigraft fluid, ectopic air or bowel wall thickening). Moreover, in 6 out of 13 patients, contrast medium extravasation from the aortic graft into the small bowel (active bleeding) was detected with CT. Detection of active bleeding was possible because CT examinations were performed without oral administration of contrast medium. Conclusions. CT is easily and readily available and provides an accurate evaluation of the aorta and surrounding retroperitoneal tissues. In our study we were able to identify the CT sign of active bleeding in more than a half of the patients with acute gastrointestinal bleeding (66%). Hence, we suggest that patients undergo CT examination without oral contrast medium administration in order to better appreciate the presence of active bleeding [it
Lisa M. Casanova
Full Text Available Sources of antibiotic resistant organisms, including concentrated animal feeding operations (CAFOs, may lead to environmental surface and groundwater contamination with resistant enteric bacteria of public health concern. The objective of this research is to determine whether Salmonella, Escherichia coli, Yersinia enterocolitica, and enterococci resistant to clinically relevant antibiotics are present in surface and groundwater sources in two eastern North Carolina counties, Craven and Wayne. 100 surface and groundwater sites were sampled for Salmonella, E. coli, and enterococci, and the bacteria isolated from these samples were tested for susceptibility to clinically relevant antibiotics. Salmonella were detected at low levels in some surface but not groundwater. E. coli were in surface waters but not ground in both counties. Enterococci were present in surface water and a small number of groundwater sites. Yersinia was not found. Bacterial densities were similar in both counties. For Salmonella in surface water, the most frequent type of resistance was to sulfamethoxazole. There was no ciprofloxacin resistance. There were a few surface water E. coli isolates resistant to chloramphenicol, gentamicin, and ampicillin. Enterococci in surface water had very low levels of resistance to vancomycin, chloramphenicol, ampicillin, and streptomycin. E. coli and enterococci are present more frequently and at higher levels in surface water than Salmonella, but groundwater contamination with any of these organisms was rare, and low levels of resistance can be found sporadically. Resistant bacteria are relatively uncommon in these eastern N.C. surface and groundwaters, but they could pose a risk of human exposure via ingestion or primary contact recreation.
Full Text Available The aim of the investigation was to determine the influence of Clostridium perfringens type A on the development of pathomorphological substrate, its intensity and distribution in fifteen weeks old heavy breeds broilers. The investigation was carried out on corpses of 8 hens and 7 roosters of heavy breeds of provenance COBB 500. After the completion of the autopsy, samples of altered parts of jejunum and liver were taken for histopathological examination, and jejunum intestinal contents for bacteriological examination. In all the corpses, in open pleuroperitoneal cavity, even in situ, an altered part of jejunum can be noticed. It was extremely dilated the entire length, and its wall was bluish-gray with disseminated subserous punctiform blood extravasates. When opened, semi-liquid content with blood coagulums and patches of necrotic mucosa went out of it. By microscopic examination of small intestine tissue cuttings, colored by HE method, there was observed a diffuse necrosis of intestinal villi. They were desroyed and replaced by eosinophilic structureless mass. Furthermore, there could be noticed submucose oedema, capillary congestion and blood extravasates in mucosa, as well as infiltration of neutrophilic granulocytes in lamina propria. These microscopic alterations reflect hemorrhagic necrotic enteritis. By microscopic examining of small intestine cuttings colored according to Brown & Brenn method, colonies of bacteria in distal parts of the submucosa were found out. Using bacteriological tests in anaerobic conditions, there was isolated a culture identified as Clostridium perfringens. After applying of multiplex PCR, the obtained isolate was genotyped as Clostridium perfringens type A. On the basis of pathomorphological, bacteriological and molecular examinations, it can be concluded that the infection of heavy breeds with Clostridium perfringens type A is manifested by appearance of haemorrhagic-necrotic jejunitis, that the causer
Damian, Maria; Usein, Codruţa-Romanita; Palade, Andi Marian; Băltoiu, Mădălina; Condei, Maria; Ciontea, Simona; Tatu-Chiţoiu, Dorina
The increase of incidence of resistance to the antibiotics became the most worrisome subject within the clinical and research communities in the medical fields. Intrinsic resistance genetic mutations, horizontal transfer of mobile structures carrying genes coding for resistance to the antibiotics within the pan-microbial genome are representing the bacterial resistome which is bearing the genetic information regarding the defensive mechanisms developed by micro-organisms to protect themselves against antibiotics. Rice in the resistance of enteric bacteria, pathogens involved in a large number of human infections, to the cephalosporin of last generation and to the fluoroquinolones is a very actual subject in the medical area. Production of beta-lactamases with extended spectrum is the most important enzymatic defence system, developed by micro-organisms, consisting in the inactivation of beta-lactam antibiotics by destroying the beta-lactam ring. Enterobacteria are able to produce beta-lactamases of type TEM, SHV and/or CTX-M. Punctual mutations in nucleotide structure of bla genes, coding for beta-lactamases synthesis, are leading on production of a large diversity of enzymes with enlarged spectrum of activity (ESBL). At the beginning of 90's the first beta-lactamases resistance to clavulanic acid were detected and in our days more then 170 TEM, 120 SVH and 90 CTX-MESBLs are known. Escherichia coli strains are producing, firstly, TEM ESBLs, Klebsiella pneumoniae SHV ESBLs. and both are producing CTX-M type ESBLs, are resistant to the fluoroquinolones due to punctual mutations in nucleotide structure of gyr gene coding for gyrases production, enzymes involved in nucleic acids replication. Resistance to the antibiotics with extended activity is a public health threat due to their capacity of large spreading within bacterial population, when the coding structures are located on mobile genetic structures. The menace increase when genes coding for fluoroquinolones
Full Text Available Background: Symptomatic bacteraemia, is a frequent condition among cancer patients with a significant morbidity and mortality all over the world. Objectives: The aim of this study was to determine the burden of enteric pathogens causing bacteremia among cancer patients. Patients and Methods: Ten ml blood samples were withdrawn from the cancer patients under aseptic conditions. The blood specimens were added to the blood culture bottles and incubated at 37°C. The bacterial isolates from these samples were identified by routine biochemical reactions. Results: During the study period, 68 blood samples from cancer patients were analyzed for bacteremia. Of these patients, six were female (08/82% and 62 were male (91.18%; with age ranging from under 40 years to 85 years old (mean, 63 years. Gastro-intestinal cancer and cancers of head and neck were the most frequent cancer types in the studied group, accounting for 51 (75% and 15 (22.1% cases, respectively. The mean weight of patients was 69.18 Kg (range: 49-100 Kg. Similarly, the mean length of hospital stay was 8 days (range: 4-12 days. Positive blood cultures were detected in only 12 (17.65% and 11 (91.7% blood specimens from the Cancer Institute, Tehran, compared with one (08.33% from Shahid Kamali hospital, Karaj. From these patients, 15 bacteria were isolated; E. coli alone outnumbered other species and accounted for 33.33% of the episodes of bacteremia. Conclusions: In conclusion, our investigation revealed that cancers of GI tract are the most common cancer types causing bacteremia and also we identified that most common bacteria causing bacteremia in Cancer Institute, Tehran and Shahid Kamali Hospital, Karaj, are E. coli and S. aureus
Elena G Sánchez
Full Text Available African swine fever (ASF is caused by a large and highly pathogenic DNA virus, African swine fever virus (ASFV, which provokes severe economic losses and expansion threats. Presently, no specific protection or vaccine against ASF is available, despite the high hazard that the continued occurrence of the disease in sub-Saharan Africa, the recent outbreak in the Caucasus in 2007, and the potential dissemination to neighboring countries, represents. Although virus entry is a remarkable target for the development of protection tools, knowledge of the ASFV entry mechanism is still very limited. Whereas early studies have proposed that the virus enters cells through receptor-mediated endocytosis, the specific mechanism used by ASFV remains uncertain. Here we used the ASFV virulent isolate Ba71, adapted to grow in Vero cells (Ba71V, and the virulent strain E70 to demonstrate that entry and internalization of ASFV includes most of the features of macropinocytosis. By a combination of optical and electron microscopy, we show that the virus causes cytoplasm membrane perturbation, blebbing and ruffles. We have also found that internalization of the virions depends on actin reorganization, activity of Na(+/H(+ exchangers, and signaling events typical of the macropinocytic mechanism of endocytosis. The entry of virus into cells appears to directly stimulate dextran uptake, actin polarization and EGFR, PI3K-Akt, Pak1 and Rac1 activation. Inhibition of these key regulators of macropinocytosis, as well as treatment with the drug EIPA, results in a considerable decrease in ASFV entry and infection. In conclusion, this study identifies for the first time the whole pathway for ASFV entry, including the key cellular factors required for the uptake of the virus and the cell signaling involved.
Hajj, the annual Muslim pilgrimage to Mecca, Saudi Arabia is a unique mass gathering event that attracts approximately 3 million pilgrims from around the globe. This diverse pilgrim population coupled with the nature of the performed activities raise major public health concerns in the host country with potential global implications. Although gastroenteritis and diarrhea are common among the pilgrims performing Hajj, the microbial etiologies of these infections are still unknown. We used molecular and antigenic approaches to identify the main pathogens associated with Hajj diarrhea. 544 fecal samples from pilgrims suffering from diarrhea whilst performing Hajj during three consecutive seasons (2011-2013) and 99 control samples from 2011 were screened for 16 pathogens that include bacterial, parasitic and viral etiologies that are commonly associated with diarrheal infections. At least one of the screened pathogens could be detected in 42% (n=228) of the samples from the diarrheal cases. Bacteria were the main agents detected in 83% (n=189) of the positive samples, followed by viral and parasitic agents detected in 6% (n=14) and 5% (n=12) respectively. We have also standardized a 16S-based metagenomic approach to identify the gut microbiome in diarrheal cases and non-diarrheal controls in 76 samples. Also, we have standardized a shotgun metagenomics protocol for the direct characterization (diagnosis) of enteric pathogens without cultivation. This approach was used successfully to identify viral (adenovirus) and bacterial causes of Enterotoxigenic E. coli diarrhea from Hajj samples. The findings in this study fill in clear gaps in our knowledge of the etiologies associated with diarrheal infections during Hajj. Foodborne bacteria were the major contributors to Hajj-diarrheal infections. This was coupled with the increased incidences of antimicrobial resistance loci associated with the identified bacteria. These findings would help the public health policy makers to
Gebetsroither, E.; Orthofer, R.; Strebl, F.
This report contains the results of an inventory for methane (CH 4 ) emissions from agricultural enteric fermentation in Austria for the period 1980-2001. Emissions were calculated according to IPCC guidelines. The detailed IPCC 'Tier 2' methodology was applied for cattle (which contribute the vast majority of emissions). The 'Tier 2' methodology relies on specific emission factors that are calculated from the energy intake for different cattle farming practices. The less detailed 'Tier 1' methodology was applied for all other animal categories. Emissions from organic and conventional farming practices were calculated separately. Results indicate that CH 4 emissions from manure management have increased from 1980 to a peak in 1984-1985, and since then have steadily declined. CH 4 emissions were about 169.300 t/yr in 'Kyoto' base year 1990 and have since declined by about 11 % to about 150.000 t/yr in 2001. Almost all emissions (95 % in 1990 and 94 % in 2001) are caused by cattle farming. The contribution of 'dairy cattle' to all emissions from cattle was 49 % in 1990, and has declined to 43 % in 2001. The overall reduction was caused mainly by a decrease in the total numbers of animals. However, in the case of dairy cows the reduction of animals is partly counterbalanced by an increase in emissions per animal (because of the increasing gross energy intake and milk production of milk cattle since 1990). Uncertainties of emissions were estimated with a 'Monte Carlo' simulation. Assuming a normal probability distribution, the calculated standard deviation is 4 %. This indicates there is a 95 % probability that CH 4 emissions are between ± 2 standard deviations, i.e. between 153.000 t and 178.000 t in the year 1990 and between 138.000 t and 162.000 t in the year 2001. (author)
Ventilator-associated pneumonia (VAP) is a common cause of morbidity in critically ill patients. Appropriate enteral feeding is the most important factor associated with the prevention of VAP. However, the standardization of enteral feeding methods needs clarification. The purpose of this systematic review was to synthesize the factors associated with enteral feeding in order to prevent VAP and to describe the characteristics of these factors. A comprehensive search was undertaken involving a...
optimal timing of the initiation of parenteral nutrition, all agree that the enteral route should be used as the first option, provided that the gut is functional.2,4-8 The concept of early enteral feeding (EEF) refers to the initiation of enteral nutrition within the first 24-48 hours post injury.4-9 Advantages of this approach include a ...
Madoshi, B; Lupindu, A. M.; Mtambo, MMA
This study explored risk factors associated with episodes of enteric disease in animal waste handlers as occupational hazards in Tanzania. A qualitative survey involving 124 animal waste handlers from Morogoro peri-urban and urban areas was carried out. Large number of respondents (84) had.......2 %). The handlers who had experienced enteric episodes were found to be those who had little knowledge on occupational hazards (p=0.000 and OR=20.5), limited knowledge on enteric zoonotic pathogens (p=0.019 and OR = 8.62), and experience on handling cattle wastes was statistically associated with enteric episodes...
Nasiri, Morteza; Farsi, Zahra; Ahangari, Mojtaba; Dadgari, Fahimeh
BACKGROUND Recent trials have shown controversial results on which enteral feeding methods has a lower risk of enteral feeding intolerance. Therefore, we aimed to compare two methods of bolus and intermittent feeding on enteral feeding intolerance of patients with sepsis. METHODS This triple-blind randomized controlled trial was conducted on 60 patients with sepsis, who were fed through tubes for at least 3 days. The patients were randomly assigned into bolus feeding, intermittent feeding, and control groups. Enteral feeding intolerance of all patients was recorded in 3 consecutive days by a researcher-made checklist including the data on gastric residual volume, vomiting, diarrhea, constipation, and abdominal distension. RESULTS There were no significant differences between the three studied groups in none of the intervention days pertaining to constipation, diarrhea, vomiting, abdominal distention, and gastric residual volume ( p > 0.05). Also, no statistically significant difference was found between all variables in the three studied groups during the 3 days ( p > 0.05). CONCLUSION As enteral feeding intolerance of patients with sepsis was similar in both bolus and intermittent feeding methods, it can be concluded that bolus method can still be used as a standard method to decrease the risk of enteral feeding intolerance if it is used properly.
Full Text Available Background: Malnutrition often occurs in a critical patient caused by various things such as decreasing function of gastrointestinal tract, high process of catabolism and homeostatie destruction. Other problem that may occur when nutrition is given with high total calories could be dangerous because it could cause hiperglikemia, the production improvement of CO blood and worsen the homeostasis destruction. Objective: To find out the difference of PaCO blood in critical patients who obtain commercial enteral food diet or combined enteral food diet. Methods: This was an experimental study using randomized controlled trial with pretest-posttest control group design. The subjects were critical patients who were given care in the intensive installation Dr. Sardjito hospital Yogyakarta who met the criteria: adult patient, using ventilator and receiving enteral food diet. Results: There was no difference between PaCO blood in critical patient who obtained commercial enteral diet and com- bined enteral food diet. There was a change difference of PaCO with 55% compared with <55% from energy total (p=0.03. Conclusion: The improvement of PaCO was not caused by the type of enteral formula given, cause of the high intake of energy and carbohydrate.
Feng, Jianli; Dong, Lingling; Zhang, Jing; Han, Xiaolei; Tang, Shi; Song, Lin; Cong, Lin; Wang, Xiang; Wang, Yongxiang; Du, Yifeng
KIBRA has been recognized as a memory-related gene, which is abundant in the brain and kidney of mammals. However, the expression pattern of KIBRA in the "second brain"-enteric nervous system (ENS) is still unknown, especially in neurodegenerative disorders. In this study, we aimed to investigate the detailed expression pattern of KIBRA in the intestinal myenteric nerve plexus of APP/PS1 and wild type mice by whole mount staining technology. The deposition of Aβ and increased levels of phosphorylated Tau (p-Tau) and total Tau (T-Tau) protein were observed in the intestinal myenteric nerve plexus of APP/PS1 mice. Interestingly, the amount of Tuj+ cells remained unchanged between these two groups. Compared to the control mice, the protein levels of KIBRA significantly increased in the jejunal myenteric plexus of APP/PS1 mice, and the proportion of KIBRA+ GABAergic neurons in both the jejunal myenteric nerve plexus and the cortex was much higher in the APP/PS1 mice. But there was no significant difference in the number of KIBRA+ cholinergic neurons and KIBRA+ nitrergic neurons between APP/PS1 and wild type mice. In summary, our study further confirmed that typical pathology features of Alzheimer's disease (AD) not only existed in the central nervous system but also in the ENS. Copyright © 2018. Published by Elsevier B.V.
Buden, D.; Angelo, J.A. Jr.; Lapin, S.
Nuclear systems are key to the success of many space missions as we have witness in the Apollo science packages, Viking Mars landers, and Pioneer and Voyager planetary exploration missions. There is always a concern that nuclear materials will re-enter the biosphere from a mission abort. In fact, this has happened for radioisotope and reactor power systems. Until now, the emphasize has been an incorporating on-board means to protect the biosphere. With possible increased use of nuclear power and propulsion systems in space, Project SIREN (Search, Intercept, Retrieve, Expulsion, Nuclear) has determined that external means can be used as a back up to current on-board systems to provide assured prevention of nuclear materials from re-entry once in space. The technology base to implement a SIREN vehicle has been assessed and a data base and mission analysis program prepared (called THOR) to evaluate various missions. The degree of hazard from existing nuclear power systems in space has been assessed and found to be significant
Gombash, S E; Cowley, C J; Fitzgerald, J A; Lepak, C A; Neides, M G; Hook, K; Todd, L J; Wang, G-D; Mueller, C; Kaspar, B K; Bielefeld, E C; Fischer, A J; Wood, J D; Foust, K D
Characterization of adeno-associated viral vector (AAV) mediated gene delivery to the enteric nervous system (ENS) was recently described in mice and rats. In these proof-of-concept experiments, we show that intravenous injections of clinically relevant AAVs can transduce the ENS in guinea pigs and non-human primates. Neonatal guinea pigs were given intravenous injections of either AAV8 or AAV9 vectors that contained a green fluorescent protein (GFP) expression cassette or phosphate-buffered saline. Piglets were euthanized three weeks post injection and tissues were harvested for immunofluorescent analysis. GFP expression was detected in myenteric and submucosal neurons along the length of the gastrointestinal tract in AAV8 injected guinea pigs. GFP-positive neurons were found in dorsal motor nucleus of the vagus and dorsal root ganglia. Less transduction occurred in AAV9-treated tissues. Gastrointestinal tissues were analyzed from young cynomolgus macaques that received systemic injection of AAV9 GFP. GFP expression was detected in myenteric neurons of the stomach, small and large intestine. These data demonstrate that ENS gene delivery translates to larger species. This work develops tools for the field of neurogastroenterology to explore gut physiology and anatomy using emerging technologies such as optogenetics and gene editing. It also provides a basis to develop novel therapies for chronic gut disorders.
Romano-García, Judit; Fernández-Morera, Juan Luis
Enteral nutrition (EN) is based on administration of liquid solutions into the gastrointestinal tract using a tube. After identifying unsolved practical difficulties in administration of EN using volume syringes, a new device to overcome such technical difficulties was proposed. Specific technologies (CAD, 3D printing) were used in collaboration with the PRODINTEC Foundation (Gijón, Asturias). Clarke Modet, a law firm specialized in intellectual property, provided legal advice on formulas for legal protection of the invention. The resulting device is a manual pump for infusion of EN to patients that solves previously identified problems and is highly functional and compact. It would allow for comfortable and safe administration of solutions. Integration of a bottle into the device itself and pump dimensions facilitate transport and patient mobility. According to the described configuration, this invention has many advantages over the previously known procedures, such as a simpler administration within the field of intermittent EN, improving the standard nutritional support technique, which in this case is use of volume syringes. This would facilitate the work of caregivers while promoting patient self-care and autonomy. The pump was accredited novelty of design, inventive activity and industrial exploitation potential by the European Patent Office (EPO), to which a patent has been requested. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.
Full Text Available Along with banning of antibiotics, necrotic enteritis (NE, especially subclinical NE (SNE whereby no clinical signs are present in chicks, has become one of the most threatening problems in poultry industry. Therefore, increasing attention has been focused on research and application of effective probiotic strains, as an alternative to antibiotics, to prevent SNE in broilers. In the present study, we evaluated the effects of Lactobacillus johnsonii BS15 on the prevention of SNE in broilers. Specifically, assessment determined the growth performance and indexes related to intestinal mucosal immunity in the ileum and cecal tonsil of broilers. A total of 300 1-day-old Cobb 500 chicks were randomly distributed into the following 5 groups: control group (fed with basal diet + de Man, Rogosa, and Sharpe liquid medium [normal diet], SNE group (normal diet, BS15 group (basal diet + 1 × 106 colony-forming units BS15/g as fed [BS15 diet], treatment group (normal diet [days 1–28] + BS15 diet [days 29–42], and prevention group (BS15 diet [days 1–28] + normal diet [days 29–42] throughout a 42-day experimental period. SNE infection was treated for all chicks in the SNE, BS15, treatment, and prevention groups. The present results demonstrated that BS15 supplementation of feeds in BS15 and prevention groups exerted a positive effect on preventing negative influences on growth performance; these negative influences included low body weight gain and increased feed conversion ratio caused by SNE. Although no changes were detected in all determined indexes in cecal tonsils, BS15-treated broilers were free from SNE-caused damage in villi in the ileum. BS15 inhibited SNE-caused decrease in immunoglobulins in the ileum. In the lamina propria of ileum, T cell subsets of lymphocytes influenced by SNE were also controlled by BS15. BS15 affected antioxidant abilities of the ileum and controlled SNE-induced mitochondrion-mediated apoptosis by
Jamali, Payman; Fotouhi, Akbar; Hashemi, Hassan; Younesian, Masud; Jafari, Alireza
To determine the prevalence of amblyopia, strabismus, and refractive errors in children entering school. In this cross-sectional population-based study, 6-year-old children enrolling in Shahrood schools were randomly sampled. Those with organic blindness or mental retardation were excluded. Ocular alignment, visual acuity, stereopsis, cover testing, and cycloplegic refraction were recorded for all children by an optometrist. A diagnosis of amblyopia was based on a best-corrected visual acuity of 6/12 or less in one or both eyes, or a bilateral difference of at least two best-corrected visual acuity lines. A total of 902 children were invited for optometry examinations, among which 827 (91.7%) responded and 815 children (98.5%) were included in the study. The prevalence of significantly reduced visual acuity (uncorrected VA amblyopia was 3.6 and 1.7%, respectively. The prevalence of hyperopia (+2.00 D or worse), myopia (-0.50 D or worse), astigmatism (0.75 D or worse), and anisometropia (1.00 D or more) were 20.5, 1.7, 19.6, and 2.2%, respectively. Significant refractive error, defined as hyperopia >+3.50 D, myopia >-3.00 D, astigmatism >1.50 D in the orthogonal meridian or >1.00 D in the oblique meridian, or anisometropia (hyperopic >1.00 D, myopic >3.00 D) was detected in 2.1, 0.1, 5.0, and 0.9% of the sample, respectively. Strabismus was diagnosed in 1.2% of children. Overall, 52 children (6.4%; 95% confidence interval [CI], 4.7-8.1%) were at risk of amblyopia; of these, 81% had significant refractive errors, 11% had strabismus, and 8% had both. A considerable proportion of 6-year-old children have strabismus and/or significant, potentially amblyogenic refractive errors. The relatively high rate of hyperopia and astigmatism in the studied population needs more attention. The results of the study emphasize the need for adequate diagnostic and therapeutic eye care services for preschool children.
Hirneisen, Kirsten A; Kniel, Kalmia E
With increasing outbreaks of gastroenteritis associated with produce, it is important to assess interventions to reduce the risk of illness. UV, ozone and high pressure are non-thermal processing technologies that have potential to inactivate human pathogens on produce and allow the retention of fresh-like organoleptic properties. The objective of this study was to determine if UV, ozone, and high pressure are effective technologies compared to traditional chlorine spray on green onions to reduce enteric viral pathogens and to determine the effect of location of the virus (surface or internalized) on the efficacy of these processes. Mature green onion plants were inoculated with murine norovirus (MNV), hepatitis A virus (HAV) and human adenovirus type 41 (Ad41) either on the surface through spot inoculation or through inoculating contaminated hydroponic solution allowing for uptake of the virus into the internal tissues. Inoculated green onions were treated with UV (240 mJ s/cm(2)), ozone (6.25 ppm for 10 min), pressure (500 MPa, for 5 min at 20°C), or sprayed with calcium hypochlorite (150 ppm, 4°C). Viral inactivation was determined by comparing treated and untreated inoculated plants using cell culture infectivity assays. Processing treatments were observed to greatly affect viral inactivation. Viral inactivation for all three viruses was greatest after pressure treatment and the lowest inactivation was observed after chlorine and UV treatment. Both surface inoculated viruses and viruses internalized in green onions were inactivated to some extent by these post-harvest processing treatments. These results suggest that ozone and high pressure processes aimed to reduce the level of microbial contamination of produce have the ability to inactivate viruses if they become localized in the interior portions of produce. © 2013.
Gulack, Brian C; Laughon, Matthew M; Clark, Reese H; Burgess, Terrance; Robinson, Sybil; Muhammad, Abdurrauf; Zhang, Angela; Davis, Adrienne; Morton, Robert; Chu, Vivian H; Arnold, Christopher J; Hornik, Christoph P; Smith, P Brian
To assess the effect of enteral feeding with human milk on the time from initiation of feeds to discharge after gastroschisis repair through review of a multi-institutional database. Infants who underwent gastroschisis repair between 1997 and 2012 with data recorded in the Pediatrix Medical Group Clinical Data Warehouse were categorized into 4 groups based on the percentage of days fed human milk out of the number of days fed enterally. Cox proportional hazards regression modeling was performed to determine the adjusted effect of human milk on the time from initiation of feeds to discharge. Among 3082 infants, 659 (21%) were fed human milk on 0% of enteral feeding days, 766 (25%) were fed human milk on 1%-50% of enteral feeding days, 725 (24%) were fed human milk on 51%-99% of enteral feeding days, and 932 (30%) were fed human milk on 100% of enteral feeding days. Following adjustment, being fed human milk on 0% of enteral feeding days was associated with a significantly increased time to discharge compared with being fed human milk on 100% of enteral feeding days (hazard ratio [HR] for discharge per day, 0.46; 95% CI, 0.40-0.52). The same was found for infants fed human milk on 1%-50% of enteral feeding days (HR, 0.37; 95% CI, 0.32-0.41) and for infants fed human milk on 51%-99% of enteral feeding days (HR, 0.51; 95% CI, 0.46-0.57). The use of human milk for enteral feeding of infants following repair of gastroschisis significantly reduces the time to discharge from initiation of feeds. Copyright © 2016 Elsevier Inc. All rights reserved.
Aiyappan, Senthil Kumar; Kalra, Naveen; Sandhu, Manavjit Singh; Kochhar, Rakesh; Wig, Jai Dev; Khandelwal, Niranjan
Objective: To compare neutral and positive enteral contrast media for MDCT enteroclysis (MDCTE) in various small bowel diseases. Materials and methods: 40 patients with suspicion of small bowel diseases were divided randomly into two equal groups. In one group, water was used as neutral enteral contrast and in other group, 2% water soluble iodinated contrast was used as positive enteral contrast. All MDCTE were done on a 16-slice multidetector row CT unit. The findings of MDCTE were compared with the standards of reference. Results: There were 12 cases of abdominal tuberculosis (30%), 5 cases of bowel masses (12%), 4 cases of Crohn's disease (10%), 3 cases of small bowel adhesions (7%), 2 cases of midgut volvulus (5%), 2 cases of segmental enteritis (5%) and 12 of all cases (30%) were normal. There was no statistically significant difference between neutral and positive enteral contrast with regards to bowel distention, contrast reflux and evaluation of duodenum. Abnormal bowel wall enhancement was appreciated only with use of neutral enteral contrast (n = 12). Evaluation of ileocaecal junction was possible in all 20 patients (100%) with positive enteral contrast but in only 17 patients (85%) with neutral enteral contrast. Overall sensitivity and specificity of MDCTE with use of neutral contrast medium (100 and 88% respectively) was greater for evaluation of small bowel diseases, when compared to MDCTE using positive enteral contrast medium (92.8 and 83.3% respectively). Conclusions: Water is a good enteral contrast medium for MDCT enteroclysis examination and allows better evaluation of abnormal bowel wall enhancement. Ileocaecal junction evaluation is better with positive enteral contrast medium.
Homann, H H; Kemen, M; Fuessenich, C; Senkal, M; Zumtobel, V
Gastrointestinal side effects, particularly diarrhea, are still the main reasons for discontinuation of enteral nutrition. Although the causes of diarrhea are diverse, the enteral nutrition solution is frequently suspected of playing a leading role in causing diarrhea. Our randomized, prospective, double-blind trial with 100 patients assessed the effects of feeding a standard diet (Nutrodrip Standard) vs the same diet supplemented with 20 g of soluble fiber, containing partially hydrolyzed guar gum (Sunfiber), per 1000 mL. Thirty patients received total enteral nutrition postoperatively, and 70 patients received enteral supplementation. The patients receiving total enteral nutrition with soluble fiber had decreased diarrhea but increased flatulence. In none of these patients did enteral feeding have to be discontinued because of gastrointestinal side effects, whereas in four patients who were on a standard diet, enteral feeding had to be interrupted because of diarrhea (p < .05). Similar observations were made in patients receiving enteral supplementation. In both groups, the incidence of diarrhea decreased significantly with the soluble fiber diet compared with the standard diet (6 vs 15, p < .05). Enteral feeding with a formula supplemented with partially hydrolyzed guar gum reduces the incidence of diarrhea in patients receiving total enteral nutrition as well as in those receiving enteral supplementation, regardless of the cause of diarrhea. The increased hydrogen production and the significantly higher rate of flatulence are likely to result from fermentation of the soluble fiber in the colon, with concomitant production of short-chain fatty acids, which leads to increased absorption of short-chain fatty acids, sodium, and water by the colonocytes. This effect, together with the observed cholecystokinin-mediated decrease in colonic transit time with partially hydrolyzed guar gum, may explain the reduction in the incidence of diarrhea in this study.
Gold, Gregg J.; Nguyen, Alyssa T.
Use of marijuana and alcohol among current college students (N = 1101) was compared to the perceptions and use of entering freshmen (N = 481) surveyed before the start of classes. Entering freshmen significantly misperceived campus norms for marijuana use, over-estimating that almost every student used in the last 30 days, p less than 0.001.…
Glenn, Gregory M; Francis, David H; Danielsen, E Michael
unexpectedly broad protective effects against LT(+) ETEC and mixed infections when using a toxin-based enteric vaccine. If toxins truly exert barrier-disruptive effects as a key step in pathogenesis, then a return to classic toxin-based vaccine strategies for enteric disease is warranted and can be expected...... to have unexpectedly broad protective effects....
Yu, Yan-Bo; Li, Yan-Qing
The intestinal epithelium constitutes a physical and functional barrier between the external environment and the host organism. It is formed by a continuous monolayer of intestinal epithelial cells maintained together by intercellular junctional complex, limiting access of pathogens, toxins and xenobiotics to host tissues. Once this barrier integrity is disrupted, inflammatory disorders and tissue injury are initiated and perpetuated. Beneath the intestinal epithelial cells lies a population of astrocyte-like cells that are known as enteric glia. The morphological characteristics and expression markers of these enteric glia cells were identical to the astrocytes of the central nervous system. In the past few years, enteric glia have been demonstrated to have a trophic and supporting relationship with intestinal epithelial cells. Enteric glia lesions and/or functional defects can be involved in the barrier dysfunction. Besides, factors secreted by enteric glia are important for the regulation of gut barrier function. Moreover, enteric glia have an important impact on epithelial cell transcriptome and induce a shift in epithelial cell phenotype towards increased cell adhesion and cell differentiation. Enteric glia can also preserve epithelial barrier against intestinal bacteria insult. In this review, we will describe the current body of evidence supporting functional roles of enteric glia on intestinal barrier.
Clostridium perfringens – associated necrotic enteritis causes significant losses and increased morbidity in poultry. The objective of this study was to evaluate the effect of bismuth citrate and acidifiers on the development of necrotic enteritis in broilers. The first study was a dose response t...
Rationale and key points Nasogastric tube feeding is a method of enteral feeding commonly administered by nurses. Feed can be administered either using a volumetric enteral feeding pump (pump feeding) or via an enteral syringe (bolus feeding). This article explains how nurses can safely undertake these two methods of nasogastric tube feed administration at the patient's bedside. » Nasogastric tube feeding can be used to provide some or all of the patient's nutrition, fluid or medication. » Nurses should be equipped with the relevant knowledge to flush a nasogastric tube before the administration of feed or medication; set up and administer an enteral feed via a volumetric enteral feeding pump; and set up and administer a feed using a bolus method. » The position of the distal tip of the nasogastric tube must be confirmed as sitting in the patient's stomach before the tube is used to administer enteral feed, fluid or medication. Reflective activity 'How to' articles can help you update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of: 1. How you think this article will change your practice when setting up and administering an enteral feed via a nasogastric tube. 2. How you could use this resource to educate your colleagues about nasogastric tube feeding via an enteral feeding pump or bolus feeding.
Campylobacter is the leading cause of foodborne enteritis worldwide and is primarily caused by consumption/mishandling of contaminated poultry. Probiotic use in poultry has been an effective strategy in reducing many enteric pathogens, but has not demonstrated consistent reduction against Campylobac...
Poult Enteritis Mortality Syndrome (PEMS) of turkeys and Runting-Stunting Syndrome (RSS) of chickens are significant viral enteric diseases of poultry. Although a number of different viruses, including avian reoviruses, rotaviruses, astroviruses and coronaviruses, have been isolated from the intesti...
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Binder, E. (Ellen); D. Natarajan (Dipa); J.E. Cooper (Julie E.); Kronfli, R. (Rania); Cananzi, M. (Mara); J.-M. Delalande (Jean-Marie); C. Mccann; A.J. Burns (Alan); N. Thapar (Nikhil)
textabstractObjectives Enteric neural stem cells provide hope of curative treatment for enteric neuropathies. Current protocols for their harvesting from humans focus on the generation of 'neurospheres' from cultures of dissociated gut tissue. The study aims to better understand the derivation,
Fentz Haastrup, Peter; Grønlykke, Thor; Jarbøl, Dorte Ejg
Low-dose acetylsalicylic acid (ASA) is widely used as antithrombotic prophylaxis. Enteric coated ASA has been developed in order to decrease the risk of gastrointestinal side effects. The consequences of enteric coating on pharmacokinetics and antiplatelet effect of ASA have not systematically been...
Full Text Available Abstract Background There is paucity of published data on the microfilarial infection among migrants from endemic countries entering Kuwait. The primary objectives of this study were to use routine health surveillance data to i to estimate the prevalence of microfilarial infection in migrant workers to Kuwait and ii to determine the occurrence of any time trends in the proportions of microfilaria positives among these workers over the recent past. Methods Monthly aggregates of microfilaria thick slide test results obtained from routine health examinations of migrant workers conducted at the Ports and Border Health Division of Ministry of Health, Kuwait between January 1, 1992 and December 31, 2006, were available for trend analysis of these time series data. Results During the study period, the prevalence (per 100,000 of microfilaraemia positive migrant workers was 48 (1169/2449360. A third-order polynomial regression model of monthly proportions of microfilaraemic workers revealed a significant initial increase (βˆ1 MathType@MTEF@5@5@+=feaafiart1ev1aaatCvAUfKttLearuWrP9MDH5MBPbIqV92AaeXatLxBI9gBaebbnrfifHhDYfgasaacPC6xNi=xH8viVGI8Gi=hEeeu0xXdbba9frFj0xb9qqpG0dXdb9aspeI8k8fiI+fsY=rqGqVepae9pg0db9vqaiVgFr0xfr=xfr=xc9adbaqaaeGaciGaaiaabeqaaeqabiWaaaGcbaGafqOSdiMbaKaadaWgaaWcbaGaeGymaedabeaaaaa@2EA2@ = 2.976 (± 0.157; P βˆ2 MathType@MTEF@5@5@+=feaafiart1ev1aaatCvAUfKttLearuWrP9MDH5MBPbIqV92AaeXatLxBI9gBaebbnrfifHhDYfgasaacPC6xNi=xH8viVGI8Gi=hEeeu0xXdbba9frFj0xb9qqpG0dXdb9aspeI8k8fiI+fsY=rqGqVepae9pg0db9vqaiVgFr0xfr=xfr=xc9adbaqaaeGaciGaaiaabeqaaeqabiWaaaGcbaGafqOSdiMbaKaadaWgaaWcbaGaeGOmaidabeaaaaa@2EA4@ = -0.0358 (± 0.002; P βˆ3 MathType@MTEF@5@5@+=feaafiart1ev1aaatCvAUfKttLearuWrP9MDH5MBPbIqV92AaeXatLxBI9gBaebbnrfifHhDYfgasaacPC6xNi=xH8viVGI8Gi=hEeeu0xXdbba9frFj0xb9qqpG0dXdb9aspeI8k8fiI+fsY=rqGqVepae9pg0db9vqaiVgFr0xfr=xfr=xc9adbaqaaeGaciGaaiaabeqaaeqabiWaaaGcbaGafqOSdiMbaKaadaWgaaWcbaGaeG4mamdabeaaaaa@2EA6@ = 0.0001 (± P Conclusion This
Branscomb, Lewis M.
Reviews aspects of technology in our society: technology as a force for social change; reasons for the frustration and dissatisfaction with technology; how technology decentralizes power; the individual's influence; resolving conflicts in the ionized" society; regulation of technology; corporate responsibility; and the potential pitfalls for the…
The United Kingdom's Department for International Development (DFID) has entered into a partnership with IDRC's Information and Communication Technology for Development (ICT4D) program area in support of research that improves livelihood opportunities, enhances social service delivery and empowers citizens in ...
Synthesizes opinions of experts regarding technologies deemed most likely to enter the telecommunications mainstream by 1998, including: (1) the Java programming language; (2) voice- over frame relay; (3) virtual local area networks (LANs); (4) cable modems; (5) gigabit LANs; (6) Internet appliances; (7) personal satellite phones; (8) intranets;…
Elipot, Yannick; Legendre, Laurent; Père, Stéphane; Sohm, Frédéric; Rétaux, Sylvie
Astyanax mexicanus, a teleost fish comprising both sighted river-dwelling and blind cave-dwelling morphs, is becoming increasingly used in the field of developmental and evolutionary biology. Thus, new experimental and technological tools are needed on this emerging fish model by the expanding scientific community. Here, we describe Astyanax husbandry and egg spawning habits, a prerequisite to the successful establishment of Astyanax transgenic lines. We then compare two different transgenesis methods on both surface and cave Astyanax. Both meganuclease (I-SceI)- and transposase (Tol2)-mediated transgenesis are equivalently efficient, resulting in ∼40% mosaic transgenic fish in F0. Furthermore, the transmission rate was analyzed in F1 in the case of the I-SceI method and was found to be 16%. Finally, the transgene was found stable up the F3 generation, demonstrating the feasibility of generating stable transgenic lines in Astyanax and opening a wide range of possibilities for this fish model.
Full Text Available The Open Skies Treaty has been a peace-building instrument between North American and European nations for over two decades. This agreement is based on the possibility for each country-signatory of the Treaty to independently conduct observation flights and obtain aerial imagery data of the territories of other Treaty States-Parties. This imagery data was originally acquired only using traditional photographic film cameras. Together with the rapid development and advancement of digital sensor technologies, the logical step forward was to amend the Treaty provisions to allow for the use of these types of sensors during observation missions. This paper describes this transition process and highlights a number of technical problems which needed to be addressed by experts working within the Open Skies Consultative Commission workgroups.
Background: The nutritional status of cancer patients is frequently impaired already before any therapy starts and may deteriorate even more by radio(chemo)therapy. Methods: This review describes the possibilities and risks of enteral and parenteral nutrition during radiotherapy. The indications of enteral nutrition will be derived from own results. Results: Enteral nutrition is the most preferable way of artificial long-term nutrition. In a prospective non-randomized trial we demonstrated that enteral nutrition via percutaneous endoscopic gastrostomy (PEG) not only improves the anthropometric and biochemical parameters during radio(chemo)therapy but also the quality of life of patients with advanced cancers of the head and neck. Moreover supportive use of megestrolacetate can improve the nutritional status. Parenteral nutrition is only recommended if enteral nutrition is not possible e.g. during radio(chemo)therapy of tumors of the upper gastrointestinal tract. Conclusions: Today adequate nutritional support is feasible during intensive radio(chemo)therapy. (orig.) [de
Ruby, E. G.; Morin, J. G.
Three taxa of luminous bacteria (Photobacterium fischeri, P. phosphoreum, and Beneckea spp.) were found in the enteric microbial populations of 22 species of surface- and midwater-dwelling fishes. These bacteria often occurred in concentrations ranging between 105 and 107 colony-forming units per ml of enteric contents. By using a genetically marked strain, it was determined that luminous cells entering the fish during ingestion of seawater or contaminated particles traversed the alimentary tract and survived the digestive processes. After excretion, luminous bacteria proliferated extensively on the fecal material and became distributed into the surrounding seawater. Thus, this enteric habitat may serve as an enrichment of viable cells entering the planktonic luminous population. PMID:16345429
Ruby, E G; Morin, J G
Three taxa of luminous bacteria (Photobacterium fischeri, P. phosphoreum, and Beneckea spp.) were found in the enteric microbial populations of 22 species of surface- and midwater-dwelling fishes. These bacteria often occurred in concentrations ranging between 10 and 10 colony-forming units per ml of enteric contents. By using a genetically marked strain, it was determined that luminous cells entering the fish during ingestion of seawater or contaminated particles traversed the alimentary tract and survived the digestive processes. After excretion, luminous bacteria proliferated extensively on the fecal material and became distributed into the surrounding seawater. Thus, this enteric habitat may serve as an enrichment of viable cells entering the planktonic luminous population.
Hristov, Alexander N; Oh, Joonpyo; Giallongo, Fabio; Frederick, Tyler; Weeks, Holley; Zimmerman, Patrick R; Harper, Michael T; Hristova, Rada A; Zimmerman, R Scott; Branco, Antonio F
Ruminant animals (domesticated or wild) emit methane (CH4) through enteric fermentation in their digestive tract and from decomposition of manure during storage. These processes are the major sources of greenhouse gas (GHG) emissions from animal production systems. Techniques for measuring enteric CH4 vary from direct measurements (respiration chambers, which are highly accurate, but with limited applicability) to various indirect methods (sniffers, laser technology, which are practical, but with variable accuracy). The sulfur hexafluoride (SF6) tracer gas method is commonly used to measure enteric CH4 production by animal scientists and more recently, application of an Automated Head-Chamber System (AHCS) (GreenFeed, C-Lock, Inc., Rapid City, SD), which is the focus of this experiment, has been growing. AHCS is an automated system to monitor CH4 and carbon dioxide (CO2) mass fluxes from the breath of ruminant animals. In a typical AHCS operation, small quantities of baiting feed are dispensed to individual animals to lure them to AHCS multiple times daily. As the animal visits AHCS, a fan system pulls air past the animal's muzzle into an intake manifold, and through an air collection pipe where continuous airflow rates are measured. A sub-sample of air is pumped out of the pipe into non-dispersive infra-red sensors for continuous measurement of CH4 and CO2 concentrations. Field comparisons of AHCS to respiration chambers or SF6 have demonstrated that AHCS produces repeatable and accurate CH4 emission results, provided that animal visits to AHCS are sufficient so emission estimates are representative of the diurnal rhythm of rumen gas production. Here, we demonstrate the use of AHCS to measure CO2 and CH4 fluxes from dairy cows given a control diet or a diet supplemented with technical-grade cashew nut shell liquid.
Full Text Available Introduction. For the treatment of exocrine pancreatic insufficiency (EPI it is recommended enzyme replacement therapy with high-dose enteric-coated preparations. In this regard, the question arises about the rationale of clinical application of the older low-dose non enteric-coated enzyme preparations (as a reference drug served Mezim® forte. Results. A number of anatomical and physiological characteristics and active use of suppressants of gastric secretion — proton pump inhibitors, antacids (sodium bicarbonate — allows significantly to increase the «survival» of pancreatic enzymes that do not contain enteric coating in gastric juice and their delivery to the duodenum. This formulation is used for the relief of pain in case of chronic pancreatitis (enteric-coated preparations are uneffective. It was proposed to use a combination of two dosage forms — enteric-coated and non enteric-coated — for more effective therapy EPI. In functional diseases of the gastrointestinal tract (irritable bowel syndrome with functional disorders of the pancreas, functional dyspepsia non enteric-coated enzyme preparations speeds recovery of patients. In inflammatory bowel disease (ulcerative colitis, Crohn’s disease and chronic obstructive pulmonary disease, this formulation increases the duration of remission, and in case of inflammatory bowel disease — also the quality of life during remission. Non enteric-coated enzyme preparations are used in a number of other diseases associated with maldigestion/malabsorption. Additionally, they are used for the gradual cessation of therapy by high-dose enzyme preparations. They also find application for the correction of EPI during snacks and some gaps in the diet. Financial sales figures indicate a high demand for low-dose non enteric-coated enzyme preparations (Mezim® forte. Conclusions. Low-dose non enteric-coated enzyme preparations are still widely used in current clinical practice.
... Page Resize Text Printer Friendly Online Chat Assistive Technology Assistive technology (AT) is any service or tool that helps ... be difficult or impossible. For older adults, such technology may be a walker to improve mobility or ...
Full Text Available Technology is transforming the games themselves and at times with dire consequences. Tony Kirkbride, Head: CSIR Technology Centre said there are a variety of sports technologies and there have been advances in material sciences and advances...
Full Text Available Entering an Information and Comunication Technologies (ICTs redefines the communication ways and the use of knowledge among students and between students and teachers. Joining the high-tech pedagogies demands for the teacher to relocate himself in light of the technological model embodied in ICTs incorporated to their classes. This investigation is framed in a case study that aspires to reconstruct the intervention of a Physics teacher's practice when incorporating applets to his classes. In order to know the state of art in the relationship between teachers and new technologies a bibliographic revision is carried out. It is possible to infer the need to keep company the teachers while they are implementing technologies in their practice.
National Aeronautics and Space Administration — Develop and mature rover technologies supporting robotic exploration including rover design, controlling rovers over time delay and for exploring . Technology...
Lee, In Sik
This book is introduction of nano technology, which describes what nano technology is, alpha and omega of nano technology, the future of Korean nano technology and human being's future and nano technology. The contents of this book are nano period is coming, a engine of creation, what is molecular engineering, a huge nano technology, technique on making small things, nano materials with exorbitant possibility, the key of nano world the most desirable nano technology in bio industry, nano development plan of government, the direction of development for nano technology and children of heart.
Full Text Available Aspirin is apt to hydrolyze. In order to improve its stability, a new method has been developed involving the application of hot-melt sub- and outercoating combined with enteric aqueous coating. The main aim was to investigate the influence of these factors on the stability of ASA and understand how they work. Satisfactory storage stability were obtained when the aspirin tablet core coated with Eudragit L30D55 film was combined with glycerin monostearate (GMS as an outercoat. Hygroscopicity testing indicated that the moisture penetrating into the tablet may result in a significant change in the physical properties of the coating film observed by scanning electron microscopy. Investigation of the compatibility between the drug and film excipients shows that the talc and methacrylic acid had a significant catalytic effect on ASA. A hypothesis was proposed that the hydrolysis of ASA enteric coated tablets (ASA-ECT was mostly concentrated in the internal film and the interfaces between the film and tablet core. In conclusion, hot-melt coating technology is an alternative to subcoating or outercoating. Also, GMS sub-coating was a better choice for forming a stable barrier between the tablet core and the polymer coating layer, and increases the structure and chemical stability.
Full text: As a result of an aging workforce at US federal agencies and federal contractors’ workforce, it is projected that over 20% of the current workforce will be retiring over the next decade. Typically, the institutional knowledge and technical expertise is possessed by senior staff members approaching retirement. In many instances, this knowledge is lost once the employee retires; therefore, creating a huge gap in knowledge and knowledge transfer to new employees joining the workforce. Companies and federal agencies should develop methods to not only maintain the corporate knowledge and technical expertise, but also a transfer this valuable knowledge to the next generation of scientist, engineer and technicians entering the workforce. For example, Florida International University supports DOE-EM’s knowledge transfer through the DOE Fellows STEM programme and the development of international technology platform such as the Knowledge Management Information Tool for nuclear decommissioning (KM-IT). This paper will discuss the knowledge transfer issues faced by federal agencies and federal contractors and innovative tools to capture, store, maintain, and transfer the knowledge to the new generation of scientists, engineers and technicians entering the workplace. (author
The end of the Cold War finds the international community no longer divided into two opposing blocks. The concerns that the community now faces are becoming more fluid, less focused, and, in many ways, much less predictable. Issues of religion, ethnicity, and nationalism; the possible proliferation of Weapons of Mass Destruction; and the diffusion of technology and information processing throughout the world community have greatly changed the international security landscape in the last decade. Although our challenges appear formidable, the United Nations, State Parties, nongovernmental organizations, and the arms control community are moving to address and lessen these concerns through both formal and informal efforts. Many of the multilateral agreements (e.g., NPT, BWC, CWC, CTBT, MTCR), as well as the bilateral efforts that are taking place between Washington and Moscow employ confidence-building and transparency measures. These measures along with on-site inspection and other verification procedures lessen suspicion and distrust and reduce uncertainty, thus enhancing stability, confidence, and cooperation
The end of the Cold War finds the international community no longer divided into two opposing blocks. The concerns that the community now faces are becoming more fluid, less focused, and, in many ways, much less predictable. Issues of religion, ethnicity, and nationalism; the possible proliferation of Weapons of Mass Destruction; and the diffusion of technology and information processing throughout the world community have greatly changed the international security landscape in the last decade. Although our challenges appear formidable, the United Nations, State Parties, nongovernmental organizations, and the arms control community are moving to address and lessen these concerns through both formal and informal efforts. Many of the multilateral agreements (e.g., NPT, BWC, CWC, CTBT, MTCR), as well as the bilateral efforts that are taking place between Washington and Moscow employ confidence-building and transparency measures. These measures along with on-site inspection and other verification procedures lessen suspicion and distrust and reduce uncertainty, thus enhancing stability, confidence, and cooperation.
Carolina Justus Buhrer Ferreira Neto
Full Text Available Abstract Objective: to analyze the impact of guidelines regarding errors in medications prescribed for administration through enteral tubes. Method: quantitative study, in three phases, undertaken in internal medicine, neurology and an intensive care unit in a general teaching hospital. In Phase 1, the following was undertaken: a protocol for dilution and unit-dose repackaging and administration for 294 medications via enteral tubes; a decision flowchart; operational-standard procedures for dilution and unit-dose repackaging of oral pharmaceutical forms and for administration of medications through enteral tubes. In phase 2, errors in 872 medications prescribed through enteral tubes, in 293 prescriptions for patients receiving inpatient treatment between March and June, were investigated. This was followed by training of the teams in relation to the guidelines established. In Phase 3, pharmaceutical errors and interventions in 945 medications prescribed through enteral tubes, in 292 prescriptions of patients receiving inpatient treatment between August and September, were investigated prospectively. The data collected, in a structured questionnaire, were compiled in the Microsoft Office Excel(r program, and frequencies were calculated. Results: 786 errors were observed, 63.9% (502 in Phase 2, and 36.1% (284 in Phase 3. In Phase 3, a reduction was ascertained in the frequency of prescription of medications delivered via enteral tubes, medications which were contraindicated, and those for which information was not available. Conclusion: guidelines and pharmaceutical interventions were determined in the prevention of errors involving medications delivered through enteral tubes.
Boesmans, Werend; Lasrado, Reena; Vanden Berghe, Pieter; Pachnis, Vassilis
Enteric glial cells are vital for the autonomic control of gastrointestinal homeostasis by the enteric nervous system. Several different functions have been assigned to enteric glial cells but whether these are performed by specialized subtypes with a distinctive phenotype and function remains elusive. We used Mosaic Analysis with Double Markers and inducible lineage tracing to characterize the morphology and dynamic molecular marker expression of enteric GLIA in the myenteric plexus. Functional analysis in individually identified enteric glia was performed by Ca(2+) imaging. Our experiments have identified four morphologically distinct subpopulations of enteric glia in the gastrointestinal tract of adult mice. Marker expression analysis showed that the majority of glia in the myenteric plexus co-express glial fibrillary acidic protein (GFAP), S100β, and Sox10. However, a considerable fraction (up to 80%) of glia outside the myenteric ganglia, did not label for these markers. Lineage tracing experiments suggest that these alternative combinations of markers reflect dynamic gene regulation rather than lineage restrictions. At the functional level, the three myenteric glia subtypes can be distinguished by their differential response to adenosine triphosphate. Together, our studies reveal extensive heterogeneity and phenotypic plasticity of enteric glial cells and set a framework for further investigations aimed at deciphering their role in digestive function and disease. © 2014 Wiley Periodicals, Inc.
Amin, Irum; Butler, Andrew J; Defries, Gail; Russell, Neil K; Harper, Simon J F; Jah, Asif; Saeb-Parsy, Kourosh; Pettigrew, Gavin J; Watson, Christopher J E
Exocrine drainage following pancreas transplantation can be achieved by drainage into the bladder or bowel, the latter typically by direct duodeno-jejunostomy; the use of Roux-en-Y enteric drainage is uncommon. We report a retrospective analysis of a single-centre experience of Roux-en-Y enteric drainage following pancreas transplantation. Over a 14-year period (2001-2015), 204 consecutive adult pancreas transplants were performed (96.6% simultaneous pancreas and kidney transplants), of which 26.0% were from donors after circulatory death (DCD). During a median follow-up of 67 months (range 13-183 months), 14 (6.9%) recipients experienced complications related to their enteric drainage. Complications during follow-up included early enteric anastomotic haemorrhage (five patients), non-anastomotic enteric bleeding (one patient), small bowel obstruction (four patients) and graft duodenal perforation (two within 6 weeks, five beyond 12 months). No recipient lost their graft as a direct result of complications related to enteric drainage. Patient and pancreas graft survival at 1 year was 99.0% and 94.0% and at 5 years 91.3% and 84.9%, respectively. We conclude that Roux-en-Y enteric drainage following pancreas transplantation is a safe and effective procedure and facilitates graft salvage in the event of graft duodenal perforation. © 2017 Steunstichting ESOT.
Full Text Available The innervations of the large intestine is responsible for it peristalsis and contractibility. Investigations of the enteric nervous system in many colon diseases have revealed changes in this structure. No study has been carried out on morphological changes of the enteric nervous system in the human large intestine with carcinoma. The aim of this study was to investigate potential changes in the structure of the enteric neurons in patients with sigmoid and rectal cancer. Material for the study was obtained from patients undergoing operations due to carcinoma of the sigmoid colon and rectum. Microscopic observation of the cancerous tumor of the human large intestine revealed changes in the enteric nervous system innervating this part of the gastrointestinal tract. In the region of the enteric plexuses located close to the tumour, disruption of their correct placement and structure was observed. The changes also consisted of the disappearance of neurons and nerve fibers forming these plexuses. In the solid cancerous tumour, elements of the enteric nervous system were not present. Destruction of the enteric nervous system in the course of carcinoma of the large intestine may cause disruption of proper intestinal function and may be responsible for part of symptoms which the patients suffer.
Jeong, Woo Seong; Song, Hyun Joo; Na, Soo Young; Boo, Sun Jin; Kim, Heung Up; Kim, Jinseok; Choi, Guk Myung
Ischemic enteritis is caused by either the interruption or significant reduction of arterial inflow to the small intestine. Risk factors are old age, diabetes mellitus and cardiovascular disease. It is very rare in young patients. We experienced a 21-year-old man with recurrent acute ischemic enteritis who was diagnosed with capsule endoscopy. He had previously taken medications for pulmonary hypertension and obstruction of both carotid arteries, and about 20 months earlier, he had been admitted due to hematochezia. Two sessions of angiography did not reveal the cause of hematochezia. At that time, capsule endoscopy showed mucosal edema and erythema in the terminal ileum, suggesting healed ischemic enteritis. The patient was admitted again due to hematochezia. Abdominal computed tomography showed focal celiac trunk stenosis and diffuse wall thickening of the small intestine, suggesting ischemic enteritis. Capsule endoscopy showed multiple active ulcers and severe hemorrhage with exudate, extending from the proximal jejunum to the terminal ileum. Using capsule endoscopy, the patient was diagnosed with acute extensive ischemic enteritis. Because endoscopic images of ischemic enteritis have rarely been reported, we report a case of a 21-year-old man who was diagnosed acute extensive ischemic enteritis with capsule endoscopy.
Volkova, Victoriya V.; Lanzas, Cristina; Lu, Zhao; Gröhn, Yrjö Tapio
Antimicrobial use in food animals may contribute to antimicrobial resistance in bacteria of animals and humans. Commensal bacteria of animal intestine may serve as a reservoir of resistance-genes. To understand the dynamics of plasmid-mediated resistance to cephalosporin ceftiofur in enteric commensals of cattle, we developed a deterministic mathematical model of the dynamics of ceftiofur-sensitive and resistant commensal enteric Escherichia coli (E. coli) in the absence of and during parenteral therapy with ceftiofur. The most common treatment scenarios including those using a sustained-release drug formulation were simulated; the model outputs were in agreement with the available experimental data. The model indicated that a low but stable fraction of resistant enteric E. coli could persist in the absence of immediate ceftiofur pressure, being sustained by horizontal and vertical transfers of plasmids carrying resistance-genes, and ingestion of resistant E. coli. During parenteral therapy with ceftiofur, resistant enteric E. coli expanded in absolute number and relative frequency. This expansion was most influenced by parameters of antimicrobial action of ceftiofur against E. coli. After treatment (>5 weeks from start of therapy) the fraction of ceftiofur-resistant cells among enteric E. coli, similar to that in the absence of treatment, was most influenced by the parameters of ecology of enteric E. coli, such as the frequency of transfer of plasmids carrying resistance-genes, the rate of replacement of enteric E. coli by ingested E. coli, and the frequency of ceftiofur resistance in the latter. PMID:22615803
Full Text Available At the moment when, in October 1341, a new Civil War broke out in the Byzantium after the death of Andronicus III, the traditional views of the imperial power and the Empire underwent considerable changes. The powers of the co-rulers had been on the rise since 1272, and during the Civil War of 1321-1328 the Byzantine Empire was in effect divided, that is, two Basileis were ruling 'imperially' (autokratorikōs over their respective territories within the formally unified Empire, under the scope of relations of Superior basileus - co-basileus. Therefore, the Empire (autokratoria, imperium could multiply in the sense of rulers’ authorities, and be divided in the sense of territoriality. The imperial power and the Empire became subject to family relations and family law. In view of the family connections between the Byzantine Emperors (basileis autokratores and the monarchs of the neighboring countries and nations, the right to succession was being used as an argument in some disputes between the rulers. The Byzantine law, that is the Byzantine political views, allowed for the possibility of the so-called 'joint rule' (e oikeia arch by a Byzantine basileus autokrator and some other, foreign member of the dynasty ruling over certain region of the Byzantine Empire - a foreign ruler would be allowed to rule on condition that the Byzantine basileus be recognized as the supreme master. This scenario is known from one recorded dispute between the Byzantine basileus Andronicus III and the Bulgarian tsar Michael Assen III dating from 1328, when the Bulgarian Emperor did not accept the Byzantine rule, however. All these circumstances are of special importance since they directly precede the King Stefan Dušan’s involvement in the Civil War, that is, his later entering into the Empire. The first phase of Dušan’s involvement in the Civil War is typically conquering and opportunistic in nature, with the aim of immediate territorial enlargement. The
Costantini, Todd W; Bansal, Vishal; Krzyzaniak, Michael; Putnam, James G; Peterson, Carrie Y; Loomis, William H; Wolf, Paul; Baird, Andrew; Eliceiri, Brian P; Coimbra, Raul
The enteric nervous system may have an important role in modulating gastrointestinal barrier response to disease through activation of enteric glia cells. In vitro studies have shown that enteric glia activation improves intestinal epithelial barrier function by altering the expression of tight junction proteins. We hypothesized that severe injury would increase expression of glial fibrillary acidic protein (GFAP), a marker of enteric glial activation. We also sought to define the effects of vagal nerve stimulation on enteric glia activation and intestinal barrier function using a model of systemic injury and local gut mucosal involvement. Mice with 30% total body surface area steam burn were used as model of severe injury. Vagal nerve stimulation was performed to assess the role of parasympathetic signaling on enteric glia activation. In vivo intestinal permeability was measured to assess barrier function. Intestine was collected to investigate changes in histology; GFAP expression was assessed by quantitative PCR, by confocal microscopy, and in GFAP-luciferase transgenic mice. Stimulation of the vagus nerve prevented injury-induced intestinal barrier injury. Intestinal GFAP expression increased at early time points following burn and returned to baseline by 24 h after injury. Vagal nerve stimulation prior to injury increased GFAP expression to a greater degree than burn alone. Gastrointestinal bioluminescence was imaged in GFAP-luciferase transgenic animals following either severe burn or vagal stimulation and confirmed the increased expression of intestinal GFAP. Injection of S-nitrosoglutathione, a signaling molecule released by activated enteric glia cells, following burn exerts protective effects similar to vagal nerve stimulation. Intestinal expression of GFAP increases following severe burn injury. Stimulation of the vagus nerve increases enteric glia activation, which is associated with improved intestinal barrier function. The vagus nerve may mediate the
Fried, David E; Watson, Ralph E; Robson, Simon C; Gulbransen, Brian D
Impaired gut motility may contribute, at least in part, to the development of systemic hyperammonemia and systemic neurological disorders in inherited metabolic disorders, or in severe liver and renal disease. It is not known whether enteric neurotransmission regulates intestinal luminal and hence systemic ammonia levels by induced changes in motility. Here, we propose and test the hypothesis that ammonia acts through specific enteric circuits to influence gut motility. We tested our hypothesis by recording the effects of ammonia on neuromuscular transmission in tissue samples from mice, pigs, and humans and investigated specific mechanisms using novel mutant mice, selective drugs, cellular imaging, and enzyme-linked immunosorbent assays. Exogenous ammonia increased neurogenic contractions and decreased neurogenic relaxations in segments of mouse, pig, and human intestine. Enteric glial cells responded to ammonia with intracellular Ca 2+ responses. Inhibition of glutamine synthetase and the deletion of glial connexin-43 channels in hGFAP :: Cre ER T2+/- /connexin43 f/f mice potentiated the effects of ammonia on neuromuscular transmission. The effects of ammonia on neuromuscular transmission were blocked by GABA A receptor antagonists, and ammonia drove substantive GABA release as did the selective pharmacological activation of enteric glia in GFAP::hM3Dq transgenic mice. We propose a novel mechanism whereby local ammonia is operational through GABAergic glial signaling to influence enteric neuromuscular circuits that regulate intestinal motility. Therapeutic manipulation of these mechanisms may benefit a number of neurological, hepatic, and renal disorders manifesting hyperammonemia. NEW & NOTEWORTHY We propose that local circuits in the enteric nervous system sense and regulate intestinal ammonia. We show that ammonia modifies enteric neuromuscular transmission to increase motility in human, pig, and mouse intestine model systems. The mechanisms underlying the
Full Text Available The consequences at the family level of having a child with enteric stoma have been a matter of deep concern in the nursing practice. This type of stoma is performed in children as an adjunctive procedure in the treatment of a congenital, pathological and traumatic problem but there is evidence to suggest that this functional change has an impact on different aspects of everyday family life. Objective: To identify evidence in the literature on the impact of enteric stoma (ileostomy and colostomy for the child and for his family. Method: A literature review of 14 research projects which address the experiences of the Family and the child with ostomy located in the Cinahl, Medline, Ovid, Proquest, Lilacs, and Dedalus databases. Result: through the analysis it may be concluded that, although health professionals believe that stomata are a technology of low complexity, for child and family they do not have the same meaning, because they alter the lifestyle and the family’s dynamics. Conclusions: test results indicated there is need for understanding the subject, in order to contribute in building knowledge, aimed at implementing interventions that consider the impact of stoma on the child and on his family. Las consecuencias para la familia de tener un hijo con estoma entérico han sido objeto de numerosas inquietudes en la práctica de enfermería. Este tipo de estoma se realiza en los niños como un procedimiento coadyuvante en el tratamiento de un problema de origen congénito, patológico o traumático, pero hay evidencias que indican que esta modificación funcional tiene impacto en diferentes aspectos de la vida cotidiana de la familia. Objetivo: identificar las evidencias en la literatura médica sobre el impacto de un estoma entérico (ileostomía y colostomía para el niño y su
The consequences at the family level of having a child with enteric stoma have been a matter of deep concern in the nursing practice. This type of stoma is performed in children as an adjunctive procedure in the treatment of a congenital, pathological and traumatic problem but there is evidence to suggest that this functional change has an impact on different aspects of everyday family life.
Objective: To identify evidence in the literature on the impact of enteric stoma (ileostomy and colostomy for the child and for his family.
Method: A literature review of 14 research projects which address the experiences of the Family and the child with ostomy located in the Cinahl, Medline, Ovid, Proquest, Lilacs, and Dedalus databases.
Result: through the analysis it may be concluded that, although health professionals believe that stomata are a technology of low complexity, for child and family they do not have the same meaning, because they alter the lifestyle and the family’s dynamics.
Conclusions: test results indicated there is need for understanding the subject, in order to contribute in building knowledge, aimed at implementing interventions that consider the impact of stoma on the child and on his family.
Las consecuencias para la familia de tener un hijo con estoma entérico han sido objeto de numerosas inquietudes en la práctica de enfermería. Este tipo de estoma se realiza en los niños como un procedimiento coadyuvante en el tratamiento de un problema de origen congénito, patológico o traumático, pero hay evidencias que indican que esta modificación funcional tiene impacto en diferentes aspectos de la vida cotidiana de la familia.
Objetivo: identificar las evidencias en la literatura médica sobre el impacto de un estoma entérico (ileostomía y colostomía para el niño y su
ão bibliográfica de 14 pesquisas que abrangem as vivências da família e da criança ostomizada, localizadas nos bancos de dados Cinahl, Medline, Ovid, Proquest, Lilacs e Dedalus. Resultados: mediante a análise realizada podemos concluir que, embora os profissionais da saúde considerem que os estomas são uma tecnologia de baixa complexidade, não significa o mesmo para a criança e a família, pois o procedimento altera o estilo de vida e a dinâmica familiar. Conclusões: os resultados da análise demonstram a necessidade de compreender melhor o tema, visando contribuir para a construção de conhecimento, voltados para a implementação de intervenções que considerem o impacto do estoma sobre a criança e sua família.The consequences at the family level of having a child with enteric stoma have been a matter of deep concern in the nursing practice. This type of stoma is performed in children as an adjunctive procedure in the treatment of a congenital, pathological and traumatic problem but there is evidence to suggest that this functional change has an impact on different aspects of everyday family life. Objective: To identify evidence in the literature on the impact of enteric stoma (ileostomy and colostomy for the child and for his family. Method: A literature review of 14 research projects which address the experiences of the Family and the child with ostomy located in the Cinahl, Medline, Ovid, Proquest, Lilacs, and Dedalus databases. Result: through the analysis it may be concluded that, although health professionals believe that stomata are a technology of low complexity, for child and family they do not have the same meaning, because they alter the lifestyle and the family’s dynamics. Conclusions: test results indicated there is need for understanding the subject, in order to contribute in building knowledge, aimed at implementing interventions that consider the impact of stoma on the child and on his family.
Heidegger, Claudia-Paula; Thibault, Ronan; Berger, Mette M; Pichard, Claude
Undernutrition is a widespread problem in the intensive care and is associated with a worse clinical outcome. Enteral nutrition is the recommended nutritional support in ICU patients. However, enteral nutrition is frequently insufficient to cover protein-energy needs. The initiation of supplemental parenteral nutrition, when enteral nutrition is insufficient, could optimize the nutritional therapy. Such a combination could allow reducing morbidity, length of stay and recovery, as well as improving quality of life and health care costs. Prospective studies are currently underway to test this hypothesis.
Hawthorne, A B; Mahida, Y R; Cole, A T; Hawkey, C J
1. Gastric damage induced by low-dose aspirin and the protective effect of enteric-coating was assessed in healthy volunteers in a double-blind placebo-controlled cross-over trial using Latin square design. Each was administered placebo, plain aspirin 300 mg daily, plain aspirin 600 mg four times daily, enteric-coated aspirin 300 mg daily, or enteric-coated aspirin 600 mg four times daily for 5 days. Gastric damage was assessed endoscopically, and gastric mucosal bleeding measured. 2. Aspirin...
Chiu, Alexander S; Bluhm, David; Xiao, Shu-Yan; Waxman, Irving; Matthews, Jeffrey B
Pancreas-associated enteric duplication cysts are rare developmental anomalies that communicate with the main pancreatic duct and may be associated with recurrent acute and chronic abdominal pain in children. In adults, these lesions may masquerade as pancreatic pseudocysts or pancreatic cystic neoplasms. An adult patient with a pancreas-associated enteric duplication is described which represents the first reported instance of association with both chronic calcific pancreatitis and pancreatic cancer. The clinical spectrum of pancreas-associated enteric duplication cyst, including diagnostic and therapeutic options, is reviewed.
Full Text Available The authors provided modern information on the basic noninvasive methods to assess the inflammatory process in the intestine in crohn's disease and colitis gravis. The researchers thoroughly described the opportunities and limitations for the use of faecal calprotectin as a marker of the inflammatory enteric diseases. Importance of this marker for the differential diagnostics of the inflammatory and functional enteric diseases has been shown.Key words: markers of the enteric inflammation, faecal calprotectin, inflammatory bowel diseases, colitis gravis, сrohn's disease.
Full Text Available The authors studied the opportunities to define the level of faecal calprotectin in diagnostics of the inflammatory enteric diseases (grohn's disease and colitis gravis among children. It was established that children, suffering from the inflammatory enteric diseases, the concentration of faecal calprotectin increases, thus, correlating with the clinical and endoscopic activity of the disease, as well as with the spread of the intestinal impairment. Faecal calprotectin may be a reliable marker of the inflammation activity in the event of grohn's disease and colitis gravis.Key words: faecal calprotectin, inflammatory enteric diseases, colitis gravis, grohn's disease, diagnostics, children.
Full Text Available At universities, educating students on real-life practices is one of the key drivers in a changing academic environment. Academic institutions encourage the study of the learning environment and ensure that appropriate strategies are in place for educating students. A first-year Accounting I student stated the importance of computerised accounting: ‘Computerised accounting is used in the workplace and therefore using it in varsity, grants students a view on how things will be after completion of their respective degrees.’ Accordingly, the purpose of this study was to empirically investigate the perceived acquisition of information technology (IT knowledge and determine the skills required for students to convert the knowledge gained into actions as a learning curve for accounting students entering the business world. The results indicated that students’ knowledge of Accounting I increased with the integration of computerised Accounting in the Accounting I Curriculum.
The first wave delivered a range of services to most areas of the world through a vast, carefully constructed global network. Cellular technology ...Information Technology and Services Alliance. Digital Planet 2002: The Global Information Economy. February 2002. Yegyazarian, Anush. Sales Taxes...Information Technology ABSTRACT: The information technology (IT) industry affects virtually every industry in the n economy. During the late 90
Guarnieri, F.; Travadel, S.
terms of methodology, we take an interdisciplinary approach driven by a narrative analysis tool for designing cognitive models, which is useful for the analysis and exploration of phenomena. The approach is comparative and rooted in the contextual examination of cases; theory is developed using a process that iterates between empirical data and concepts from a broad range of disciplines (sociology, history, philosophy, science and technology studies). Our work shows the need to go beyond a purely cognitive sensemaking approach, and integrate the macro and meso scales, the material context and the embodied dimension of the making of sense. We propose an interpretative model that integrates these aspects and captures the transition from a ‘normal’ situation to a crisis. We also identify some initial lessons in terms of the management of extreme situations and propose some avenues for future research. (author)
In the development of advanced technologies, there are several forces which are involved in the success of the development of those technologies. In the overall development of new technologies, a sufficient number of these forces must be present and working in order to have a successful opportunity at developing, introducing and integrating into the marketplace a new technology. This paper discusses some of these forces and how they enter into the equation for success in advanced technology research, development, demonstration, commercialization and deployment. This paper limits itself to programs which are generally governmental funded, which in essence represent most of the technology development efforts that provide defense, energy and environmental technological products. Along with the identification of these forces are some suggestions as to how changes may be brought about to better ensure success in a long term to attempt to minimize time and financial losses
Kim, Jin Su
This book is composed of five chapters, which introduces electronic technology about understanding of electronic, electronic component, radio, electronic application, communication technology, semiconductor on its basic, free electron and hole, intrinsic semiconductor and semiconductor element, Diode such as PN junction diode, characteristic of junction diode, rectifier circuit and smoothing circuit, transistor on structure of transistor, characteristic of transistor and common emitter circuit, electronic application about electronic equipment, communication technology and education, robot technology and high electronic technology.
Environmental enteric dysfunction (EED), a condition characterized by small intestine inflammation and abnormal gut permeability, is widespread in children in developing countries and a major cause of growth failure. The pathophysiology of EED remains poorly understood. We measured serum metabolite...
Borade, S.; Dhawde, R.; Maloo, A.; Gajbhiye, S.N.; Ram, A.; Dastager, S.G.
In present study, the prevalence of enteric bacterial indicators like Escherichia coli, Salmonella, Shigella, Proteus, Klebsiella, Vibrio cholerae and Vibrio parahaemolyticus like organism in water and sediment of Veraval coast were studied at six...
Turner, Ann; Ngwira, Bagrey; Witte, Desiree; Mwapasa, Mphatso; Dove, Winifred; Cunliffe, Nigel
Rotavirus is a leading cause of acute gastro-enteritis in infants and young children worldwide. Previous studies of rotavirus gastro-enteritis in Malawi have documented a high disease burden with an extensive diversity of circulating rotavirus strains. In anticipation of the introduction of national rotavirus vaccination, a 2-year surveillance study was undertaken in 2008 and 2009 of children in Blantyre seeking hospital care for acute gastro-enteritis. Rotavirus was detected in faecal specimens by ELISA. Rotavirus G and P types were determined by RT-PCR. Rotavirus, which circulated throughout the year, was detected in 220/720 (31%) children. Over 85% of patients with rotavirus gastro-enteritis were Blantyre. Together with previous observations, the findings contribute to a baseline of data against which the impact of future rotavirus vaccination in Malawi can be assessed.
Full Text Available Gene probes developed locally for both enteric Adenoviruses 40 and 41 were used to determine whether these viruses were present in both raw and treated waters. Approximately sixty water samples were concentrated by ultra filtration and analysed...
Stamp, L A; Young, H M
As current options for treating most enteric neuropathies are either non-effective or associated with significant ongoing problems, cell therapy is a potential attractive possibility to treat congenital and acquired neuropathies. Studies using animal models have shown that following transplantation of enteric neural progenitors into the bowel of recipients, the transplanted cells migrate, proliferate, and generate neurons that are electrically active and receive synaptic inputs. Recent studies have transplanted human enteric neural progenitors into the mouse colon and shown engraftment. In this article, we summarize the significance of these recent advances and discuss priorities for future research that might lead to the use of regenerative medicine to treat enteric neuropathies in the clinic. © 2016 John Wiley & Sons Ltd.
Volkova, Victoriya V; Lu, Zhao; Lanzas, Cristina; Scott, H Morgan; Gröhn, Yrjö T
The ubiquitous commensal bacteria harbour genes of antimicrobial resistance (AMR), often on conjugative plasmids. Antimicrobial use in food animals subjects their enteric commensals to antimicrobial pressure. A fraction of enteric Escherichia coli in cattle exhibit plasmid-gene mediated AMR to a third-generation cephalosporin ceftiofur. We adapted stochastic differential equations with diffusion approximation (a compartmental stochastic mathematical model) to research the sources and roles of stochasticity in the resistance dynamics, both during parenteral antimicrobial therapy and in its absence. The results demonstrated that demographic stochasticity among enteric E. coli in the occurrence of relevant events was important for the AMR dynamics only when bacterial numbers were depressed during therapy. However, stochasticity in the parameters of enteric E. coli ecology, whether externally or intrinsically driven, contributed to a wider distribution of the resistant E. coli fraction, both during therapy and in its absence, with stochasticities in individual parameters interacting in their contribution.
Heyneman, LE; Keogan, MT; Tuttle-Newhall, JE; Porte, RJ; Leder, RA; Nelsen, RC
Purpose: To review the normal radiologic appearance of pancreatic transplants that use portal venous and enteric drainage, and to review the appearance of a variety of postoperative complications. Method: We retrospectively reviewed the computed tomographic (CT) scans, magnetic resonance (MR)
Willems, Rhea; Krych, Lukasz; Rybicki, Verena
AIM: To analyze how enteral food introduction affects intestinal gene regulation and chromatin structure in preterm pigs. MATERIALS & METHODS: Preterm pigs were fed parenteral nutrition plus/minus slowly increasing volumes of enteral nutrition. Intestinal gene-expression and chromatin structure...... were analyzed 5 days after birth. RESULTS: Enteral feeding led to differential upregulation of inflammatory and pattern recognition receptor genes, including IL8 (median: 5.8, 95% CI: 3.9-7.8 for formula; median: 2.2, 95% CI: 1.3-3.3 for colostrum) and TLR4 (median: 3.7, 95% CI: 2.6-4.8 for formula...... stimulation with lipopolysaccharide (median: 7.0; interquartile range: 5.63-8.85) compared with naive cells (median 4.2; interquartile range: 2.45-6.33; p = 0.03). CONCLUSION: Enteral feeding, particular with formula, induces subclinical inflammation in the premature intestine and more open chromatin...
Bruno, M. J.; Borm, J. J.; Hoek, F. J.; Delzenne, B.; Hofmann, A. F.; de Goeij, J. J.; van Royen, E. A.; van Gulik, T. M.; de Wit, L. T.; Gouma, D. J.; van Leeuwen, D. J.; Tytgat, G. N.
BACKGROUND: A comparative study was performed between patients with exocrine pancreatic insufficiency after conventional pancreatoduodenectomy (Whipple's procedure) and pylorus-preserving pancreatoduodenectomy (PPPD). In these patients the pharmacodynamics of 2-mm enteric-coated pancreatin
Pedrón-Giner, C.; Calderón Garrido, Caterina; Martínez-Zazo, A.; Cañedo-Villaroya, E.; Malillos González, P.; Sesmero-Lillo, M. A.
Background & aims: Home enteral nutrition is used increasingly in pediatric populations. Our objective was to describe the profile of pediatric patients requiring this treatment. Material and methods: All patients under 18 years old requiring treatment with home enteral nutrition between January 1995 and December 2004 were analyzed retrospectively. Results: 304 patients were studied (157 boys). The mean age at the start of treatment was 4.02 ± 4.09 years, median of 2.5 years; 28% of all patie...
... 34 Education 1 2010-07-01 2010-07-01 false What must the ALJ do if the parties enter settlement negotiations? 86.406 Section 86.406 Education Office of the Secretary, Department of Education DRUG AND ALCOHOL ABUSE PREVENTION Appeal Procedures § 86.406 What must the ALJ do if the parties enter settlement negotiations? (a) If the parties to a case...
Pani, Pier Paolo; Trogu, Emanuela; Vigna-Taglianti, Federica; Mathis, Federica; Diecidue, Roberto; Kirchmayer, Ursula; Amato, Laura; Davoli, Marina; Ghibaudi, Joli; Camposeragna, Antonella; Saponaro, Alessio; Faggiano, Fabrizio; Maremmani, Angelo Giovanni Icro; Maremmani, Icro
Background The relationship between substance use disorders and psychiatric pathology is still an open question. The main aim of the present study was to verify whether the five psychopathological dimensions identified through the SCL-90 tool in a previous study carried out on patients with heroin addiction entering an outpatient opioid agonist treatment (OAT) were also observable in those entering a residential treatment community (TC). Further aims were to look at differences in the psychop...
This thesis introduces the significant factors of market research and its importance when considering doing international business. Furthermore, it could be useful for investors who have same favour to enter Finnish market. The case company is Asian Snack FuLoi- a German food industry company looking for new market. The goal of this study was to investigate the possibility for a company to enter Finland in general and Greater Helsinki in particular. The thesis was structured with theor...
AWARD NUMBER: W81XWH-16-1-0676 TITLE: Defining the Role of Alpha-Synuclein in Enteric Dysfunction in Parkinson’s Disease PRINCIPAL...TITLE AND SUBTITLE 5a. CONTRACT NUMBER Defining the Role of Alpha-Synuclein in Enteric Dysfunction in Parkinson’s Disease 5b. GRANT NUMBER W81XWH-16...STATEMENT Approved for Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT The most recognizable feature of Parkinson’s disease (PD
Full Text Available Enteric duplication cysts lacking anatomic association with the gastrointestinal tract are called isolated enteric duplication cysts (IEDCs. We present an atypical case of a retroperitoneal IEDC with a tortuous tubular complex shape that enfolded the surrounding retroperitoneal fat and mimicked a retroperitoneal teratoma. Multiplanar reconstruction images should be used to evaluate such a lesion correctly. A tortuous tubular complex shape could be a key finding to differentiate from other retroperitoneal cysts.
Ojo, Omorogieva; Bowden, Julie
This article examines the infection risk to adult patients receiving home enteral nutrition (HEN) and strategies for its prevention and management. Enteral nutrition was historically associated with acute care settings owing to its invasive nature. The changing landscape of community care means that it is now likely to be administered in the patient’s home or in other community settings such as nursing homes. HEN is associated with two main routes of infection risks: the risk of gastrointesti...
Full Text Available Background: Adequate nutritional support is important for the comprehensive management of patients in intensive care units (ICUs. Aim: The study was aimed to survey prevalent enteral nutrition practices in the trauma intensive care unit, nurses′ perception, and their knowledge of enteral feeding. Study Design: The study was conducted in the ICU of a level 1 trauma center, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India. The study design used an audit. Materials and Methods: Sixty questionnaires were distributed and the results analyzed. A database was prepared and the audit was done. Results: Forty-two (70% questionnaires were filled and returned. A majority (38 of staff nurses expressed awareness of nutrition guidelines. A large number (32 of staff nurses knew about nutrition protocols of the ICU. Almost all (40 opined enteral nutrition to be the preferred route of nutrition unless contraindicated. All staff nurses were of opinion that enteral nutrition is to be started at the earliest (within 24-48 h of the ICU stay. Everyone opined that the absence of bowel sounds is an absolute contraindication to initiate enteral feeding. Passage of flatus was considered mandatory before starting enteral nutrition by 86% of the respondents. Everyone knew that the method of Ryle′s tube feeding in their ICU is intermittent boluses. Only 4 staff nurses were unaware of any method to confirm Ryle′s tube position. The backrest elevation rate was 100%. Gastric residual volumes were always checked, but the amount of the gastric residual volume for the next feed to be withheld varied. The majority said that the unused Ryle′s tube feed is to be discarded after 6 h. The most preferred (48% method to upgrade their knowledge of enteral nutrition was from the ICU protocol manual. Conclusion: Information generated from this study can be helpful in identifying nutrition practices that are lacking and may be used to review and revise enteral feeding
Schäppi, M G; Staiano, A; Milla, P J
OBJECTIVE: Primary gastrointestinal neuropathies are a heterogeneous group of enteric nervous system (ENS) disorders that continue to cause difficulties in diagnosis and histological interpretation. Recently, an international working group published guidelines for histological techniques and repo......OBJECTIVE: Primary gastrointestinal neuropathies are a heterogeneous group of enteric nervous system (ENS) disorders that continue to cause difficulties in diagnosis and histological interpretation. Recently, an international working group published guidelines for histological techniques...
Pinto,Raquel Oliveira Medrado; Correia,Eliznara Fernades; Pereira,Keyla Carvalho; Costa Sobrinho,Paulo de Souza; Silva,Daniele Ferreira da
Contamination of enteral diets represents a high risk of compromising the patient's medical condition. To assess the microbiological quality and aseptic conditions in the preparation and administration of handmade and industrialized enteral diets offered in a hospital in the Valley of Jequitinhonha, MG, Brazil, we performed a microbiological analysis of 50 samples of diets and 27 samples of surfaces, utensils, and water used in the preparation of the diets. In addition, we assessed the good h...
Heidegger, Claudia-Paula; Darmon, Patrice; Pichard, Claude
Current recommendations suggest starting enteral feeding as soon as possible whenever the gastrointestinal tract is functioning. The disadvantage of enteral support is that insufficient energy and protein coverage can occur. This review focuses on some recent findings regarding the nutritional support of critically ill patients and evaluates the data presented. An increasing nutritional deficit during a long ICU stay is associated with increased morbidity (infection rate, wound healing, mechanical ventilation, length of stay, duration of recovery), and costs. Evidence shows that enteral nutrition can result in underfeeding and that nutritional goals are frequently reached only after 1 week. Contrary to former beliefs, recent meta-analyses of ICU studies showed that parenteral nutrition is not related to a surplus mortality and may even be associated with improved survival. Early enteral nutrition is recommended for critically ill patients. Supplemental parenteral nutrition combined with enteral nutrition can be considered to cover the energy and protein targets when enteral nutrition alone fails to achieve the caloric goal. Whether such a combined nutritional support provides additional benefit on the overall outcome has to be proven in further studies on clinical outcome, including physical and cognitive functioning, quality of life, cost-effectiveness, and cost-utility.
Full Text Available Objective: To explore the changes and clinical significance of liver function and myocardial zymogram in children with rotavirus (RV enteritis. Methods: A total of 70 children with RV enteritis who were admitted in our hospital were included in the study and served as the observation group. The liver function and myocardial zymogram before and after treatment were detected. The proportion of RV enteritis children with liver and myocardial damage was calculated. The effect of dehydration on the liver function and myocardial zymogram in children with RV enteritis was analyzed. A total of 65 children with non-RV enteritis who were admitted in our hospital at the same stage were served as the control group. Results: The serum ALT, AST, CK, CK-MB, LDH, and α-HBDH levels, and liver myocardial damage children proportion in the observation group were significantly higher than those in the control group (P<0.05. The serum ALT, AST, CK, CK-MB, LDH, and α-HBDH levels in the observation group were significantly elevated with the acceleration of dehydration degree (P<0.05. In the observation group, 45 children had liver and myocardial damage, whose ALT, AST, CK, CKMB, LDH, and α-HBDH levels after treatment were significantly reduced when compared with before treatment (P<0.05. Conclusions: Early detection of liver function and myocardial zymogram can accurately reflect the condition in children with RV enteritis, which can provide an evidence for the formulation of clinical treatment protocol.
Gil-Almagro, Fernanda; Carmona-Monge, Francisco Javier
Enteral nutrition has a relatively low incidence of major complications. The most common complications are mechanical problems, bronchoaspiration and diarrhoea. A rare complication associated with the use of enteral nutrition is oesophageal bezoar. A bezoar is a body of undigested and partially digested matter in the gastrointestinal tract. The main risks factors are gastric motility dysfunction and the use of opiates or sucralfate. The aim of this paper was to present two cases of oesophageal obstruction resulting from the formation of bezoars due to enteral nutrition. Both patients experienced prolonged stays in the intensive care unit and were receiving enteral nutrition, and both cases involved an obstruction of the nasogastric tube and the regurgitation of solid chunks of enteral nutrition through the mouth and the nose. Impactions of solidified enteral nutrition in the distal parts of the oesophagus were confirmed with gastroscopies. Enzymatic complexes containing papain, cellulose, pancreatin, pepsin and diastase were used to successfully dissolve the bezoars in both cases. Copyright © 2015 Elsevier Ltd. All rights reserved.
Full Text Available Ulcerative enteritis or “quail disease” is an acute clostridial infection of young birds reported in many avian species, chicken and turkey included. Clostridium colinum is the causative agent of ulcerative enteritis and because of the difficulties bound to the isolation and identification of this bacterium by means of classic bacteriological techniques, its detection appears very hard and the prevalence of this disease could be underestimated. To investigate the diffusion of C. colinum in enteric disease of birds, a recently developed PCR protocol was applied to 42 cultural broths previously inoculated with organs and intestinal samples collected from diseased subjects. PCR-positive broths were cultivated to attempt the isolation of C. colinum. Samples collected from positive birds were subjected to histological examinations. 4 birds (3 broilers chickens and 1 pigeon resulted PCR-positive and, in one case, C. colinum was isolated. Gross and histological lesions of positive birds were compatible with those described in other ulcerative enteritis outbreaks. These preliminary results demonstrates that C. colinum is sporadically implicated in enteric diseases of broiler chickens (14.2%. In addition, the PCR assay proved to be an useful and reliable instrument to support the diagnosis of ulcerative enteritis and to facilitate the isolation of C. colinum.
Full Text Available This study aimed to research the preparation and content determination of capsaicin-chitosan microspheres (CCMS enteric coated tablets. The core tablets were prepared with the method of wet granulation. Nine formulae were designed to determine the optimal formula of the core tablet. Eudragit L100 was used to prepare the CCMS enteric-coated tablets. The effect of enteric coated formulation variables such as content of talc (10%, 25% and 40%, plasticisers (TEC and DBS, dosage of plasticiser (10%, 20% and 30% and coating weight (2%, 3% and 5% were evaluated for drug release characteristics. The in vitro release was studied using 0.1 N HCl and pH 6.8 phosphate buffer. Enteric coated tablets without ruptures or swelling behaviour over 2 h in 0.1 N HCl indicated that these tablets showed acid resistance. The accumulated release rate in phosphate buffer (pH 6.8 revealed that the prepared tablets were able to sustain drug release into the intestine and a first-order release was obtained for capsaicin. This research is the first report of the preparation and content determination of CCMS enteric coated tablets. The sustained release behavior of enteric coated formulations in pH 6.8 phosphate buffer demonstrated that it would be a potential drug delivery platform for sustained delivery of gastric irritant drugs.
Pinto, Raquel Oliveira Medrado; Correia, Eliznara Fernades; Pereira, Keyla Carvalho; Costa Sobrinho, Paulo de Souza; da Silva, Daniele Ferreira
Contamination of enteral diets represents a high risk of compromising the patient's medical condition. To assess the microbiological quality and aseptic conditions in the preparation and administration of handmade and industrialized enteral diets offered in a hospital in the Valley of Jequitinhonha, MG, Brazil, we performed a microbiological analysis of 50 samples of diets and 27 samples of surfaces, utensils, and water used in the preparation of the diets. In addition, we assessed the good handling practices of enteral diets according to the requirements specified by the Brazilian legislation. Both kinds of enteral diets showed contamination by coliforms and Pseudomonas spp. No sample was positive for Staphylococcus aureus and Salmonella spp. On the other hand, Listeria spp. was detected in only one sample of handmade diets. Contamination was significantly higher in the handmade preparations (p diet safety. The results indicate that the sanitary quality of the enteral diets is unsatisfactory, especially handmade diets. Contamination by Pseudomonas spp. is significant because it is often involved in infection episodes. With regard to aseptic practices, it was observed the need of implementing new procedures for handling enteral diets.
The Center for Environmental Technology's (CET) mission is to provide a fully integrated system for accelerated evaluation, development, commercialization, and public acceptance of creative environmental solutions which match the foremost demands in today's environmentally sensitive world. In short, CET will create a means to provide quick, effective solutions for environmental needs. To meet this mission objective, CET has created a unique and innovative approach to eliminating the usual barriers in developing and testing environmental technologies. The approach paves the way for these emerging, cutting-edge technologies by coordinating environmental restoration and waste management activities of industry, universities, and the government to: efficiently and effectively transfer technology to these users, provide market-driven, cost-effective technology programs to the public and DOE, and aid in developing innovative ideas by initiating efforts between DOE facilities and private industry. The central part to this mission is selecting and evaluating specific innovative technologies for demonstration and application at United States Department of Energy (DOE) installations. The methodology and criteria used for this selection, which is called the CET Innovative Technology Screening Process, is the subject of this paper. The selection criteria used for the screening process were modeled after other DOE technology transfer programs and were further developed by CET's Technology Screening and Evaluation Board (TSEB). The process benefits both CET and the proposing vendors by providing objective selection procedures based on predefined criteria. The selection process ensures a rapid response to proposing vendors, all technologies will have the opportunity to enter the selection process, and all technologies are evaluated on the same scale and with identical criteria
Josiel Paiva Vieira
Full Text Available PURPOSE: To compare the effect of parenteral versus enteral nutritional support in severe acute pancreatitis, with respect to efficacy, safety, morbidity, mortality and length of hospitalization. METHODS: The study was comprised of 31 patients, divided into a parenteral group (n=16 and an enteral group (n=15, who met severity criteria for abdominal tomography (Balthazar classes C, D, and E. The patients were compared by demographics, disease etiology, antibiotic prophylaxis, use or not of somatostatin, nutritional support, complications and disease progression. RESULTS: There was no statistical difference in the average duration of nutritional support, somatostatin, or antibiotics in the two groups. Imipenem was the drug of choice for prophylaxis of pancreatic infections in both groups. More complications occurred in the parenteral group, although the difference was not statistically significant (p=0.10. Infectious complications, such as catheter sepsis and infections of the pancreatic tissue, were significantly more frequent in the parenteral group (p=0.006. There was no difference in average length of hospitalization in the two groups. There were three deaths in the parenteral group and none in the enteral group. CONCLUSION: Enteral nutritional support is associated with fewer septic complications compared to parenteral nutritional support.OBJETIVO: Comparar o efeito do suporte nutricional parenteral versus enteral, em pancreatite aguda grave, com relação à eficácia, à segurança, à morbi-mortalidade e ao tempo de internação. MÉTODOS: Foram estudados 31 pacientes distribuídos em grupo parenteral (n=16, no período de 1995 a 1998 e grupo enteral (n=15, no período de 1999 a 2002, que preencheram os critérios de gravidade pela tomografia de abdome (Balthazar C,D,E. Os pacientes foram comparados quanto aos dados demográficos, etiologia, antibioticoprofilaxia, somatostatina, suporte nutricional, complicações e evolução. RESULTADOS
National Aeronautics and Space Administration — Aero-assist technologies are used to control the velocity of exploration vehicles (EV) when entering earth or other planetary atmospheres. Since entry of EVs in...
Le Berre-Scoul, Catherine; Chevalier, Julien; Oleynikova, Elena; Cossais, François; Talon, Sophie; Neunlist, Michel; Boudin, Hélène
Unlike astrocytes in the brain, the potential role of enteric glial cells (EGCs) in the formation of the enteric neuronal circuit is currently unknown. To examine the role of EGCs in the formation of the neuronal network, we developed a novel neuron-enriched culture model from embryonic rat intestine grown in indirect coculture with EGCs. We found that EGCs shape axonal complexity and synapse density in enteric neurons, through purinergic- and glial cell line-derived neurotrophic factor-dependent pathways. Using a novel and valuable culture model to study enteric neuron-glia interactions, our study identified EGCs as a key cellular actor regulating neuronal network maturation. In the nervous system, the formation of neuronal circuitry results from a complex and coordinated action of intrinsic and extrinsic factors. In the CNS, extrinsic mediators derived from astrocytes have been shown to play a key role in neuronal maturation, including dendritic shaping, axon guidance and synaptogenesis. In the enteric nervous system (ENS), the potential role of enteric glial cells (EGCs) in the maturation of developing enteric neuronal circuit is currently unknown. A major obstacle in addressing this question is the difficulty in obtaining a valuable experimental model in which enteric neurons could be isolated and maintained without EGCs. We adapted a cell culture method previously developed for CNS neurons to establish a neuron-enriched primary culture from embryonic rat intestine which was cultured in indirect coculture with EGCs. We demonstrated that enteric neurons grown in such conditions showed several structural, phenotypic and functional hallmarks of proper development and maturation. However, when neurons were grown without EGCs, the complexity of the axonal arbour and the density of synapses were markedly reduced, suggesting that glial-derived factors contribute strongly to the formation of the neuronal circuitry. We found that these effects played by EGCs were
Full Text Available Ventilator-associated pneumonia (VAP is a common cause of morbidity in critically ill patients. Appropriate enteral feeding is the most important factor associated with the prevention of VAP. However, the standardization of enteral feeding methods needs clarification. The purpose of this systematic review was to synthesize the factors associated with enteral feeding in order to prevent VAP and to describe the characteristics of these factors. A comprehensive search was undertaken involving all major databases from their inception to September 2008 using medical subject heading terms associated with enteral feeding in relation to VAP. The overall reference list of identified studies was audited, and eligible studies included randomized controlled trials, controlled before-and-after (pre–post studies and meta-analyses. To generate the characteristics of the factors associated with VAP, the reported components of these trials were pinpointed and categorized. A total of 14 papers were found that had investigated the factors linking enteral feeding and VAP. For these, 11 were randomized controlled trials, 1 was a meta-analysis and 2 were case-controlled analyses. Twelve of these 14 studies were conducted at a single institute and 2 were conducted at multiple institutes. The sample sizes varied from 10 to 2,528 subjects. Three major issues were identified based on the purpose of study interventions, and these were the effects of feeding method (continuous vs. intermittent, feeding site on aspiration (gastric vs. small bowel, and the timing of enteral feeding (early vs. late. The evidence suggests that a correct choice of enteral feeding method can effectively reduce complications due to aspiration. Furthermore, intermittent enteral feeding and with a small residual volume feed can reduce gastroesophageal reflux, and increased total intake volume and early feeding can reduce ICU mortality. Nonetheless, the effects of these choices on preventing VAP
Ventilator-associated pneumonia (VAP) is a common cause of morbidity in critically ill patients. Appropriate enteral feeding is the most important factor associated with the prevention of VAP. However, the standardization of enteral feeding methods needs clarification. The purpose of this systematic review was to synthesize the factors associated with enteral feeding in order to prevent VAP and to describe the characteristics of these factors. A comprehensive search was undertaken involving all major databases from their inception to September 2008 using medical subject heading terms associated with enteral feeding in relation to VAP. The overall reference list of identified studies was audited, and eligible studies included randomized controlled trials, controlled before-and-after (pre-post) studies and meta-analyses. To generate the characteristics of the factors associated with VAP, the reported components of these trials were pinpointed and categorized. A total of 14 papers were found that had investigated the factors linking enteral feeding and VAP. For these, 11 were randomized controlled trials, 1 was a meta-analysis and 2 were case-controlled analyses. Twelve of these 14 studies were conducted at a single institute and 2 were conducted at multiple institutes. The sample sizes varied from 10 to 2,528 subjects. Three major issues were identified based on the purpose of study interventions, and these were the effects of feeding method (continuous vs. intermittent), feeding site on aspiration (gastric vs. small bowel), and the timing of enteral feeding (early vs. late). The evidence suggests that a correct choice of enteral feeding method can effectively reduce complications due to aspiration. Furthermore, intermittent enteral feeding and with a small residual volume feed can reduce gastroesophageal reflux, and increased total intake volume and early feeding can reduce ICU mortality. Nonetheless, the effects of these choices on preventing VAP still need further
Lim, Kyoung Ja; Choi, Chul Soon; Yeun, Eun Joo; Seo, Young Lan; Lee, Il Sung; Yang, Ik; Whang, Woo Chul; Bae, Sang Hoon; Kang, Ik Won
To differentiate tuberculous enteritis and Crohn's disease with barium study using Bayes theory. The study group consisted of 34 patients with tuberculous enteritis (age range 16-86 years, mean age 43.3 years, M:F19:15) and 36 patients with Crohn's disease (age range 19-78 years, mean age 35.2 years, M:F= 18:18). These diagnoses were confirmed by therapeutic tests (tuberculous enteritis: 15, Crohn's disease:16) or histopathological examinations (tuberculous enteritis: 19, Crohn's disease: 20) conducted from January 1993 to May 2003. Three radiologists (two abdominal specialists and one trainee) analyzed each radiological finding of tuberculous enteritis and Crohn's disease by means of a barium enema and/or small bowel series. We used Fisher's exact test to verify the statistical significance of each radiological finding and p-values less than 0.05 were considered to be significant. We calculated the likelihood ratio (LR) of tuberculous enteritis versus Crohn's disease for each finding by employing Bayes theory. The radiological findings associated with a high likelihood ratio for tuberculous enteritis were the involvement of the cecum (LR= 2.65) and ascending colon (LR= 1.99), rigid narrowing (LR= 1.94), shortening of the bowel (LR= 1.99), haustral loss (LR= 1.97) and sacculation (LR= 3.88). The radiological findings associated with a high LR for Crohn's disease (low LR for tuberculous enteritis) were age between 20 and 29 years (LR = 0.53), the involvement of the jejunum (LR= 0.12), terminal ileum (LR= 0.19), sigmoid colon (LR= 0.30) or rectum (LR= 0.17), and the presence of skip lesions (LR0.19) or strictures (LR =0.21). With these LRs, the probability of the subject having tuberculous enteritis versus Crohn's disease could be calculated using Bayes theory. The analysis of a barium study using Bayes theory could provide an objective, easy and fast method of differentiating tuberculous enteritis and Crohn's disease
Technology and globalization are interdependent processes. Globalization has a fundamental influence on the creation and diffusion of technology, which, in turn, affects the interdependence of firms and locations. This volume examines the international aspect of this interdependence at two levels...
This book is aimed at anyone who is interested in learning more about living technology, whether coming from business, the government, policy centers, academia, or anywhere else. Its purpose is to help people to learn what living technology is, what it might develop into, and how it might impact...... our lives. The phrase 'living technology' was coined to refer to technology that is alive as well as technology that is useful because it shares the fundamental properties of living systems. In particular, the invention of this phrase was called for to describe the trend of our technology becoming...... increasingly life-like or literally alive. Still, the phrase has different interpretations depending on how one views what life is. This book presents nineteen perspectives on living technology. Taken together, the interviews convey the collective wisdom on living technology's power and promise, as well as its...
Hilton, Jason Theodore
As emerging technology continues to enter the social studies classroom, teachers need to approach integration of such technology in a systematic manner to ensure that such technology enhances the learning of their students. Currently, scholars of technology integration advocate for the use of one of two different models, either SAMR or TPACK. This…
In this article, we reflect on the conditions under which new technologies emerge in the Anthropocene and raise the question of how to conceptualize sustainable technologies therein. To this end, we explore an eco-centric approach to technology development, called biomimicry. We discuss opposing
A technology tier is a level in a product system: final product, system, subsystem, component, or part. As a concept, it contrasts traditional “vertical” special technologies (for example, mechanics and electronics) and focuses “horizontal” feature technologies such as product characteristics...
Rikhardsson, Pall M.
Information technology has changed, is changing and will continue to change the face of business as we further enter the Information Society. Today it would be difficult for a company to function effectively without the aid of various information technologies such as accounting software, production...... software, the Internet, computer networks, telecommunications devices, etc. Information technology also has an impact on how companies perform environmental management. This paper looks at the relations between corporate environmental management and information technology. First it presents a framework...... for mapping information technology. Using this framework it focuses on the use of information technology in corporate environmental management, describes the market for standard environmental management information systems and implementation experiences from one large international company....
Weenen, T C; Jentink, A; Pronker, E S; Commandeur, H R; Claassen, E; Boirie, Y; Singer, P
A quantitative systematic identification and prioritization of unmet needs and research opportunities in relation to enteral nutrition was conducted by means of a tailor-made health research prioritization process. The research objectives were reached by conducting qualitative interviews followed by quantitative questionnaires targeting enteral nutrition key opinion leaders (KOLs). (1) Define disease areas that deserve more research attention; (2) Rank importance of product characteristics of tube feeding (TF) and oral nutritional supplements (ONS); (3) Assess involvement of KOLs in enteral nutrition R&D process. KOLs ranked three product characteristics and three disease areas that deserve additional research attention. From these, overall priority scores were calculated by multiplying ranks for both product characteristics and disease areas. 17 qualitative interviews were conducted and 77 questionnaires (response rate 35%) were completed and returned. (1) Disease areas in ONS and TF with highest priorities are: ONS: general malnutrition & geriatrics, TF: intensive care. (2) TF product characteristics with highest priorities are: composition and clinical evidence from a KOL perspective; tolerance and ease of use from a patient perspective. ONS product characteristics with highest priorities are: composition, clinical evidence and taste from a KOL perspective; taste from a patient perspective. We find a high discrepancy between product characteristic prioritization from a KOL and patient perspective. (3) Although 62% of all KOLs give advice to enteral nutrition companies on patient needs, they under-influence the setting of research priorities by enteral nutrition companies. This study provides a systematic approach to achieve research prioritization in enteral nutrition. In addition to providing new directions for enteral nutrition research and development, this study highlights the relevance of involving KOLs in the identification of research priorities as they
Rezaeinejad, S; Vergara, G G R V; Woo, C H; Lim, T T; Sobsey, M D; Gin, K Y H
An assessment of the occurrence and concentration of enteric viruses and coliphages was carried out in highly urbanized catchment waters in the tropical city-state of Singapore. Target enteric viruses in this study were noroviruses, adenoviruses, astroviruses and rotaviruses. In total, 65 water samples were collected from canals and the reservoir of the Marina catchment on a monthly basis over a period of a year. Quantitative PCR (qPCR) and single agar layer plaque assay (SAL) were used to enumerate target enteric viruses and coliphages in water samples, respectively. The most prevalent pathogen were noroviruses, detected in 37 samples (57%), particularly norovirus genogroup II (48%), with a mean concentration of 3.7 × 10(2) gene copies per liter. Rotavirus was the second most prevalent virus (40%) with a mean concentration of 2.5 × 10(2) GC/L. The mean concentrations of somatic and male-specific coliphages were 2.2 × 10(2) and 1.1 × 10(2) PFU/100 ml, respectively. The occurrence and concentration of each target virus and the ratio of somatic to male-specific coliphages varied at different sampling sites in the catchment. For sampling sites with higher frequency of occurrence and concentration of viruses, the ratio of somatic to male-specific coliphages was generally much lower than other sampling sites with lower incidences of enteric viruses. Overall, higher statistical correlation was observed between target enteric viruses than between enteric viruses and coliphages. However, male-specific coliphages were positively correlated with norovirus concentrations. A multi-level integrated surveillance system, which comprises the monitoring of bacterial indicators, coliphages and selected enteric viruses, could help to meet recreational and surface water quality criteria in a complex urbanized catchment. Copyright © 2014 Elsevier Ltd. All rights reserved.
Whitfield, Yvonne; Johnson, Karen; Hobbs, Leigh; Middleton, Dean; Dhar, Badal; Vrbova, Linda
Contact with animals and their environment has long been recognized as an important source of enteric zoonoses. However, there are limited data available on the burden of illness associated with specific types of animals in Canada. This study describes the overall burden of enteric zoonoses in Ontario, Canada from 2010 to 2012. Confirmed cases of seven enteric zoonotic diseases (campylobacteriosis, cryptosporidiosis, giardiasis, listeriosis, salmonellosis, verotoxin-producing E. coli (VTEC) infection, and yersiniosis) with episode dates from 2010 to 2012 were extracted from the integrated Public Health Information System (iPHIS). Reported exposures were categorized as animal contact, foodborne, waterborne and 'other', with animal contact grouped into nine sub-categories based on the type of animal or transmission setting. Overall incidence rates and proportions by animal exposure categories, age and sex-specific incidence rates and hospitalization and death proportions were calculated and sex proportions compared. Our study found that approximately 26% of the enteric pathogens assessed during the 2010 to 2012 period reported contact with animals and their environments as the mode of transmission. Of enteric disease cases reporting animal contact, farm exposures were reported for 51.3%, dog or cat exposures for 26.3%, and reptile or amphibian exposures for 8.9%. Contact with animals was reported more frequently during the period 2010 to 2012 in comparison to the period 1997 to 2003 when 6% or less of enteric cases were associated with animal contact. Public health professionals, stakeholders associated with animals and their related industries (e.g., pet treats, mobile zoos, abattoirs), and the public should recognize that animal contact is an important source of enteric illnesses in order to take measures to reduce the burden of illness from animal sources.
Kim, Hee-Young; Bang, Kyung-Sook
To prove the effects of an enteral feeding improvement massage for premature infants with regard to their feeding, growing and superior mesentery artery blood flow aspect by a randomised controlled trial. Premature infants have feeding-related problems related to eating and absorbing nutrition due to their immature gastrointestinal function. Studies regarding the effectiveness of premature infants' enteral feeding improvement by tactile stimulation massage are rare. The study group was composed of 55 patients. Of the 55 patients, 26 were randomised into an experimental group and 29 were randomised into a control group. They were all born group received enteral feeding improvement massage twice a day for 14 days, and infants in the control group received a sham exercise. The collected data were analysed by spss 19.0, through t test, chi-square test (Fisher's exact) and ANCOVA. (i) The experimental group had reached the day of full enteral feeding significantly faster. (ii) The experimental group had a higher superior mesentery artery peak velocity (V max ) and lower RI (resistant index). (iii) The experimental group of the feeding-intolerant subgroup had a higher superior mesentery artery V max and V min . (iv) The experimental group had a heavier weight and larger head circumference after 14 days. This study demonstrates that enteral feeding improvement massage can be helpful for achieving earlier full enteral feeding, more increased superior mesentery artery, and faster growing. In particular, it can be a therapeutic, independent and evidence-based nursing intervention for feeding-intolerant premature infants. Neonatal nurses in neonatal intensive care unit can apply enteral feeding improvement massage massage for feeding-intolerant infants. © 2017 John Wiley & Sons Ltd.
The use of educational technologies as a tool to improve academic achievement continues to increase as more technologies becomes available to students. However, teachers are entering the classroom not fully prepared to integrate technology into their daily classroom teaching because they have not been adequately prepared to do so. Teacher…
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Warnick, Bryan R.
This essay is an attempt to understand how technological metaphors, particularly computer metaphors, are relevant to moral education. After discussing various types of technological metaphors, it is argued that technological metaphors enter moral thought through their "functional descriptions." The computer metaphor is then explored by turning to…
Silva, Camila F A; de Vasconcelos, Simone G; da Silva, Thales A; Silva, Flávia M
The aim of this study was to systematically review the effect of permissive underfeeding/trophic feeding on the clinical outcomes of critically ill patients. A systematic review of randomized clinical trials to evaluate the mortality, length of stay, and mechanical ventilation duration in patients randomized to either hypocaloric or full-energy enteral nutrition was performed. Data sources included PubMed and Scopus and the reference lists of the articles retrieved. Two independent reviewers participated in all phases of this systematic review as proposed by the Cochrane Handbook, and the review was reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 7 randomized clinical trials that included a total of 1,717 patients were reviewed. Intensive care unit length of stay and mechanical ventilation duration were not statistically different between the intervention and control groups in all randomized clinical trials, and mortality rate was also not different between the groups. In conclusion, hypocaloric enteral nutrition had no significantly different effects on morbidity and mortality in critically ill patients when compared with full-energy nutrition. It is still necessary to determine the safety of this intervention in this group of patients, the optimal amount of energy provided, and the duration of this therapy. © 2018 American Society for Parenteral and Enteral Nutrition.
or anthropomorphism is important for the branding of new technology. Technology is seen as creating a techno-transcendence towards a more qualified humanity which is in contact with fundamental human values like intuition, vision, and sensing; all the qualities that technology, industrialization, and rationalization......, - in short modernity - have taken away from human existence. What old technology has removed now comes back through new technology promoting a better humanity. The present article investigates how digital technology and affects are presented and combined, with examples from everyday imagery, e.g. TV......Samsung introduced in 2008 a mobile phone called "Soul" made with a human touch and including itself a "magic touch". Through the analysis of a Nokia mobile phone TV-commercials I want to examine the function and form of digital technology in everyday images. The mobile phone and its digital camera...
Pedrón-Giner, C; Calderón, C; Martínez-Zazo, A; Cañedo Villaroya, E; Malillos González, P; Sesmero-Lillo, M Á
Home enteral nutrition is used increasingly in pediatric populations. Our objective was to describe the profile of pediatric patients requiring this treatment. All patients under 18 years old requiring treatment with home enteral nutrition between January 1995 and December 2004 were analyzed retrospectively. 304 patients were studied (157 boys). The mean age at the start of treatment was 4.02 ± 4.09 years, median of 2.5 years; 28% of all patients were under 1 year. The main indications were oncological disease in 91 patients (29.9%) and digestive diseases in 84 (27.6%). There were significant differences depending on the clinical diagnosis for the start age, type of access, infusion regime and formula prescribed. Nutrients were delivered by nasogastric tube in 218 patients (71.7%). Overnight enteral nutrition was the preferred infusion regime in 155 patients (51%). Adult or pediatric polymeric formulas were mostly prescribed in 190 patients (62.5%). The mean treatment duration was 306 ± 544 days. In our series, enteral support usually begins at an early age. Its characteristics varied depending on patient pathology. Knowledge of the pediatric patient profile is important to design the most effective strategy for home enteral nutrition.
Cheong, Sooryun; Lee, Cheonghoon; Song, Sung Won; Choi, Weon Cheon; Lee, Chan Hee; Kim, Sang-Jong
Raw vegetables irrigated with groundwater that may contain enteric viruses can be associated with food-borne viral disease outbreaks. In this study, we performed reverse transcription-PCR (RT-PCR) and cell culture-PCR to monitor the occurrence of enteric viruses in groundwater samples and in raw vegetables that were cultivated using that groundwater in South Korea. Samples were collected 10 times from three farms located in Gyeonggi Province, South Korea. RT-PCR and cell culture-PCR were performed to detect adenoviruses (AdVs), enteroviruses (EVs), noroviruses (NoVs), and rotaviruses, followed by sequence analyses of the detected strains. Of the 29 groundwater samples and the 30 vegetable samples, five (17%) and three (10%) were positive for enteric viruses, respectively. AdVs were the most frequently detected viruses in four groundwater and three vegetable samples. EVs and NoVs were detected in only one groundwater sample and one spinach sample, respectively. The occurrence of enteric viruses in groundwater and vegetable samples was not correlated with the water temperature and the levels of indicator bacteria, respectively. Phylogenetic analysis indicated that most of the detected AdVs were temporally distributed, irrespective of sample type. Our results indicate that raw vegetables may be contaminated with a broad range of enteric viruses, which may originate from virus-infected farmers and virus-contaminated irrigation water, and these vegetables may act as a potential vector of food-borne viral transmission.
Rastogi, R.C.; Sjoeblom, K.L.
Contracting Parties to the Convention on the Prevention of Marine Pollution by Dumping of Wastes and other Matter (LC 1972) have requested the IAEA to develop an inventory of radioactive material entering the marine environment from all sources. The rationale for developing and maintaining the inventory is related to its use as an information base with which the impact of radionuclides entering the marine environment from different sources can be assessed and compared. Five anthropogenic sources of radionuclides entering the marine environment can be identified. These sources are: radioactive waste disposal at sea; accidents and losses at sea involving radioactive material; discharge of low level liquid effluents from land-based nuclear facilities; the fallout from nuclear weapons testing; and accidental releases from land-based nuclear facilities. The first two of these sources are most closely related to the objective of the LC 1972 and its request to the IAEA. This paper deals with the Agency's work on developing a database on radioactive material entering the marine environment from these two sources. The database has the acronym RAMEM (RAdioactive Material Entering the Marine Environment). It includes two modules: inventory of radioactive waste disposal at sea and inventory of accidents and losses at sea involving radioactive material
Ahmad Hatib, Nur Adila; Chong, Chia Yin; Thoon, Koh Cheng; Tee, Nancy Ws; Krishnamoorthy, Subramania S; Tan, Natalie Wh
Enteric fever is a multisystemic infection which largely affects children. This study aimed to analyse the epidemiology, clinical presentation, treatment and outcome of paediatric enteric fever in Singapore. A retrospective review of children diagnosed with enteric fever in a tertiary paediatric hospital in Singapore was conducted from January 2006 to January 2012. Patients with positive blood cultures for Salmonella typhi or paratyphi were identified from the microbiology laboratory information system. Data was extracted from their case records. Of 50 enteric fever cases, 86% were due to Salmonella typhi, with 16.3% being multidrug resistant (MDR) strains. Sixty-two percent of S. typhi isolates were of decreased ciprofloxacin susceptibility (DCS). Five cases were both MDR and DCS. The remaining 14% were Salmonella paratyphi A. There were only 3 indigenous cases. Ninety-four percent had travelled to typhoid-endemic countries, 70.2% to the Indian subcontinent and the rest to Indonesia and Malaysia. All patients infected with MDR strains had travelled to the Indian subcontinent. Anaemia was a significant finding in children with typhoid, as compared to paratyphoid fever (P = 0.04). Although all children were previously well, 14% suffered severe complications including shock, pericardial effusion and enterocolitis. None had typhoid vaccination prior to their travel to developing countries. Enteric fever is largely an imported disease in Singapore and has contributed to significant morbidity in children. The use of typhoid vaccine, as well as education on food and water hygiene to children travelling to developing countries, needs to be emphasised.
Fernández, Sonsire; Año, Gemma; Castaño, Jorge; Pino, Yadira; Uribarri, Evangelina; Riverón, Luis A; Cedré, Bárbara; Valmaseda, Tania; Falero, Gustavo; Pérez, José L; Infante, Juan F; García, Luis G; Solís, Rosa L; Sierra, Gustavo; Talavera, Arturo
A vaccine candidate against cholera was developed in the form of oral tablets to avoid difficulties during application exhibited by current whole cell inactivated cholera vaccines. In this study, enteric-coated tablets were used to improve the protection of the active compound from gastric acidity. Tablets containing heat-killed whole cells of Vibrio cholerae strain C7258 as the active pharmaceutical compound was enteric-coated with the polymer Kollicoat(®) MAE-100P, which protected them efficiently from acidity when a disintegration test was carried out. Enzyme-linked immunosorbent assay (ELISA) anti-lipopolysaccharide (LPS) inhibition test and Western blot assay revealed the presence of V. cholerae antigens as LPS, mannose-sensitive haemagglutinin (MSHA) and outer membrane protein U (Omp U) in enteric-coated tablets. Immunogenicity studies (ELISA and vibriocidal test) carried out by intraduodenal administration in rabbits showed that the coating process of tablets did not affect the immunogenicity of V. cholerae-inactivated cells. In addition, no differences were observed in the immune response elicited by enteric-coated or uncoated tablets, particularly because the animal model and immunization route used did not allow discriminating between acid resistances of both tablets formulations in vivo. Clinical studies with volunteers will be required to elucidate this aspect, but the results suggest the possibility of using enteric-coated tablets as a final pharmaceutical product for a cholera vaccine. Copyright © 2013 Elsevier Ltd. All rights reserved.
Morin, C L; Roulet, M; Roy, C C; Weber, A
Four children aged (11.7-13.5 yr) with protracted growth retardation related to Crohn's disease, received a 6-wk period of continuous elemental enteral alimentation with no other form of treatment. Despite drug therapy the yearly height and weight gain velocities of these children (1.7 +/- 0.3 cm and -0.8 +/- 1.4 kg, respectively) had been abnormal during the previous 2 yr. All patients experienced a complete remission of symptoms, improved nutritional status, and significant height (1.8 +/- 0.3 cm) and weight (3.8 +/- 0.5 kg) gains during the 67 wk of treatment. After cessation of elemental enteral alimentation, 3 of the 4 patients continued to grow, and over a period of 4.5 mo from the beginning of this form of nutritional therapy, they gained an average of 5.0 +/- 1.6 kg and 3.5 +/- 0.3 cm. The disease became active thereafter, and the 3 children resumed their previously abnormal growth patterns during the ensuing year. The 4th patient had surgery 2 mo after elemental enteral alimentation and experienced a subsequent second spurt of growth and pubertal changes. This study suggests that a relatively short course of elemental enteral alimentation leads to a temporary resumption of growth in children with severe growth failure and Crohn's disease. The possibility that repeated courses of elemental enteral alimentation might be beneficial needs to be explored.
Lipman, T O
To assess the literature documenting the existence of bacterial translocation in humans, the effects of enteral nutrition on bacterial translocation in humans, and the hypothesis that enteral nutrition prevents bacterial translocation in humans. Sources included Medline search, references from review articles, and references from animal and human studies. The goal was to include all animal and human studies directly addressing questions of bacterial translocation and nutritional status or nutritional support. An attempt was made to briefly summarize methodology and findings of relevent studies. No general attempt was made to assess quality of individual studies. Bacterial translocation is a well documented phenomenon in animal models. Starvation and malnutrition of themselves do not induce bacterial translocation, but may facilitate translocation in the presence of other systemic insults. Parenteral nutrition and many forms of enteral nutrition may induce and/or facilitate bacterial translocation. Chow and certain fiber sources seem protective. Moderate direct and several lines of indirect evidence support the existence of bacterial translocation in humans. There is no direct evidence and questionable indirect evidence suggesting that enteral nutrition prevents or modifies bacterial translocation in humans. The hypothesis relating enteral nutrition and bacterial translocation in critically ill patients remains attractive, but unproven.
Uyttebroek, Leen; Shepherd, Iain T.; Harrisson, Fernand; Hubens, Guy; Blust, Ronny; Timmermans, Jean-Pierre; Van Nassauw, Luc
Although the morphology and development of the zebrafish enteric nervous system have been extensively studied, the precise neurochemical coding of enteric neurons and their proportional enteric distribution are currently not known. By using immunohistochemistry, we determined the proportional expression and coexpression of neurochemical markers in the embryonic and adult zebrafish intestine. Tyrosine hydroxylase (TH), vasoactive intestinal peptide (VIP), and pituitary adenylate cyclase-activating peptide (PACAP) were observed only in nerve fibers, whereas other markers were also detected in neuronal cell bodies. Calretinin and calbindin had similar distributions. In embryos, all markers, except for choline acetyltransferase (ChAT) and TH, were present from 72 hours postfertilization. Nitrergic neurons, evenly distributed and remaining constant in time, constituted the major neuronal subpopulation. The neuronal proportions of the other markers increased during development and were characterized by regional differences. In the adult, all markers examined were expressed in the enteric nervous system. A large percentage of enteric neurons displayed calbindin and calretinin, and serotonin was the only marker showing significant distribution differences in the three intestinal regions. Colocalization studies showed that serotonin was not coexpressed with any of the other markers. At least five neuronal subpopulations were determined: a serotonergic, a nitrergic noncholinergic, two cholinergic nonnitrergic subpopulations along with one subpopulation expressing both ChAT and neuronal nitric oxide synthase. Analysis of nerve fibers revealed that nitrergic neurons coexpress VIP and PACAP, and that nitrergic neurons innervate the tunica muscularis, whereas serotonergic and cholinergic nonnitrergic neurons innervate the lamina propria and the tunica muscularis. PMID:20853514
Elegbe, I A; Juba, A
Five hundred and fifteen homes of nursing mothers in Ile-Ife, Nigeria, who had earlier brought their children for treatment of diarrhoeal diseases at the IUTHC infant child welfare clinics were visited between January 1982 and June 1984. The mothers' perceptions as to causes, prevention and control of childhood enteritis were elicited: 49.7% of the mothers attributed the cause of the disease to evil spirits; and 9.5% believed enteritis in children to be due to contamination of children's feeds. Modern medicine was perceived to be the ideal method for treating this disease by only 7.4% of the mothers, while 88.8% opted for any of the traditional methods. In order to reduce the devasting effects of enteric diseases among children born to mothers in tropical countries of Africa and Asia, it is imperative that all health workers understand the cultural and social perceptions of their clients towards the disease in question. Illiteracy, and unsanitary and unhygienic environmental conditions were found to be the main factors precipitating enteritis. Implications and strategies for minimizing diarrhoea and other childhood enteric diseases are discussed in the text.
Green, Stephen A; Uy, Benjamin R; Bronner, Marianne E
The enteric nervous system of jawed vertebrates arises primarily from vagal neural crest cells that migrate to the foregut and subsequently colonize and innervate the entire gastrointestinal tract. Here we examine development of the enteric nervous system in the basal jawless vertebrate the sea lamprey (Petromyzon marinus) to gain insight into its evolutionary origin. Surprisingly, we find no evidence for the existence of a vagally derived enteric neural crest population in the lamprey. Rather, labelling with the lipophilic dye DiI shows that late-migrating cells, originating from the trunk neural tube and associated with nerve fibres, differentiate into neurons within the gut wall and typhlosole. We propose that these trunk-derived neural crest cells may be homologous to Schwann cell precursors, recently shown in mammalian embryos to populate post-embryonic parasympathetic ganglia, including enteric ganglia. Our results suggest that neural-crest-derived Schwann cell precursors made an important contribution to the ancient enteric nervous system of early jawless vertebrates, a role that was largely subsumed by vagal neural crest cells in early gnathostomes.
Lal, Aparna; Lill, Adrian W T; Mcintyre, Mary; Hales, Simon; Baker, Michael G; French, Nigel P
To review the available evidence that examines the association between climatic and agricultural land use factors and the risks of enteric zoonoses in humans and consider information needs and possible pathways of intervention. The electronic databases PubMed, Web of Science and Embase and government websites were searched systematically for published literature that investigated the association of climatic and/or agricultural exposures with the incidence of the four most common enteric zoonotic diseases in New Zealand (campylobacteriosis, salmonellosis, cryptosporidiosis and giardiasis). Results The 16 studies in the review demonstrated significant associations between climate, agricultural land use and enteric disease occurrence. The evidence suggests that enteric disease risk from environmental reservoirs is pathogen specific. In some rural regions, environmental pathogen load is considerable, with multiple opportunities for zoonotic transmission. Enteric disease occurrence in NZ is associated with climate variability and agricultural land use. However, these relationships interact with demographic factors to influence disease patterns. Improved understanding of how environmental and social factors interact can inform effective public health interventions under scenarios of projected environmental change. © 2014 Public Health Association of Australia.
Full Text Available Objective. This study aimed to determine the use of fecal elastase in evaluating the effect of simultaneous pancreas–kidney transplantation with enteric drainage on the pancreatic exocrine function of diabetic patients with uremia. Methods. A total of 19 patients with simultaneous pancreas–kidney transplantation (SPK with enteric drainage, 31 diabetic patients with uremia (chronic renal failure (CRF, 22 diabetic patients with uremia who underwent renal transplantation (RT, and 20 normal individuals (CON were included in the study. Pancreatic exocrine insufficiency was determined using fecal elastase. Results. The fecal pancreatic elastase level in SPK patients with enteric drainage was 479 μg/g, which was significantly higher than 229 μg/g in CRF patients and 197 μg/g in RT patients. Using 200 μg/g as the established threshold, a reduced fecal pancreatic elastase level was found in 14/31 of CRF patients, 12/22 of RT patients, 1/19 of SPK patients with enteric drainage, and 1/20 of CON patients. The correlation analysis revealed a significant association between fecal elastase and glycosylated hemoglobin. Conclusions. The present study indicated that SPK with enteric drainage improves pancreatic endocrine and exocrine functions. Fecal elastase may be a clinically relevant means to determine the therapeutic effects.
Bendas, Ehab R; Abdelbary, Aly A
Recently, great attention has been paid to nanocapsules. The interest of these structures is due to their promising applications as drug delivery systems. The objective of this study was to develop novel enteric coating technique based on instantaneous encapsulation of the acid-labile drug, omeprazole in innovative enteric nanocapsules. Omeprazole enteric nanocapsules were formulated by varying the type and amount of the enteric polymer. The particle size (PS), polydispersity index (PDI), zeta potential (ZP) and encapsulation efficiency (EE) values of the prepared enteric nanocapsules were determined. A full 2(1)×3(1) factorial design was used for planning and analysis of the experimental trials to select the optimized formulation. The highest desirability value was 0.7463 for formula E3 (containing 200mg hydroxypropyl methylcellulose phthalate (HPMCP)). The stability of omeprazole was reflected by the absence of the exothermal peak when the drug was encapsulated as detected by differential scanning calorimetry (DSC) thermograms. In vitro drug release study confirmed the USP specifications required to meet the key formulation characteristics of gastro-resistance. In vivo pharmacological assessment showed that the optimized nanocapsules were able to protect rat stomach against ulcer formation compared to the aqueous suspension of the drug which showed less significant protection. Copyright © 2014 Elsevier B.V. All rights reserved.
Mechteld A. R. Vermeulen
Full Text Available Glutamine supplementation in specific groups of critically ill patients results in favourable clinical outcome. Enhancement of citrulline and arginine synthesis by glutamine could serve as a potential mechanism. However, while receiving optimal enteral nutrition, uptake and enteral metabolism of glutamine in critically ill patients remain unknown. Therefore we investigated the effect of a therapeutically relevant dose of L-glutamine on synthesis of L-citrulline and subsequent L-arginine in this group. Ten versus ten critically ill patients receiving full enteral nutrition, or isocaloric isonitrogenous enteral nutrition including 0.5 g/kg L-alanyl-L-glutamine, were studied using stable isotopes. A cross-over design using intravenous and enteral tracers enabled splanchnic extraction (SE calculations. Endogenous rate of appearance and SE of glutamine citrulline and arginine was not different (SE controls versus alanyl-glutamine: glutamine 48 and 48%, citrulline 33 versus 45%, and arginine 45 versus 42%. Turnover from glutamine to citrulline and arginine was not higher in glutamine-administered patients. In critically ill nonseptic patients receiving adequate nutrition and a relevant dose of glutamine there was no extra citrulline or arginine synthesis and glutamine SE was not increased. This suggests that for arginine synthesis enhancement there is no need for an additional dose of glutamine when this population is adequately fed. This trial is registered with NTR2285.
Zhang, Yun; Gao, Shun-Liang; Zhang, Shao-Yang; Liang, Zhong-Yan; Yu, Wen-Qiao; Liang, Ting-Bo
The objective of this study was to explore the clinical manifestations and possible mechanisms of vancomycin-resistant enterococcus (VRE)-induced severe enteritis and extraenteric disseminations. In six patients with severe acute pancreatitis (SAP) complicated with acute infectious diarrhea, VRE was confirmed by bacterial genotyping, minimum inhibitory concentration testing, and empiric linezolid treatment. Samples collected from stools and peripancreatic effusions were used to compare the genotypes of VRE by pulsed-field gel electrophoresis and multilocus sequence typing and to validate the suspected extraenteric disseminations caused by VRE. To further elucidate the mechanisms of VRE-inflicted enteric mucosal injury, in vitro infection of human intestinal Caco-2 cell line with VRE was performed followed by inflammatory cytokine assays and morphological characterization by electron microscopy. All six VRE strains isolated from stool samples caused severe enteritis in SAP patients. The same strains further inflicted significant damage and induced inflammatory reactions in Caco-2 cells. Homologous assays demonstrated high homology between samples from stool and peripancreatic effusions in two patients, indicating the occurrence of extraenteric disseminations. Alterations in drug resistance and virulence of enterococci, part of the symbiotic bacteria, during the course of SAP may cause inflammatory injuries to enteric epithelium, resulting in enteritis and extraenteric disseminations.
Meissner, W; Hartmann, M; Kähler, G; Brauer, M
Gastrtis and esophagitis are frequent and severe complications in intensive care patients, mainly caused by increased duodenogastral reflux. Opioids, commonly used in intensive care, are known to impair gastrointestinal (GI) motility which increases retrograd flow of gastric content. In a previous study, we showed that enteral administered naloxone reduces gastric reflux by selectively blocking GI opioid receptors. Therefore, in a subpopulation of these patients we studied the effect of enteral naloxone on the incidence of mucosal injury in opioid-treated, mechanically ventilated patients. After IRB approval, mechanically ventilated, fentanyl-treated patients without gastrointestinal surgery or diseases were assigned to receive 8 mg naloxone or placebo four times daily via a gastric tube. Additional inclusion criteria were opioid treatment for at least three days and endoscopy of the upper GI tract. Frequency of gastritis and esophagitis was quantified according to the Savary-Miller Score, and further parameter of GI motility (frequency of propulsive medication, amount of enteral feeding) were measured. In four of seventeen patients of the naloxone group (24 %) and 14 of 22 patients of the placebo group (64 %; p = 0.02), esophageal or gastral mucosal injuries were detected. In the naloxone group, gastral reflux as well as need for propulsive medication were significantly lower. Volume of enteral feeding showed an increasing trend in the second half of the study. Reduction of esophagogastral mucosal injury and reduced need for procinetic medication suggests an improvement of GI motility by enteral naloxone in fentanyl-treated, mechanically ventilated patients.
Kasper Matthew R
Full Text Available Abstract The mission of the Armed Forces Health Surveillance Center, Division of Global Emerging Infections Surveillance and Response System (AFHSC-GEIS is to support global public health and to counter infectious disease threats to the United States Armed Forces, including newly identified agents or those increasing in incidence. Enteric diseases are a growing threat to U.S. forces, which must be ready to deploy to austere environments where the risk of exposure to enteropathogens may be significant and where routine prevention efforts may be impractical. In this report, the authors review the recent activities of AFHSC-GEIS partner laboratories in regards to enteric disease surveillance, prevention and response. Each partner identified recent accomplishments, including support for regional networks. AFHSC/GEIS partners also completed a Strengths, Weaknesses, Opportunities and Threats (SWOT survey as part of a landscape analysis of global enteric surveillance efforts. The current strengths of this network include excellent laboratory infrastructure, equipment and personnel that provide the opportunity for high-quality epidemiological studies and test platforms for point-of-care diagnostics. Weaknesses include inconsistent guidance and a splintered reporting system that hampers the comparison of data across regions or longitudinally. The newly chartered Enterics Surveillance Steering Committee (ESSC is intended to provide clear mission guidance, a structured project review process, and central data management and analysis in support of rationally directed enteric disease surveillance efforts.
Diarrhea is a major cause of morbidity and mortality in human immunodeficiency virus (HIV)-infected individuals. Opportunistic enteric parasitic infections are encountered in 30-60% of HIV seropositive patients in developed countries and in 90% of patients in developing countries. Once the CD4(+) cell count drops below 200 cells/μl, patients are considered to have developed acquired immunodeficiency syndrome (AIDS), with the risk of an AIDS-defining illness or opportunistic infection significantly increasing. Opportunistic enteric parasites encountered in these patients are Cryptosporidium, Isospora, Cyclospora, and microsporidia; as well as those more commonly associated with gastrointestinal disease, for example, Giardia intestinalis, Entamoeba histolytica, Strongyloides stercoralis, and also rarely Balantidium coli. In view of AIDS explosion in India, opportunistic enteric parasites are becoming increasingly important and it has to be identified properly. Apart from wet mounts, concentration methods for stool samples and special staining techniques for identification of these parasites, commercially available fecal immunoassays are widely available for the majority of enteric protozoa. Molecular methods such as polymerase chain reaction (PCR), PCR-restriction fragment length polymorphism, flow cytometry, and sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE), have also come in the pipeline for early diagnosis of these infections. Proper disposal of the feces to prevent contamination of the soil and water, boiling/filtering drinking water along with improved personal hygiene might go a long way in preventing these enteric parasitic infections.
Full Text Available SUMMARY A caloric requirement of the patients who do not have an access for feeding through an oral route is supported by enteral or parenteral nutrition. In the patients who have suitable gastrointestinal function, enteral feeding is preferred initially. Enteral feeding is also used for administration of medications in patients who cannot swallow. However, an administration of drugs via a feeding tube is complicated; appropriate techniques should be used in order to prevent obstruction of feeding tube and thereby avoid reduction of the drug effect and to minimize the risk of toxicity of given pharmaceuticals. In the patients who are not able to take medication orally, alternative routes such as intravenous, intramuscular, subcutaneous, inhaled, transdermal, rectal, and sublingual administrations are available and should be preferred at the first place. According to the American Society for Parenteral and Enteral Nutrition, an effect of a size and the position of the feeding tube, characteristics of pharmaceutical dosage form and methods of administration should be considered when applying medication via enteral tube. The risk of the drug interactions arises in patients who have nutritional support. In order to prevent drug interactions, a pharmacist, who has an extensive education and knowledge on drugs, its characteristics and mechanism of action is required for multidisciplinary team in clinical practice.