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Sample records for utilizacao como bolus

  1. Gastrostomy feeding tube - bolus

    Science.gov (United States)

    Feeding - gastrostomy tube - bolus; G-tube - bolus; Gastrostomy button - bolus; Bard Button - bolus; MIC-KEY - bolus ... KEY, 3 to 8 weeks after surgery. These feedings will help your child grow strong and healthy. ...

  2. Bolus use in radiotherapy

    Directory of Open Access Journals (Sweden)

    Sérgio Spezzia

    2017-01-01

    Full Text Available Preliminary to the radiation therapy, it is posisble to develop a therapeutic device contained in the buccomaxillofacial prosthesis resources, creating the bolus. Bolus are materials used to increase the dose on the entrance surface of a field or to compensate for a lack of tissue. The requirements for a material to be used as a bolus include to interact with ionizing radiations in a similar manner to tissues and to be soft enough to allow its molding to the patient’s contour. There are various materials available for this purpose, however, with a relatively high cost. Some inexpensive options can also be used, such as pressed cellophane and wet gauze, however, these materials do not present favorable malleability and do not offer true reproducibility. The aim of this article was to ascertain whether there is harmonious knowledge of this technique by dental surgeons, medical oncologists and radiotherapists. This technique or device minimizes the deleterious effects resulting from exposure to radiation. It was concluded the bolus can reduce possible complications arising from radiation therapy, concomitantly offering improved living conditions during treatment.

  3. Bolus obstruction by Ascaris lumbricoides

    African Journals Online (AJOL)

    In 67 cases conservative treatment was successful. ... bolus of worms, biliary ascariasis,3.6 pancreatitis and acute ... or chronic granulomatous peritonitis is rare.i These complica- ... obstruction admitted to the paediatric surgical wards of the.

  4. Characterization of an intravenously injected bolus

    International Nuclear Information System (INIS)

    Samuel, A.M.; Raikar, U.R.; Atmaram, S.H.; Ganatra, R.D.

    1976-01-01

    A study of some parameters affecting the time activity histogram of an intravenous bolus injection of radioactivity was performed. A scoring system for bolus compactness was attempted. A score of 2 and above was considered to be a satisfactory bolus. Volumes less than 1 ml tended to result in a satisfactory bolus. The nature of radiopharmaceutical injected, different injecters and age of the patient did not affect the score. Thyrotoxic patients gave the best bolus score. (orig.) [de

  5. Bolus characteristics based on Magnetic Resonance Angiography

    Directory of Open Access Journals (Sweden)

    Bi Xiaoming

    2006-10-01

    Full Text Available Abstract Background A detailed contrast bolus propagation model is essential for optimizing bolus-chasing Computed Tomography Angiography (CTA. Bolus characteristics were studied using bolus-timing datasets from Magnetic Resonance Angiography (MRA for adaptive controller design and validation. Methods MRA bolus-timing datasets of the aorta in thirty patients were analyzed by a program developed with MATLAB. Bolus characteristics, such as peak position, dispersion and bolus velocity, were studied. The bolus profile was fit to a convolution function, which would serve as a mathematical model of bolus propagation in future controller design. Results The maximum speed of the bolus in the aorta ranged from 5–13 cm/s and the dwell time ranged from 7–13 seconds. Bolus characteristics were well described by the proposed propagation model, which included the exact functional relationships between the parameters and aortic location. Conclusion The convolution function describes bolus dynamics reasonably well and could be used to implement the adaptive controller design.

  6. Pharyngeal Pressure and Timing During Bolus Transit

    Science.gov (United States)

    Walczak, Chelsea C.; Jones, Corinne A.; McCulloch, Timothy M.

    2018-01-01

    Determining intrabolus pressure (IBP) at the upper esophageal sphincter (UES) and in the esophagus has given compelling evidence that IBP can be a predictor for swallowing dysfunction. Studies have looked most superiorly at the low hypopharynx region but there has been no inquiry into what IBP measures throughout the entire pharynx can tell us. We present a study to describe the pressures within and surrounding the moving bolus throughout the pharynx and into the UES. Simultaneous HRM and videofluoroscopy were performed in 10 healthy subjects swallowing ten 10 mL thin-liquid barium boluses. Three events surrounding bolus movement were tracked via videofluoroscopy, two additional events were found using manometric measures. As the bolus passes through the pharynx, low pressure is created at and below the head of the bolus. A modest pressure increase is seen as the bolus passes through the pharynx and finally, high pressure is observed at the bolus tail, followed by an even larger pressure generation of a clearance event. HRM allows for greater resolution in data collection in the pharynx and in this study, aided in identifying semi unique characteristics around the hypopharynx and the UES which are consistent with the complex anatomy of the regions and the transition of the UES from active closure to relaxed opening. In the future, additional studies designed to look at aged and diseased populations may lead to better understanding of disease etiology, and treatment options. PMID:27565155

  7. Bolus injections of measured amounts of radioactivity

    International Nuclear Information System (INIS)

    Wesolowski, C.A.; Hogendoorn, P.; Vandierendonck, R.; Driedger, A.A.

    1988-01-01

    Many time-based radionuclide techniques, such as glomerular filtration rate measurement (GFR), require prompt intravenous delivery of and accurately measured tracer bolus with minimal residual tracer retention at the injection site. The quality assurance aspects of two antecubital vein, quantitative injection techniques were investigated. A flush bolus technique using a tuberculin syringe piggybacked onto a 10-ml saline flush was compared to a single blood pressure cuff injection technique. Scintillation camera data for each technique were compared for bolus duration in the abdominal aorta and for residual activity at the injection site at 5 min. Bolus times were measured as the FWHM of the gamma variate fit to the abdominal aortic regional time-activity curves. Relatively little focal activity was seen in the antecubital injection site following the flush bolus: marked residual activity was seen following the blood pressure cuff injections. The injection site/arm background ratios averaged 1.3 for the flush bolus and 30.1 for the cuff technique. Although both methods allowed accurate in vitro determination of administered radioactivity, only the tuberculin syringe flush bolus technique was acceptable for time-based quantitation because of its superior in vivo characteristics

  8. Technology for bolus verification in proton therapy

    Science.gov (United States)

    Shipulin, K. N.; Mytsin, G. V.; Agapov, A. V.

    2015-01-01

    To ensure the conformal depth-dose distribution of a proton beam within a target volume, complex shaped range shifters (so-called boluses), which account for the heterogeneous structure of patient tissue and organs in the beam path, were calculated and manufactured. The precise manufacturing of proton compensators used for patient treatment is a vital step in quality assurance in proton therapy. In this work a software-hardware complex that verifies the quality and precision of bolus manufacturing at the Medico-Technical Complex (MTC) was developed. The boluses consisted of a positioning system with two photoelectric biosensors. We evaluated 20 boluses used in proton therapy of five patients. A total number of 2562 experimental points were measured, of which only two points had values that differed from the calculated value by more than 0.5 mm. The other data points displayed a deviation within ±0.5 mm from the calculated value. The technology for bolus verification developed in this work can be used for the high precision testing of geometrical parameters of proton compensators in radiotherapy.

  9. Tranexamic Acid in Bolus Alone Vs Bolus and Continuous Infusion in Hip Arthroscopy

    OpenAIRE

    Fatih Karaaslan; Roberto Seijas; Andrea Sallent; Oscar Ares; Wenceslao Espinosa; Pedro Alvarez; Ramón Cugat; Patricia Lopez

    2017-01-01

    AIM: the present study examines the effects of tranexamic acid (TXA) on reducing blood loss during hip arthroscopy, comparing two different methods of administration (bolus vs infusion). METHODS: a prospective study with 70 patients undergoing hip arthroscopy was carried out. The patients within the TXA infusion group (group A) received TXA an 2-g intravenous bolus 30 min before skin incision intravenously followed by 10 mg/kg/h infusion (continued during the entire surgery)...

  10. Safe structural food bolus in elderly: the relevant parameters

    OpenAIRE

    Vandenberghe-Descamps, Mathilde; Septier, Chantal; Prot, Aurélie; Tournier, Carole; Hennequin, Martine; Vigneau, Evelyne; Feron, Gilles; Labouré, Hélène

    2017-01-01

    Mastication is essential to prepare food into a bolus ready to be swallowed safely, with no choking risk. Based on food bolus properties, a masticatory normative indicator was developed by Woda et al. (2010) to identify impaired masticatory function within good oral health population. The aim of the present study was to identify relevant parameters of bolus' structure to differentiate safe to unsafe bolus among elderly contrasting by their dental status.93 elderly, 58% with at least 7 posteri...

  11. Custom bolus of hydrogel: dosimetric characterization, clinical use and placement uncertainties; Bolus de compensación personalizado de hidrogel: Caracterización radiológica, uso clínico e incertidumbre de colocación

    Energy Technology Data Exchange (ETDEWEB)

    Pérez-García, H.; Antón, D.; Miguel, D.; Ángel del Castillo, D.; Alonso, D.; De Frutos, J.; Pérez, C.

    2017-11-01

    When using electron beams over irregular surfaces it shows remarkable dose heterogeneity in target tissue, the use of a hydrogel bolus by Varihesive® ConvaTec as a custom bolus is proposed to compensate this effect. Radiological characterization is carried out comparing hydrogel with water by a CT study and by measuring percentage depth dose for electron beams. The dosimetric impact due to the uncertainty of bolus placement is quantitatively evaluated and it is concluded that the use of hydrogel is an acceptable solution as compensation bolus with radiological properties similar to water. [Spanish] La incidencia de un campo de electrones en una superficie irregular produce distribuciones heterogéneas de dosis. En este trabajo se propone el uso de un bolus personalizado de hidrogel Varihesive® de ConvaTec para compensar dichas irregularidades. El hidrogel se caracteriza radiológicamente comparándolo con agua mediante una adquisición TC y se obtiene el porcentaje de dosis en profundidad para campos de electrones. Se evalúa cuantitativamente el impacto dosimétrico debido a la incertidumbre de colocación y se concluye que el uso de hidrogel resulta una solución aceptable como bolus de compensación con propiedades radiológicas similares al agua.

  12. Esophageal contractions, bolus transit and perception of transit after swallows of liquid and solid boluses in normal subjects

    Directory of Open Access Journals (Sweden)

    Juciléia Dalmazo

    2012-12-01

    Full Text Available CONTEXT: Esophageal dysphagia is the sensation that the ingested material has a slow transit or blockage in its normal passage to the stomach. It is not always associated with motility or transit alterations. OBJECTIVES: To evaluate in normal volunteers the possibility of perception of bolus transit through the esophagus after swallows of liquid and solid boluses, the differences in esophageal contraction and transit with these boluses, and the association of transit perception with alteration of esophageal contraction and/or transit. METHODS: The investigation included 11 asymptomatic volunteers, 4 men and 7 women aged 19-58 years. The subjects were evaluated in the sitting position. They performed swallows of the same volume of liquid (isotonic drink and solid (macaroni boluses in a random order and in duplicate. After each swallow they were asked about the sensation of bolus passage through the esophagus. Contractions and transit were evaluated simultaneously by solid state manometry and impedance. RESULTS: Perception of bolus transit occurred only with the solid bolus. The amplitude and area under the curve of contractions were higher with swallows of the solid bolus than with swallows of the liquid bolus. The difference was more evident in swallows with no perception of transit (n = 12 than in swallows with perception (n = 10. The total bolus transit time was longer for the solid bolus than for the liquid bolus only with swallows followed by no perception of transit. CONCLUSION: The results suggest that the perception of esophageal transit may be the consequence of inadequate adaptation of esophageal transit and contraction to the characteristics of the swallowed bolus.

  13. A study on developing customized bolus using 3D prints

    International Nuclear Information System (INIS)

    Jung, Sang Min; Yang, Jin Ho; Lee, Seung Hyun; Kim, Jin Uk; Yeom, Du Seok

    2015-01-01

    3D Printers are used to create three-dimensional models based on blueprints. Based on this characteristic, it is feasible to develop a bolus that can minimize the air gap between skin and bolus in radiotherapy. This study aims to compare and analyze air gap and target dose at the branded 1 cm bolus with the developed customized bolus using 3D printers. RANDO phantom with a protruded tumor was used to procure images using CT simulator. CT DICOM file was transferred into the STL file, equivalent to 3D printers. Using this, customized bolus molding box (maintaining the 1 cm width) was created by processing 3D printers, and paraffin was melted to develop the customized bolus. The air gap of customized bolus and the branded 1 cm bolus was checked, and the differences in air gap was used to compare D max , D min , D mean , D 95% and V 95% in treatment plan through Eclipse. Customized bolus production period took about 3 days. The total volume of air gap was average 3.9 cm 3 at the customized bolus. And it was average 29.6cm 3 at the branded 1 cm bolus. The customized bolus developed by the 3D printer was more useful in minimizing the air gap than the branded 1 cm bolus. In the 6 MV photon, at the customized bolus, D max , D min , D mean , D 95% , V 95% of GTV were 102.8%, 88.1%, 99.1%, 95.0%, 94.4% and the D max , D min , D mean , D 95% , V 95% of branded 1 cm bolus were 101.4%, 92.0%, 98.2%, 95.2%, 95.7%, respectively. In the proton, at the customized bolus, D max , D min , D mean , D 95% , V 95% of GTV were 104.1%, 84.0%, 101.2%, 95.1%, 99.8% and the D max , D min , D mean , D 95% , V 95% of branded 1cm bolus were 104.8%, 87.9%, 101.5%, 94.9%, 99.9%, respectively. Thus, in treatment plan, there was no significant difference between the customized bolus and 1 cm bolus. However, the normal tissue nearby the GTV showed relatively lower radiation dose. The customized bolus developed by 3D printers was effective in minimizing the air gap, especially when it is used against

  14. A study on developing customized bolus using 3D prints

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Sang Min; Yang, Jin Ho; Lee, Seung Hyun; Kim, Jin Uk; Yeom, Du Seok [Dept. of Proton Therapy Center, National Cancer Center, Ilsan (Korea, Republic of)

    2015-06-15

    3D Printers are used to create three-dimensional models based on blueprints. Based on this characteristic, it is feasible to develop a bolus that can minimize the air gap between skin and bolus in radiotherapy. This study aims to compare and analyze air gap and target dose at the branded 1 cm bolus with the developed customized bolus using 3D printers. RANDO phantom with a protruded tumor was used to procure images using CT simulator. CT DICOM file was transferred into the STL file, equivalent to 3D printers. Using this, customized bolus molding box (maintaining the 1 cm width) was created by processing 3D printers, and paraffin was melted to develop the customized bolus. The air gap of customized bolus and the branded 1 cm bolus was checked, and the differences in air gap was used to compare D{sub max}, D{sub min}, D{sub mean}, D{sub 95%} and V{sub 95%} in treatment plan through Eclipse. Customized bolus production period took about 3 days. The total volume of air gap was average 3.9 cm{sup 3} at the customized bolus. And it was average 29.6cm{sup 3} at the branded 1 cm bolus. The customized bolus developed by the 3D printer was more useful in minimizing the air gap than the branded 1 cm bolus. In the 6 MV photon, at the customized bolus, D{sub max}, D{sub min}, D{sub mean}, D{sub 95%}, V{sub 95%} of GTV were 102.8%, 88.1%, 99.1%, 95.0%, 94.4% and the D{sub max}, D{sub min}, D{sub mean}, D{sub 95%}, V{sub 95%} of branded 1 cm bolus were 101.4%, 92.0%, 98.2%, 95.2%, 95.7%, respectively. In the proton, at the customized bolus, D{sub max}, D{sub min}, D{sub mean}, D{sub 95%}, V{sub 95%} of GTV were 104.1%, 84.0%, 101.2%, 95.1%, 99.8% and the D{sub max}, D{sub min}, D{sub mean}, D{sub 95%}, V{sub 95%} of branded 1cm bolus were 104.8%, 87.9%, 101.5%, 94.9%, 99.9%, respectively. Thus, in treatment plan, there was no significant difference between the customized bolus and 1 cm bolus. However, the normal tissue nearby the GTV showed relatively lower radiation dose. The

  15. Optical tracking of contrast medium bolus to optimize bolus shape and timing in dynamic computed tomography

    International Nuclear Information System (INIS)

    Eisa, Fabian; Brauweiler, Robert; Peetz, Alexander; Hupfer, Martin; Nowak, Tristan; Kalender, Willi A

    2012-01-01

    One of the biggest challenges in dynamic contrast-enhanced CT is the optimal synchronization of scan start and duration with contrast medium administration in order to optimize image contrast and to reduce the amount of contrast medium. We present a new optically based approach, which was developed to investigate and optimize bolus timing and shape. The time-concentration curve of an intravenously injected test bolus of a dye is measured in peripheral vessels with an optical sensor prior to the diagnostic CT scan. The curves can be used to assess bolus shapes as a function of injection protocols and to determine contrast medium arrival times. Preliminary results for phantom and animal experiments showed the expected linear behavior between dye concentration and absorption. The kinetics of the dye was compared to iodinated contrast medium and was found to be in good agreement. The contrast enhancement curves were reliably detected in three mice with individual bolus shapes and delay times of 2.1, 3.5 and 6.1 s, respectively. The optical sensor appears to be a promising approach to optimize injection protocols and contrast enhancement timing and is applicable to all modalities without implying any additional radiation dose. Clinical tests are still necessary. (note)

  16. Safety and efficacy of Bolus administration of magnesium sulphate ...

    African Journals Online (AJOL)

    Safety and efficacy of Bolus administration of magnesium sulphate for preeclampsia. ... On-going research is addressing its administration in terms of dosage, duration and safety. Objective: We evaluated a ... Keywords: safety, efficacy, bolus magnesium sulphate, preeclampsia, University of Benin Teaching Hospital

  17. Bolus obstruction by Ascaris lumbricoides | Wynne | South African ...

    African Journals Online (AJOL)

    Bolus obstruction by Ascaris lumbricoides. J.M. Wynne, B.A.H. Ellman. Abstract. Seventy-three cases of obstruction due to a bolus of Ascaris worms are reviewed, The diagnosis was made on the basis either of a characteristic palpable mass or a characteristic radiographic appearance. In 67 cases conservative treatment ...

  18. EFFECT OF A BITTER BOLUS ON ORAL, PHARYNGEAL AND ESOPHAGEAL TRANSIT OF HEALTHY SUBJECTS

    Directory of Open Access Journals (Sweden)

    Leda Maria Tavares ALVES

    2013-03-01

    Full Text Available Context During swallowing, boluses stimulate sensory receptors of the oral, pharyngeal, laryngeal, and esophageal regions. Sweet and tasteless foods are more acceptable for swallowing than bitter foods. A bitter bolus is unpleasant for most subjects. Our hypothesis was that the ingestion of a bitter bolus might alter the oral behavior, pharyngeal and esophageal transit when compared to a sweet bolus. Objective To evaluate whether the bitter taste of a liquid bolus causes alteration on oral, pharyngeal and/or esophageal transit in normal subjects in comparison with sweet bolus.' Method Scintigraphic evaluation of oral, pharyngeal and esophageal transit was performed in 43 asymptomatic subjects, 22 women and 21 men, ages 23-71 years, without problems with the ingestion of liquid and solid foods, and without digestive, cardiac or neurologic diseases. Each subject swallowed in random sequence and at room temperature 5 mL of a liquid bolus with bitter taste, prepared with 50 mL of water with 2 g of leaves of Peumus boldus, heated until boiling (boldus tea, and 5 mL of a liquid bolus with sweet taste, prepared with 50 mL of water with 3 g of sucrose, both labeled with 37 MBq of technetium phytate (Tc99m. Results There was no difference between the bitter bolus and the sweet bolus in mouth, pharynx and esophageal transit and clearance duration and in the amount of residues. Conclusion A bitter bolus, considered an unpleasant bolus, does not alter the duration of oral, pharyngeal and esophageal phases of swallowing, when compared with a sweet bolus, considered a pleasant bolus. Contexto Durante a deglutição o bolo estimula os receptores sensoriais da boca, faringe, laringe e esôfago. Os alimentos doces e sem gosto são mais aceitáveis para a deglutição do que os alimentos amargos, que tem gosto desagradável para a maioria dos indivíduos. A hipótese destes autores era que a ingestão de um bolo amargo pode alterar o trânsito oral

  19. Micropropagation of Gerbera (Gerbera jamesonii Bolus).

    Science.gov (United States)

    Minerva, Ghani; Kumar, Surinder

    2013-01-01

    Gerbera (Gerbera jamesonii Bolus) is one of the most popular ornamental flowers worldwide and used both as cut flower and potted plant. Some of them show excellent agronomic characters such as color, floral diameter, stem length, and vigor, which make this plant of commercial importance. Conventionally, multiplication is done through seeds or rhizome cuttings. Rapid multiplication of elite cultivars of Gerbera, with improved agronomic traits, has been achieved by using both direct and indirect tissue culture methods. Direct shoot regeneration was accomplished from stem apices on MS medium supplemented with 1 mg/L 6-benzyladenine (BA) and 1 mg/L kinetin. Indirect shoot induction succeeded from callus differentiation has been achieved on MS medium containing 2 mg/L 2,4-dichlorophenoxyacetic acid, 0.5 mg/L indole-3-acetic acid, and 2 mg/L BA. The in vitro shoots, 4-5 cm long, were rooted by quick dipping the shoot bases for 3-5 s in 2,000 mg/L indole-3-butyric acid solution followed by transfer to the pots containing farmyard manure, soil, and sand (1:1:1 by volume). Initially, in vitro plantlets were covered with glass jars to maintain a high relative humidity (85-90%). As soon as new shoot growth begins, relative humidity is decreased by exposing them to the open environmental conditions prior transferring to the glasshouse. Indirect shoot regeneration increased the frequency of somaclonal variations. The selected somaclones were used in developing new and novel cultivars.

  20. Contrast bolus technique with rapid CT scanning

    International Nuclear Information System (INIS)

    Arnold, H.; Kuehne, D.; Rohr, W.; Heller, M.

    1981-01-01

    Twenty-three patients complying with the clinical criteria for brain death were studied by contrast-enhanced CT. In all but one, the great intracranial vessels escaped visualization; accordingly, angiography demonstrated cerebral circulatory arrest. In the remaining case, faint enhancement of the circle of Willis corresponded to angiographic demonstration of the proximal segments of cerebral arteris. Neither in normal brain nor in dead brain did slow CT scanning disclose any postcontrast increase in parenchymal attenuation. An improved technique is proposed to demonstrate the transit of the contrast bolus by rapid CT with image splitting. If cerebral blood flow is preserved, the grey and white matter will enhance significantly following administration of contrast medium. Vice versa, the absence of enhancement confirms brain death, even in instances in which the great cerebral vessels are obscured by hemorrhage or other extensive lesions. Two additional cases of brain death were evaluated by rapid CT scanning. As to brain death, the technique obviates the need for angiography or radionuclide angiography, usually applied in prospective organ donors, because its informative content is superior to that of either method. The CT technique described affords a reliable and safe diagnosis of brain death, and can be interpreted easily. (orig.)

  1. Ocular Dynamics of Bolus Ingestion of Eleis guineensis Sap (Palm ...

    African Journals Online (AJOL)

    Elaeis guineensis), and is widely consumed among the various ethnic nationalities in Nigeria. The effect of bolus ingestion of 600ml, palm wine was undertaken so as to determine its ocular dynamics in healthy volunteers. Results showed that ...

  2. Structural characterization of bentonite clays for utilization as nanofillers in nanocomposites; Caracterizacao estrutural de argilas bentoniticas para utilizacao como nanocargas

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Carlos Ivan Ribeiro de; Rocha, Marisa Cristina Guimares; Vogas, Arthur Considera, E-mail: carlosivanr@gmail.com [Universidade do Estado do Rio de Janeiro (UERJ), Nova Friburgo, RJ (Brazil). Instituto Politecnico; Silva, Ana Lucia Nazareth da [Universidade Federal do Rio de Janeiro (IMA/UFRJ), RJ (Brazil). Instituto de Macromoleculas Professora Eloisa Mano; Bertolino, Luiz Carlos [Centro de Tecnologia Mineral (CETEM/MCTI), Rio de Janeiro, RJ (Brazil)

    2014-07-01

    Clays of different composition have been used in the development of polymer nanocomposites. However, the utilization of bentonite clays has been emphasized in Brazil, mainly due to their availability.The best known and studied deposits of bentonite clays are located in the state of Paraiba. However, these deposits are becoming exhausted after decades of exploitation. In this context, the aim of this work is to proceed the physical-mineralogical characterization of bentonite clays recently discovered in Cubati, PB. In order to achieve this objective, the samples underwent a particle size classification step and were characterized by X-ray fluorescence, X-ray diffraction, infrared spectroscopy, thermal analysis and scanning electron microscopy. Results of X-ray diffraction showed that the samples are composed of smectite, and kaolinite and quartz. The characterization of the samples by FTIR confirmed these results. Results of chemical analysis showed that the clays have predominantly different exchangeable cations. (author)

  3. Application of thermoelectric generator as an alternative energy source; Utilizacao dos geradores termoeletricos como fonte de energia alternativa

    Energy Technology Data Exchange (ETDEWEB)

    Pepino, Giovana [Newmar Energia, Rio de Janeiro, RJ (Brazil)

    2004-07-01

    This document will deal some information about the TEG and design of TEGs. Thermoelectric energy conversion is a solid state process that converts heat energy to electrical energy without moving parts. The result is a device that is characterized by a very high degree of reliability and low maintenance requirement. These characteristics lend the unit to service in remote areas where limited access is available fore service. Technicians that service the other equipment on location can be trained to service the thermoelectric generator. There are many other uses for TEGs including power supplies for supervisory control and data acquisition systems. (author)

  4. On bolus for megavoltage photon and electron radiation therapy

    International Nuclear Information System (INIS)

    Vyas, Vedang; Palmer, Lisa; Mudge, Ray; Jiang, Runqing; Fleck, Andre; Schaly, Bryan; Osei, Ernest; Charland, Paule

    2013-01-01

    Frequently, in radiation therapy one must treat superficial lesions on cancer patients; these are at or adjacent to the skin. Megavoltage photon radiotherapy penetrates through the skin to irradiate deep-seated tumors, with skin-sparing property. Hence, to treat superficial lesions, one must use a layer of scattering material to feign as the skin surface. Although megavoltage electron beams are used for superficial treatments, one occasionally needs to enhance the dose near the surface. Such is the function of a “bolus,” a natural or synthetically developed material that acts as a layer of tissue to provide a more effective treatment to the superficial lesions. Other uses of boluses are to correct for varying surface contours and to add scattering material around the patient's surface. Materials used as bolus vary from simple water to metal and include various mixtures and compounds. Even with the modernization of the technology for external-beam therapy and the emergence of various commercial boluses, the preparation and utilization of a bolus in clinical radiotherapy remains an art. Considering the varying experiences and practices, this paper briefly summarizes available boluses that have been proposed and are employed in clinical radiotherapy. Although this review is not exhaustive, it provides some initial guidance and answers questions that may arise in clinical practice

  5. Methods of bolusing the tracheostomy stoma

    International Nuclear Information System (INIS)

    Beitler, Jonathan J.; Yaparpalvi, Ravindra; Biancia, Cesar Della; Fontenla, Doracy P.

    2001-01-01

    Purpose: The tracheostomy stoma is a potential site of recurrence for patients who have subglottic cancer or subglottic spread of cancer. In these patients, it is important that the anterior supraclavicular field does not underdose the posterior wall of the tracheostomy stoma when using a 6-MV anterior photon field. Conventionally, this problem is surmounted with placement of a plastic tracheostomy tube, which is uncomfortable for the patient, potentially traumatic, and can interfere with vocalization via a tracheal esophageal puncture. Our study was designed to investigate the dosimetry of this region and see if alternate methods would be effective. Methods and Materials: A phantom was constructed using a No. 6 tracheostomy tube as the model for the tracheostomy curvature and size. Using the water-equivalent phantom, film dosimetry, and films oriented parallel to the en face field, we investigated the dose at the depth of the surface of the posterior wall of the phantom's tracheostomy stoma. Dose was measured both in space and at the tissue interface by scanning points of interest both horizontally and vertically. We measured doses with a No. 6 and No. 8 plastic tracheostomy tube, either 0.5 cm and 1.0 cm of bolus (1-cm airhole) with no tracheostomy tube, as well as 0.3 cm and 0.6 cm tissue-equivalent Aquaplast (Med-Tec Co., Orange City, Iowa) over the tracheostomy. Dosimetry at the posterior interface was confirmed using thermoluminescent dosimeters. Results: Three mm and 6 mm of Aquaplast produced a posterior tracheal dose of 93% and 100%. Conclusion: There is no need for these patients to wear a temporary plastic tracheostomy tube during their external radiation therapy. Aquaplast should allow better position reproducibility, reduce trauma, not interfere with patient respiratory efforts, and be compatible with vocalization via a tracheal esophageal puncture

  6. Practice Change From Intermittent Medication Boluses to Bolusing From a Continuous Infusion in Pediatric Critical Care: A Quality Improvement Project.

    Science.gov (United States)

    Hochstetler, Jessica L; Thompson, A Jill; Ball, Natalie M; Evans, Melissa C; Frame, Shaun C; Haney, A Lauren; Little, Amelia K; O'Donnell, Jaime L; Rickett, Bryna M; Mack, Elizabeth H

    2018-04-12

    To determine whether implementing a guideline to bolus medications from continuous infusions in PICUs affects nursing satisfaction, patient safety, central line entries, medication utilization, or cost. This is a pre- and postimplementation quality improvement study. An 11-bed ICU and 14-bed cardiac ICU in a university-affiliated children's hospital. Patients less than 18 years old admitted to the PICU or pediatric cardiac ICU receiving a continuous infusion of dexmedetomidine, midazolam, fentanyl, morphine, vecuronium, or cisatracurium from May 2015 to May 2016, excluding November 2015 (washout period), were eligible for inclusion. Change in practice from administering bolus doses from an automated dispensing machine to administering bolus medications from continuous infusion in PICUs. Timing studies were conducted pre- and post implementation in 29 and 26 occurrences, respectively. The median time from the decision to give a bolus until it began infusing decreased by 169 seconds (p 0.05). Annualized cost avoidance was $124,160. Implementation of bolus medications from continuous infusion in PICUs significantly decreased time to begin a bolus dose and increased nursing satisfaction. The practice change also improved medication utilization without negatively impacting patient safety.

  7. A prospective, randomized, blinded-endpoint, controlled study – continuous epidural infusion versus programmed intermittent epidural bolus in labor analgesia

    Directory of Open Access Journals (Sweden)

    Joana Nunes

    2016-09-01

    mulheres com gravidezes viáveis foram incluídas. Após uma dose epidural de 10 mL de Ropivacaína a 0,16% e adição de 10 μg de Sufentanil, as parturientes foram aleatoriamente designadas para um dos três regimes: A - ropivacaína a 0,15% mais solução de sufentanil (0,2 μg/mL como infusão peridural contínua (5 mL/h, começando imediatamente após o bolus inicial; B - ropivacaína a 0,1% mais sufentanil (0,2 μg/mL como bolus epidural intermitente programado; C - solução idêntica à do Grupo A com bolus epidural intermitente programado. Os regimes BEIP foram programados como 10 mL por hora, iniciando 60 minutos após o bolus inicial. Bolus de resgate de 5 mL da mesma solução foram administrados com bomba de infusão. A satisfação materna foi avaliada utilizando uma escala numérica verbal de 0 a 10. Também avaliamos os resultados adversos maternais e neonatais. Resultados: Foram avaliadas 30 gestantes (A = 60, B = 33; C = 37 foram avaliados. A mediana na escala numérica verbal para a satisfação materna foi de 8,8 no grupo A; 8,6 no grupo B e 8,6 no grupo C (p = 0,83. Encontramos uma taxa mais elevada para parto cesário no grupo A (56,7%; p = 0,02. Não observamos diferenças no bloqueio motor, taxa de parto instrumental e resultados neonatais. Conclusões: A manutenção da analgesia peridural com bolus epidural intermitente programado está associada a uma redução da incidência de parto cesariano com satisfação materna igualmente elevada e sem resultados adversos. Keywords: Analgesia, Epidural, Epidural analgesic techniques, Infusion, Obstetric analgesia, Programmed intermittent bolus, Palavras-chave: Analgesia, Epidural, Técnicas de analgesia epidural, Infusão, Analgesia obstétrica, Bolus intermitente programado

  8. Fabrication of malleable three-dimensional-printed customized bolus using three-dimensional scanner.

    Directory of Open Access Journals (Sweden)

    Jae Won Park

    Full Text Available A three-dimensional (3D-printed customized bolus (3D bolus can be used for radiotherapy application to irregular surfaces. However, bolus fabrication based on computed tomography (CT scans is complicated and also delivers unwanted irradiation. Consequently, we fabricated a bolus using a 3D scanner and evaluated its efficacy. The head of an Alderson Rando phantom was scanned with a 3D scanner. The 3D surface data were exported and reconstructed with Geomagic Design X software. A 3D bolus of 5-mm thickness designed to fit onto the nose was printed with the use of rubber-like printing material, and a radiotherapy plan was developed. We successfully fabricated the customized 3D bolus, and further, a CT simulation indicated an acceptable fit of the 3D bolus to the nose. There was no air gap between the bolus and the phantom surface. The percent depth dose (PDD curve of the phantom with the 3D bolus showed an enhanced surface dose when compared with that of the phantom without the bolus. The PDD of the 3D bolus was comparable with that of a commercial superflab bolus. The radiotherapy plan considering the 3D bolus showed improved target coverage when compared with that without the bolus. Thus, we successfully fabricated a customized 3D bolus for an irregular surface using a 3D scanner instead of a CT scanner.

  9. Solid bolus swallowing in the radiologic evaluation of dysphagia

    International Nuclear Information System (INIS)

    Westen, D. van; Ekberg, O.

    1993-01-01

    Patients with dysphagia, heartburn and chest pain are regularly referred for radiologic evaluation of swallowing. The liquid barium swallow has been of great value for the biphasic evaluation of the pharynx and esophagus. Though many patients complain of dysphagia specifically for solids, solid bolus swallow is ususally not part of the evaluation. For the present study we therefore included the use of a solid bolus with a diameter of 13 mm and interviewed the patients carefully for any symptoms during this tablet swallow. Of 200 patients examined, the tablet passed through the esophagus without delay in 102. In the 98 patients with delayed passage, the solid bolus arrest occurred in the pharynx in 5 and in the esophagus in 93. Arrest in the esophagus was due to esophageal dysmotility in 48 patients. Twenty of these were symptomatic during the tablet swallow. A narrowing was the cause in 45, of whom 9 had symptoms. In 18 patients (9%) the solid bolus added key information to the radiologic evaluation. We therefore recommend that the solid bolus is included in the routine radiologic work-up of patients with dysphagia. Careful attention to symptoms during the tablet swallow is important. (orig.)

  10. Solid bolus swallowing in the radiologic evaluation of dysphagia

    Energy Technology Data Exchange (ETDEWEB)

    Westen, D. van (Dept. of Diagnostic Radiology, Malmoe General Hospital, Univ. Lund (Sweden)); Ekberg, O. (Dept. of Diagnostic Radiology, Malmoe General Hospital, Univ. Lund (Sweden))

    1993-07-01

    Patients with dysphagia, heartburn and chest pain are regularly referred for radiologic evaluation of swallowing. The liquid barium swallow has been of great value for the biphasic evaluation of the pharynx and esophagus. Though many patients complain of dysphagia specifically for solids, solid bolus swallow is ususally not part of the evaluation. For the present study we therefore included the use of a solid bolus with a diameter of 13 mm and interviewed the patients carefully for any symptoms during this tablet swallow. Of 200 patients examined, the tablet passed through the esophagus without delay in 102. In the 98 patients with delayed passage, the solid bolus arrest occurred in the pharynx in 5 and in the esophagus in 93. Arrest in the esophagus was due to esophageal dysmotility in 48 patients. Twenty of these were symptomatic during the tablet swallow. A narrowing was the cause in 45, of whom 9 had symptoms. In 18 patients (9%) the solid bolus added key information to the radiologic evaluation. We therefore recommend that the solid bolus is included in the routine radiologic work-up of patients with dysphagia. Careful attention to symptoms during the tablet swallow is important. (orig.).

  11. Intravenous contrast medium administration at 128 multidetector row CT pulmonary angiography: Bolus tracking versus test bolus and the implications for diagnostic quality and effective dose

    International Nuclear Information System (INIS)

    Rodrigues, J.C.L.; Mathias, H.; Negus, I.S.; Manghat, N.E.; Hamilton, M.C.K.

    2012-01-01

    Aim: To investigate the effects of a test bolus protocol contrast medium administration on diagnostic image quality in computed tomography pulmonary angiography (CTPA). Materials and methods: Fifty patients referred for exclusion of pulmonary embolism underwent CTPA using a test bolus protocol CTPA at 120 kVp and were compared with 50 patients undergoing CTPA using a standard bolus-tracking protocol at 120 kVp, via assessment of attenuation, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) seen in the pulmonary arteries (PAs). An additional group of 10 non-obese patients who underwent CTPA using a test bolus protocol performed at 100 kVp were also analysed. Mean effective dose was calculated from the dose–length product, using standard conversion factors. Results: The test bolus protocol showed significantly higher attenuation, SNR, and CNR in the pulmonary vasculature down to the segmental level compared to bolus-tracking CTPA (p < 0.0001). There was no significant difference in effective dose between the test bolus and bolus tracking cohorts. The additional group of test bolus CTPA examinations performed at 100 kVp had a significantly reduced effective dose in comparison to both test bolus CTPA at 120 kVp and bolus-tracking CTPA at 120 kVp (p < 0.005) yet maintained mean PA attenuation to segmental level significantly better than bolus-tracking CTPA performed at 120 kVp and comparable to the test bolus cohort performed at 120 kVp. Conclusion: Test bolus contrast administration should be used as an optimal protocol. Performing test bolus CTPA at 100 kVp, as opposed to 120 kVp, significantly reduces dose without compromising PA attenuation in non-obese subjects.

  12. Esophageal Transit, Contraction and Perception of Transit After Swallows of Two Viscous Boluses.

    Science.gov (United States)

    Dalmazo, Jucileia; Aprile, Lilian Rose Otoboni; Dantas, Roberto Oliveira

    2015-10-01

    There have been results showing the influence of bolus viscosities and consistency on esophageal motility and transit. However, there is no description about the influence of two different viscous boluses on esophageal contractions, bolus transit and perception of transit. Our objective in this investigation was to evaluate the esophageal transit and contraction after swallows of two viscous boluses. By impedance and manometric methods, we measured the esophageal transit and contraction after swallows of two viscous boluses of 5 mL volume, 100% barium sulfate and yogurt, swallowed in duplicate in the supine and upright positions. The bolus transit, esophageal contractions and the perception of bolus transit through the esophagus were evaluated in both positions. Impedance and contraction were measured at 5, 10, 15 and 20 cm from the lower esophageal sphincter. After each swallow, the volunteers were asked about the sensation of bolus transit through the esophagus. In supine position, the yogurt had a less frequent complete bolus transit than barium. Also in the supine position, the esophageal transit was longer with yogurt than with barium. Esophageal contractions after swallows were similar between barium and yogurt boluses. There was no difference in perception of transit between the two boluses. Although both 100% barium sulfate and yogurt are viscous boluses and have similar viscosities, the transit through the esophagus is slower with yogurt bolus than with barium bolus, which suggests that viscosity may be not the sole factor to determine transit.

  13. A customized bolus produced using a 3-dimensional printer for radiotherapy.

    Science.gov (United States)

    Kim, Shin-Wook; Shin, Hun-Joo; Kay, Chul Seung; Son, Seok Hyun

    2014-01-01

    Boluses are used in high-energy radiotherapy in order to overcome the skin sparing effect. In practice though, commonly used flat boluses fail to make a perfect contact with the irregular surface of the patient's skin, resulting in air gaps. Hence, we fabricated a customized bolus using a 3-dimensional (3D) printer and evaluated its feasibility for radiotherapy. We designed two kinds of bolus for production on a 3D printer, one of which was the 3D printed flat bolus for the Blue water phantom and the other was a 3D printed customized bolus for the RANDO phantom. The 3D printed flat bolus was fabricated to verify its physical quality. The resulting 3D printed flat bolus was evaluated by assessing dosimetric parameters such as D1.5 cm, D5 cm, and D10 cm. The 3D printed customized bolus was then fabricated, and its quality and clinical feasibility were evaluated by visual inspection and by assessing dosimetric parameters such as Dmax, Dmin, Dmean, D90%, and V90%. The dosimetric parameters of the resulting 3D printed flat bolus showed that it was a useful dose escalating material, equivalent to a commercially available flat bolus. Analysis of the dosimetric parameters of the 3D printed customized bolus demonstrated that it is provided good dose escalation and good contact with the irregular surface of the RANDO phantom. A customized bolus produced using a 3D printer could potentially replace commercially available flat boluses.

  14. Impaired bolus transit across the esophagogastric junction in postfundoplication dysphagia

    NARCIS (Netherlands)

    Scheffer, R. C. H.; Samsom, M.; Haverkamp, A.; Oors, J.; Hebbard, G. S.; Gooszen, H. G.

    2005-01-01

    This study assessed the effect of fundoplication on liquid and solid bolus transit across the esophagogastric junction (EGJ) in relation to EGJ dynamics and dysphagia. Twelve patients with gastro-esophageal reflux disease (GERD) were studied before and after fundoplication. Concurrent

  15. Dextrose boluses versus burette dextrose infusions in prevention of ...

    African Journals Online (AJOL)

    The incidence of hypoglycemia in the bolus arm was 59% (40/68) compared to 11% (8/72) in the ... and safety monitoring board (DSMB) was set up to oversee to ..... On the other hand, Namukwaya et al in a prospective study at Mulago ...

  16. Comparison and evaluation between 3D-bolus and step-bolus, the assistive radiotherapy devices for the patients who had undergone modified radical mastectomy surgery

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Won Seok; Park, Kwang Woo; Shin, Dong Bong; Kim, Jong Dae; Kim, Sei Joon; Ha, Jin Sook; Jeon, Mi Jin; Cho, Yoojin; Jung, Inho [Dept. of Radiation Oncology, Gangnam Severance Hospital, Seoul, (Korea, Republic of)

    2016-06-15

    This study aimed to compare and evaluate between the efficiency of two respective devices, 3D-bolus and step-bolus when the devices were used for the treatment of patients whose chest walls were required to undergo the electron beam therapy after the surgical procedure of modified radical mastectomy, MRM. The treatment plan of reverse hockey stick method, using the photon beam and electron beam, had been set for six breast cancer patients and these 6 breast cancer patients were selected to be the subjects for this study. The prescribed dose of electron beam for anterior chest wall was set to be 180 cGy per treatment and both the 3D-bolus, produced using 3D printer(CubeX, 3D systems, USA) and the self-made conventional step-bolus were used respectively. The surface dose under 3D-bolus and step-bolus was measured at 5 measurement spots of iso-center, lateral, medial, superior and inferior point, using GAFCHROMIC EBT3 film (International specialty products, USA) and the measured value of dose at 5 spots was compared and analyzed. Also the respective treatment plan was devised, considering the adoption of 3D-bolus and stepbolus and the separate treatment results were compared to each other. The average surface dose was 179.17 cGy when the device of 3D-bolus was adopted and 172.02 cGy when step-bolus was adopted. The average error rate against the prescribed dose of 180 cGy was -(minus) 0.47% when the device of 3D-bolus was adopted and it was -(minus) 4.43% when step-bolus was adopted. It was turned out that the maximum error rate at the point of iso-center was 2.69%, in case of 3D-bolus adoption and it was 5,54% in case of step-bolus adoption. The maximum discrepancy in terms of treatment accuracy was revealed to be about 6% when step-bolus was adopted and to be about 3% when 3D-bolus was adopted. The difference in average target dose on chest wall between 3D-bolus treatment plan and step-bolus treatment plan was shown to be insignificant as the difference was only 0

  17. Comparison and evaluation between 3D-bolus and step-bolus, the assistive radiotherapy devices for the patients who had undergone modified radical mastectomy surgery

    International Nuclear Information System (INIS)

    Jang, Won Seok; Park, Kwang Woo; Shin, Dong Bong; Kim, Jong Dae; Kim, Sei Joon; Ha, Jin Sook; Jeon, Mi Jin; Cho, Yoojin; Jung, Inho

    2016-01-01

    This study aimed to compare and evaluate between the efficiency of two respective devices, 3D-bolus and step-bolus when the devices were used for the treatment of patients whose chest walls were required to undergo the electron beam therapy after the surgical procedure of modified radical mastectomy, MRM. The treatment plan of reverse hockey stick method, using the photon beam and electron beam, had been set for six breast cancer patients and these 6 breast cancer patients were selected to be the subjects for this study. The prescribed dose of electron beam for anterior chest wall was set to be 180 cGy per treatment and both the 3D-bolus, produced using 3D printer(CubeX, 3D systems, USA) and the self-made conventional step-bolus were used respectively. The surface dose under 3D-bolus and step-bolus was measured at 5 measurement spots of iso-center, lateral, medial, superior and inferior point, using GAFCHROMIC EBT3 film (International specialty products, USA) and the measured value of dose at 5 spots was compared and analyzed. Also the respective treatment plan was devised, considering the adoption of 3D-bolus and stepbolus and the separate treatment results were compared to each other. The average surface dose was 179.17 cGy when the device of 3D-bolus was adopted and 172.02 cGy when step-bolus was adopted. The average error rate against the prescribed dose of 180 cGy was -(minus) 0.47% when the device of 3D-bolus was adopted and it was -(minus) 4.43% when step-bolus was adopted. It was turned out that the maximum error rate at the point of iso-center was 2.69%, in case of 3D-bolus adoption and it was 5,54% in case of step-bolus adoption. The maximum discrepancy in terms of treatment accuracy was revealed to be about 6% when step-bolus was adopted and to be about 3% when 3D-bolus was adopted. The difference in average target dose on chest wall between 3D-bolus treatment plan and step-bolus treatment plan was shown to be insignificant as the difference was only 0

  18. SU-C-213-03: Custom 3D Printed Boluses for Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, B; Yang, M; Yan, Y; Rahimi, A; Chopra, R; Jiang, S [UT Southwestern Medical Center, Dallas, TX (United States)

    2015-06-15

    Purpose: To develop a clinical workflow and to commission the process of creating custom 3d printed boluses for radiation therapy. Methods: We designed a workflow to create custom boluses using a commercial 3D printer. Contours of several patients were deformably mapped to phantoms where the test bolus contours were designed. Treatment plans were created on the phantoms following our institutional planning guideline. The DICOM file of the bolus contours were then converted to stereoLithography (stl) file for the 3d printer. The boluses were printed on a commercial 3D printer using polylactic acid (PLA) material. Custom printing parameters were optimized in order to meet the requirement of bolus composition. The workflow was tested on multiple anatomical sites such as skull, nose and chest wall. The size of boluses varies from 6×9cm2 to 12×25cm2. To commission the process, basic CT and dose properties of the printing materials were measured in photon and electron beams and compared against water and soft superflab bolus. Phantoms were then scanned to confirm the placement of custom boluses. Finally dose distributions with rescanned CTs were compared with those computer-generated boluses. Results: The relative electron density(1.08±0.006) of the printed boluses resemble those of liquid tap water(1.04±0.004). The dosimetric properties resemble those of liquid tap water(1.04±0.004). The dosimetric properties were measured at dmax with an ion chamber in electron and photon open beams. Compared with solid water and soft bolus, the output difference was within 1% for the 3D printer material. The printed boluses fit well to the phantom surfaces on CT scans. The dose distribution and DVH based on the printed boluses match well with those based on TPS generated boluses. Conclusion: 3d printing provides a cost effective and convenient solution for patient-specific boluses in radiation therapy.

  19. SU-C-213-03: Custom 3D Printed Boluses for Radiation Therapy

    International Nuclear Information System (INIS)

    Zhao, B; Yang, M; Yan, Y; Rahimi, A; Chopra, R; Jiang, S

    2015-01-01

    Purpose: To develop a clinical workflow and to commission the process of creating custom 3d printed boluses for radiation therapy. Methods: We designed a workflow to create custom boluses using a commercial 3D printer. Contours of several patients were deformably mapped to phantoms where the test bolus contours were designed. Treatment plans were created on the phantoms following our institutional planning guideline. The DICOM file of the bolus contours were then converted to stereoLithography (stl) file for the 3d printer. The boluses were printed on a commercial 3D printer using polylactic acid (PLA) material. Custom printing parameters were optimized in order to meet the requirement of bolus composition. The workflow was tested on multiple anatomical sites such as skull, nose and chest wall. The size of boluses varies from 6×9cm2 to 12×25cm2. To commission the process, basic CT and dose properties of the printing materials were measured in photon and electron beams and compared against water and soft superflab bolus. Phantoms were then scanned to confirm the placement of custom boluses. Finally dose distributions with rescanned CTs were compared with those computer-generated boluses. Results: The relative electron density(1.08±0.006) of the printed boluses resemble those of liquid tap water(1.04±0.004). The dosimetric properties resemble those of liquid tap water(1.04±0.004). The dosimetric properties were measured at dmax with an ion chamber in electron and photon open beams. Compared with solid water and soft bolus, the output difference was within 1% for the 3D printer material. The printed boluses fit well to the phantom surfaces on CT scans. The dose distribution and DVH based on the printed boluses match well with those based on TPS generated boluses. Conclusion: 3d printing provides a cost effective and convenient solution for patient-specific boluses in radiation therapy

  20. SU-C-213-06: Dosimetric Verification of 3D Printed Electron Bolus

    International Nuclear Information System (INIS)

    Rasmussen, K; Corbett, M; Pelletier, C; Huang, Z; Feng, Y; Jung, J

    2015-01-01

    Purpose: To determine the dosimetric effect of 3D printed bolus in an anthropomorphic phantom. Methods: Conformable bolus material was generated for an anthropomorphic phantom from a DICOM volume. The bolus generated was a uniform expansion of 5mm applied to the nose region of the phantom, as this is a difficult area to uniformly apply bolus clinically. A Printrbot metal 3D Printer using PLA plastic generated the bolus. A 9MeV anterior beam with a 5cm cone was used to deliver dose to the nose of the phantom. TLD measurements were compared to predicted values at the phantom surface. Film planes were analyzed for the printed bolus, a standard 5mm bolus sheet placed on the phantom, and the phantom with no bolus applied to determine depth and dose distributions. Results: TLDs measured within 2.5% of predicted value for the 3D bolus. Film demonstrated a more uniform dose distribution in the nostril region for the 3d printed bolus than the standard bolus. This difference is caused by the air gap created around the nostrils by the standard bolus, creating a secondary build-up region. Both demonstrated a 50% central axis dose shift of 5mm relative to the no bolus film. HU for the bolus calculated the PLA electron density to be ∼1.1g/cc. Physical density was measured to be 1.3g/cc overall. Conclusion: 3D printed PLA bolus demonstrates improved dosimetric performance to standard bolus for electron beams with complex phantom geometry

  1. The influence of a solid and liquid bolus on food-stimulated gastroesophageal reflux

    International Nuclear Information System (INIS)

    Naeser, A.; Behrens, J.K.; Vejen-Christiansen, L.; Funch-Jensen, P.; Thommesen, P.; Aarhus Kommunehospital

    1992-01-01

    Using a radiological method to demonstrate food-stimulated gastroesophageal reflux (GER), a comparative study was carried out employing a solid, already validated bolus versus a liquid one. One hundred and four consecutive patients received both a solid and a liquid bolus in randomized order. GER was observed in 37 (35.6%) patients receiving the solid bolus versus 28 (26.9%) with the liquid one. This means that the solid bolus provokes significantly more reflux (P [de

  2. SU-C-213-06: Dosimetric Verification of 3D Printed Electron Bolus

    Energy Technology Data Exchange (ETDEWEB)

    Rasmussen, K; Corbett, M; Pelletier, C; Huang, Z; Feng, Y; Jung, J [East Carolina Univ, Greenville, NC (United States)

    2015-06-15

    Purpose: To determine the dosimetric effect of 3D printed bolus in an anthropomorphic phantom. Methods: Conformable bolus material was generated for an anthropomorphic phantom from a DICOM volume. The bolus generated was a uniform expansion of 5mm applied to the nose region of the phantom, as this is a difficult area to uniformly apply bolus clinically. A Printrbot metal 3D Printer using PLA plastic generated the bolus. A 9MeV anterior beam with a 5cm cone was used to deliver dose to the nose of the phantom. TLD measurements were compared to predicted values at the phantom surface. Film planes were analyzed for the printed bolus, a standard 5mm bolus sheet placed on the phantom, and the phantom with no bolus applied to determine depth and dose distributions. Results: TLDs measured within 2.5% of predicted value for the 3D bolus. Film demonstrated a more uniform dose distribution in the nostril region for the 3d printed bolus than the standard bolus. This difference is caused by the air gap created around the nostrils by the standard bolus, creating a secondary build-up region. Both demonstrated a 50% central axis dose shift of 5mm relative to the no bolus film. HU for the bolus calculated the PLA electron density to be ∼1.1g/cc. Physical density was measured to be 1.3g/cc overall. Conclusion: 3D printed PLA bolus demonstrates improved dosimetric performance to standard bolus for electron beams with complex phantom geometry.

  3. 21 CFR 520.1660c - Oxytetracycline hydrochloride tablets/boluses.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Oxytetracycline hydrochloride tablets/boluses. 520....1660c Oxytetracycline hydrochloride tablets/boluses. (a) Specifications. Each tablet or bolus contains 250, 500, or 1,000 milligrams of oxytetracycline hydrochloride. (b) Sponsors. For sponsors in § 510...

  4. Role of physical bolus properties as sensory inputs in the trigger of swallowing.

    Science.gov (United States)

    Peyron, Marie-Agnès; Gierczynski, Isabelle; Hartmann, Christoph; Loret, Chrystel; Dardevet, Dominique; Martin, Nathalie; Woda, Alain

    2011-01-01

    Swallowing is triggered when a food bolus being prepared by mastication has reached a defined state. However, although this view is consensual and well supported, the physical properties of the swallowable bolus have been under-researched. We tested the hypothesis that measuring bolus physical changes during the masticatory sequence to deglutition would reveal the bolus properties potentially involved in swallowing initiation. Twenty normo-dentate young adults were instructed to chew portions of cereal and spit out the boluses at different times in the masticatory sequence. The mechanical properties of the collected boluses were measured by a texture profile analysis test currently used in food science. The median particle size of the boluses was evaluated by sieving. In a simultaneous sensory study, twenty-five other subjects expressed their perception of bolus texture dominating at any mastication time. Several physical changes appeared in the food bolus as it was formed during mastication: (1) in rheological terms, bolus hardness rapidly decreased as the masticatory sequence progressed, (2) by contrast, adhesiveness, springiness and cohesiveness regularly increased until the time of swallowing, (3) median particle size, indicating the bolus particle size distribution, decreased mostly during the first third of the masticatory sequence, (4) except for hardness, the rheological changes still appeared in the boluses collected just before swallowing, and (5) physical changes occurred, with sensory stickiness being described by the subjects as a dominant perception of the bolus at the end of mastication. Although these physical and sensory changes progressed in the course of mastication, those observed just before swallowing seem to be involved in swallowing initiation. They can be considered as strong candidates for sensory inputs from the bolus that are probably crucially involved in the triggering of swallowing, since they appeared in boluses prepared in various

  5. Role of physical bolus properties as sensory inputs in the trigger of swallowing.

    Directory of Open Access Journals (Sweden)

    Marie-Agnès Peyron

    Full Text Available BACKGROUND: Swallowing is triggered when a food bolus being prepared by mastication has reached a defined state. However, although this view is consensual and well supported, the physical properties of the swallowable bolus have been under-researched. We tested the hypothesis that measuring bolus physical changes during the masticatory sequence to deglutition would reveal the bolus properties potentially involved in swallowing initiation. METHODS: Twenty normo-dentate young adults were instructed to chew portions of cereal and spit out the boluses at different times in the masticatory sequence. The mechanical properties of the collected boluses were measured by a texture profile analysis test currently used in food science. The median particle size of the boluses was evaluated by sieving. In a simultaneous sensory study, twenty-five other subjects expressed their perception of bolus texture dominating at any mastication time. FINDINGS: Several physical changes appeared in the food bolus as it was formed during mastication: (1 in rheological terms, bolus hardness rapidly decreased as the masticatory sequence progressed, (2 by contrast, adhesiveness, springiness and cohesiveness regularly increased until the time of swallowing, (3 median particle size, indicating the bolus particle size distribution, decreased mostly during the first third of the masticatory sequence, (4 except for hardness, the rheological changes still appeared in the boluses collected just before swallowing, and (5 physical changes occurred, with sensory stickiness being described by the subjects as a dominant perception of the bolus at the end of mastication. CONCLUSIONS: Although these physical and sensory changes progressed in the course of mastication, those observed just before swallowing seem to be involved in swallowing initiation. They can be considered as strong candidates for sensory inputs from the bolus that are probably crucially involved in the triggering of

  6. 21 CFR 520.1720a - Phenylbutazone tablets and boluses.

    Science.gov (United States)

    2010-04-01

    ... Section 520.1720a Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES...-mg or 1-g tablets, or 2- or 4-g boluses, in dogs and horses. (2) Nos. 000010 and 059130 for use of 100- or 200-mg or 1-g tablets in dogs and horses. (3) Nos. 000856 and 061623 for use of 100-mg or 1-g...

  7. Transversus Abdominis Plane Catheter Bolus Analgesia after Major Abdominal Surgery

    Directory of Open Access Journals (Sweden)

    Nils Bjerregaard

    2012-01-01

    Full Text Available Purpose. Transversus abdominis plane (TAP blocks have been shown to reduce pain and opioid requirements after abdominal surgery. The aim of the present case series was to demonstrate the use of TAP catheter injections of bupivacaine after major abdominal surgery. Methods. Fifteen patients scheduled for open colonic resection surgery were included. After induction of anesthesia, bilateral TAP catheters were placed, and all patients received a bolus dose of 20 mL bupivacaine 2.5 mg/mL with epinephrine 5 μg/mL through each catheter. Additional bolus doses were injected bilaterally 12, 24, and 36 hrs after the first injections. Supplemental pain treatment consisted of paracetamol, ibuprofen, and gabapentin. Intravenous morphine was used as rescue analgesic. Postoperative pain was rated on a numeric rating scale (NRS, 0–10 at regular predefined intervals after surgery, and consumption of intravenous morphine was recorded. Results. The TAP catheters were placed without any technical difficulties. NRS scores were ≤3 at rest and ≤5 during cough at 4, 8, 12, 18, 24, and 36 hrs after surgery. Cumulative consumption of intravenous morphine was 28 (23–48 mg (median, IQR within the first 48 postoperative hours. Conclusion. TAP catheter bolus injections can be used to prolong analgesia after major abdominal surgery.

  8. A customized bolus produced using a 3-dimensional printer for radiotherapy.

    Directory of Open Access Journals (Sweden)

    Shin-Wook Kim

    Full Text Available OBJECTIVE: Boluses are used in high-energy radiotherapy in order to overcome the skin sparing effect. In practice though, commonly used flat boluses fail to make a perfect contact with the irregular surface of the patient's skin, resulting in air gaps. Hence, we fabricated a customized bolus using a 3-dimensional (3D printer and evaluated its feasibility for radiotherapy. METHODS: We designed two kinds of bolus for production on a 3D printer, one of which was the 3D printed flat bolus for the Blue water phantom and the other was a 3D printed customized bolus for the RANDO phantom. The 3D printed flat bolus was fabricated to verify its physical quality. The resulting 3D printed flat bolus was evaluated by assessing dosimetric parameters such as D1.5 cm, D5 cm, and D10 cm. The 3D printed customized bolus was then fabricated, and its quality and clinical feasibility were evaluated by visual inspection and by assessing dosimetric parameters such as Dmax, Dmin, Dmean, D90%, and V90%. RESULTS: The dosimetric parameters of the resulting 3D printed flat bolus showed that it was a useful dose escalating material, equivalent to a commercially available flat bolus. Analysis of the dosimetric parameters of the 3D printed customized bolus demonstrated that it is provided good dose escalation and good contact with the irregular surface of the RANDO phantom. CONCLUSIONS: A customized bolus produced using a 3D printer could potentially replace commercially available flat boluses.

  9. Association between swallow perception and esophageal bolus clearance in patients with globus sensation.

    Science.gov (United States)

    Chen, Chien-Lin; Yi, Chih-Hsun; Liu, Tso-Tsai

    2013-04-01

    Globus sensation is common, but its pathogenesis is not yet clear. Our purpose was to investigate subjective perception of swallowing and esophageal motility by combined multichannel intraluminal impedance and manometry (MII-EM) for patients with globus sensation. Combined MII-EM was performed for 25 globus patients and 15 healthy controls. Swallows were abnormal if hypocontractivity or simultaneous contractions occurred. Esophageal bolus transit was incomplete if bolus exit was not found at one or more of all measurement sites. Perception of each swallow was assessed by use of a standardized scoring system, and was enhanced if the score was >1. Few globus patients reported enhanced perception during viscous or solid swallows. Incomplete bolus transit and enhanced perception occurred similarly between viscous and solid boluses. Agreement between enhanced perception and proximal bolus clearance was greater during solid swallows (κ = 0.45, 95 % CI: 0.32-0.58) than during viscous swallows (κ = 0.13, 95 % CI: 0-0.25) (P perception and total bolus clearance was greater during solid swallows (κ = 0.46, 95 % CI: 0.34-0.58) than during viscous swallows (κ = 0.11, 95 % CI: 0-0.22) (P perception is uncommon in patients with globus sensation, although there is a significant association between enhanced esophageal perception and solid bolus clearance. Application of a solid bolus may help better delineation of the interrelationship between the subjective perception of bolus passage and the objective measurement of bolus clearance.

  10. Radionuclide esophageal transit of a liquid bolus: A reappraisal

    International Nuclear Information System (INIS)

    Holloway, R.H.; Lange, R.C.; Magyar, L.; Greene, R.; McCallum, R.W.

    1984-01-01

    Measurement of radionuclide esophageal transit (RT) using a liquid bolus has been suggested as a screening test for esophageal motor disorders (EMD). The authors prospectively evaluated RT in 49 patients referred for esophageal manometry. Ten subjects with normal manometry served as controls. RT was performed using two 10 ml boluses of water labeled with 250 μCi /sup 99m/Tc-sulfur colloid. Patients were studied supine and the swallow sequences framed in 1 second intervals. Transit time was measured from the time of entry to the time of exit from the esophagus. Mean transit time in normal subjects was 9.1 +- 2.1 (SD) sec. The test was abnormal if the transit time was prolonged (> 15 sec) in at least 1 of 2 swallows. RT agreed with manometry in 36/49 patients (75%), including 9/9 achalasics, 3/3 diffuse esophageal spasm, 3/7 'nutcracker esophagus' and 7/8 non-specific motor disorders (NSMD). 4/18 patients with normal manometry had abnormal RT. 9/31 patients with abnormal manometry had normal RT, including 4/7 nutcracker esophagus, 3/3 hypertrensive LES, 1/1 scleroderma and 1/8 NSMD. Sensitivity of RT was 70% and specificity 77%. The false positive rate was 15% and the false negative rate 39%. The authors conclude the following: 1) RT identifies patients with absent or impaired peristalsis; 2) There is substantial incidence of false negatives among patients with manometric disorders but normal peristalsis; and 3) Abnormal RT did occur in some patients with normal menometry. RT using a liquid bolus may not be sensitive enough as a screening test for EMD, but it may be an important adjunct to manometry

  11. MR liver imaging after bolus administration of Teslascan

    International Nuclear Information System (INIS)

    Costa, S.; Marti-Bonmati, L.; Delgado, F.; Torregrosa, A.

    2003-01-01

    Mn-DPDP (Teslascan. Amersham-Health) improves the detection of small hepatic lesions and the accuracy with which certain focal lesions can be characterized. Slow infusion (2-3 ml per minute) is the accepted European standard for its administration. Our aim was to evaluate the efficiency of bolus administration. A prospective MR evaluation at 0.5 was performed on 31 consecutive patients. A GE T1 sequence was performed on all before contrast administration. Teslascan was administered by rapid intravenous infusion (=1 ml/s), and the GE sequence was repeated and completed by an STIR sequence. Correlations between presence of cirrhosis and enhancement pattern of hepatic parenchyma, number of lesions detected before and after bolus administration, as well as lesion histology and degree of enhancement were all analyzed. Adverse clinical reactions as reported by patients were also noted. Cirrhotic liver was found in 49% of the patients. Enhancement was mainly heterogeneous with hypointense areas and heterogeneous with hypointense areas together with more greatly enhanced regenerative nodules. Enhancement of cirrhotic livers was homogeneous in a third of the cases. Non-cirrhotic patients exhibited a homogeneous hepatic mass in most cases,ith only one liver showing heterogeneous enhancement containing hypointense bands caused by necrotic debris having resulted from treated metastases. Enhancement pattern differences between cirrhotic and non-cirrhotic patients were statistically significant (p=0.001). In 20 of the 31 patients, solid focal lesions were detected. Sequences performed after bolus administration of contrast media detected more lesions than did those before administration. Combination of both post-administration sequences (T1 and STIR) detected the most lesions, with differences between it and pre-administration sequences being statistically significant (p=0.0014). There was observed a varying degree of lesion enhancement. Such variability was associated with the

  12. Effect of contrast media iodine concentration on bolus tracking

    International Nuclear Information System (INIS)

    Ishihara, Toshihiro; Hayashi, Takayuki; Nakaya, Yoshihiro; Naoi, Kuniji; Ikeno, Naoya; Kobayashi, Tatsushi; Satake, Mitsuo

    2006-01-01

    Computer-assisted bolus tracking has been confirmed to be a useful technique in computed tomography (CT) imaging and allows images to be captured with automated timing. The inflow of the contrast medium is monitored, and when the contrast medium reaches a predetermined level, CT image capture starts automatically. However, it has been shown that the preset threshold value of contrast medium is affected by its iodine concentration, which causes variations in image capture times. Greater speed in current multislice CT imaging requires that medical technicians pay more attention to setting the timing of image capture during venous examinations by taking into account the iodine concentration in contrast media. (author)

  13. The influence of a solid and liquid bolus on food-stimulated gastroesophageal reflux

    Energy Technology Data Exchange (ETDEWEB)

    Naeser, A.; Behrens, J.K.; Vejen-Christiansen, L.; Funch-Jensen, P.; Thommesen, P. (Aarhus Kommunehospital (Denmark). GI Motility Lab. Aarhus Kommunehospital (Denmark). Dept. of Diagnostic Radiology R)

    1992-02-01

    Using a radiological method to demonstrate food-stimulated gastroesophageal reflux (GER), a comparative study was carried out employing a solid, already validated bolus versus a liquid one. One hundred and four consecutive patients received both a solid and a liquid bolus in randomized order. GER was observed in 37 (35.6%) patients receiving the solid bolus versus 28 (26.9%) with the liquid one. This means that the solid bolus provokes significantly more reflux (P<0.02). GER, grade II (reflux above the level of the carina), occurred equally often as a result of both types of bolus, however. The study suggests that significant, food-stimulated GER is independent of the consistency of the foodstuffs and may be detected employing a liquid bolus. This result might be used in the examination of infants for GER, using milk as a food stimulus. (orig.).

  14. Assessment of bolus transit with intraluminal impedance measurement in patients with esophageal motility disorders.

    Science.gov (United States)

    Bogte, A; Bredenoord, A J; Oors, J; Siersema, P D; Smout, A J P M

    2015-10-01

    The clinical management of patients with non-obstructive dysphagia is notoriously difficult. Esophageal impedance measurement can be used to measure esophageal bolus transit without the use of radiation exposure to patients. However, validation of measurement of bolus transit with impedance monitoring has only been performed in healthy subjects with normal motility and not in patients with dysphagia and esophageal motility disorders. The aim was, therefore, to investigate the relationship between transit of swallowed liquid boluses in healthy controls and in patients with dysphagia. Twenty healthy volunteers and 20 patients with dysphagia underwent concurrent impedance measurement and videofluoroscopy. Each subject swallowed five liquid barium boluses. The ability of detecting complete or incomplete bolus transit by means of impedance measurement was assessed, using radiographic bolus transit as the gold standard. Impedance monitoring recognized stasis and transit in 80.5% of the events correctly, with 83.9% of bolus transit being recognized and 77.2% of stasis being recognized correctly. In controls 79.8% of all swallows were scored correctly, whereas in patients 81.3% of all swallows were scored correctly. Depending on the contractility pattern, between 77.0% and 94.3% of the swallows were scored correctly. Impedance measurement can be used to assess bolus clearance patterns in healthy subjects, but can also be used to reliably assess bolus transit in patients with dysphagia and motility disorders. © 2015 John Wiley & Sons Ltd.

  15. Efficacy of a Targeted Drug Delivery on-Demand Bolus Option for Chronic Pain.

    Science.gov (United States)

    Bolash, Robert B; Niazi, Tariq; Kumari, Meera; Azer, Gerges; Mekhail, Nagy

    2018-03-01

    Intrathecal targeted drug delivery systems historically required physician office visits for dose adjustment to manage fluctuating pain. A wireless device now enables patients to supplement their basal intrathecal infusion with a programmed on-demand bolus dose. We sought to quantify the change in oral breakthrough opioid need associated with the use of an intrathecal bolus in comparison to those treated with the basal infusion alone. Demographic, dosage, bolus usage and longevity data were extracted from the historical medical record of 69 patients (18/51 bolus/nonbolus) followed continuously at our center. Medication consumption and Pain Disability Index measures were obtained at baseline and most recent follow-up. Among patients with the bolus option, only 2 (11%; confidence interval [CI] 0% to 26%) continued to require oral opiates to manage breakthrough pain compared to 29 (57%; CI 43% to 71%) without the bolus option. The Pain Disability Index score decreased by 19% in patients with the bolus option and by 25% in those with the basal infusion. Total daily intrathecal opioid intake was 34% lower in the group with the bolus device. Utilizing an intrathecal bolus to treat incident pain was a safe way to manage unpredictable breakthrough pain and may represent a cost-saving opportunity by eliminating the need for oral analgesic medications. © 2017 World Institute of Pain.

  16. Distribution and mixing of a liquid bolus in pleural space.

    Science.gov (United States)

    Bodega, Francesca; Tresoldi, Claudio; Porta, Cristina; Zocchi, Luciano; Agostoni, Emilio

    2006-02-28

    Distribution and mixing time of boluses with labeled albumin in pleural space of anesthetized, supine rabbits were determined by sampling pleural liquid at different times in various intercostal spaces (ics), and in cranial and caudal mediastinum. During sampling, lung and chest wall were kept apposed by lung inflation. This was not necessary in costo-phrenic sinus. Here, 10 min after injection, lung inflation increased concentration of labeled albumin by 50%. Lung inflation probably displaces some pleural liquid cranio-caudally, increasing labeled albumin concentration caudally to injection point (6th ics), and decreasing it cranially. Boluses of 0.1-1 ml did not preferentially reach mediastinal regions, as maintained by others. Time for an approximate mixing was approximately 1 h for 0.1 ml, and approximately 30 min for 1 ml. This relatively long mixing time does not substantially affect determination of contribution of lymphatic drainage through stomata to overall removal of labeled albumin from 0.3 ml hydrothoraces lasting 3 h [Bodega, F., Agostoni, E., 2004. Contribution of lymphatic drainage through stomata to albumin removal from pleural space. Respir. Physiol. Neurobiol. 142, 251-263].

  17. Bolus fluid therapy and sodium homeostasis in paediatric gastroenteritis.

    Science.gov (United States)

    Freedman, Stephen B; Geary, Denis F

    2013-03-01

    The study aims to assess the risk of developing hyponatraemia when large-volume bolus fluid rehydration therapy is administered. We conducted a prospective randomised study in a tertiary-care centre emergency department. Participants included children with gastroenteritis and dehydration requiring intravenous rehydration. They were randomised to receive 60 mL/kg (large) or 20 mL/kg (standard) 0.9% saline bolus followed by maintenance 0.9% saline for 3 h. Biochemical tests were performed at baseline and 4 h. The primary outcome measure was the development of hyponatraemia at 4 h. Secondary outcome measures were (i) change in sodium relative to baseline value; (ii) magnitude of decrease among those who experienced a decrease; (iii) risk of hypernatraemia; (iv) correlations between urine parameters and hyponatraemia; and (v) fluid overload. Eighty-four of 224 (38%) participants were hyponatraemic at baseline. At 4 h, 22% (48/217) had a dysnatraemia, and similar numbers of children were hyponatraemic in both groups: large (23% (26/112)) versus standard (21% (22/105)) (P = 0.69). Among initially hyponatraemic children, 63% (30/48) who received large-volume rehydration and 44% (15/34) of those administered standard rehydration were isonatraemic at 4 h (P = 0.10). Overall, children who received 60 mL/kg experienced a larger mean increase (1.6 ± 2.4 mEq/L vs. 0.9 ± 2.2 mEq/L; P = 0.04) and were less likely to experience a sodium decrease of ≥2 mEq/L (8/112 vs. 17/105; P = 0.04) than those administered 20 mL/kg. Large-volume bolus rehydration therapy with 0.9% saline is safe. It does not promote the development of hyponatraemia over the short term, but hastens the resolution of baseline hyponatraemia. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  18. Correlations between aorto-popliteal bolus transit speed and aortic and popliteal bolus transit time during CT angiography of aortoiliac and lower extremity arteries

    Energy Technology Data Exchange (ETDEWEB)

    Nakaya, Yasuhiro, E-mail: y-nakaya@radiol.med.osaka-u.ac.jp [Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka 565-0871 (Japan); Kim, Tonsok; Hori, Masatoshi; Onishi, Hiromitsu; Nakamoto, Atsushi; Tsuboyama, Takahiro; Maeda, Noboru; Higashihara, Hiroki; Tomoda, Kaname; Nakamura, Hironobu [Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka 565-0871 (Japan)

    2011-08-15

    Purpose: The purpose of this study was to investigate correlations between the aorto-popliteal bolus transit speed and aortic and popliteal bolus transit time in order to evaluate the possibility for prediction of bolus transit speed by single test injection technique. Materials and methods: Approval was obtained from our institutional review board for this study, which included 42 patients, from all of whom written informed consent was obtained. Low-dose serial CT scanning after injection of 12 ml contrast material (300 mg/ml) at a rate of 3 ml/s followed by saline flush was performed twice, first at the level of the upper abdomen and second at the level of the knee joint. The times needed to reach peak enhancement of the upper abdominal aorta (T-aorta) and bilateral popliteal arteries (T-popliteal) were obtained, and aorto-popliteal bolus transit speeds between the abdominal aorta and popliteal arteries were calculated. ABI was recorded for the bilateral feet. The Pearson's product-moment correlation coefficient was used to investigate the correlation between the bolus transit speed and T-aorta, T-popliteal, ABI, and patient age. Result: The respective correlation coefficients for bolus transit speed on the one hand and T-aorta, T-popliteal, ABI, patient age on the other were -0.50, -0.84, 0.36, and -0.52. Conclusion: The time to peak enhancement for popliteal arteries showed the strongest correlation with aorto-popliteal bolus transit speeds, and was considered to be the most accurate predictor for aorto-popliteal bolus transit speeds.

  19. Qualitative indices and enhancement rate of CT pulmonary angiography in patients with suspected pulmonary embolism: Comparison between test bolus and bolus-tracking methods

    Directory of Open Access Journals (Sweden)

    Maryam Moradi

    2016-01-01

    Full Text Available Background: The aim of the present study was to assess the qualitative indices and enhancement rate of computed tomographic pulmonary angiography (CTPA in patients with suspected pulmonary embolism using Test bolus and Bolus-tracking techniques. Materials and Methods: Fifty-two patients with suspected pulmonary embolism that passed informed consent were randomly divided in the two groups. In each group, demographic characteristics, qualitative indices, and enhancement rate of CTPA were recorded. Results: The diagnostic result obtained in majority of the participants in the two groups (88.5 % in Test bolus group vs. 73.1% in the Bolus tracking group. In the case of quantitative variables, no statistically significant differences were found between the groups (P > 0.05. The only statistically significant difference between the two groups is average of "X-ray dose". Conclusion: The results of our study show that there is no statistically significant difference between the Bolus Tracking and Test Bolus techniques for producing more homogeneous enhancement.

  20. 21 CFR 520.1242b - Levamisole hydrochloride tablet or oblet (bolus).

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Levamisole hydrochloride tablet or oblet (bolus... § 520.1242b Levamisole hydrochloride tablet or oblet (bolus). (a) Chemical name. (-)-2,3,5,6-Tetrahydro... using in severely debilitated animals. (2) It is used in a tablet for sheep as follows: (i) Amount. 0...

  1. Sensation of stasis is poorly correlated with impaired esophageal bolus transport

    NARCIS (Netherlands)

    Bogte, A.; Bredenoord, A. J.; Oors, J.; Siersema, P. D.; Smout, A. J. P. M.

    2014-01-01

    It is common belief that symptoms of patients with non-obstructive dysphagia are the result of impaired bolus clearance in the esophagus, usually caused by esophageal motility disorders. We therefore investigated the relationship between transit of swallowed boluses and the symptom dysphagia. Twenty

  2. MO-H-19A-03: Patient Specific Bolus with 3D Printing Technology for Electron Radiotherapy

    International Nuclear Information System (INIS)

    Zou, W; Swann, B; Siderits, R; McKenna, M; Khan, A; Yue, N; Zhang, M; Fisher, T

    2014-01-01

    Purpose: Bolus is widely used in electron radiotherapy to achieve desired dose distribution. 3D printing technologies provide clinicians with easy access to fabricate patient specific bolus accommodating patient body surface irregularities and tissue inhomogeneity. This study presents the design and the clinical workflow of 3D printed bolus for patient electron therapy in our clinic. Methods: Patient simulation CT images free of bolus were exported from treatment planning system (TPS) to an in-house developed software package. Bolus with known material properties was designed in the software package and then exported back to the TPS as a structure. Dose calculation was carried out to examine the coverage of the target. After satisfying dose distribution was achieved, the bolus structure was transferred in Standard Tessellation Language (STL) file format for the 3D printer to generate the machine codes for printing. Upon receiving printed bolus, a quick quality assurance was performed with patient resimulated with bolus in place to verify the bolus dosimetric property before treatment started. Results: A patient specific bolus for electron radiotherapy was designed and fabricated in Form 1 3D printer with methacrylate photopolymer resin. Satisfying dose distribution was achieved in patient with bolus setup. Treatment was successfully finished for one patient with the 3D printed bolus. Conclusion: The electron bolus fabrication with 3D printing technology was successfully implemented in clinic practice

  3. MO-H-19A-03: Patient Specific Bolus with 3D Printing Technology for Electron Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Zou, W; Swann, B; Siderits, R; McKenna, M; Khan, A; Yue, N; Zhang, M [Rutgers University, New Brunswick, NJ (United States); Fisher, T [Memorial Medical Center, Modesto, CA (United States)

    2014-06-15

    Purpose: Bolus is widely used in electron radiotherapy to achieve desired dose distribution. 3D printing technologies provide clinicians with easy access to fabricate patient specific bolus accommodating patient body surface irregularities and tissue inhomogeneity. This study presents the design and the clinical workflow of 3D printed bolus for patient electron therapy in our clinic. Methods: Patient simulation CT images free of bolus were exported from treatment planning system (TPS) to an in-house developed software package. Bolus with known material properties was designed in the software package and then exported back to the TPS as a structure. Dose calculation was carried out to examine the coverage of the target. After satisfying dose distribution was achieved, the bolus structure was transferred in Standard Tessellation Language (STL) file format for the 3D printer to generate the machine codes for printing. Upon receiving printed bolus, a quick quality assurance was performed with patient resimulated with bolus in place to verify the bolus dosimetric property before treatment started. Results: A patient specific bolus for electron radiotherapy was designed and fabricated in Form 1 3D printer with methacrylate photopolymer resin. Satisfying dose distribution was achieved in patient with bolus setup. Treatment was successfully finished for one patient with the 3D printed bolus. Conclusion: The electron bolus fabrication with 3D printing technology was successfully implemented in clinic practice.

  4. Radiation dosimetry for bolus administration of oxygen-15-water

    International Nuclear Information System (INIS)

    Brihaye, C.; Depresseux, J.C.; Comar, D.

    1995-01-01

    The authors describe the development of a biokinetic model which permits an estimation of organ activities and the dosimetry of a bolus of 15 O-water. The aim of this study was to estimate time-activity functions and deduce the cumulated activities in different organs so that the radiation absorbed dose values can be estimated. The model used includes the right heart chambers, lungs, left heart chambers, brain, liver, kidneys, muscles, gasrointestinal tract and the remainder of the body. Activity in an organ will decay by physical decay with the decay constant, γ, and can diffuse in the organ. An exception is the heart, where blood is ejected from the heart chambers. Depending on the location of the organ in relation to the blood sampling point, organ activities can be calculated by convolution or deconvolution. The radiation absorbed dose values were estimated and an effective dose equivalent H E of 1.16 μSv/MBq (4.32 mrem/mCi) as well as an effective dose E of 1.15 μSv/MBq (4.25 mrem/mCi) were calculated. The cumulated activities in select organs measured by PET gave good agreement with the values calculated by this model. The values of effective dose equivalent and effective dose for bolus administration of 15 O-water calculated from the absorbed doses estimated by the proposed kinetic model are almost three times higher than those previously published. A total of 8700 MBq (235 mCi) of 15 O-water can be administered if an effective dose of 10 mSv (1 rem) is accepted. 32 refs., 5 figs., 2 tabs

  5. A Bolus Calculator Based on Continuous-Discrete Unscented Kalman Filtering for Type 1 Diabetics

    DEFF Research Database (Denmark)

    Boiroux, Dimitri; Aradóttir, Tinna Björk; Hagdrup, Morten

    2015-01-01

    both reduces the risk of hypoglycemia in case of an overestimated meal and the time spent in hyperglycemia if the meal size is underestimated. Faster insulin and the use of glucagon will have the potential to encourage postprandial meal bolus administration and hence will not require to accurately......In patients with type 1 diabetes, the effects of meals intake on blood glucose level are usually mitigated by administering a large amount of insulin (bolus) at mealtime or even slightly before. This strategy assumes, among other things, a prior knowledge of the meal size and the postprandial...... glucose dynamics. On the other hand, administering the meal bolus during or after mealtime could benefit from the information provided by the postprandial meal dynamics at the expense of a delayed meal bolus. The present paper investigates different bolus administration strategies (at mealtime, 15 minutes...

  6. An Adaptive Nonlinear Basal-Bolus Calculator for Patients With Type 1 Diabetes

    DEFF Research Database (Denmark)

    Boiroux, Dimitri; Aradóttir, Tinna Björk; Nørgaard, Kirsten

    2017-01-01

    size. Following meal announcements, the meal compartment and the meal time constant are estimated, otherwise insulin sensitivity is estimated. Results : We compare the performance of a conventional linear bolus calculator with the proposed bolus calculator. The proposed basal-bolus calculator......Background : Bolus calculators help patients with type 1 diabetes to mitigate the effect of meals on their blood glucose by administering a large amount of insulin at mealtime. Intraindividual changes in patients physiology and nonlinearity in insulin-glucose dynamics pose a challenge...... glucose monitor (CGM). The basal rate is determined by calculating the steady state of the model and is adjusted once a day before breakfast. The bolus size is determined by optimizing the postprandial glucose values based on an estimate of the insulin sensitivity and states, as well as the announced meal...

  7. Modeling the retention of rumen boluses for the electronic identification of goats.

    Science.gov (United States)

    Carné, S; Caja, G; Ghirardi, J J; Salama, A A K

    2011-02-01

    We constructed a regression model to estimate the retention of electronic boluses in goats. With this aim, 2,482 boluses were administered to goats from dairy (Murciano-Granadina, n=1,326; French Alpine, n=381) and meat (Blanca de Rasquera, n=532) breeds. A total of 19 bolus types made of materials (ceramic, plastic tubes filled with concrete or silicone, and ballasts) differing in their specific gravity (SG) were used, thereby obtaining a wide variation in bolus features: diameter (9 to 22 mm), length (37 to 84 mm), weight (5 to 111 g), volume (2.6 to 26 mL), and SG (1.0 to 5.5). Each bolus contained a half-duplex glass encapsulated transponder (32 × 3.8mm) and was administered using adapted balling guns. Murciano-Granadina and Blanca de Rasquera goats also wore 2 visual plastic ear tags: V1 (double flag, 5.1g) and V2 (flag-button, 4.2g). No data on ear tags in French Alpine goats was available. Bolus and ear tag retention [(retained/monitored) × 100] was recorded for at least 1 yr. Dynamic reading efficiency [(dynamic reading/static reading) × 100] was also evaluated from 1,496 bolus readings. No administration incidences or apparent negative behavior or performance effects were observed for any bolus type. Static reading efficiency of retained boluses was 100%, except for the prototypes with metal ballasts, which yielded a 93.3% reading efficiency. Retention of metal-ballasted boluses was confirmed using x-ray equipment. Excluding ballasted boluses, a 99.5% dynamic reading efficiency was obtained. Ear tag losses were 6.5% for V1 and 3.7% for V2, ranging from 3.2 to 7.8% depending on ear tag type and goat breed. Bolus retention varied (0 to 100%) according to their physical features. Obtained data allowed the fitting of a logistic model of bolus retention rate according to bolus volume and weight (R(2) = 0.98); the SG was implicitly considered. Estimated weight and SG to produce medium- (15 mL) and standard-sized (22 mL) boluses for 99.95% retention rate in

  8. The comparison of bolus tracking and test bolus techniques for computed tomography thoracic angiography in healthy beagles

    Directory of Open Access Journals (Sweden)

    Nicolette Cassel

    2013-05-01

    Full Text Available Computed tomography thoracic angiography studies were performed on five adult beagles using the bolus tracking (BT technique and the test bolus (TB technique, which were performed at least two weeks apart. For the BT technique, 2 mL/kg of 300 mgI/mL iodinated contrast agent was injected intravenously. Scans were initiated when the contrast in the aorta reached 150 Hounsfield units (HU. For the TB technique, the dogs received a test dose of 15% of 2 mL/kg of 300 mgI/mL iodinated contrast agent, followed by a series of low dose sequential scans. The full dose of the contrast agent was then administered and the scans were conducted at optimal times as identified from time attenuation curves. Mean attenuation in HU was measured in the aorta (Ao and right caudal pulmonary artery (rCPA. Additional observations included the study duration, milliAmpere (mA, computed tomography dose index volume (CTDI[vol] and dose length product (DLP. The attenuation in the Ao (BT = 660 52 HU ± 138 49 HU, TB = 469 82 HU ± 199 52 HU, p = 0.13 and in the rCPA (BT = 606 34 HU ± 143 37 HU, TB = 413 72 HU ± 174.99 HU, p = 0.28 did not differ significantly between the two techniques. The BT technique was conducted in a significantly shorter time period than the TB technique (p = 0.03. The mean mA for the BT technique was significantly lower than the TB technique (p = 0.03, as was the mean CTDI(vol (p = 0.001. The mean DLP did not differ significantly between the two techniques (p = 0.17. No preference was given to either technique when evaluating the Ao or rCPA but the BT technique was shown to be shorter in duration and resulted in less DLP than the TB technique.

  9. Intravenous Tranexamic Acid Bolus plus Infusion Is Not More Effective than a Single Bolus in Primary Hip Arthroplasty: A Randomized Controlled Trial.

    Science.gov (United States)

    Zufferey, Paul J; Lanoiselée, Julien; Chapelle, Céline; Borisov, Dmitry B; Bien, Jean-Yves; Lambert, Pierre; Philippot, Rémi; Molliex, Serge; Delavenne, Xavier

    2017-09-01

    Preoperative administration of the antifibrinolytic agent tranexamic acid reduces bleeding in patients undergoing hip arthroplasty. Increased fibrinolytic activity is maintained throughout the first day postoperation. The objective of the study was to determine whether additional perioperative administration of tranexamic acid would further reduce blood loss. This prospective, double-blind, parallel-arm, randomized, superiority study was conducted in 168 patients undergoing unilateral primary hip arthroplasty. Patients received a preoperative intravenous bolus of 1 g of tranexamic acid followed by a continuous infusion of either tranexamic acid 1 g (bolus-plus-infusion group) or placebo (bolus group) for 8 h. The primary outcome was calculated perioperative blood loss up to day 5. Erythrocyte transfusion was implemented according to a restrictive transfusion trigger strategy. The mean perioperative blood loss was 919 ± 338 ml in the bolus-plus-infusion group (84 patients analyzed) and 888 ± 366 ml in the bolus group (83 patients analyzed); mean difference, 30 ml (95% CI, -77 to 137; P = 0.58). Within 6 weeks postsurgery, three patients in each group (3.6%) underwent erythrocyte transfusion and two patients in the bolus group experienced distal deep-vein thrombosis. A meta-analysis combining data from this study with those of five other trials showed no incremental efficacy of additional perioperative administration of tranexamic acid. A preoperative bolus of tranexamic acid, associated with a restrictive transfusion trigger strategy, resulted in low erythrocyte transfusion rates in patients undergoing hip arthroplasty. Supplementary perioperative administration of tranexamic acid did not achieve any further reduction in blood loss.

  10. The use of Coca-Cola in the management of bolus obstruction in benign oesophageal stricture.

    Science.gov (United States)

    Karanjia, N. D.; Rees, M.

    1993-01-01

    Oesophageal stricture is a complication of oesophageal reflux and may itself be complicated by bolus obstruction. We reviewed the records of patients presenting with dysphagia and who were found to have benign oesophageal strictures. We studied the outcome of bolus obstruction in 13 episodes affecting eight patients. In six episodes Coca-Cola was administered on the day before endoscopy, and in all these patients the bolus had cleared. In seven episodes nothing was administered before endoscopy, and in all seven a bolus was evident at endoscopy. In five of these seven the bolus was removed piecemeal and in each of these instances the endoscope had to be passed between two and five times. In the remaining two instances the procedure was abandoned and the patients returned to the ward for the administration of Coca-Cola. At subsequent endoscopy these patients were found to be clear of any bolus. These results suggest that the administration of Coca-Cola (or other aerated drinks) may clear a bolus in the acutely obstructed oesophagus. PMID:8476194

  11. The usefulness of esophagogram with marchmallow bolus in patients with esophageal related symptoms

    International Nuclear Information System (INIS)

    Yoon, Sang Wook; Kim, Ki Whang; Park, Hyo Jin; Kim, Eun Kyung; Yu, Jeong Sik; Seo, Jung Kun; Kwon, Ryang; Shin, Hyung Cheol

    1996-01-01

    To evaluate the usefulness of the esophagogram using marshmallow bolus in the evaluation of the causes of variable esophageal-related symptoms. Esophagograms using marshmallow bolus were performed on 44 patients with esophageal-related symptoms and on ten normal volunteers. Videofluoroscopic studies were also made. Patients were classified into three groups according to their esophageal-related symptoms ; those with dysphagia, those with globus symptom, and those with chest pain. Abnormal findings on an esophagogram with marshmallow were graded in to three categories ; mild, moderate, and severe. Provocation of the same symptom was also evaluated. Esophageal monometric studies were performed on 16 patients and those results were compared with the results obtained from the esophagogram using marshmallow bolus. The provocation rate of the some symptom was 33% in the first group, 47% in the second, and 24% in the third. The provocation rate was highest in the second group. The provocation rate was also higher in patients with a severe degree of abnormality on an esophagogram using marshmallow bolus. Where there were abnormal findings, an esophagogram using marshmallow bolus showed a higher abnormality rate than did a conventional esophagogram. In cases showing abnormal finding son the esophageal monometric study, an esophagogram using marshmallow bolus showed a higher provocation rate and more severe abnormality than in cases showing normal findings on manometric study. An esophagogram using marshmallow bolus will a useful radiologic screening modality for the evaluation of patients with esophageal-related symptoms

  12. The usefulness of esophagogram with marchmallow bolus in patients with esophageal related symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Sang Wook; Kim, Ki Whang; Park, Hyo Jin; Kim, Eun Kyung; Yu, Jeong Sik; Seo, Jung Kun; Kwon, Ryang; Shin, Hyung Cheol [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1996-03-01

    To evaluate the usefulness of the esophagogram using marshmallow bolus in the evaluation of the causes of variable esophageal-related symptoms. Esophagograms using marshmallow bolus were performed on 44 patients with esophageal-related symptoms and on ten normal volunteers. Videofluoroscopic studies were also made. Patients were classified into three groups according to their esophageal-related symptoms ; those with dysphagia, those with globus symptom, and those with chest pain. Abnormal findings on an esophagogram with marshmallow were graded in to three categories ; mild, moderate, and severe. Provocation of the same symptom was also evaluated. Esophageal monometric studies were performed on 16 patients and those results were compared with the results obtained from the esophagogram using marshmallow bolus. The provocation rate of the some symptom was 33% in the first group, 47% in the second, and 24% in the third. The provocation rate was highest in the second group. The provocation rate was also higher in patients with a severe degree of abnormality on an esophagogram using marshmallow bolus. Where there were abnormal findings, an esophagogram using marshmallow bolus showed a higher abnormality rate than did a conventional esophagogram. In cases showing abnormal finding son the esophageal monometric study, an esophagogram using marshmallow bolus showed a higher provocation rate and more severe abnormality than in cases showing normal findings on manometric study. An esophagogram using marshmallow bolus will a useful radiologic screening modality for the evaluation of patients with esophageal-related symptoms.

  13. Nonlinear pharmacokinetics of visnagin in rats after intravenous bolus administration.

    Science.gov (United States)

    Haug, Karin G; Weber, Benjamin; Hochhaus, Guenther; Butterweck, Veronika

    2012-01-23

    Ammi visnaga L. (syn. Khella, Apiaceae) preparations have traditionally been used in the Middle East for the treatment of kidney stone disease. Visnagin, a furanocoumarin derivative, is one of the main compounds of Ammi visnaga with potential effects on kidney stone prevention. To date, no information is available about the pharmacokinetic (PK) properties of visnagin. It was the aim of the study to characterize the PK properties of visnagin after intravenous (i.v.) bolus administration in rats and to develop an adequate model for the description of the observed data, including model parameter estimates. Therefore, three doses of visnagin (1.25, 2.5, and 5mg/kg) solubilized in 25% Captisol® were administered by i.v. bolus injection to male Sprague-Dawley rats. Plasma samples were extracted and subsequently analyzed using a validated LC-MS/MS method. Both non-compartmental and compartmental PK analyses were performed. A stepwise model building approach was applied including nonlinear mixed effect modeling for final model selection and to obtain final model estimates in NONMEM VI. The average areas under the curve (AUC(0-last)) after doses of 1.25, 2.5, and 5mg/kg were 1.03, 3.61, and 12.6 mg *h/l, respectively. The shape of the plasma concentration-time profiles and the observed disproportionate increase in AUC(0-last) with increasing dose suggested nonlinearity in the elimination of visnagin. A two-compartment Michaelis-Menten model provided the best fit with following typical values of the parameter estimates: 2.09 mg/(l*h) (V(max)), 0.08 mg/l (K(M)), 0.175 l (V(C)), 1.0 h⁻¹ (k₁₂), and 1.22 h⁻¹ (k₂₁). Associated inter-subject variability estimates (% CV) for V(max), K(M) and V(C) were 21.8, 70.9, and 9.2, respectively. Intra-subject variability (constant CV error model) was estimated to be 7.0%. The results suggest the involvement of a saturable process in the elimination of visnagin, possibly an enzyme or transporter system. Copyright © 2011

  14. SU-F-T-517: Determining the Tissue Equivalence of a Brass Mesh Bolus in a Reconstructed Chest Wall Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Shekel, E; Epstein, D; Levin, D [Dept of radiotherapy, Assuta Medical Centers, Tel Aviv (Israel)

    2016-06-15

    Purpose: To determine the tissue equivalence of a brass mesh bolus (RPD) in the setting of a reconstructed chest wall irradiation Methods: We measured breast skin dose delivered by a tangential field plan on an anthropomorphic phantom using Mosfet and nanoDot (Landauer) dosimeters in five different locations on the breast. We also measured skin dose using no bolus, 5mm and 10 mm superflab bolus. In the Eclipse treatment planning system (Varian, Palo Alto, CA) we calculated skin dose for different bolus thicknesses, ranging from 0 to 10 mm, in order to evaluate which calculation best matches the brass mesh measurements, as the brass mesh cannot be simulated due to artefacts.Finally, we measured depth dose behavior with the brass mesh bolus to verify that the bolus does not affect the dose to the breast itself beyond the build-up region. Results: Mosfet and nanoDot measurements were consistent with each other.As expected, skin dose measurements with no bolus had the least agreement with Eclipse calculation, while measurements for 5 and 10 mm agreed well with the calculation despite the difficulty in conforming superflab bolus to the breast contour. For the brass mesh the best agreement was for 3 mm bolus Eclipse calculation. For Mosfets, the average measurement was 90.8% of the expected dose, and for nanoDots 88.33% compared to 83.34%, 88.64% and 93.94% (2,3 and 5 mm bolus calculation respectively).The brass mesh bolus increased skin dose by approximately 25% but there was no dose increase beyond the build-up region. Conclusion: Brass mesh bolus is most equivalent to a 3 mm bolus, and does not affect the dose beyond the build-up region. The brass mesh cannot be directly calculated in Eclipse, hence a 3mm bolus calculation is a good reflection of the dose response to the brass mesh bolus.

  15. Efficacy study of Styplon Vet Bolus as supportive therapy in management of hemorrhagic conditions of ruminants

    Directory of Open Access Journals (Sweden)

    B R Ravikumar

    Full Text Available On-field trial was conducted in dairy animals to evaluate efficacy of Styplon Vet Bolus (M/s Himalaya Drug Company, Banglore, India as supportive therapy in management of hemorrhagic conditions (Hematuria, hemoagalectia, bleeding wounds, uterine bleeding and epistaxis of ruminants. Styplon Vet 1-2 boli twice daily was administered to cows and buffaloes, and ½ bolus twice daily for sheep till they recover clinically. The results indicated that Styplon Vet Bolus is a safe and effective styptic in ruminants. [Vet World 2009; 2(12.000: 470-471

  16. Performance of a diesel engine transformed to spark ignition using natural gas; Desempenho de um motor diesel convertido para utilizacao de gas natural como combustivel

    Energy Technology Data Exchange (ETDEWEB)

    Gutierrez, Ricardo H.R. [Coordenacao dos Programas de Pos-Graduacao de Engenharia (LEDAV/COPPE/UFRJ), RJ (Brazil). Lab. de Ensaios Dinamicos e Analise de Vibracao; Belchior, Carlos R.P. [Coordenacao dos Programas de Pos-Graduacao de Engenharia (LMT/COPPE/UFRJ), RJ (Brazil). Lab. de Maquinas Termicas; Sodre, Jose Ricardo [Pontificia Universidade Catolica de Minas Gerais (PUC/Minas), MG (Brazil)

    2012-07-01

    A zero-dimensional thermodynamic model for a diesel engine converted for dedicated use of natural gas was developed in this work. The computational model covers from the time of closing the inlet valve to the time of opening the exhaust valve and it was divided into three stages (compression, combustion and expansion). A model based on the first law of thermodynamics for closed cycle has been developed to study the performance of the engine. The combustion process was modeled using the equation of Wiebe. It was taken into consideration the convective heat transfer through the walls of the cylinder and the heat transfer coefficient was calculated by the Eichelberg correlation. It was also considered that the thermodynamic properties vary with temperature. To represent the gas mixture behavior inside the cylinder two approaches (Ideal Gas Equation and Van Der Waals's Real Gas Equation) were used and results compared. The computational model was validated with experimental tests. (author)

  17. Investigation of the benzotriazole as addictive for carbon steel phosphating; Estudo da utilizacao do benzotriazol como aditivo para a fosfatizacao de aco carbono

    Energy Technology Data Exchange (ETDEWEB)

    Annies, V.; Cunha, M.T.; Rodrigues, P.R.P.; Banczek, E.P. [Universidade Estadual do Centro-Oeste, Guarapuava, PR (Brazil). Dept. de Quimica; Costa, I. [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Terada, M. [Universidade de Sao Paulo (POLI/USP), SP (Brazil). Escola Politecnica. Dept. de Engenharia Metalurgica e de Materiais

    2010-07-01

    This work studied the viability of substitution of sodium nitrite (NaNO{sub 2}) for benzotriazole (BTAH) in the zinc phosphate bath (PZn+NaNO{sub 2}) for phosphating of carbon steel (SAE 1010). The characterization of the samples was carried out by Scanning Electron Microscopy, Optical Microscopy and X-ray diffraction. The chemical composition was evaluated by Energy Dispersive Spectroscopy. The corrosion behavior of the samples was investigated by Open Circuit Potential, Electrochemical Impedance Spectroscopy and Anodic Potentiodynamic Polarization Curves in a 0.5 mol L{sup -1} NaCl electrolyte. The experimental results showed that the phosphate layer obtained in the solution with benzotriazole (PZn+BTAH) presented better corrosion resistance properties than that obtained in sodium nitrite. The results demonstrated that the sodium nitrite NaNO{sub 2} can be replaced by benzotriazole (BTAH) in zinc phosphate baths. (author)

  18. Quantitative computed tomography as a test of endurance for evaluation of bony plates; Utilizacao da tomografia computadorizada quantitativa como teste de resistencia para avaliacao de placas osseas

    Energy Technology Data Exchange (ETDEWEB)

    Melo Filho, E.V.; Costa, L.A.V.S.; Oliveira, D.C. [Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil); Freitas, P.M.C. [Escola de Veterinaria - Universidade Federal de Minas Gerais - Belo Horizonte, MG (Brazil); Teixeira, M.W.; Costa, F.S. [Universidade Federal Rural de Pernambuco - Recife, PE (Brazil)

    2012-06-15

    Quantitative computed tomography was used to determine the radiodensity of bony plates. The CT scans provided information regarding radiodensity of bony plates and allowed to verify the uniformity of bone mineral density in their scope. The proposed methodology should be considered as another tool for determining the resistance of these biomaterials. (author)

  19. Characterization of cellulose biomass for use as an excipient in pharmaceutical field; Caracterizacao de biomassa de celulose para utilizacao como excipiente na area farmaceutica

    Energy Technology Data Exchange (ETDEWEB)

    Garcia, Keth R.; Turella, Tais C.; Santos, Venina dos; Brandalise, Rosmary N. [Universidade de Caxias do Sul (UCS), Caxias do Sul, RS (Brazil). Centro de Ciencias Exatas e da Tecnologia; Angeli, Valeria W., E-mail: rnbranda@ucs.br [Universidade de Caxias do Sul (UCS), Caxias do Sul, RS (Brazil). Centro de Ciencias Biologicas e da Saude

    2015-07-01

    Every day the industry of paper and cellulose discards large amounts of waste. An alternative to reuse this kind of biomass is to transform part of it in cellulose nanocrystals and nanofibrils to be used as excipients in pharmaceutical field. Thus, cellulose fibrils were obtained in nanoscale using mill and fibrils' characterization study were performed by scanning electron microscopy, transmission electron microscopy, thermal analysis, differential scanning calorimetry, infrared Fourier transform and X-rays diffraction. Hence, the methodology used to obtain and characterize nanocellulose was effective and the fibers/fibrils lengths are in nanometer dimension with high potential to apply in the pharmaceutical field. (author)

  20. Hybrid environmental robot: a tool for monitoring gas on flooded area; Robo ambiental hibrido: utilizacao como ferramenta para monitoramento de gases em areas alagadas

    Energy Technology Data Exchange (ETDEWEB)

    Goes, Emerson de; Cerqueira, Romulo Curty; Reis, Ney Robinson S. [PETROBRAS, Rio de Janeiro, RJ (Brazil)

    2008-07-01

    The impoundment of rivers for power generation leads to flooding of vast areas of land vegetation. Most submerged plants, die and enter into decomposition, releasing CO2 (carbon dioxide), CH4 (methane gas) into the air for many years. Scientists from around the world seek to clarify the processes to which these gases are submitted and their contributions to the process of global warming. Estimates suggest that the re-use of methane that passes through the turbines of these power plants could increase their energy potential by 75% and reduce their emissions of these gases by 65%, reducing their impact on global warming and resulting in carbon credits. To check the feasibility of using new processes and technologies to generate energy that recycles this biogas, operations for monitoring these biogases become routine tasks. The frequency is such that the exposure of humans to the risks of gas combustion, inherent to scenarios where these operations take place, becomes unacceptable. This motivates the use of robots in this activity. This paper presents the multi-mission platform Hybrid Environmental Robot, named 'Chico Mendes', as a tool for tracking gas emission and specially designed for flooded forest areas.

  1. Serum levels of bupivacaine after pre-peritoneal bolus vs. epidural bolus injection for analgesia in abdominal surgery: A safety study within a randomized controlled trial.

    Science.gov (United States)

    Mungroop, Timothy H; van Samkar, Ganapathy; Geerts, Bart F; van Dieren, Susan; Besselink, Marc G; Veelo, Denise P; Lirk, Philipp

    2017-01-01

    Continuous wound infiltration (CWI) has become increasingly popular in recent years as an alternative to epidural analgesia. As catheters are not placed until the end of surgery, more intraoperative opioid analgesics might be needed. We, therefore, added a single pre-peritoneal bolus of bupivacaine at the start of laparotomy, similar to the bolus given with epidural analgesia. This was a comparative study within a randomized controlled trial (NTR4948). Patients undergoing hepato-pancreato-biliary surgery received either a pre-peritoneal bolus of 30ml bupivacaine 0.25%, or an epidural bolus of 10ml bupivacaine 0.25% at the start of laparotomy. In a subgroup of patients, we sampled blood and determined bupivacaine serum levels 20, 40, 60 and 80 minutes after bolus injection. We assumed toxicity of bupivacaine to be >1000 ng/ml. A total of 20 patients participated in this sub-study. All plasma levels measured as well as the upper limit of the predicted 99% confidence intervals per time point were well below the toxicity limit. In a mixed linear-effect model both groups did not differ statistically significant (p = 0.131). The intra-operative use of opioids was higher with CWI as compared to epidural (86 (SD 73) μg sufentanil vs. 50 (SD 32). In this exploratory study, the pre-peritoneal bolus using bupivacaine resulted in serum bupivacaine concentrations well below the commonly accepted toxic threshold. With CWI more additional analgesics are needed intraoperatively as compared to epidural analgesia, although this is compensated by a reduction in use of vasopressors with CWI. Netherlands Trial Register NTR4948.

  2. 21 CFR 520.1802b - Piperazine-carbon disulfide complex boluses.

    Science.gov (United States)

    2010-04-01

    ...) per 500 pounds body weight; removal of large strongyles, pinworms, and bots, 1 bolus per 250 pounds...), large strongyles (Strongylus spp.) bots (Gastrophilus spp.), small strongyles, and pinworms (Oxyuris...

  3. Assessment of myocardial perfusion with MRI using a modified dual bolus method

    International Nuclear Information System (INIS)

    Husso, M; Sipola, P; Manninen, H; Vainio, P; Kuittinen, T; Hartikainen, J; Saarakkala, S; Töyräs, J; Kuikka, J

    2014-01-01

    Quantification of regional myocardial blood flow (rMBF) with first-pass magnetic resonance imaging (FP-MRI) requires two contrast agent injections (dual bolus technique), inducing error in the determined rMBF if the injections differ. We hypothesize that using input and residue curves of the same injection would be more reliable. We aim to introduce and evaluate a novel method to correct the high concentration arterial input function (AIF) for determination of rMBF. Sixteen patients with non-Hodgkin's lymphoma were examined before and after chemotherapy. The input function was solved by correcting initial high concentration AIF using the ratio of low and high contrast AIF areas, normalized by corresponding heart rates (modified dual bolus method). For comparison, the scaled low contrast AIF was used as an input function (dual bolus method). Unidirectional transfer coefficient K trans  was calculated using both methods. K trans -values determined with the dual bolus (0.81 ± 0.32 ml g −1  min −1 ) and modified dual bolus (0.77 ± 0.42 ml g −1  min −1 ) methods were in agreement (p = 0.21). Mean K trans -values increased from 0.76 ± 0.43 to 0.89 ± 0.55 ml g −1  min −1  after chemotherapy (p = 0.17). The modified dual bolus technique agrees with the dual bolus technique (R2 = 0.899) when the low and high contrast injections are similar. However, when this is not the case, the modified dual bolus technique may be more reliable. (paper)

  4. Barium and meat. A comparison between pharyngeal swallow of fluid and solid boluses

    Energy Technology Data Exchange (ETDEWEB)

    Ekberg, O.; Liedberg, B.; Oewall, B.

    The influence of bolus consistency on pharyngeal swallow was radiologically studied in 24 individuals by comparing liquid barium and solid meat after chewing. Pharyngeal function was apparently performed synchronously and symmetrically on both boluses. No definite conclusion about the influence on epiglottic mobility, closure of the laryngeal vestibule and relaxation of the circopharyngeal muscle could be drawn from this study. There was no difference in the elevation of the pharynx and larynx. The transit time for a solid bolus was shorter compared with that of a fluid bous. The transit time for the apex of the bolus was shorter than for the tail. A more marked elevation of the pharynx and larynx was followed by a shorter transit time. The width of the pharyngo-esophageal segment was larger in the transverse than in the sagittal diameter during the passage of the bolus and larger on solid compared with fluid swallow. Our results reflect the ability of pharyngeal swallow to be executed with precision and with few alterations due to variable bolus consistency.

  5. The Interactive Effect of Diabetes Family Conflict and Depression on Insulin Bolusing Behaviors for Youth.

    Science.gov (United States)

    Maliszewski, Genevieve; Patton, Susana R; Midyett, L Kurt; Clements, Mark A

    2017-05-01

    Adherence to type 1 diabetes management declines as children enter adolescence. For youth, psychosocial variables including mood and interpersonal relationships play a large role in diabetes maintenance. The current study assessed the unique and interactive roles diabetes family conflict and depression have on insulin bolusing behaviors for youth ages 10-16 years. Ninety-one youth-parent dyads completed a survey assessing family conflict and depression. Mean daily blood glucose levels, mealtime insulin bolus scores ( BOLUS), and glycated hemoglobin (HbA1c) were collected from the medical record as outcome variables. Parent-reported diabetes-related family conflict and youths' endorsed depression both significantly predicted insulin bolusing behavior, R 2 = .13, F(2, 88) = 6.66, P family conflict and youth depression played a significant role in youths' bolusing behaviors, above and beyond that which was predicted by conflict and depression separately, R 2 = .18, F change (1, 87) = 4.63, P family conflict, while there was no change in BOLUS scores among depressed youth living in families reporting less conflict. Findings underscore the importance of screening for depression and family conflict in youth experiencing or at risk for poor adherence to mealtime insulin and higher HbA1c levels.

  6. Serum levels of bupivacaine after pre-peritoneal bolus vs. epidural bolus injection for analgesia in abdominal surgery: A safety study within a randomized controlled trial

    NARCIS (Netherlands)

    Mungroop, Timothy H.; van Samkar, Ganapathy; Geerts, Bart F.; van Dieren, Susan; Besselink, Marc G.; Veelo, Denise P.; Lirk, Philipp

    2017-01-01

    Continuous wound infiltration (CWI) has become increasingly popular in recent years as an alternative to epidural analgesia. As catheters are not placed until the end of surgery, more intraoperative opioid analgesics might be needed. We, therefore, added a single pre-peritoneal bolus of bupivacaine

  7. A Patient-Specific Polylactic Acid Bolus Made by a 3D Printer for Breast Cancer Radiation Therapy.

    Directory of Open Access Journals (Sweden)

    So-Yeon Park

    Full Text Available The aim of this study was to assess the feasibility and advantages of a patient-specific breast bolus made using a 3D printer technique.We used the anthropomorphic female phantom with breast attachments, which volumes are 200, 300, 400, 500 and 650 cc. We simulated the treatment for a right breast patient using parallel opposed tangential fields. Treatment plans were used to investigate the effect of unwanted air gaps under bolus on the dose distribution of the whole breast. The commercial Super-Flex bolus and 3D-printed polylactic acid (PLA bolus were applied to investigate the skin dose of the breast with the MOSFET measurement. Two boluses of 3 and 5 mm thicknesses were selected.There was a good agreement between the dose distribution for a virtual bolus generated by the TPS and PLA bolus. The difference in dose distribution between the virtual bolus and Super-Flex bolus was significant within the bolus and breast due to unwanted air gaps. The average differences between calculated and measured doses in a 200 and 300 cc with PLA bolus were not significant, which were -0.7% and -0.6% for 3mm, and -1.1% and -1.1% for 5 mm, respectively. With the Super-Flex bolus, however, significant dose differences were observed (-5.1% and -3.2% for 3mm, and -6.3% and -4.2% for 5 mm.The 3D-printed solid bolus can reduce the uncertainty of the daily setup and help to overcome the dose discrepancy by unwanted air gaps in the breast cancer radiation therapy.

  8. A Patient-Specific Polylactic Acid Bolus Made by a 3D Printer for Breast Cancer Radiation Therapy.

    Science.gov (United States)

    Park, So-Yeon; Choi, Chang Heon; Park, Jong Min; Chun, MinSoo; Han, Ji Hye; Kim, Jung-In

    2016-01-01

    The aim of this study was to assess the feasibility and advantages of a patient-specific breast bolus made using a 3D printer technique. We used the anthropomorphic female phantom with breast attachments, which volumes are 200, 300, 400, 500 and 650 cc. We simulated the treatment for a right breast patient using parallel opposed tangential fields. Treatment plans were used to investigate the effect of unwanted air gaps under bolus on the dose distribution of the whole breast. The commercial Super-Flex bolus and 3D-printed polylactic acid (PLA) bolus were applied to investigate the skin dose of the breast with the MOSFET measurement. Two boluses of 3 and 5 mm thicknesses were selected. There was a good agreement between the dose distribution for a virtual bolus generated by the TPS and PLA bolus. The difference in dose distribution between the virtual bolus and Super-Flex bolus was significant within the bolus and breast due to unwanted air gaps. The average differences between calculated and measured doses in a 200 and 300 cc with PLA bolus were not significant, which were -0.7% and -0.6% for 3mm, and -1.1% and -1.1% for 5 mm, respectively. With the Super-Flex bolus, however, significant dose differences were observed (-5.1% and -3.2% for 3mm, and -6.3% and -4.2% for 5 mm). The 3D-printed solid bolus can reduce the uncertainty of the daily setup and help to overcome the dose discrepancy by unwanted air gaps in the breast cancer radiation therapy.

  9. A Study on the Necessary Number of Bolus Treatments in Radiotherapy after Modified Radical Mastectomy

    International Nuclear Information System (INIS)

    Hong, Chae Seon; Kim, Jong Sik; Kim, Young Kon; Park, Young Hwan

    2006-01-01

    Post-mastectomy radiotherapy (PMR) is known to decrease loco-regional recurrence. Adequate skin and dermal dose are achieved by adding bolus. The more difficult clinical issue is determining the necessary number of bolus treatment, given the limits of normal skin tolerance. The aim of this study is to evaluate the necessary number of bolus treatment after PMR in patients with breast cancer. Four female breast cancer patients were included in the study. The median age was 53 years(range, 38-74), tumor were left sided in 2 patients and right sided in 2 patients. All patients were treated with postoperative radiotherapy after MRM. Radiotherapy was delivered to the chest wall (C.W) and supraclavicular lymph nodes (SCL) using 4 MV X-ray. The total dose was 50 Gy, in 2 Gy fractions (with 5 times a week). CT was performed for treatment planning, treatment planning was performed using A DAC-Pinnacles 3 (Phillips, USA) for all patients without and with bolus. Bolus treatment plans were generated using image tool (0.5 cm of thickness and 6 cm of width). Dose distribution was analyzed and the increased skin dose rate in the build-up region was computed and the skin dose using TLD-100 chips (Harshaw, USA) was measured. No significant difference was found in dose distribution without and with bolus; C.W coverage was 95-100% of the prescribed dose in both. But, there was remarkable difference in the skin dose to the scar. The skin dose to the scar without and with bolus were 100-105% and 50-75%. The increased skin dose rates in the build-up region for Pt. 1, Pt. 2. Pt. 3 and Pt. 4 were 23.3%, 35.6%, 34.9%, and 41.7%. The results of measured skin dose using TLD-100 chips in the cases without and with bolus were 209.3 cGy and 161.1 cGy, 200 cGy and 150.2 cGy, 211.4 cGy and 160.5 cGy, 198.6 cGy and 155.5 cGy for Pt. 1, Pt. 2, Pt. 3, and Pt. 4. It was concludes through this analysis that the adequate number of bolus treatments is 50-60% of the treatment program. Further, clinical

  10. Cineradiography of the liquid bolus swallow. A study of the speed ot the bolus and peristaltic wave and of movement of the hyoid bone, larynx, and epiglottis

    International Nuclear Information System (INIS)

    Sundgren, P.

    1991-01-01

    In the evaluation of the dysphagic patient, radiology is crucial as a technique for monitoring morphology and function. In particular, high-speed cineradiography can reveal a variety of pharyngeal dysfunctions. However, in the literature and in practice the difference between normal and abnormal function is not always clear. This monography is based on high-speed cineradiographies of swallowing in 75 non-dysphagic volunteers and in 189 dysphagic patients. The purpose was to study whether differences in bolus volumes, patient position, age and gender had any effects on the following parameters: the speed of the peristaltic wave and apex of the liquid barium bolus, the length of movement and the movement pattern of the hyoid bone and larynx, and epiglottic function. The study disclosed that the speed of the bolus, the anterior-superior movement and net movement of the hyoid bone increased significantly with larger bolus volumes. The position of the individual in relation to gravity significantly influenced the speed of peristalsis. In most of the measured parameters there were no differences between non-dysphagic and dysphagic individuals expect for differences in the intrapersonal variations and in the anterior-superior movement of the hyoid bone. In patients with pharyngeal dysfunction the initial stage of the elevation of the larynx was significantly lower than in patients without dysfunction. The approximation of the thyroid cartilage to the hyoid bone was significantly greater in individuals with normal epiglottic function than in those with epiglottic dysmobility. It is suggested that abnormal speed of peristalsis may be a mild form of dysfunction. Measurements of the aforementioned speed and movements can be done if bolus volume, age and position of the patient, film speed and magnifications factors are known. Hypotheses concerning epiglottic function and central control of swallowing are proposed. (au)

  11. The predictive ability of six pharmacokinetic models of rocuronium developed using a single bolus: evaluation with bolus and continuous infusion regimen.

    Science.gov (United States)

    Sasakawa, Tomoki; Masui, Kenichi; Kazama, Tomiei; Iwasaki, Hiroshi

    2016-08-01

    Rocuronium concentration prediction using pharmacokinetic (PK) models would be useful for controlling rocuronium effects because neuromuscular monitoring throughout anesthesia can be difficult. This study assessed whether six different compartmental PK models developed from data obtained after bolus administration only could predict the measured plasma concentration (Cp) values of rocuronium delivered by bolus followed by continuous infusion. Rocuronium Cp values from 19 healthy subjects who received a bolus dose followed by continuous infusion in a phase III multicenter trial in Japan were used retrospectively as evaluation datasets. Six different compartmental PK models of rocuronium were used to simulate rocuronium Cp time course values, which were compared with measured Cp values. Prediction error (PE) derivatives of median absolute PE (MDAPE), median PE (MDPE), wobble, divergence absolute PE, and divergence PE were used to assess inaccuracy, bias, intra-individual variability, and time-related trends in APE and PE values. MDAPE and MDPE values were acceptable only for the Magorian and Kleijn models. The divergence PE value for the Kleijn model was lower than -10 %/h, indicating unstable prediction over time. The Szenohradszky model had the lowest divergence PE (-2.7 %/h) and wobble (5.4 %) values with negative bias (MDPE = -25.9 %). These three models were developed using the mixed-effects modeling approach. The Magorian model showed the best PE derivatives among the models assessed. A PK model developed from data obtained after single-bolus dosing can predict Cp values during bolus and continuous infusion. Thus, a mixed-effects modeling approach may be preferable in extrapolating such data.

  12. Endoscopic evaluation of food bolus formation and its relationship with the number of chewing cycles.

    Science.gov (United States)

    Fukatsu, H; Nohara, K; Kotani, Y; Tanaka, N; Matsuno, K; Sakai, T

    2015-08-01

    It is known that solid food is transported to the pharynx actively in parallel to it being crushed by chewing and mixed with saliva in the oral cavity. Therefore, food bolus formation should be considered to take place from the oral cavity to the pharynx. In previous studies, the chewed food was evaluated after the food had been removed from the oral cavity. However, it has been pointed out that spitting food out of the oral cavity interferes with natural food bolus formation. Therefore, we observed food boluses immediately before swallowing using an endoscope to establish a method to evaluate the food bolus-forming function, and simultaneously performed endoscopic evaluation of food bolus formation and its relationship with the number of chewing cycles. The subject was inserted the endoscope nasally and instructed to eat two coloured samples of boiled rice simultaneously in two ingestion conditions ('as usual' and 'chewing well'). The condition of the food bolus was graded into three categories for each item of grinding, mixing and aggregation and scored 2, 1 and 0. The score of aggregation was high under both ingestion conditions. The scores of grinding and mixing tended to be higher in subjects with a high number of chewing cycles, and the score of aggregation was high regardless of the number of chewing cycles. It was suggested that food has to be aggregated, even though the number of chewing cycles is low and the food is not ground or mixed for a food bolus to reach the swallowing threshold. © 2015 John Wiley & Sons Ltd.

  13. Characterization of swallow modulation in response to bolus volume in healthy subjects accounting for catheter diameter.

    Science.gov (United States)

    Ferris, Lara; Schar, Mistyka; McCall, Lisa; Doeltgen, Sebastian; Scholten, Ingrid; Rommel, Nathalie; Cock, Charles; Omari, Taher

    2018-06-01

    Characterization of the pharyngeal swallow response to volume challenges is important for swallowing function assessment. The diameter of the pressure-impedance recording catheter may influence these results. In this study, we captured key physiological swallow measures in response to bolus volume utilizing recordings acquired by two catheters of different diameter. Ten healthy adults underwent repeat investigations with 8- and 10-Fr catheters. Liquid bolus swallows of volumes 2.5, 5, 10, 20, and 30 mL were recorded. Measures indicative of distension, contractility, and flow timing were assessed. Pressure-impedance recordings with pressure-flow analysis were used to capture key distension, contractility, and pressure-flow timing parameters. Larger bolus volumes increased upper esophageal sphincter distension diameter (P < .001) and distension pressures within the hypopharynx and upper esophageal sphincter (P < .05). Bolus flow timing measures were longer, particularly latency of bolus propulsion ahead of the pharyngeal stripping wave (P < .001). Use of a larger-diameter catheter produced higher occlusive pressures, namely upper esophageal sphincter basal pressure (P < .005) and upper esophageal sphincter postdeglutitive pressure peak (P < .001). The bolus volume swallowed changed measurements indicative of distension pressure, luminal diameter, and pressure-flow timing; this is physiologically consistent with swallow modulation to accommodate larger, faster-flowing boluses. Additionally, catheter diameter predominantly affects lumen occlusive pressures. Appropriate physiological interpretation of the pressure-impedance recordings of pharyngeal swallowing requires consideration of the effects of volume and catheter diameter. NA. Laryngoscope, 128:1328-1334, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  14. Delivery confirmation of bolus electron conformal therapy combined with intensity modulated x-ray therapy

    International Nuclear Information System (INIS)

    Kavanaugh, James A.; Hogstrom, Kenneth R.; Fontenot, Jonas P.; Henkelmann, Gregory; Chu, Connel; Carver, Robert A.

    2013-01-01

    Purpose: The purpose of this study was to demonstrate that a bolus electron conformal therapy (ECT) dose plan and a mixed beam plan, composed of an intensity modulated x-ray therapy (IMXT) dose plan optimized on top of the bolus ECT plan, can be accurately delivered. Methods: Calculated dose distributions were compared with measured dose distributions for parotid and chest wall (CW) bolus ECT and mixed beam plans, each simulated in a cylindrical polystyrene phantom that allowed film dose measurements. Bolus ECT plans were created for both parotid and CW PTVs (planning target volumes) using 20 and 16 MeV beams, respectively, whose 90% dose surface conformed to the PTV. Mixed beam plans consisted of an IMXT dose plan optimized on top of the bolus ECT dose plan. The bolus ECT, IMXT, and mixed beam dose distributions were measured using radiographic films in five transverse and one sagittal planes for a total of 36 measurement conditions. Corrections for film dose response, effects of edge-on photon irradiation, and effects of irregular phantom optical properties on the Cerenkov component of the film signal resulted in high precision measurements. Data set consistency was verified by agreement of depth dose at the intersections of the sagittal plane with the five measured transverse planes. For these same depth doses, results for the mixed beam plan agreed with the sum of the individual depth doses for the bolus ECT and IMXT plans. The six mean measured planar dose distributions were compared with those calculated by the treatment planning system for all modalities. Dose agreement was assessed using the 4% dose difference and 0.2 cm distance to agreement. Results: For the combined high-dose region and low-dose region, pass rates for the parotid and CW plans were 98.7% and 96.2%, respectively, for the bolus ECT plans and 97.9% and 97.4%, respectively, for the mixed beam plans. For the high-dose gradient region, pass rates for the parotid and CW plans were 93.1% and 94

  15. Assessment of injection bolus in first-pass radionuclide angiography. Evaluation of injection site and needle size

    International Nuclear Information System (INIS)

    Tonami, Syuichi; Inagaki, Syoichi; Yasui, Masakazu; Sugishita, Kouki; Yoshita, Hisashi; Nakamura, Mamoru; Kuranishi, Makoto

    1996-01-01

    First-pass radionuclide angiography (FPRNA) using a multi-crystal gamma camera can correctly provide many quantitative and qualitative indices of left ventricular function as well as anatomic information. A compact injection bolus of radiotracer is, however, essential to the first-pass study since the temporal separation of cardiac chambers is required for the first-pass acquisition. To examine which factors affect the quality of an injection bolus, 327 patients who had FPRNA in the anterior projection were randomized for injection site of radiotracer (right or left external jugular veins, and right antecubital vein) and needle size (19- or 21-gauge). The injected bolus was assessed from the full width at half maximum (FWHM) of the bolus time-activity curve in the superior vena cava. As to injection site using a 19-gauge needle, an attemption through right external jugular vein (EJV) revealed the shortest FWHM of an injection bolus, followed by left EJV and right antecubital vein (AV). In right EJV 91% of injected bolus FWHM was less than 1.5 sec, which was significantly higher (p<0.001) than those of the other sites (left EJV: 70%. right AV: 65%). Approximately 7% of injection from left EJV and right AV, showed a split bolus of radiotracer. However, no split bolus was observed from right EJV. There was no significant difference in FWHM of an injection bolus between 19- and 21-gauge needle from EJV. Our present study demonstrated that the quality of an injection bolus from left EJV and AV was affected by RVEF in a case of low right ventricular function. In conclusion, right EJV is the first choice of injection site to obtain a compact bolus of radiotracer for the first-pass cardiac study. A 21-gauge needle can also be inserted from the external jugular vein to perform a good bolus injection. (author)

  16. Assessment of injection bolus in first-pass radionuclide angiography. Evaluation of injection site and needle size

    Energy Technology Data Exchange (ETDEWEB)

    Tonami, Syuichi; Inagaki, Syoichi; Yasui, Masakazu; Sugishita, Kouki; Yoshita, Hisashi; Nakamura, Mamoru; Kuranishi, Makoto [Toyama Medical and Pharmaceutical Univ. (Japan). Hospital

    1996-09-01

    First-pass radionuclide angiography (FPRNA) using a multi-crystal gamma camera can correctly provide many quantitative and qualitative indices of left ventricular function as well as anatomic information. A compact injection bolus of radiotracer is, however, essential to the first-pass study since the temporal separation of cardiac chambers is required for the first-pass acquisition. To examine which factors affect the quality of an injection bolus, 327 patients who had FPRNA in the anterior projection were randomized for injection site of radiotracer (right or left external jugular veins, and right antecubital vein) and needle size (19- or 21-gauge). The injected bolus was assessed from the full width at half maximum (FWHM) of the bolus time-activity curve in the superior vena cava. As to injection site using a 19-gauge needle, an attemption through right external jugular vein (EJV) revealed the shortest FWHM of an injection bolus, followed by left EJV and right antecubital vein (AV). In right EJV 91% of injected bolus FWHM was less than 1.5 sec, which was significantly higher (p<0.001) than those of the other sites (left EJV: 70%. right AV: 65%). Approximately 7% of injection from left EJV and right AV, showed a split bolus of radiotracer. However, no split bolus was observed from right EJV. There was no significant difference in FWHM of an injection bolus between 19- and 21-gauge needle from EJV. Our present study demonstrated that the quality of an injection bolus from left EJV and AV was affected by RVEF in a case of low right ventricular function. In conclusion, right EJV is the first choice of injection site to obtain a compact bolus of radiotracer for the first-pass cardiac study. A 21-gauge needle can also be inserted from the external jugular vein to perform a good bolus injection. (author)

  17. The impact of mastication, salivation and food bolus formation on salt release during bread consumption.

    Science.gov (United States)

    Tournier, Carole; Grass, Manon; Septier, Chantal; Bertrand, Dominique; Salles, Christian

    2014-11-01

    Health authorities recommend higher fibre and lower salt content in bread products. However, these basic ingredients of bread composition are multifunctional, and important changes in their content influence the texture, flavour and acceptability of the product. This study was designed to investigate the link between oral processing, bolus formation and sodium release during the consumption of four different breads that varied in composition and structure. Chewing behaviour was determined by surface electromyography, and salivation was quantified from the water content of the boluses collected. The kinetics of bread degradation during food bolus formation was characterised by measuring the bolus heterogeneity by texture image analysis, and sodium release into the saliva was quantified. Mastication and salivation varied between products and between subjects, thus highlighting different bolus formation strategies. In vivo salt release was mainly explained by mastication parameters. The initial slope of sodium release increased when the chewing muscles' activity increased, and the maximum sodium concentration was reached later when more masticatory cycles were required to reach the swallowing point.

  18. Impacts of palatal coverage on bolus formation during mastication and swallowing and subsequent adaptive changes.

    Science.gov (United States)

    Sato, T; Furuya, J; Tamada, Y; Kondo, H

    2013-10-01

    Palatal coverage is often required for elderly edentulous patients with complete dentures. The purpose of this study was to clarify impacts of palatal coverage on bolus formation and subsequent adaptive changes. Subjects were 18 healthy young dentulous adults who wore 1·5-mm-thick palatal plates. Subjects were asked to feed 12 g of bicoloured rice as usual, and the bolus formation by mastication and swallowing in the pharynx was observed using a nasal videoendoscopy. The bolus formation index (BFI), number of mastication strokes until swallowing, visual analogue scale about swallowing easiness and masticatory performance using colour-changeable gum were measured under three conditions: before placement of the palatal plate (day 0), immediately after placement (day 1) and after 7 days of wearing the plate (day 7). BFI and visual analogue scale on day 1 were significantly lower than those on day 0, but those on day 7 significantly recovered to the level of day 0. The number of mastication strokes did not change from day 0 to day 1, however, that on day 7 was significantly higher. Masticatory performance on days 1 and 7 was significantly lower than that on day 0. Although palatal coverage inhibits bolus formation during feeding, subjects increased the number of mastication strokes until swallowing threshold as they adapted to palatal coverage over time. This adaptive change was due to compensate for the lowered masticatory performance to achieve bolus formation for comfortable swallowing. © 2013 John Wiley & Sons Ltd.

  19. Saving radiation dose and contrast media in intravenous digital subtraction angiography by use of bolus chasing

    International Nuclear Information System (INIS)

    Rueckforth, J.; Schuermann, K.; Vorwerk, D.; Guenther, R.W.

    1998-01-01

    Purpose: This study evaluates the dose area product, the amount of contrast media and the examination quality of the bolus chasing technique compared to the single-step technique in intravenous digital subtraction angiography. Material and Methods: 15 examinations each with bolus chasing and single-step technique were compared. The dose area product and the volume of contrast media were recorded. The examination quality was scored by two examiners. Results: With bolus chasing the volume of the administered contrast media could be decreased on average by 114 ml (43%). The difference between the dose area product of bolus chasing (722 dGy/cm 2 ) and single-step technique (1910 dGy/cm 2 ) was significant. No significant difference in examination quality was found. Conclusions: The intravenous bolus chasing technique is a practicable method. Compared to the single-step technique it allows a remarkable dose reduction and a low consumption of contrast media without restriction of examination quality. (orig.) [de

  20. Endoleak detection using single-acquisition split-bolus dual-energy computer tomography (DECT)

    Energy Technology Data Exchange (ETDEWEB)

    Javor, D.; Wressnegger, A.; Unterhumer, S.; Kollndorfer, K.; Nolz, R.; Beitzke, D.; Loewe, C. [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria)

    2017-04-15

    To assess a single-phase, dual-energy computed tomography (DECT) with a split-bolus technique and reconstruction of virtual non-enhanced images for the detection of endoleaks after endovascular aneurysm repair (EVAR). Fifty patients referred for routine follow-up post-EVAR CT and a history of at least one post-EVAR follow-up CT examination using our standard biphasic (arterial and venous phase) routine protocol (which was used as the reference standard) were included in this prospective trial. An in-patient comparison and an analysis of the split-bolus protocol and the previously used double-phase protocol were performed with regard to differences in diagnostic accuracy, radiation dose, and image quality. The analysis showed a significant reduction of radiation dose of up to 42 %, using the single-acquisition split-bolus protocol, while maintaining a comparable diagnostic accuracy (primary endoleak detection rate of 96 %). Image quality between the two protocols was comparable and only slightly inferior for the split-bolus scan (2.5 vs. 2.4). Using the single-acquisition, split-bolus approach allows for a significant dose reduction while maintaining high image quality, resulting in effective endoleak identification. (orig.)

  1. Effect of chest wall radiotherapy in different manners using tissue equivalent bolus on skin and lung of cavia cobayas

    International Nuclear Information System (INIS)

    Huang Wei; Qu Yaqin; Song Xiangfu; Liu Shixin; Jia Xiaojing; Guo He; Yang Lei

    2009-01-01

    Objective: To probe the influence of electron beam radiotherapy in different manners using different tissue equivalent boluses on skin and lung. Methods: Adult female cavia cobayas were randomly divided into four groups as control group, half-time with bolus group, half-time with bolus group and without bolus group. Acute-irradiation animal models were established using electron beam in different manners with or without 0.5 cm tissue equivalent bolus. Pathological changes in lung, hair vesicle and fibroblast cell count were analyzed 40 clays after irradiation. Results: The radiation dermatitis in the group with bolus was slighter than that of the group without bolus, but the radiation pneumonia was reverse. With bolus, the radiation dermatitis of haft-time group was slighter than that of full-time group. The injury repair of half-time group was more active than full-time group. Conclusions: The treatment of haft-time bolus could protect lung without serious skin complications. (authors)

  2. Effects of copper oxide wire particle bolus therapy on trichostrongyle fecal egg counts in exotic artiodactylids.

    Science.gov (United States)

    Fontenot, Deidre K; Kinney-Moscona, Allyson; Kaplan, Ray M; Miller, James

    2008-12-01

    Four species of artiodactylids (scimitar-horned oryx [Oryx dama]), roan antelope [Hippotragus equinus], blackbuck [Antilope cervicapra]), and blesbok [Damaliscus pygargus phillipsi]) totaling 13 animals were treated with a one-time 12.5-g dose of copper oxide wire particles (COWPs) in a bolus form. Pretreatment, individual trichostrongyle fecal egg counts (FECs) were performed using the McMaster technique. Individual posttreatment FECs were performed every 7 days for 35 days beginning 7 days after bolus administration, and FEC reduction ratios (FECRRs) expressed as percentage reductions from pretreatment values were calculated every 7 days. Mean FECRRs for the 13 animals were 93% +/- 16%, 98% +/- 7%, 91% +/- 28%, 94% +/- 16%, and 90% +/- 13% at 7, 14, 21, 28, and 35 days posttreatment, respectively. These data demonstrate that COWPs in a bolus form were an effective method for reducing FEC in exotic artiodactylids. Based on this limited data, COWPs show promise as an anthelmintic alternative for exotic artiodactylids in zoologic collections.

  3. Study of dose modification in skin cancers induced by the kind of bolus used - Bibliography

    International Nuclear Information System (INIS)

    Camilleri, Jeremy

    2011-01-01

    As tumour irradiation modalities differ from one pathology to another, and are even proper to each pathology (they depend on tumour nature, histology, size, location, and so on), but as therapeutic objectives remain unchanged (to deliver the prescribed dose to the target-volume with the highest possible precision while preserving as much as possible sane tissues as well as neighbouring organs at risk), this bibliographical study aims, on the one hand, at quantifying the dose variation generated by heterogeneous structures crossed by the electron beam, and on the other hand, at optimising the use of boluses during surface irradiations, notably in the case of skin cancers. The author addresses therapeutic indications of irradiation of skin cancers and of thoracic wall for which the application of a bolus is required, and then the associated irradiation techniques as well as bolus characteristics

  4. Comparison of Bolus Phenylephrine, Ephedrine and Mephentermine for Maintenance of Arterial Pressure during Spinal Anesth

    Directory of Open Access Journals (Sweden)

    B Bhattarai

    2010-03-01

    Full Text Available INTRODUCTION: Hypotension is common following spinal anesthesia. Various vasopressors have been indicated to prevent it. The study compares three such agents namely phenylephrine, ephedrine and mephentermine. METHODS: The study included 90 patients undergoing elective and emergency cesarean section who developed hypotension following subarachnoid blockade. Parturient were randomly divided into three groups each group had 30 patients. Group P received bolus of Phenylephrine 25 microgram, where as group E received Ephedrine 5mg and Group M received Mephentermine 6mg. RESULTS: It was found that rise of blood pressure was significantly higher in case of phenylephrine group in first six minutes, after the bolus, there was significant reduction in the heart rate in phenylephrine group, but there was tachycardia following administration of bolus ephedrine and mephenteramine. Neonatal APGAR score were similar in all three groups. CONCLUSIONS: All three drugs maintained hemodynamics within 20 percent of the baseline values on intravenous administration. Keywords: APGAR, ephedrine, hypotension, mephentermine, phenylephrine, spinal anesthesia.

  5. Dynamic computed tomography after bolus injection and infusion of perfluorooctylbromide (PFOB)

    International Nuclear Information System (INIS)

    Adam, G.; Guenther, R.W.; Goertz, H.; Schiffer, C.

    1992-01-01

    We investigated the enhancement of the liver, the spleen, and of induced abscesses and the abdominal vessels after administration of 3 g/kg bodyweight Perfluoroocytlbromide (PFOB) on an animal model. Twenty-one rabbits each received the contrast medium as bolus injection and as slow infusion over half an hour. CT was performed between 2 and 48 hours after contrast medium application. Peak enhancement of the liver, the spleen and the liver abscess membrane was found between 24 and 48 hours after PFOB administration, independently of the application mode. Peak enhancement of the abdominal aorta and the IVC was observed within two hours after bolus injection. In this rabbit model PFOB permits best delineation of the vessels after bolus injection within the first two hours, while CT imaging of the liver, the spleen and the liver abscess membrane is best between 24 and 48 hours after contrast medium application, independent of the injection velocity. (orig.) [de

  6. Development of test bolus tracking method and usefulness in coronary CT angiography

    International Nuclear Information System (INIS)

    Yamaguchi, Takayoshi; Takahashi, Daichi

    2009-01-01

    The test bolus tracking (TBT) method is a new injection method of contrast medium that we developed. The TBT method is an injection technique that continuously performs the test bolus injection and the main bolus injection, such that the best acquisition of scan timing and the improvement of examination efficiency can be expected. We compared the TBT method and the test injection method by coronary CT angiography. The results demonstrated that the contrast enhancement of the coronary arteries was high and the variation of the CT value was also small in the TBT method. When the scan timing expected by the TI method and the TBT method were compared, it was different of two seconds or more by the case with 43%. However, the variation of CT value was small for the TBT method in these cases. Therefore, the TBT method is a very useful method for coronary CT angiography (CCTA). (author)

  7. Rapid contrast infusion of bolus injection for i.v. urography

    International Nuclear Information System (INIS)

    Kaltenborn, H.; Klose, P.; Klose, K.; Schmiedel, E.

    1993-01-01

    The rate of contrast injection during i.v. urography may vary considerably (bolus injection or drip infusion). The effect of 5 rates of injection (6, 12, 18, 36 and 72 ml/min) on the contrast density in the renal collecting system was examined over a period of 30 minutes. Measurements showed an inter-individual difference of more than 200% in each group. The intra-individual variations for different rates of injection were very slight; individual concentration in the kidney for a given dose depends only slightly on the rate of injection. There is no statistically significant improvement in contrast values as a result of a bolus injection. The reduced incidence of side effects justifies the use of bolus injections but pressure injections are unnecessary from a diagnostic point view. (orig.) [de

  8. A custom three-dimensional electron bolus technique for optimization of postmastectomy irradiation

    International Nuclear Information System (INIS)

    Perkins, George H.; McNeese, Marsha D.; Antolak, John A.; Buchholz, Thomas A.; Strom, Eric A.; Hogstrom, Kenneth R.

    2001-01-01

    Purpose: Postmastectomy irradiation (PMI) is a technically complex treatment requiring consideration of the primary tumor location, possible risk of internal mammary node involvement, varying chest wall thicknesses secondary to surgical defects or body habitus, and risk of damaging normal underlying structures. In this report, we describe the application of a customized three-dimensional (3D) electron bolus technique for delivering PMI. Methods and Materials: A customized electron bolus was designed using a 3D planning system. Computed tomography (CT) images of each patient were obtained in treatment position and the volume to be treated was identified. The distal surface of the wax bolus matched the skin surface, and the proximal surface was designed to conform to the 90% isodose surface to the distal surface of the planning target volume (PTV). Dose was calculated with a pencil-beam algorithm correcting for patient heterogeneity. The bolus was then fabricated from modeling wax using a computer-controlled milling device. To aid in quality assurance, CT images with the bolus in place were generated and the dose distribution was computed using these images. Results: This technique optimized the dose distribution while minimizing irradiation of normal tissues. The use of a single anterior field eliminated field junction sites. Two patients who benefited from this option are described: one with altered chest wall geometry (congenital pectus excavatum), and one with recurrent disease in the medial chest wall and internal mammary chain (IMC) area. Conclusion: The use of custom 3D electron bolus for PMI is an effective method for optimizing dose delivery. The radiation dose distribution is highly conformal, dose heterogeneity is reduced compared to standard techniques in certain suboptimal settings, and excellent immediate outcome is obtained

  9. The Consideration of Bolus Effects of Games Attached on Lesion area

    International Nuclear Information System (INIS)

    Park, Ju Young; Ju, Sang Kyu; Park, Young Chul; Han, Young Yi; Shin, Eun Hyuk; Park, Yong Hwan

    2004-01-01

    The aim of this study is to evaluate the effect of skin dose and PDD by using wounds protecting gauzes or Vaselinespread gauzes. And it was studied that the possibility to substitute custom bolus into gauzes. 4 MV photon (CL600C, varian, US), Polystyrene Phantom (30(W) X 30(L) X 30(H)) with Markus chamber(PTW, US) were used for dose measurement. This study was distinguished natural gauzes and spread over Vaseline gauzes. We gave variety to the gauze thickness at 5, 10 and 15 sheets respectively. For comparison between using bolus and not that, we had used 1.0 cm thickness bolus so that analyzed surface dose and PDD at the same conditions above mentioned. When maximum point was defined as reference point, surface dose was measured as 35% in open beam. When the gauzes were attached to surface as 5, 10 and 15 sheets, surface dose were increased as 69, 80 and 91% respectively according to thickness of gauzes. When spread over Vaseline gauzes were attached to surface as 5, 10 and 15 sheets, surface dose were increased respectively as 98, 100 and 98% according to thickness of gauzes. Also when 0.5 cm bolus and 5 sheets gauzes were composed, surface dose was measured as 98%. The gauzes that were attached to skin surface in radiation therapy had been scattering material and contributed increasing surface dose without variation of percentage depth dose. However, if we want to delivery much dose to skin surface then we have to apply many sheets of gauzes to skin surface. Although we get easy that result by bolus or spread over Vaseline gauzes, we have to revise percentage depth dose at calculation. Therefore, if we find pertinent conditions based on measured data that are considered skin dose and patient setup efficiency, to replace custom bolus with gauzes will be helpful to efficient treatment.

  10. Oral declines and mastication deficiencies cause alteration of food bolus properties.

    Science.gov (United States)

    Peyron, M-A; Santé-Lhoutellier, V; François, O; Hennequin, M

    2018-02-21

    In the elderly, masticatory function often presents failure in certain oral tasks due to impairment such as decline in muscular force, jaw or tongue motility, neuro-muscular coordination, tooth damage, malocclusion and saliva production. Great disparity is observed in the various and potentially cumulative oral declines that occur with ageing. Such difficulties may have an impact on food consumption and nutritional status. To obtain better understanding of the consequences of several oral deficiencies, a series of swallowable boluses were prepared in vitro with the AM 2 masticator apparatus with normal and deficient programming. Physiological normal mastication (NM) was simulated using in vivo data from healthy subjects. Chewing deficiencies were reproduced by alteration of NM programming to perform different levels and combinations of force loss, lack of saliva and decrease in the motility of oral elements. Poultry meatballs were used as test-food. Particle size distribution in the food bolus was measured by sieving and rheological features (hardness, cohesiveness and elasticity) were assessed with a TPA test. Compared to the NM outcome, significant and gradual deterioration of the food bolus was observed and associated with alteration in force, saliva and motility. Combinations of several failures led to greater or cumulative deficiencies in swallowable bolus properties. For the elderly presenting a high prevalence of various oral injuries, tailoring textured food cannot be ignored as a solution for remedying deficiencies and favoring the formation of a safe-swallowable bolus, which is an essential vector of nutrients. Knowing the impacts of oral injuries on the food bolus is obviously a requisite for developing diet strategies, including nutritional items for specific populations.

  11. TUBERCULOSIS COMO ENFERMEDAD OCUPACIONAL

    Science.gov (United States)

    Mendoza-Ticona, Alberto

    2014-01-01

    Existe evidencia suficiente para declarar a la tuberculosis como enfermedad ocupacional en diversos profesionales especialmente entre los trabajadores de salud. En el Perú están normados y reglamentados los derechos laborales inherentes a la tuberculosis como enfermedad ocupacional, como la cobertura por discapacidad temporal o permanente. Sin embargo, estos derechos aún no han sido suficientemente socializados. En este trabajo se presenta información sobre el riesgo de adquirir tuberculosis en el lugar de trabajo, se revisan las evidencias para declarar a la tuberculosis como enfermedad ocupacional en trabajadores de salud y se presenta la legislación peruana vigente al respecto. PMID:22858771

  12. Normal mediastinal and hilar lymph nodes evaluated by 5 mm slice bolus injection CT scan

    International Nuclear Information System (INIS)

    Yamamoto, Takako; Tsukada, Hiroshi; Koizumi, Naoya; Akita, Shinichi; Oda, Junichi; Sakai, Kunio

    1995-01-01

    We evaluated the number and size of normal mediastinal and hilar lymph nodes by 5 mm slice bolus injection CT (12 patients), compared with 10 mm slice CT (12 patients). More lymph nodes were clearly demonstrated by 5 mm slice CT than by 10 mm slice CT. Especially left-sided tracheobronchial (no.4), subaortic (no.5), subcarinal (no.7) and hilar lymph nodes were clearly visible. We concluded 5 mm slice bolus injection CT was useful to evaluate mediastinal and hilar lymph nodes. (author)

  13. Use of cornmeal bolus as an aid in obtaining cranial four-vessel angiograms.

    Science.gov (United States)

    Weathers, R M; Lee, A

    1975-01-01

    In cranial angiography it has always been difficult to visualize extracranial vessels of the cervico-thoracic region, upon one radiograph, by using the same exposure factors for both regions. For this reason, we experimented and found that by applying a dry cornmeal bolus on specific areas of the neck a technically superior radiograph of these regions can be achieved. This bolus simulated added soft tissue to the cervical region. The density of the cervical region is now similar to that of the upper thoracic. As a result, factors set for one exposure will adequately penetrate both areas.

  14. Comparison of Insulin Detemir and Insulin Glargine for Hospitalized Patients on a Basal-Bolus Protocol

    Directory of Open Access Journals (Sweden)

    Sondra Davis

    2017-04-01

    Full Text Available BACKGROUND: The primary purpose of this study is to determine whether insulin detemir is equivalent to insulin glargine in controlling hyperglycemia for the adult hospitalized patient on a basal-bolus treatment regimen. METHODS: A retrospective study was conducted at two acute care hospitals within the same health system. Patients from both facilities who were initiated on a basal-bolus subcutaneous insulin regimen were included in the study. The basal-bolus regimen consisted of three components: basal, bolus, and corrective insulin with only the data from the first seven days analyzed. Once the basal-bolus protocol was initiated, all previous glycemic agents were discontinued. The target glycemic goal of the study was 100–180 mg/dL. RESULTS: In both groups, 50% of the patients had achieved the target glycemic control goal (100–180 mg/dL by day 2 (p = 0.3. However, on the seventh or last day of basal-bolus treatment, whichever came first, 36.36% of patients receiving insulin detemir (n = 88 achieved the blood glucose reading goal compared to 52.00% in patients receiving insulin glargine (n = 100 (p = 0.03. This corresponded to an adjusted odds ratio of 2.12 (1.08 to 4.15, p = 0.03. The adjusting variables were provider type, whether the patient was hospitalized within 30 days prior and diagnosis of stroke. The mean blood glucose readings for the insulin glargine and the insulin detemir groups while on basal-bolus therapy were 200 mg/dL and 215 mg/dL, respectively (p = 0.05. The total number of blood glucose readings less than 70 mg/dL and less than 45 mg/dL was very low and there were no differences in number of episodes with hypoglycemia between the two groups. CONCLUSION: There was not a statistical difference between the two groups at 2 days, however there was on the seventh day or the last day of basal-bolus treatment. There were nonsignificant hypoglycemia events between basal insulin groups and the results for the last or seventh day

  15. Commentary on "Performance of a glucose meter with a built-in automated bolus calculator versus manual bolus calculation in insulin-using subjects".

    Science.gov (United States)

    Rossetti, Paolo; Vehí, Josep; Revert, Ana; Calm, Remei; Bondia, Jorge

    2012-03-01

    Since the early 2000s, there has been an exponentially increasing development of new diabetes-applied technology, such as continuous glucose monitoring, bolus calculators, and "smart" pumps, with the expectation of partially overcoming clinical inertia and low patient compliance. However, its long-term efficacy in glucose control has not been unequivocally proven. In this issue of Journal of Diabetes Science and Technology, Sussman and colleagues evaluated a tool for the calculation of the prandial insulin dose. A total of 205 insulin-treated patients were asked to compute a bolus dose in two simulated conditions either manually or with the bolus calculator built into the FreeStyle InsuLinx meter, revealing the high frequency of wrong calculations when performed manually. Although the clinical impact of this study is limited, it highlights the potential implications of low diabetesrelated numeracy in poor glycemic control. Educational programs aiming to increase patients' empowerment and caregivers' knowledge are needed in order to get full benefit of the technology. © 2012 Diabetes Technology Society.

  16. Review article : intra-oesophageal impedance monitoring for the assessment of bolus transit and gastro-oesophageal reflux

    NARCIS (Netherlands)

    Conchillo, J. M.; Smout, A. J.

    2009-01-01

    Background Intra-oesophageal impedance monitoring can be used to assess the clearance of a swallowed bolus (oesophageal transit) and to detect gastro-oesophageal reflux independent of its acidity. Aim To discuss the clinical application of the impedance technique for the assessment of bolus transit

  17. Continuous indomethacin infusion may be less effective than bolus infusions for ductal closure in very low birth weight infants

    NARCIS (Netherlands)

    de Vries, NKS; Jagroep, FK; Jaarsma, AS; Elzenga, NJ; Bos, AF

    The effectiveness of continuous indomethacin (INDO) infusion versus bolus infusions for closure of patent ductus arteriosus (PDA) was investigated. The study design was an open-label case series (continuous INDO) with historic controls matched for gestational age (bolus INDO). Ductal closure rates

  18. Evaluation of a Water-based Bolus Device for Radiotherapy to the Extremities in Kaposi's Sarcoma Patients

    International Nuclear Information System (INIS)

    Ahn, Seung Kwon; Kim, Yong Bae; Lee, Ik Jae

    2008-01-01

    We designed a water-based bolus device for radiation therapy in Kaposi's sarcoma. This study evaluated the usefulness of this new device and compared it with the currently used rice-based bolus. Materials and Methods: We fashioned a polystyrene box and cut a hole in order to insert patient's extremities while the patient was in the supine position. We used a vacuum-vinyl based polymer to reduce water leakage. Next, we eliminated air using a vacuum pump and a vacuum valve to reduce the air gap between the water and extremities in the vacuum-vinyl box. We performed CT scans to evaluate the density difference of the fabricated water-based bolus device when the device in which the rice-based bolus was placed directly, the rice-based bolus with polymer-vinyl packed rice, and the water were all put in. We analyzed the density change with the air gap volume using a planning system. In addition, we measured the homogeneity and dose in the low-extremities phantom, attached to six TLD, and wrapped film exposed in parallel-opposite fields with the LINAC under the same conditions as the set-up of the CT-simulator. Results: The density value of the rice-based bolus with the rice put in directly was 14% lower than that of the water-based bolus. Moreover, the value of the other experiments in the rice-based bolus with the polymer-vinyl packed rice showed an 18% reduction in density. The analysis of the EDR2 film revealed that the water-based bolus shows a more homogeneous dose plan, which was superior by 4.0-4.4% to the rice-base bolus. The mean TLD readings of the rice-based bolus, with the rice put directly into the polystyrene box had a 3.4% higher density value. Moreover, the density value in the case of the rice-based bolus with polymer-vinyl packed rice had a 4.3% higher reading compared to the water-based bolus. Conclusion: Our custom-made water-based bolus device increases the accuracy of the set-up by confirming the treatment field. It also improves the accuracy of the

  19. Adductor Canal Block With Continuous Infusion Versus Intermittent Boluses and Morphine Consumption

    DEFF Research Database (Denmark)

    Jaeger, Pia; Baggesgaard, Jonas; Sørensen, Johan K

    2018-01-01

    a randomized, blinded, controlled study, including patients scheduled for total knee arthroplasty with spinal anesthesia. Patients received 0.2% ropivacaine via a catheter in the adductor canal administered as either repeated intermittent boluses (21 mL/3 h) or continuous infusion (7 mL/h). The primary outcome...

  20. Dual-phase helical CT using bolus triggering technique: optimization of transition time

    International Nuclear Information System (INIS)

    Choi, Young Ho; Kim, Tae Kyoung; Park, Byung Kwan; Koh, Young Hwan; Han, Joon Koo; Choi, Byung Ihn

    1999-01-01

    To optimize the transition time between the triggering point in monitoring scanning and the initiation of diagnostic hepatic arterial phase (HAP) scanning in hepatic spiral CT, using a bolus triggering technique. One hundred consecutive patients with focal hepatic lesion were included in this study. Patients were randomized into two groups. Transition times of 7 and 11 seconds were used in group 1 and 2, respectively. In all patients, bolus triggered HAP spiral CT was obtained using a semi-automatic bolus tracking program after the injection of 120mL of non-ionic contrast media at a rate of 3mL/sec. When aortic enhancement reached 90 HU, diagnostic HAP scanning began after a given transition time. From images of group 1 and group 2, the degree of parenchymal enhancement of the liver and tumor-to-liver attenuation difference were measured. Also, for qualitative analysis, conspicuity of the hepatic artery and hypervascular tumor was scored and analyzed. Hepatic parenchymal enhancement on HAP was 12.07 + /-6.44 HU in group 1 and 16.03 + /-5.80 HU in group 2 (p .05). In the evaluation of conspicuity of hepatic artery, there was no statistically significant difference between the two groups (p > .05). The conspicuity of hypervascular tumors in group 2 was higher than in group 1 (p < .05). HAP spiral CT using a bolus triggering technique with a transition time of 11 seconds provides better HAP images than when the transition time is 7 seconds

  1. Precision flow-controlled rubidium-82 generator for bolus and constant infusion studies

    International Nuclear Information System (INIS)

    Yano, Y.

    1981-01-01

    A unique flow rate controller and large reservoir pumping system have been developed for infusing rubidium-82 intravenously at bolus, constant, or variable infusion rates. Using rubidium-82 and the positron ring detector tomograph, extraction or flow information can be obtained in studies of the heart, head, or kidneys

  2. Split bolus technique in polytrauma: a prospective study on scan protocols for trauma analysis

    NARCIS (Netherlands)

    Beenen, Ludo F. M.; Sierink, Joanne C.; Kolkman, Saskia; Nio, C. Yung; Saltzherr, Teun Peter; Dijkgraaf, Marcel G. W.; Goslings, J. Carel

    2015-01-01

    For the evaluation of severely injured trauma patients a variety of total body computed tomography (CT) scanning protocols exist. Frequently multiple pass protocols are used. A split bolus contrast protocol can reduce the number of passes through the body, and thereby radiation exposure, in this

  3. The effect of food bolus location on jaw movement smoothness and masticatory efficiency

    NARCIS (Netherlands)

    Molenaar, W.N.B.; Gezelle Meerburg, P.J.; Luraschi, J.; Whittle, T.; Schimmel, M.; Lobbezoo, F.; Peck, C.C.; Murray, G.M.; Minami, I.

    2012-01-01

    Masticatory efficiency in individuals with extensive tooth loss has been widely discussed. However, little is known about jaw movement smoothness during chewing and the effect of differences in food bolus location on movement smoothness and masticatory efficiency. The aim of this study was to

  4. Use of a marshmallow bolus for evaluating lower esophageal mucosal rings.

    Science.gov (United States)

    Ott, D J; Kelley, T F; Chen, M Y; Gelfand, D W; Wu, W C

    1991-07-01

    Sixty-three patients (35 women, 28 men; mean age 55 yr) with lower esophageal mucosal ring shown radiographically were examined with a semi-solid bolus consisting of a portion of a standard marshmallow. The most common symptom was dysphagia, present in 46 (73%) patients. Impaction of the marshmallow bolus by the ring occurred in 40 (63%) of the 63 patients, and produced symptoms in 27 (68%) of these 40 patients. Nine (14%) rings were detected radiographically only with a solid bolus; eight of these patients had dysphagia and seven rings were 20 mm or less in caliber. Impaction related to ring caliber, and was found in all 17 (100%) rings that were 13 mm or less in diameter, in 17/24 (71%) 14- to 19-mm rings, and in 6/22 (27%) rings 20 mm or more in caliber. Endoscopy in 23 patients detected 16 (70%) rings, and also depended on ring caliber: less than or equal to 13 mm, 6/6 (100%); 14-19 mm, 5/9 (56%); greater than or equal to 20 mm, 5/8 (63%). Marshmallow impaction occurred in 17 (74%) of 23 patients who had endoscopy; three of the 23 patients had normal endoscopy. In conclusion, radiographic examination supplemented by the use of a marshmallow bolus best detects lower esophageal mucosal ring.

  5. Pharmacokinetics of rocuronium after bolus and continuous infusion during halothane anaesthesia

    NARCIS (Netherlands)

    McCoy, E.P; Mirakhur, R.K; Maddineni, V.R; Wierda, J.MKH; Proost, Hans

    We have studied the pharmacokinetics of a single bolus of rocuronium (Org 9426), followed by an infusion, in eight patients during anaesthesia with halothane and nitrous oxide in oxygen. Neuromuscular block was monitored using train-of-four (TOF) stimulation and recording the force of contraction of

  6. Tolerance to continuous intrathecal baclofen infusion can be reversed by pulsatile bolus infusion

    NARCIS (Netherlands)

    Heetla, H. W.; Staal, M. J.; van Laar, T.

    Study design: Pilot study. Objective: To study the effect of pulsatile bolus infusion of intrathecal baclofen (ITB) on daily ITB dose, in patients showing dose increases, probably due to tolerance. Setting: Department of neurology and neurosurgery, University Medical Center Groningen, the

  7. Use of an automated bolus calculator in MDI-treated type 1 diabetes

    DEFF Research Database (Denmark)

    Schmidt, Signe; Meldgaard, Merete; Serifovski, Nermin

    2012-01-01

    To investigate the effect of flexible intensive insulin therapy (FIIT) and an automated bolus calculator (ABC) in a Danish type 1 diabetes population treated with multiple daily injections. Furthermore, to test the feasibility of teaching FIIT in a 3-h structured course....

  8. Soft-robotic esophageal swallowing as a clinically-inspired bolus rheometry technique

    International Nuclear Information System (INIS)

    Dirven, Steven; Allen, Jacqueline; Xu, Weiliang; Cheng, Leo K

    2017-01-01

    To investigate the impact of viscosity and peristaltic transport parameters on manometric pressure signatures, a reproducible swallowing process is required. Due to inter- and intra-subject variability from swallow to swallow, the human body does not represent an optimal mechanism for such an investigation. A smooth and continuous swallowing soft-robot has been developed to produce biomimetic swallowing trajectories, and is proposed to operate as a bench-top bolus rheometric investigation method. The method compares conventional viscometry and pressure signature findings from robotic swallowing experiments. The robotic aspect of experimentation involved 450 biomimetic swallows (10 repetitions of 45 unique experiments). The method examined swallowing transport in three dimensions: bolus formulation, peristaltic wavelength, and peristaltic velocity, each of which are known to contribute to safe and effective swallowing in vivo . It is found that the pressure gradients and magnitudes are commensurate with clinical reports on biological swallowing, on the order of 100 mmHg peak, however, the relationship between viscosity and pressure signatures is less clear. Bolus transport cannot be predicted as a function of bolus viscosity alone. Traditional viscometric data at 50 s −1 , as used in clinical practice, may not be a strong indicator of swallow effort, safety, or efficacy in vivo . (paper)

  9. Continuous transversus abdominis plane block vs intermittent bolus for analgesia after abdominal surgery: a randomized trial

    Directory of Open Access Journals (Sweden)

    Rao Kadam V

    2017-07-01

    Full Text Available Vasanth Rao Kadam,1 Roelof M Van Wijk,1 John L Moran,2 Shantan Ganesh,3 A Kumar,1 Rajesh Sethi,1 Patricia Williams2,4 1Department of Anaesthesia, The Queen Elizabeth Hospital, School of Medicine, University of Adelaide, Adelaide, SA, 2Intensive Care Unit, The Queen Elizabeth Hospital, School of Medicine, University of Adelaide, Adelaide, SA, 3Department of Surgery, The Queen Elizabeth Hospital, School of Medicine, University of Adelaide, Adelaide, SA, 4Department of Epidemiology and Preventive Medicine, School Public Health and Preventive Medicine, Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia Background: Continuous and intermittent bolus techniques of transversus abdominis plane (TAP blocks have been used for analgesia after abdominal surgery. Although both are effective, there are no studies comparing them. The aim of this study is to compare analgesia and cost-effectiveness between these groups.Methods: After obtaining ethical approval, 20 American Society of Anesthesiologists ASA grade I to III patients undergoing elective abdominal surgery were recruited with 10 patients allocated to each arm. Bilateral ultrasound-guided TAP blocks were performed with an initial bolus of 0.5% ropivacaine 20 mL per side, followed by catheter insertion. After surgery, the continuous infusion group received 0.2% ropivacaine 8 mL/hour on each side and the intermittent bolus group received doses of 0.2% ropivacaine 20 mL per side every 8 hours for 48 hours. Both groups received intravenous fentanyl patient-controlled analgesia and regular oral paracetamol. Parameters recorded included numerical rating scores for pain and post-operative analgesic consumption at baseline (time 0 and at 1 hour, 1 day and 2 days post-operatively. The duration of catheter insertion, complications, patient satisfaction and information regarding costs were also recorded. Patient satisfaction was assessed utilizing a 4-point

  10. Comparison of first-pass and second-bolus dynamic susceptibility perfusion MRI in brain tumors

    International Nuclear Information System (INIS)

    Spampinato, M.V.; Besenski, Nada; Rumboldt, Zoran; Wooten, Caroline; Dorlon, Margaret

    2006-01-01

    Our goal was to evaluate whether the T1 shortening effect caused by contrast leakage into brain tumors, a well-known confounding effect in the quantification of relative cerebral blood volume (rCBV) measurements, may be corrected by the administration of a predose of gadolinium-DTPA. As part of their presurgical imaging protocol, 25 patients with primary brain tumors underwent two consecutive dynamic susceptibility-weighted contrast-enhanced (DSC) perfusion MR studies. Intratumoral rCBV measurements and normalized rCBV values obtained during the first-pass and second-bolus studies were compared (Wilcoxon signed-ranks test). The frequency of relatively increased rCBV ratios on the second-bolus study was compared between enhancing and non-enhancing neoplasms (Fisher's exact test). Postprocessing perfusion studies were evaluated for image quality on a scale of 0-3 (Wilcoxon signed-ranks test). Four studies were excluded due to unacceptable image quality. Mean normalized rCBVs were 9.04 (SD 4.64) for the first-pass and 7.99 (SD 3.84) for the second-bolus study. There was no statistically significant difference between the two perfusion studies in either intratumoral rCBV (P=0.237) or rCBV ratio (P=0.181). Five enhancing and four non-enhancing tumors showed a relative increase in rCBV ratio on the second-bolus study, without a significant difference between the groups. Image quality was not significantly different between perfusion studies. Our results did not demonstrate a significant difference between first-pass and second-bolus rCBV measurements in DSC perfusion MR imaging. The administration of a predose of gadolinium-DTPA does not appear to be an efficient way of compensating for the underestimation of intratumoral rCBV values due to the T1 shortening effect. (orig.)

  11. Pre-pharyngeal swallow effects of recurrent laryngeal nerve lesion on bolus shape and airway protection in an infant pig model

    Science.gov (United States)

    Gould, Francois D. H.; Yglesias, B.; Ohlemacher, J.; German, R. Z.

    2016-01-01

    Recurrent laryngeal nerve (RLN) damage in infants leads to increased dysphagia and aspiration pneumonia. Recent work has shown that intra oral transport and swallow kinematics change following RLN lesion, suggesting potential changes in bolus formation prior to the swallow. In this study we used geometric morphometrics to understand the effect of bolus shape on penetration and aspiration in infants with and without RLN lesion. We hypothesized 1) that geometric bolus properties are related to airway protection outcomes and 2) that in infants with RLN lesion, the relationship between geometric bolus properties and dysphagia is changed. In five infant pigs, dysphagia in 188 swallows was assessed using the Infant Mammalian Penetration Aspiration Score (IMPAS). Using images from high-speed VFSS, bolus shape, bolus area, and tongue outline were quantified digitally. Bolus shape was analyzed using elliptical Fourier analysis, and tongue outline using polynomial curve fitting. Despite large inter-individual differences, significant within individual effects of bolus shape and bolus area on airway protection exist. The relationship between penetration-aspiration score and both bolus area and shape changed post lesion. Tongue shape differed between pre and post lesion swallows, and between swallows with different IMPAS scores. Bolus shape and area affect airway protection outcomes. RLN lesion changes that relationship, indicating that proper bolus formation and control by the tongue requires intact laryngeal sensation. The impact of RLN lesion on dysphagia is pervasive. PMID:27873091

  12. Performance of a glucose meter with a built-in automated bolus calculator versus manual bolus calculation in insulin-using subjects.

    Science.gov (United States)

    Sussman, Allen; Taylor, Elizabeth J; Patel, Mona; Ward, Jeanne; Alva, Shridhara; Lawrence, Andrew; Ng, Ronald

    2012-03-01

    Patients consider multiple parameters in adjusting prandial insulin doses for optimal glycemic control. Difficulties in calculations can lead to incorrect doses or induce patients to administer fixed doses, rely on empirical estimates, or skip boluses. A multicenter study was conducted with 205 diabetes subjects who were on multiple daily injections of rapid/ short-acting insulin. Using the formula provided, the subjects manually calculated two prandial insulin doses based on one high and one normal glucose test result, respectively. They also determined the two doses using the FreeStyle InsuLinx Blood Glucose Monitoring System, which has a built-in, automated bolus calculator. After dose determinations, the subjects completed opinion surveys. Of the 409 insulin doses manually calculated by the subjects, 256 (63%) were incorrect. Only 23 (6%) of the same 409 dose determinations were incorrect using the meter, and these errors were due to either confirmed or potential deviations from the study instructions by the subjects when determining dose with meter. In the survey, 83% of the subjects expressed more confidence in the meter-calculated doses than the manually calculated doses. Furthermore, 87% of the subjects preferred to use the meter than manual calculation to determine prandial insulin doses. Insulin-using patients made errors in more than half of the manually calculated insulin doses. Use of the automated bolus calculator in the FreeStyle InsuLinx meter minimized errors in dose determination. The patients also expressed confidence and preference for using the meter. This may increase adherence and help optimize the use of mealtime insulin. © 2012 Diabetes Technology Society.

  13. Evaluation of various boluses in dose distribution for electron therapy of the chest wall with an inward defect

    Science.gov (United States)

    Mahdavi, Hoda; Jabbari, Keyvan; Roayaei, Mahnaz

    2016-01-01

    Delivering radiotherapy to the postmastectomy chest wall can be achieved using matched electron fields. Surgical defects of the chest wall change the dose distribution of electrons. In this study, the improvement of dose homogeneity using simple, nonconformal techniques of thermoplastic bolus application on a defect is evaluated. The proposed phantom design improves the capability of film dosimetry for obtaining dose profiles of a patient's anatomical condition. A modeled electron field of a patient with a postmastectomy inward surgical defect was planned. High energy electrons were delivered to the phantom in various settings, including no bolus, a bolus that filled the inward defect (PB0), a uniform thickness bolus of 5 mm (PB1), and two 5 mm boluses (PB2). A reduction of mean doses at the base of the defect was observed by any bolus application. PB0 increased the dose at central parts of the defect, reduced hot areas at the base of steep edges, and reduced dose to the lung and heart. Thermoplastic boluses that compensate a defect (PB0) increased the homogeneity of dose in a fixed depth from the surface; adversely, PB2 increased the dose heterogeneity. This study shows that it is practical to investigate dose homogeneity profiles inside a target volume for various techniques of electron therapy. PMID:27051169

  14. Effects of a sour bolus on the intramuscular electromyographic (EMG) activity of muscles in the submental region.

    Science.gov (United States)

    Palmer, Phyllis M; McCulloch, Timothy M; Jaffe, Debra; Neel, Amy T

    2005-01-01

    A sour bolus has been used as a modality in the treatment of oropharyngeal dysphagia based on the hypothesis that this stimulus provides an effective preswallow sensory input that lowers the threshold required to trigger a pharyngeal swallow. The result is a more immediate swallow onset time. Additionally, the sour bolus may invigorate the oral muscles resulting in stronger contractions during the swallow. The purpose of this investigation was to compare the intramuscular electromyographic activity of the mylohyoid, geniohyoid, and anterior belly of the digastric muscles during sour and water boluses with regard to duration, strength, and timing of muscle activation. Muscle duration, swallow onset time, and pattern of muscle activation did not differ for the two bolus types. Muscle activation time was more tightly approximated across the onsets of the three muscles when a sour bolus was used. A sour bolus also resulted in a stronger muscle contraction as evidenced by greater electromyographic activity. These data support the use of a sour bolus as part of a treatment paradigm.

  15. Sci—Thur AM: YIS - 07: Design and production of 3D printed bolus for electron radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Su, Shiqin [Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia (Canada); Moran, Kathryn [Queen Elizabeth II Health Sciences Centre, Nova Scotia Cancer Centre, Halifax, Nova Scotia (Canada); Robar, James L. [Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia (Canada); Department of Radiation Oncology, Dalhousie University, Halifax, Nova Scotia (Canada)

    2014-08-15

    This is a proof-of-concept study demonstrating the capacity for modulated electron radiation therapy (MERT) using 3D printed bolus. Previous reports have involved bolus design using an electron pencil beam model and fabrication using a milling machine. In this study, an in-house algorithm is presented that optimizes the dose distribution with regard to dose coverage, conformity and homogeneity within planning target volume (PTV). The algorithm uses calculated result of a commercial electron Monte Carlo dose calculation as input. Distances along ray lines from distal side of 90% isodose to distal surface of PTV are used to estimate the bolus thickness. Inhomogeneities within the calculation volume are accounted for using coefficient of equivalent thickness method. Several regional modulation operators are applied to improve dose coverage and uniformity. The process is iterated (usually twice) until an acceptable MERT plan is realized, and the final bolus is printed using solid polylactic acid. The method is evaluated with regular geometric phantoms, anthropomorphic phantoms and a clinical rhabdomyosarcoma pediatric case. In all cases the dose conformity is improved compared to that with uniform bolus. The printed boluses conform well to the surface of complex anthropomorphic phantoms. For the rhabdomyosarcoma patient, the MERT plan yields a reduction of mean dose by 38.2% in left kidney relative to uniform bolus. MERT using 3D printed bolus appears to be a practical, low cost approach to generating optimized bolus for electron therapy. The method is effective in improving conformity of prescription isodose surface and in sparing immediately adjacent normal tissues.

  16. Sci—Thur AM: YIS - 07: Design and production of 3D printed bolus for electron radiation therapy

    International Nuclear Information System (INIS)

    Su, Shiqin; Moran, Kathryn; Robar, James L.

    2014-01-01

    This is a proof-of-concept study demonstrating the capacity for modulated electron radiation therapy (MERT) using 3D printed bolus. Previous reports have involved bolus design using an electron pencil beam model and fabrication using a milling machine. In this study, an in-house algorithm is presented that optimizes the dose distribution with regard to dose coverage, conformity and homogeneity within planning target volume (PTV). The algorithm uses calculated result of a commercial electron Monte Carlo dose calculation as input. Distances along ray lines from distal side of 90% isodose to distal surface of PTV are used to estimate the bolus thickness. Inhomogeneities within the calculation volume are accounted for using coefficient of equivalent thickness method. Several regional modulation operators are applied to improve dose coverage and uniformity. The process is iterated (usually twice) until an acceptable MERT plan is realized, and the final bolus is printed using solid polylactic acid. The method is evaluated with regular geometric phantoms, anthropomorphic phantoms and a clinical rhabdomyosarcoma pediatric case. In all cases the dose conformity is improved compared to that with uniform bolus. The printed boluses conform well to the surface of complex anthropomorphic phantoms. For the rhabdomyosarcoma patient, the MERT plan yields a reduction of mean dose by 38.2% in left kidney relative to uniform bolus. MERT using 3D printed bolus appears to be a practical, low cost approach to generating optimized bolus for electron therapy. The method is effective in improving conformity of prescription isodose surface and in sparing immediately adjacent normal tissues

  17. Perception of Diabetic Patients Regarding Basal Bolus Insulin Injections and Outcome of its Use

    International Nuclear Information System (INIS)

    Shahid, M.; Sarfraz, A.; Mahar, S. A.; Alam, M.; Shaikh, S.; Shahid, N.

    2016-01-01

    Objective: To assess the perceptions regarding basal bolus insulin injections and the changes in blood glucose levels and glycosylated hemoglobin (HbA1c) before and after 3 months of such treatment in diabetic patients. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Endocrinology, Liaquat National Hospital, Karachi, from December 2014 to March 2015. Methodology: A total of 222 diabetic patients started on basal bolus insulin injection were enrolled and asked to answer 17 questions. Those with complications of diabetes were excluded. Fasting blood glucose (FBS), random blood glucose (RBS) and HbA1c levels were checked initially, and after 3 months of getting basal bolus insulin. Paired t-test and chi-square test were used for determining p-value with significance at p < 0.05. Results: Majority (n=217, 97.7 percentage) of the patients were previously taking other insulins. Before starting this treatment, the mean FBS was 260.5 ± 52.2 mg/dl, RBS was 385.5 percentage 47.61 mg/dl and HbA1c was 12.76 percentage 1.92 percentage. After 3 months of treatment, FBS improved to 117.9 ± 14.2 mg/dl, RBS was 156.7 ± 17.09 mg/dl and HbA1c was 7.72 ± 4.41 percentage (p < 0.001). Two hundred and sixteen (97.3 percentage) patients believed that basal bolus insulin was started as their diabetes worsened; 15 (70.70 percentage) thought that their blood glucose control would improve with the use of this form of insulin. One hundred and ninety four (87.4 percentage) had fear of needle injections. Perceptions regarding hypoglycemia with this form of insulin were observed in 157 (70.7 percentage). One hundred and twenty seven (84.1 percentage) of the females and 51 (71.8 percentage) of the males thought that the basal bolus insulin regimen was too expensive (p=0.032). Conclusion: There were many misconceptions in patients who were started on basal bolus insulin. Marked improvement in blood glucose levels and HbA1c were observed after the use of this

  18. SU-C-213-05: Evaluation of a Composite Copper-Plastic Material for a 3D Printed Radiation Therapy Bolus

    Energy Technology Data Exchange (ETDEWEB)

    Vitzthum, L; Ehler, E; Sterling, D; Reynolds, T; Higgins, P; Dusenbery, K [University of Minnesota, Minneapolis, MN (United States)

    2015-06-15

    Purpose: To evaluate a novel 3D printed bolus fabricated from a copper-plastic composite as a thin flexible, custom fitting device that can replicate doses achieved with conventional bolus techniques. Methods: Two models of bolus were created on a 3D printer using a composite copper-PLA/PHA. Firstly, boluses were constructed at thicknesses of 0.4, 0.6 and 0.8 mm. Relative dose measurements were performed under the bolus with an Attix Chamber as well as with radiochromic film. Results were compared to superficial Attix Chamber measurements in a water equivalent material to determine the dosimetric water equivalence of the copper-PLA/PHA plastic. Secondly, CT images of a RANDO phantom were used to create a custom fitting bolus across the anterolateral scalp. Surface dose with the bolus placed on the RANDO phantom was measured with radiochromic film at tangential angles with 6, 10, 10 flattening filter free (FFF) and 18 MV photon beams. Results: Mean surface doses for 6, 10, 10FFF and 18 MV were measured as a percent of Dmax for the flat bolus devices of each thickness. The 0.4 mm thickness bolus was determined to be near equivalent to 2.5 mm depth in water for all four energies. Surface doses ranged from 59–63% without bolus and 85–90% with the custom 0.4 mm copper-plastic bolus relative to the prescribed dose for an oblique tangential beam arrangement on the RANDO phantom. Conclusion: Sub-millimeter thickness, 3D printed composite copper-PLA/PHA bolus can provide a build-up effect equivalent to conventional bolus. At this thickness, the 3D printed bolus allows a level of flexure that may provide more patient comfort than current 3D printing materials used in bolus fabrication while still retaining the CT based custom patient shape. Funding provided by an intra-department grant of the University of Minnesota Department of Radiation Oncology.

  19. SU-C-213-05: Evaluation of a Composite Copper-Plastic Material for a 3D Printed Radiation Therapy Bolus

    International Nuclear Information System (INIS)

    Vitzthum, L; Ehler, E; Sterling, D; Reynolds, T; Higgins, P; Dusenbery, K

    2015-01-01

    Purpose: To evaluate a novel 3D printed bolus fabricated from a copper-plastic composite as a thin flexible, custom fitting device that can replicate doses achieved with conventional bolus techniques. Methods: Two models of bolus were created on a 3D printer using a composite copper-PLA/PHA. Firstly, boluses were constructed at thicknesses of 0.4, 0.6 and 0.8 mm. Relative dose measurements were performed under the bolus with an Attix Chamber as well as with radiochromic film. Results were compared to superficial Attix Chamber measurements in a water equivalent material to determine the dosimetric water equivalence of the copper-PLA/PHA plastic. Secondly, CT images of a RANDO phantom were used to create a custom fitting bolus across the anterolateral scalp. Surface dose with the bolus placed on the RANDO phantom was measured with radiochromic film at tangential angles with 6, 10, 10 flattening filter free (FFF) and 18 MV photon beams. Results: Mean surface doses for 6, 10, 10FFF and 18 MV were measured as a percent of Dmax for the flat bolus devices of each thickness. The 0.4 mm thickness bolus was determined to be near equivalent to 2.5 mm depth in water for all four energies. Surface doses ranged from 59–63% without bolus and 85–90% with the custom 0.4 mm copper-plastic bolus relative to the prescribed dose for an oblique tangential beam arrangement on the RANDO phantom. Conclusion: Sub-millimeter thickness, 3D printed composite copper-PLA/PHA bolus can provide a build-up effect equivalent to conventional bolus. At this thickness, the 3D printed bolus allows a level of flexure that may provide more patient comfort than current 3D printing materials used in bolus fabrication while still retaining the CT based custom patient shape. Funding provided by an intra-department grant of the University of Minnesota Department of Radiation Oncology

  20. Should colloid boluses be prioritized over crystalloid boluses for the management of dengue shock syndrome in the presence of ascites and pleural effusions?

    Directory of Open Access Journals (Sweden)

    Weerasinghe Mindu

    2011-02-01

    Full Text Available Abstract Background Although the WHO guideline for the management of dengue fever considers the presence of ascites or pleural effusions in the diagnosis of DSS, it does not emphasize the importance of their presence when selecting fluids for resuscitation. Case presentation We highlight three patients with DSS who received boluses of crystalloids on priority basis as recommended by WHO guidelines during resuscitation. All three patients had varying degrees of third space fluid loss (ascites and pleural effusions at the time of development of DSS. Ascites and pleural effusions were detected in all 3 patients at the time of shock irrespective of whether iv fluids were given or not. All three patients had documented liver involvement at the time of shock evidenced by elevation of AST (4800 iu/L, 5000 iu/L and 1960 iu/L. One patient who had profound shock died 6 hours after admission with evidence of acute pulmonary oedema in the convalescence phase. All of them needed CPAP ventilator support and potent diuretics. Conclusions We therefore feel that resuscitation of patients with DSS who already have third space fluid accumulation with crystalloid boluses on priority basis may contribute to recovery phase pulmonary oedema.

  1. SU-F-T-500: The Effectiveness of a Patient Specific Bolus Made by Using Three-Dimensional Printing Technique in Photon Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Fujimoto, K; Yuasa, Y [Department of Radiological Technology, Yamaguchi University Hospital (Japan); Shiinoki, T; Hanazawa, H; Shibuya, K [Department of Radiation Oncology, Graduate school of Medicine, Yamaguchi University (Japan)

    2016-06-15

    Purpose: A commercially available bolus (commercial-bolus) would not completely contact with the irregular shape of a patient’s skin. The purposes of this study were to customize a patient specific three-dimensional (3D) bolus using a 3D printer (3D-bolus) and to evaluate its clinical feasibility for photon radiotherapy. Methods: The 3D-bolus was designed using a treatment planning system (TPS) in DICOM-RT format. To print the 3D bolus, the file was converted into stereolithography format. To evaluate its physical characteristics, plans were created for water equivalent phantoms without the bolus, with the 3D-bolus printed in a flat form, and with the virtual bolus which supposed a commercial-bolus. These plans were compared with the percent depth dose (PDD) measured from the TPS. Furthermore, to evaluate its clinical feasibility, the treatment plans were created for RANDO phantoms without the bolus and with the 3D-bolus which was customized for contacting with the surface of the phantom. Both plans were compared with the dose volume histogram (DVH) of the target volume. Results: In the physical evaluation, dmax of the plan without the bolus, with the 3D-bolus, and with the virtual bolus were 2.2 cm, 1.6 cm, and 1.7 cm, respectively. In the evaluation of clinical feasibility, for the plan without the bolus, Dmax, Dmin, Dmean, D90%, and V90% of the target volume were 102.6 %, 1.6 %, 88.8 %, 57.2 %, and 69.3 %, respectively. By using the 3D-bolus, the prescription dose could be delivered to at least 90 % of the target volume, Dmax, Dmin, Dmean, D90%, and V90% of the target volume were 104.3 %, 91.6 %, 92.1 %, 91.7 %, and 98.0 %, respectively. The 3D-bolus has the potential to be useful for providing effective dose coverage in the buildup region. Conclusion: A 3D-bolus produced using 3D printing technique is comparable to a commercially available bolus.

  2. SU-F-T-500: The Effectiveness of a Patient Specific Bolus Made by Using Three-Dimensional Printing Technique in Photon Radiotherapy

    International Nuclear Information System (INIS)

    Fujimoto, K; Yuasa, Y; Shiinoki, T; Hanazawa, H; Shibuya, K

    2016-01-01

    Purpose: A commercially available bolus (commercial-bolus) would not completely contact with the irregular shape of a patient’s skin. The purposes of this study were to customize a patient specific three-dimensional (3D) bolus using a 3D printer (3D-bolus) and to evaluate its clinical feasibility for photon radiotherapy. Methods: The 3D-bolus was designed using a treatment planning system (TPS) in DICOM-RT format. To print the 3D bolus, the file was converted into stereolithography format. To evaluate its physical characteristics, plans were created for water equivalent phantoms without the bolus, with the 3D-bolus printed in a flat form, and with the virtual bolus which supposed a commercial-bolus. These plans were compared with the percent depth dose (PDD) measured from the TPS. Furthermore, to evaluate its clinical feasibility, the treatment plans were created for RANDO phantoms without the bolus and with the 3D-bolus which was customized for contacting with the surface of the phantom. Both plans were compared with the dose volume histogram (DVH) of the target volume. Results: In the physical evaluation, dmax of the plan without the bolus, with the 3D-bolus, and with the virtual bolus were 2.2 cm, 1.6 cm, and 1.7 cm, respectively. In the evaluation of clinical feasibility, for the plan without the bolus, Dmax, Dmin, Dmean, D90%, and V90% of the target volume were 102.6 %, 1.6 %, 88.8 %, 57.2 %, and 69.3 %, respectively. By using the 3D-bolus, the prescription dose could be delivered to at least 90 % of the target volume, Dmax, Dmin, Dmean, D90%, and V90% of the target volume were 104.3 %, 91.6 %, 92.1 %, 91.7 %, and 98.0 %, respectively. The 3D-bolus has the potential to be useful for providing effective dose coverage in the buildup region. Conclusion: A 3D-bolus produced using 3D printing technique is comparable to a commercially available bolus.

  3. Hoy como ayer

    OpenAIRE

    Rodríguez M.

    2010-01-01

    Leyendo el artículo titulado “Los medicamentos baratos” de la revista La Farmacia Española, publicada en Madrid el jueves 21 de diciembre de 1893, uno se pregunta cómo puede ser que se reconozca la situación como si fuera de ahora mismo, cómo puede ser que estemos igual que hace más de cien años. Entonces eran los descuentos que se empezaban a extender en las farmacias, francesas sobre todo, y que amenazaban el prestigio profesional de todo el colectivo. Con frases como éstas se define la sit...

  4. La razonabilidad como virtud

    OpenAIRE

    Muñoz Oliveira, Luis Humberto

    2008-01-01

    Consultable des del TDX Títol obtingut de la portada digitalitzada Esta tesis doctoral explora la idea de que la razonabilidad es una virtud fundamental para que las sociedades plurales puedan convertirse en, o mantenerse como, un sistema de cooperación donde la justicia sea posible. La hipótesis central es que la razonabilidad como virtud es una manera de ser tolerante de forma solidaria, es entender al conciudadano, escucharlo, saber que juntos acordaron las reglas de cooperación y ac...

  5. A Factor Increasing Venous Contamination on Bolus Chase Three-dimensional Magnetic Resonance Imaging: Charcot Neuroarthropathy.

    Science.gov (United States)

    Çildağ, Mehmet B; Ertuğrul, Mustafa B; Köseoğlu, Ömer Fk; Armstrong, David G

    2018-01-01

    The study aimed to evaluate the ratio of venous contamination in diabetic cases without foot lesion, with foot lesion and with Charcot neuroarthropathy (CN). Bolus-chase three-dimensional magnetic resonance (MR) of 396 extremities of patients with diabetes mellitus was analyzed, retrospectively. Extremities were divided into three groups as follows: diabetic patients without foot ulcer or Charcot arthropathy (Group A), patients with diabetic foot ulcers (Group B) and patients with CN accompanying diabetic foot ulcers (Group C). Furthermore, amount of venous contamination classified as no venous contamination, mild venous contamination, and severe venous contamination. The relationship between venous contamination and extremity groups was investigated. Severe venous contamination was seen in Group A, Group B, and Group C, 5.6%, 15.2%, and 34.1%, respectively. Statistically significant difference was seen between groups with regard to venous contamination. Venous contamination following bolus chase MR was higher in patients with CN.

  6. A factor increasing venous contamination on bolus chase three-dimensional magnetic resonance imaging: Charcot neuroarthropathy

    Directory of Open Access Journals (Sweden)

    Mehmet B Cildag

    2018-01-01

    Full Text Available Background: The study aimed to evaluate the ratio of venous contamination in diabetic cases without foot lesion, with foot lesion and with Charcot neuroarthropathy (CN. Materials and Methods: Bolus-chase three-dimensional magnetic resonance (MR of 396 extremities of patients with diabetes mellitus was analyzed, retrospectively. Extremities were divided into three groups as follows: diabetic patients without foot ulcer or Charcot arthropathy (Group A, patients with diabetic foot ulcers (Group B and patients with CN accompanying diabetic foot ulcers (Group C. Furthermore, amount of venous contamination classified as no venous contamination, mild venous contamination, and severe venous contamination. The relationship between venous contamination and extremity groups was investigated. Results: Severe venous contamination was seen in Group A, Group B, and Group C, 5.6%, 15.2%, and 34.1%, respectively. Statistically significant difference was seen between groups with regard to venous contamination. Conclusion: Venous contamination following bolus chase MR was higher in patients with CN.

  7. Review of adverse reactions, including anaphylaxis, in 4,260 intravenous bolus injections

    International Nuclear Information System (INIS)

    Kanal, E.; Applegate, G.R.; Gillen, C.P.

    1990-01-01

    This paper evaluates the incidence and type of adverse reactions to Gd-DTPA (Magnevist) after bolus administration in an active clinical MR setting. Between May 1988 and March 1990, 4,260 bolus intravenous injections of Gd-DTPA, 0.1 mmol/kg, were administered during clinical MR examinations. Patient tolerance and reactions were recorded in each instance. All cases of suspected local infiltration were excluded from this study. Review of this data revealed 15 instances of nausea and 12 of emesis following contrast administration. In addition, there were five or fewer cases of associated headaches, dizziness, odd tastes, seizures (with prior seizure histories) mild chest pain, palpitations, hives, or wheezing

  8. Post-mastectomy radiation therapy without usage of a bolus may be a reasonable option

    International Nuclear Information System (INIS)

    Nakamura, Naoki; Arahira, Satoko; Zenda, Sadamoto; Yoneyama, Kimiyasu; Mukai, Hirofumi; Onozawa, Masakatsu; Toshima, Masamichi; Motegi, Atsushi; Hirano, Yasuhiro; Hojo, Hidehiro; Kibe, Yuichi; Akimoto, Tetsuo

    2017-01-01

    To clarify the efficacy and toxicity of post-mastectomy radiation therapy (PMRT) without usage of a bolus, we identified 129 consecutive patients who received PMRT at the National Cancer Center Hospital East between 2003 and 2012. Seven of the 129 patients who received breast reconstruction before PMRT were excluded. All patients received PMRT of 6 MV photons, without usage of a bolus. The median follow-up duration for all eligible patients was 47.7 months (range: 4.0–123.2). Local, locoregional and isolated locoregional recurrence was found in 12 (9.8%), 14 (11%) and 5 patients (4.1%), respectively. The 3- and 5-year cumulative incidence of local recurrence, locoregional recurrence and isolated locoregional recurrence was 9.2 and 10.7%, 10.8 and 12.4%, and 4.3 and 4.3%, respectively. Although Grade 2 dermatitis was found in 11 patients (9.0%), no Grade 3–4 dermatitis was found. On univariate analysis, only a non-luminal subtype was a significant predictor for local recurrence (P < 0.001). On multivariate analysis, a non-luminal subtype remained as an independent predictor for local recurrence (P = 0.003, odds ratio: 10.9, 95% confidence interval: 2.23–53.1). In conclusion, PMRT without usage of a bolus resulted in a low rate of severe acute dermatitis without an apparent increase in local recurrence. PMRT without usage of a bolus may be reasonable, especially for patients with a luminal subtype.

  9. Replacement of oxytocin bolus administration by infusion: influences on postpartum outcome.

    Science.gov (United States)

    Löytved-Hardegg, Julia J; Brunner, Mirjam; Ries, Jean-Jacques; von Felten, Stefanie; Heugel, Christina; Lapaire, Olav; Voekt, Cora; Hösli, Irene

    2016-06-01

    Postpartum haemorrhage (PPH) represents a leading cause of maternal morbidity and mortality. Giving oxytocin after birth reduces the risk for PPH. It has never been tested whether different methods of oxytocin administration affect the maternal outcome. This study aims to compare the infusion versus the bolus application of oxytocin after singleton vaginal delivery. This retrospective monocentre study compares the incidence of clinically relevant postpartum complications in women receiving 5 IE of oxytocin as a bolus or as a 100 ml-infusion over 5 min, given immediately after birth. Included were women delivering singletons vaginally at term. We used propensity score weighting to compare outcomes between women receiving bolus and infusion and to minimize the selection bias in this retrospective cohort. 1765 patients were included. Patient characteristics were balanced. We found no significant differences for the combined overall postpartum adverse outcome (the incidence of PPH, manual removal of the placenta and/or curettage). For the single outcomes, we observed a significantly higher frequency of manual removal of the placenta (Odds ratio 1.47, 95 % CI 1.02-2.13) and a slightly higher but clinically not relevant estimated blood loss (Relative effect 1.05, 95 % CI 1.01-1.10) in the infusion group. The data show a tendency towards more complications in the infusion group. It is related to a more frequent need for manual removal of the placenta.

  10. Bolus electron conformal therapy for the treatment of recurrent inflammatory breast cancer: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Michelle M., E-mail: mmkim@mdanderson.org [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Kudchadker, Rajat J.; Kanke, James E.; Zhang, Sean; Perkins, George H. [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States)

    2012-07-01

    The treatment of locoregionally recurrent breast cancer in patients who have previously undergone radiation therapy is challenging. Special techniques are often required that both eradicate the disease and minimize the risks of retreatment. We report the case of a patient with an early-stage left breast cancer who developed inflammatory-type recurrence requiring re-irradiation of the chest wall using bolus electron conformal therapy with image-guided treatment delivery. The patient was a 51-year-old woman who had undergone lumpectomy, axillary lymph node dissection, and adjuvant whole-breast radiation therapy for a stage I left breast cancer in June 1998. In March 2009, she presented at our institution with biopsy-proven recurrent inflammatory carcinoma and was aggressively treated with multi-agent chemotherapy followed by mastectomy that left a positive surgical margin. Given the patient's prior irradiation and irregular chest wall anatomy, bolus electron conformal therapy was used to treat her chest wall and draining lymphatics while sparing the underlying soft tissue. The patient still had no evidence of disease 21 months after treatment. Our results indicate that bolus electron conformal therapy is an accessible, effective radiation treatment approach for recurrent breast cancer in patients with irregular chest wall anatomy as a result of surgery. This approach may complement standard techniques used to reduce locoregional recurrence in the postmastectomy setting.

  11. A mathematical model for the movement of food bolus of varying viscosities through the esophagus

    Science.gov (United States)

    Tripathi, Dharmendra

    2011-09-01

    This mathematical model is designed to study the influence of viscosity on swallowing of food bolus through the esophagus. Food bolus is considered as viscous fluid with variable viscosity. Geometry of esophagus is assumed as finite length channel and flow is induced by peristaltic wave along the length of channel walls. The expressions for axial velocity, transverse velocity, pressure gradient, volume flow rate and stream function are obtained under the assumptions of long wavelength and low Reynolds number. The impacts of viscosity parameter on pressure distribution, local wall shear stress, mechanical efficiency and trapping are numerically discussed with the help of computational results. On the basis of presented study, it is revealed that swallowing of low viscous fluids through esophagus requires less effort in comparison to fluids of higher viscosity. This result is similar to the experimental result obtained by Raut et al. [1], Dodds [2] and Ren et al. [3]. It is further concluded that the pumping efficiency increases while size of trapped bolus reduces when viscosity of fluid is high.

  12. Lower esophageal mucosal ring: correlation of referred symptoms with radiographic findings using a marshmallow bolus.

    Science.gov (United States)

    Smith, D F; Ott, D J; Gelfand, D W; Chen, M Y

    1998-11-01

    The purpose of this investigation was to determine the prevalence of lower esophageal mucosal rings and to correlate the relationship between these mucosal rings and the presence and anatomic level of symptoms evoked using a marshmallow bolus. Our prospective study included 130 patients who underwent barium examination of the esophagus. All patients completed a questionnaire regarding the anatomic location of their symptoms of dysphagia. In addition to a multiphasic examination of the esophagus, all patients also underwent fluoroscopic observation and videotaping while swallowing a marshmallow bolus; any symptoms that were provoked were recorded. Lower esophageal mucosal rings were shown in 26 (20%) of the 130 patients. The diameter of the rings was 9-12 mm in six patients, 13-20 mm in 18 patients, and larger than 20 mm in two patients. In 16 (62%) of the 26 patients, a marshmallow bolus became impacted at the ring; the impaction caused dysphagia in 12 (75%) of the 16 patients. In these 12 patients, dysphagia was referred to the neck in seven, the sternal angle in two, the mid chest in two, and the lower chest in one patient. None of the 12 patients had a pharyngeal or cervical esophageal abnormality that would account for their symptoms. Because proximal referral of symptoms is common in patients with lower esophageal mucosal rings, a thorough radiographic examination of the entire esophagus and esophagogastric region is required regardless of the level of their swallowing complaints.

  13. Evaluation of the esophagus with a marshmallow bolus: clarifying the cause of dysphagia.

    Science.gov (United States)

    Ott, D J; Kelley, T F; Chen, M Y; Gelfand, D W

    1991-01-01

    We reviewed the radiographic examinations of the esophagus and medical records in 117 patients (55 women and 62 men; mean age, 52 years) in which a marshmallow bolus was also given. A one-third to one-half piece of a standard marshmallow was used with a mean size of 23 mm (+/- 4.5 mm SD) measured in vivo. In 62 patients with no intrinsic structural narrowing of the esophagus, impaction occurred in only seven (11%). Four of these patients had an esophageal motility disorder, and three had a previous Nissen fundoplication. The remaining 55 patients had lower esophageal mucosal rings (47) or peptic strictures (8). Marshmallow impaction was seen in 27 of 47 rings (57%) and was inversely related to ring size, and in six of eight strictures (75%). Also, impaction was related to the ratio of bolus size to ring caliber, and invariably occurred when this ratio was greater than 1.5. Dysphagia was the presenting complaint in 76 (65%) patients, but was found equally in those without intrinsic narrowing and in those with ring or stricture. However, dysphagia was reproduced by the marshmallow bolus only in patients with esophageal narrowing or abnormal motility.

  14. In Silico Assessment of Literature Insulin Bolus Calculation Methods Accounting for Glucose Rate of Change.

    Science.gov (United States)

    Cappon, Giacomo; Marturano, Francesca; Vettoretti, Martina; Facchinetti, Andrea; Sparacino, Giovanni

    2018-05-01

    The standard formula (SF) used in bolus calculators (BCs) determines meal insulin bolus using "static" measurement of blood glucose concentration (BG) obtained by self-monitoring of blood glucose (SMBG) fingerprick device. Some methods have been proposed to improve efficacy of SF using "dynamic" information provided by continuous glucose monitoring (CGM), and, in particular, glucose rate of change (ROC). This article compares, in silico and in an ideal framework limiting the exposition to possibly confounding factors (such as CGM noise), the performance of three popular techniques devised for such a scope, that is, the methods of Buckingham et al (BU), Scheiner (SC), and Pettus and Edelman (PE). Using the UVa/Padova Type 1 diabetes simulator we generated data of 100 virtual subjects in noise-free, single-meal scenarios having different preprandial BG and ROC values. Meal insulin bolus was computed using SF, BU, SC, and PE. Performance was assessed with the blood glucose risk index (BGRI) on the 9 hours after meal. On average, BU, SC, and PE improve BGRI compared to SF. When BG is rapidly decreasing, PE obtains the best performance. In the other ROC scenarios, none of the considered methods prevails in all the preprandial BG conditions tested. Our study showed that, at least in the considered ideal framework, none of the methods to correct SF according to ROC is globally better than the others. Critical analysis of the results also suggests that further investigations are needed to develop more effective formulas to account for ROC information in BCs.

  15. Comparison of bolus versus fractionated oral applications of [13C]-linoleic acid in humans.

    Science.gov (United States)

    Demmelmair, H; Iser, B; Rauh-Pfeiffer, A; Koletzko, B

    1999-07-01

    The endogenous conversion of linoleic acid into long-chain polyunsaturated fatty acids is of potential importance for meeting substrate requirements, particularly in young infants. After application of [13C]-linoleic acid, we estimated its conversion to dihomo-gamma-linolenic and arachidonic acids from only two blood samples. Oral tracer doses were given to five healthy adults as a single bolus. In four subjects the tracer was given in nine equal portions over 3 days. Concentration and 13C content of fatty acids from serum phospholipids were analysed by gas chromatography combustion isotope ratio-mass spectrometry. Areas under the tracer-concentration curves were calculated, and fractional transfer and turnover rates estimated from compartmental models. The median fractional turnover of linoleic acid was 93.7% per day (interquartile range 25.3) in the bolus group and 80. 0% per day (6.3) in the fraction group (NS). Fractional conversion of linoleic to dihomo-gamma-linolenic acid was 1.5% (0.9) vs. 2.1% (0.7) (bolus vs. fraction, P /= 0.94, P < 0.05) with the ratio of areas under the curve. Using areas under the curve overestimates the conversion, because different residence times are not considered. Estimation of conversion intensity appears possible with only one blood sample obtained after tracer application.

  16. Causes of death after fluid bolus resuscitation: new insights from FEAST.

    Science.gov (United States)

    Myburgh, John; Finfer, Simon

    2013-03-14

    The Fluid Expansion as Supportive Therapy (FEAST study) was an extremely well conducted study that gave unexpected results. The investigators had reported that febrile children with impaired perfusion treated in low-income countries without access to intensive care are more likely to die if they receive bolus resuscitation with albumin or saline compared with no bolus resuscitation at all. In a secondary analysis of the trial, published in BMC Medicine, the authors found that increased mortality was evident in patients who presented with clinical features of severe shock in isolation or in conjunction with features of respiratory or neurological failure. The cause of excess deaths was primarily refractory shock and not fluid overload. These features are consistent with a potential cardiotoxic or ischemia-reperfusion injury following resuscitation with boluses of intravenous fluid. Although these effects may have been amplified by the absence of invasive monitoring, mechanical ventilation or vasopressors, the results provide compelling insights into the effects of intravenous fluid resuscitation and potential adverse effects that extend beyond the initial resuscitation period. These data add to the increasing body of literature about the safety and efficacy of intravenous resuscitation fluids, which may be applicable to management of other populations of critically ill patients.

  17. Accuracy of pencil-beam redefinition algorithm dose calculations in patient-like cylindrical phantoms for bolus electron conformal therapy.

    Science.gov (United States)

    Carver, Robert L; Hogstrom, Kenneth R; Chu, Connel; Fields, Robert S; Sprunger, Conrad P

    2013-07-01

    The purpose of this study was to document the improved accuracy of the pencil beam redefinition algorithm (PBRA) compared to the pencil beam algorithm (PBA) for bolus electron conformal therapy using cylindrical patient phantoms based on patient computed tomography (CT) scans of retromolar trigone and nose cancer. PBRA and PBA electron dose calculations were compared with measured dose in retromolar trigone and nose phantoms both with and without bolus. For the bolus treatment plans, a radiation oncologist outlined a planning target volume (PTV) on the central axis slice of the CT scan for each phantom. A bolus was designed using the planning.decimal(®) (p.d) software (.decimal, Inc., Sanford, FL) to conform the 90% dose line to the distal surface of the PTV. Dose measurements were taken with thermoluminescent dosimeters placed into predrilled holes. The Pinnacle(3) (Philips Healthcare, Andover, MD) treatment planning system was used to calculate PBA dose distributions. The PBRA dose distributions were calculated with an in-house C++ program. In order to accurately account for the phantom materials a table correlating CT number to relative electron stopping and scattering powers was compiled and used for both PBA and PBRA dose calculations. Accuracy was determined by comparing differences in measured and calculated dose, as well as distance to agreement for each measurement point. The measured doses had an average precision of 0.9%. For the retromolar trigone phantom, the PBRA dose calculations had an average ± 1σ dose difference (calculated - measured) of -0.65% ± 1.62% without the bolus and -0.20% ± 1.54% with the bolus. The PBA dose calculation had an average dose difference of 0.19% ± 3.27% without the bolus and -0.05% ± 3.14% with the bolus. For the nose phantom, the PBRA dose calculations had an average dose difference of 0.50% ± 3.06% without bolus and -0.18% ± 1.22% with the bolus. The PBA dose calculations had an average dose difference of 0.65%

  18. The Impact of Injector-Based Contrast Agent Administration on Bolus Shape and Magnetic Resonance Angiography Image Quality.

    Science.gov (United States)

    Jost, Gregor; Endrikat, Jan; Pietsch, Hubertus

    2017-01-01

    To compare injector-based contrast agent (CA) administration with hand injection in magnetic resonance angiography (MRA). Gadobutrol was administered in 6 minipigs with 3 protocols: (a) hand injection (one senior technician), (b) hand injection (6 less-experienced technicians), and (c) power injector administration. The arterial bolus shape was quantified by test bolus measurements. A head and neck MRA was performed for quantitative and qualitative comparison of signal enhancement. A significantly shorter time to peak was observed for protocol C, whereas no significant differences between protocols were found for peak height and bolus width. However, for protocol C, these parameters showed a much lower variation. The MRA revealed a significantly higher signal-to-noise ratio for injector-based administration. A superimposed strong contrast of the jugular vein was found in 50% of the hand injections. Injector-based CA administration results in a more standardized bolus shape, a higher vascular contrast, and a more robust visualization of target vessels.

  19. Electrical characterization of bolus material as phantom for use in electrical impedance and computed tomography fusion imaging

    Directory of Open Access Journals (Sweden)

    Parvind Kaur Grewal

    2014-04-01

    Full Text Available Phantoms are widely used in medical imaging to predict image quality prior to clinical imaging. This paper discusses the possible use of bolus material, as a conductivity phantom, for validation and interpretation of electrical impedance tomography (EIT images. Bolus is commonly used in radiation therapy to mimic tissue. When irradiated, it has radiological characteristics similar to tissue. With increased research interest in CT/EIT fusion imaging there is a need to find a material which has both the absorption coefficient and electrical conductivity similar to biological tissues. In the present study the electrical properties, specifically resistivity, of various commercially available bolus materials were characterized by comparing their frequency response with that of in-vivo connective adipose tissue. It was determined that the resistivity of Gelatin Bolus is similar to in-vivo tissue in the frequency range 10 kHz to 1MHz and therefore has potential to be used in EIT/CT fusion imaging studies.

  20. Development of a universal dual-bolus injection scheme for the quantitative assessment of myocardial perfusion cardiovascular magnetic resonance

    Directory of Open Access Journals (Sweden)

    Alfakih Khaled

    2011-05-01

    Full Text Available Abstract Background The dual-bolus protocol enables accurate quantification of myocardial blood flow (MBF by first-pass perfusion cardiovascular magnetic resonance (CMR. However, despite the advantages and increasing demand for the dual-bolus method for accurate quantification of MBF, thus far, it has not been widely used in the field of quantitative perfusion CMR. The main reasons for this are that the setup for the dual-bolus method is complex and requires a state-of-the-art injector and there is also a lack of post processing software. As a solution to one of these problems, we have devised a universal dual-bolus injection scheme for use in a clinical setting. The purpose of this study is to show the setup and feasibility of the universal dual-bolus injection scheme. Methods The universal dual-bolus injection scheme was tested using multiple combinations of different contrast agents, contrast agent dose, power injectors, perfusion sequences, and CMR scanners. This included 3 different contrast agents (Gd-DO3A-butrol, Gd-DTPA and Gd-DOTA, 4 different doses (0.025 mmol/kg, 0.05 mmol/kg, 0.075 mmol/kg and 0.1 mmol/kg, 2 different types of injectors (with and without "pause" function, 5 different sequences (turbo field echo (TFE, balanced TFE, k-space and time (k-t accelerated TFE, k-t accelerated balanced TFE, turbo fast low-angle shot and 3 different CMR scanners from 2 different manufacturers. The relation between the time width of dilute contrast agent bolus curve and cardiac output was obtained to determine the optimal predefined pause duration between dilute and neat contrast agent injection. Results 161 dual-bolus perfusion scans were performed. Three non-injector-related technical errors were observed (1.9%. No injector-related errors were observed. The dual-bolus scheme worked well in all the combinations of parameters if the optimal predefined pause was used. Linear regression analysis showed that the optimal duration for the predefined

  1. SU-F-T-325: On the Use of Bolus in Dosimetry and Dose Reduction for Pacemaker and Defibrillator

    International Nuclear Information System (INIS)

    Liu, W; Kenneth, R; Higgins, S; Nath, R; Zhu, D; Trumpore, S; Chen, Z

    2016-01-01

    Purpose: Special attention is required in planning and administering radiation therapy to patients with cardiac implantable electronic devices (CIEDs), such as pacemaker and defibrillator. The range of dose to CIEDs that can induce malfunction is very large among CIEDs. Significant defects have been reported at dose as low as 0.15Gy. Failures causing discomfort have been reported at dose as low as 0.05Gy. Therefore, accurate estimation of dose to CIED and dose reduction are both important even if the dose is expected to be less than the often-used 2Gy limit. We investigate the use of bolus in in vivo dosimetry for CIEDs. Methods: In our clinic, high-energy beams (>10MV) are not used for patients with CIED due to neutron production. Solid water phantom measurements of out-of-field dose for a 6MV beam were performed using parallel plate chamber at different depth with and without 2cm bolus covering the chamber. In vivo dosimetry at skin surface above the pacemaker was performed with and without bolus for 3 patients with pacemaker <5cm from the field edge. Results: Chamber measured dose at depth ∼1 to 1.5cm below the skin surface, where the CIED is normally located, was reduced by ∼6% – 20% with bolus. The dose reduction became smaller at deeper depth. In vivo dosimetry at skin surface also yielded ∼20% – 60% lower dose when using bolus for the 3 patients. In general, TPS calculation underestimated the dose. The dose measured with bolus is closer to the dose at the depth of the pacemaker and less affected by contaminant electrons and linac head leakage. Conclusion: In vivo CIED dose measurements should be performed with 1 to 2cm bolus covering the dosimeter on the skin above the CIED for more accurate CIED dose estimation. The use of bolus also reduces the dose delivered to CIED.

  2. SU-F-T-325: On the Use of Bolus in Dosimetry and Dose Reduction for Pacemaker and Defibrillator

    Energy Technology Data Exchange (ETDEWEB)

    Liu, W; Kenneth, R; Higgins, S; Nath, R [Yale University School of Medicine, New Haven, CT (United States); Zhu, D [Saint Thomas Hospital, Murfreesboro, TN (United States); Trumpore, S [Yale-New Haven Hospital, New Haven, CT (United States); Chen, Z [Yale New Haven Hospital, New Haven, CT (United States)

    2016-06-15

    Purpose: Special attention is required in planning and administering radiation therapy to patients with cardiac implantable electronic devices (CIEDs), such as pacemaker and defibrillator. The range of dose to CIEDs that can induce malfunction is very large among CIEDs. Significant defects have been reported at dose as low as 0.15Gy. Failures causing discomfort have been reported at dose as low as 0.05Gy. Therefore, accurate estimation of dose to CIED and dose reduction are both important even if the dose is expected to be less than the often-used 2Gy limit. We investigate the use of bolus in in vivo dosimetry for CIEDs. Methods: In our clinic, high-energy beams (>10MV) are not used for patients with CIED due to neutron production. Solid water phantom measurements of out-of-field dose for a 6MV beam were performed using parallel plate chamber at different depth with and without 2cm bolus covering the chamber. In vivo dosimetry at skin surface above the pacemaker was performed with and without bolus for 3 patients with pacemaker <5cm from the field edge. Results: Chamber measured dose at depth ∼1 to 1.5cm below the skin surface, where the CIED is normally located, was reduced by ∼6% – 20% with bolus. The dose reduction became smaller at deeper depth. In vivo dosimetry at skin surface also yielded ∼20% – 60% lower dose when using bolus for the 3 patients. In general, TPS calculation underestimated the dose. The dose measured with bolus is closer to the dose at the depth of the pacemaker and less affected by contaminant electrons and linac head leakage. Conclusion: In vivo CIED dose measurements should be performed with 1 to 2cm bolus covering the dosimeter on the skin above the CIED for more accurate CIED dose estimation. The use of bolus also reduces the dose delivered to CIED.

  3. Total intravenous anaesthesia by boluses or by continuous rate infusion of propofol in mute swans (Cygnus olor).

    Science.gov (United States)

    Müller, Kerstin; Holzapfel, Judith; Brunnberg, Leo

    2011-07-01

    To investigate intravenous (IV) propofol given by intermittent boluses or by continuous rate infusion (CRI) for anaesthesia in swans. Prospective randomized clinical study. Twenty mute swans (Cygnus olor) (eight immature and 12 adults) of unknown sex undergoing painless diagnostic or therapeutic procedures. Induction of anaesthesia was with 8 mg kg(-1) propofol IV. To maintain anaesthesia, ten birds (group BOLI) received propofol as boluses, whilst 10 (group CRI) received propofol as a CRI. Some physiological parameters were measured. Anaesthetic duration was 35 minutes. Groups were compared using Mann-Whitney U-test. Results are median (range). Anaesthetic induction was smooth and tracheal intubation was achieved easily in all birds. Bolus dose in group BOLI was 2.9 (1.3-4.3) mg kg(-1); interval between and number of boluses required were 4 (1-8) minutes and 6 (4-11) boluses respectively. Total dose of propofol was 19 (12.3-37.1) mg kg(-1). Awakening between boluses was very abrupt. In group CRI, propofol infusion rate was 0.85 (0.8-0.9) mg kg(-1) minute(-1), and anaesthesia was stable. Body temperature, heart and respiratory rates, oxygen saturation (by pulse oximeter) and reflexes did not differ between groups. Oxygen saturations (from pulse oximeter readings) were low in some birds. Following anaesthesia, all birds recovered within 40 minutes. In 55% of all, transient signs of central nervous system excitement occurred during recovery. 8 mg kg(-1) propofol appears an adequate induction dose for mute swans. For maintenance, a CRI of 0.85 mg kg(-1) minute(-1) produced stable anaesthesia suitable for painless clinical procedures. In contrast bolus administration, was unsatisfactory as birds awoke very suddenly, and the short intervals between bolus requirements hampered clinical procedures. Administration of additional oxygen throughout anaesthesia might reduce the incidence of low arterial haemoglobin saturation. © 2011 The Authors. Veterinary Anaesthesia and

  4. Evaluation of surface and shallow depth dose reductions using a Superflab bolus during conventional and advanced external beam radiotherapy.

    Science.gov (United States)

    Yoon, Jihyung; Xie, Yibo; Zhang, Rui

    2018-03-01

    The purpose of this study was to evaluate a methodology to reduce scatter and leakage radiations to patients' surface and shallow depths during conventional and advanced external beam radiotherapy. Superflab boluses of different thicknesses were placed on top of a stack of solid water phantoms, and the bolus effect on surface and shallow depth doses for both open and intensity-modulated radiotherapy (IMRT) beams was evaluated using thermoluminescent dosimeters and ion chamber measurements. Contralateral breast dose reduction caused by the bolus was evaluated by delivering clinical postmastectomy radiotherapy (PMRT) plans to an anthropomorphic phantom. For the solid water phantom measurements, surface dose reduction caused by the Superflab bolus was achieved only in out-of-field area and on the incident side of the beam, and the dose reduction increased with bolus thickness. The dose reduction caused by the bolus was more significant at closer distances from the beam. Most of the dose reductions occurred in the first 2-cm depth and stopped at 4-cm depth. For clinical PMRT treatment plans, surface dose reductions using a 1-cm Superflab bolus were up to 31% and 62% for volumetric-modulated arc therapy and 4-field IMRT, respectively, but there was no dose reduction for Tomotherapy. A Superflab bolus can be used to reduce surface and shallow depth doses during external beam radiotherapy when it is placed out of the beam and on the incident side of the beam. Although we only validated this dose reduction strategy for PMRT treatments, it is applicable to any external beam radiotherapy and can potentially reduce patients' risk of developing radiation-induced side effects. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

  5. Functional aspects of distal oesophageal spasm: the role of onset velocity and contraction amplitude on bolus transit

    Science.gov (United States)

    Pohl, Daniel; Ciolino, Jody; Roberts, Jason; Savarino, Edoardo; Freeman, Janice; Nietert, Paul J; Tutuian, Radu; Castell, Donald

    2012-01-01

    Background Distal oesophageal spasm (DES) is a rare and under-investigated motility abnormality. Recent studies indicate effective bolus transit in varying percentages of DES patients. Aim Explore functional aspects including contraction onset velocity and contraction amplitude cut-off values for simultaneous contractions to predict complete bolus transit Methods We re-examined data from 107 impedance-manometry recordings with a diagnosis of DES. Receiver operating characteristic (ROC) analysis was conducted, regarding effects of onset velocity on bolus transit taking into account distal oesophageal amplitude (DEA) and correcting for intra-individual repeated measures. Results Mean area under the ROC curve for saline and viscous swallows were 0.84±0.05 and 0.84±0.04, respectively. Velocity criteria of >30cm/s when DEA>100mmHg and 8cm/s when DEADEA>100mmHg and >7cm/s when DEAsensitivity of 75% and specificity of 80% to identify complete bolus transit. Using these criteria, final diagnosis changed in 44.9% of patients. Abnormal bolus transit was observed in 50.9% of newly diagnosed DES patients versus 7.5% of patients classified as normal. DES patients with DEA>100mmHg suffered twice as often from chest pain than those with DEA<100mmHg. Conclusion The proposed velocity cut-offs for diagnosing distal oesophageal spasm improve the ability to identify patients with spasm and abnormal bolus transit. PMID:22475443

  6. Esophagogastric junction outflow obstruction is often associated with coexistent abnormal esophageal body motility and abnormal bolus transit.

    Science.gov (United States)

    Zheng, E; Gideon, R M; Sloan, J; Katz, P O

    2017-10-01

    Currently, the diagnosis of esophageal motility disorders is in part based upon a hierarchical algorithm in which abnormalities of the esophagogastric junction (EGJ) is prioritized. An important metric in evaluating the EGJ is the integrated relaxation pressure (IRP). Patients who do not have achalasia but are found to have an elevated IRP are diagnosed with EGJ outflow obstruction. It has been our observation that a subset of these patients also has a second named motility disorder and may also have abnormal bolus transit. The aim of this study is to determine the frequency of abnormal body motility and or abnormal bolus movement in patients with EGJ outflow obstruction. Further, in an effort to evaluate the potential clinical value in measuring bolus transit as a complement to esophageal manometry, specifically in patients with EGJ outflow obstruction, we analyzed the presenting symptoms of these patients. A total of 807 patients with a mean age of 53 years completed esophageal function testing with impedance monitoring and high-resolution manometry between January 2012 and October 2016. There were 74 patients with achalasia who were excluded from the study. Of the remaining 733 patients, 138 (19%) had an elevated IRP and were given a diagnosis of EGJ outflow obstruction. Among these patients, 56 (40%) were diagnosed with an abnormal motility pattern to liquids (ineffective esophageal motility = 28, distal esophageal spasm = 19, Jackhammer = 6), of which 44 (76%) had abnormal bolus transit to liquids, viscous, or both. In contrast, there were 82 patients with EGJ outflow obstruction and normal esophageal motility, of which 33 (40%) had abnormal bolus transit. Patients with preserved esophageal motility and EGJ outflow obstruction were then evaluated. Of the 733 patients, 299 (40%) had intact esophageal motility. Of the 299 patients with normal esophageal motility, 56 patients had an elevated IRP, of which 16 (28%) had abnormal bolus transit. There were 243 (33

  7. Ensaios in vitro com a linhagem celular ZF-L para análise dos efeitos de gasolina e efluentes de postos de combustível

    OpenAIRE

    Débora Lachner

    2013-01-01

    O uso de linhagens celulares e bastante promissor como modelo biologico in vitro, tanto para a melhoria do rendimento dos testes de toxicidade quanto para reducao dos seus custos. Destaca-se no presente trabalho a utilizacao da linhagem celular permanente de hepatocitos de Danio rerio, denominada ZF-L. Diversos trabalhos comprovam a sensibilidade de ZF-L quando expostas a diversos contaminantes, com a utilizacao satisfatoria de diferentes biomarcadores. Assim, o objetivo deste trabalho foi av...

  8. Automatic Bolus Tracking Versus Fixed Time-Delay Technique in Biphasic Multidetector Computed Tomography of the Abdomen

    International Nuclear Information System (INIS)

    Adibi, Atoosa; Shahbazi, Ali

    2014-01-01

    Bolus tracking can individualize time delay for the start of scans in spiral computed tomography (CT). We compared automatic bolus tracking method with fixed time-delay technique in biphasic contrast enhancement during multidetector CT of abdomen. Adult patients referred for spiral CT of the abdomen were randomized into two groups; in group 1, the arterial and portal phases of spiral scans were started 25 s and 55 s after the start of contrast material administration; in group 2, using the automatic bolus tracking software, repetitive monitoring scans were performed within the lumen of the descending aorta as the region of interest with the threshold of starting the diagnostic scans as 60 HU. The contrast enhancement of the aorta, liver, and spleen were compared between the groups. Forty-eight patients (23 males, 25 females, mean age=56.4±13.5 years) were included. The contrast enhancement of the aorta, liver, and spleen at the arterial phase was similar between the two groups (P>0.05). Regarding the portal phase, the aorta and spleen were more enhanced in the bolus-tracking group (P<0.001). The bolus tracking provided more homogeneous contrast enhancement among different patients than the fixed time-delay technique in the liver at portal phase, but not at the arterial phase. The automatic bolus-tracking method, results in higher contrast enhancement of the aorta and spleen at the portal phase, but has no effect on liver enhancement. However, bolus tracking is associated with reduced variability for liver enhancement among different patients

  9. Cardiac T1 mapping in congenital heart disease: bolus vs. infusion protocols for measurements of myocardial extracellular volume fraction.

    Science.gov (United States)

    Al-Wakeel-Marquard, Nadya; Rastin, Sanaz; Muench, Frédéric; O H-Ici, Darach; Yilmaz, Sevim; Berger, Felix; Kuehne, Titus; Messroghli, Daniel R

    2017-12-01

    Myocardial extracellular volume fraction (ECV) reflecting diffuse myocardial fibrosis can be measured with T1 mapping cardiovascular magnetic resonance (CMR) before and after the application of a gadolinium-based extracellular contrast agent. The equilibrium between blood and myocardium contrast concentration required for ECV measurements can be obtained with a primed contrast infusion (equilibrium contrast-CMR). We hypothesized that equilibrium can also be achieved with a single contrast bolus to accurately measure diffuse myocardial fibrosis in patients with congenital heart disease (CHD). Healthy controls (n = 17; median age 24.0 years) and patients with CHD (n = 19; 25.0 years) were prospectively enrolled. Using modified Look-Locker inversion recovery T1 mapping before, 15 min after bolus injection, and during constant infusion of gadolinium-DOTA, T1 values were obtained for blood pool and myocardium of the left ventricle (LV), the interventricular septum (IVS), and the right ventricle (RV) in a single midventricular plane in short axis or in transverse orientation. ECV of LV, IVS and RV by bolus-only and bolus-infusion correlated significantly in CHD patients (r = 0.94, 0.95, and 0.74; p < 0.01, respectively) and healthy controls (r = 0.96, 0.89, and 0.64; p < 0.05, respectively). Bland-Altman plots revealed no significant bias between the techniques for any of the analyzed regions. ECV of LV and RV myocardium measured by bolus-only T1 mapping agrees well with bolus-infusion measurements in patients with CHD. The use of a bolus-only approach facilitates the integration of ECV measurements into existing CMR imaging protocols, allowing for assessment of diffuse myocardial fibrosis in CHD in clinical routine.

  10. A prospective, randomized, blinded-endpoint, controlled study - continuous epidural infusion versus programmed intermittent epidural bolus in labor analgesia

    Directory of Open Access Journals (Sweden)

    Joana Nunes

    Full Text Available Abstract Background: There is evidence that administration of a programmed intermittent epidural bolus (PIEB compared to continuous epidural infusion (CEI leads to greater analgesia efficacy and maternal satisfaction with decreased anesthetic interventions. Methods: In this study, 166 women with viable pregnancies were included. After an epidural loading dose of 10 mL with Ropivacaine 0.16% plus Sufentanil 10 µg, parturient were randomly assigned to one of three regimens: A - Ropivacaine 0.15% plus Sufentanil 0.2 µg/mL solution as continuous epidural infusion (5 mL/h, beginning immediately after the initial bolus; B - Ropivacaine 0.1% plus Sufentanil 0.2 µg/mL as programmed intermittent epidural bolus and C - Same solution as group A as programmed intermittent epidural bolus. PIEB regimens were programmed as 10 mL/h starting 60 min after the initial bolus. Rescue boluses of 5 mL of the same solution were administered, with the infusion pump. We evaluated maternal satisfaction using a verbal numeric scale from 0 to 10. We also evaluated adverse, maternal and neonatal outcomes. Results: We analyzed 130 pregnants (A = 60; B = 33; C = 37. The median verbal numeric scale for maternal satisfaction was 8.8 in group A; 8.6 in group B and 8.6 in group C (p = 0.83. We found a higher caesarean delivery rate in group A (56.7%; p = 0.02. No differences in motor block, instrumental delivery rate and neonatal outcomes were observed. Conclusions: Maintenance of epidural analgesia with programmed intermittent epidural bolus is associated with a reduced incidence of caesarean delivery with equally high maternal satisfaction and no adverse outcomes.

  11. A prospective, randomized, blinded-endpoint, controlled study - continuous epidural infusion versus programmed intermittent epidural bolus in labor analgesia.

    Science.gov (United States)

    Nunes, Joana; Nunes, Sara; Veiga, Mariano; Cortez, Mara; Seifert, Isabel

    2016-01-01

    There is evidence that administration of a programmed intermittent epidural bolus (PIEB) compared to continuous epidural infusion (CEI) leads to greater analgesia efficacy and maternal satisfaction with decreased anesthetic interventions. In this study, 166 women with viable pregnancies were included. After an epidural loading dose of 10mL with Ropivacaine 0.16% plus Sufentanil 10μg, parturient were randomly assigned to one of three regimens: A - Ropivacaine 0.15% plus Sufentanil 0.2μg/mL solution as continuous epidural infusion (5mL/h, beginning immediately after the initial bolus); B - Ropivacaine 0.1% plus Sufentanil 0.2μg/mL as programmed intermittent epidural bolus and C - Same solution as group A as programmed intermittent epidural bolus. PIEB regimens were programmed as 10mL/h starting 60min after the initial bolus. Rescue boluses of 5mL of the same solution were administered, with the infusion pump. We evaluated maternal satisfaction using a verbal numeric scale from 0 to 10. We also evaluated adverse, maternal and neonatal outcomes. We analyzed 130 pregnants (A=60; B=33; C=37). The median verbal numeric scale for maternal satisfaction was 8.8 in group A; 8.6 in group B and 8.6 in group C (p=0.83). We found a higher caesarean delivery rate in group A (56.7%; p=0.02). No differences in motor block, instrumental delivery rate and neonatal outcomes were observed. Maintenance of epidural analgesia with programmed intermittent epidural bolus is associated with a reduced incidence of caesarean delivery with equally high maternal satisfaction and no adverse outcomes. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  12. Ouabaina como Hormona

    OpenAIRE

    J. Hernando Ordoñez

    1996-01-01

    Comentario sobre su origen endógeno y sus aplicaciones terapéuticas

    Pocas drogas han sido más estudiadas que el grupo de los digitálicos, estrofantinas y ouabaina, cuyo estudio es objeto del presente trabajo.

    La ouabaina empezó a ser estudiada desde el siglo pasado. La primera referencia conocida corresponde a Pelikan, 1865 (1), como veneno que empleaban para las flechas en Gabón (Africa). (.)

  13. Hoy como ayer

    Directory of Open Access Journals (Sweden)

    Rodríguez M.

    2010-06-01

    Full Text Available Leyendo el artículo titulado “Los medicamentos baratos” de la revista La Farmacia Española, publicada en Madrid el jueves 21 de diciembre de 1893, uno se pregunta cómo puede ser que se reconozca la situación como si fuera de ahora mismo, cómo puede ser que estemos igual que hace más de cien años. Entonces eran los descuentos que se empezaban a extender en las farmacias, francesas sobre todo, y que amenazaban el prestigio profesional de todo el colectivo. Con frases como éstas se define la situación que se presentaba en aquel momento: “…el desprestigio de que vaya por unos cuantos desnaturalizándose el ejercicio de la farmacia en tal forma que se convierta en un comercio impuro y de la peor estofa; pero conviene mucho combatir con mano firme la tendencia a la baratería, tanto más cuanto que no puede dudarse que significa un rebajamiento a todas luces nocivo y que supone una desorganización que nos llevaría en breve a la más completa ruina, y lo que creo aún más grave, a la desmoralización y el desorden, que no se compadecen en modo alguno con lo que en realidad es hoy y ha sido siempre el ejercicio de una profesión genuinamente científica como lo es la de la farmacia”. La propuesta que se hacía para controlar la situación era “la limitación de farmacias, con vigilancia estrecha del Estado y tarifa uniforme oficial”, así como “hace falta mucha inteligencia y mucha unión, hace falta que nadie permanezca indiferente, que todos y cada uno pongan de su parte lo que puedan”. Nuestra profesión mezcla una doble vertiente sanitaria y comercial que no siempre es fácil mantener equilibrada y, por lo que se ve, esto ha ocurrido así desde siempre. El problema que existe hoy en día es la mercantilización de la farmacia, un desplazamiento de establecimiento sanitario hacia una simple empresa.

  14. Amniotic fluid index predicts the relief of variable decelerations after amnioinfusion bolus.

    Science.gov (United States)

    Spong, C Y; McKindsey, F; Ross, M G

    1996-10-01

    Our purpose was to determine whether intrapartum amniotic fluid index before amnioinfusion can be used to predict response to therapeutic amnioinfusion. Intrapartum patients (n = 85) with repetitive variable decelerations in fetal heart rate that necessitated amnioinfusion (10 ml/min for 60 minutes) underwent determination of amniotic fluid index before and after bolus amnioinfusion. The fetal heart tracing was scored (scorer blinded to amniotic fluid index values) for number and characteristics of variable decelerations before and 1 hour after initiation of amnioinfusion. The amnioinfusion was considered successful if it resulted in a decrease of > or = 50% in total number of variable decelerations or a decrease of > or = 50% in the rate of atypical or severe variable decelerations after administration of the bolus. Spontaneous vaginal births before completion of administration of the bolus (n = 18) were excluded from analysis. The probability of success of amnioinfusion in relation to amniotic fluid index was analyzed with the chi(2) test for progressive sequence. The mean amniotic fluid index before amnioinfusion was 6.2 +/- 3.3 cm. An amniotic fluid index of amnioinfusion decreased with increasing amniotic fluid index before amnioinfusion (76% [16/21] when initial amniotic fluid index was 0 to 4 cm, 63% [17/27] when initial amniotic fluid index was 4 to 8 cm, 44% [7/16] when initial amniotic fluid index was 8 to 12 cm, and 33% [1/3] when initial amniotic fluid index was > 12 cm, p = 0.03). The incidence of nuchal cords or true umbilical cord knots increased in relation to amniotic fluid index before amnioinfusion. Amniotic fluid index before amnioinfusion can be used to predict the success of amnioinfusion for relief of variable decelerations in fetal heart rate. Failure of amnioinfusion at a high amniotic fluid index before amnioinfusion may be explained by the increased prevalence of nuchal cords or true knots in the umbilical cord.

  15. INFLUENCE OF AGE ON SWALLOWS OF A HIGHLY VISCOUS LIQUID BOLUS

    Directory of Open Access Journals (Sweden)

    Weslania Viviane NASCIMENTO

    2015-03-01

    Full Text Available Background Swallow function has a decline with aging, mainly in those over 80 years old. In the population over 69 years, about 11% of subjects reported symptoms indicative of significant dysphagia. Objectives Our objective was to evaluate the hypothesis that older asymptomatic subjects before 80 years old have compensations to sustain a safe and efficient swallow, at least with swallows of liquid bolus. Methods We performed videofluoroscopic evaluation of swallows in 55 normal volunteers, a younger group with 33 subjects (16 men and 17 women aged 19 to 55 years, mean 35.5±9.8 years, and an older group with 22 subjects (15 men and 7 women aged 56 to 77 years, mean 64.8±6.8 years. The subjects swallowed in duplicate 5 mL and 10 mL of liquid barium with a pH of 7.9, density of 1.82 g/cm3, and viscosity of 895 cp. Results The mean duration of pharyngeal transit, pharyngeal clearance, upper esophageal sphincter opening, hyoid movement and oral-pharyngeal transit were longer in the younger group compared with the older group. The relation between pharyngeal clearance duration and hyoid movement duration was similar in younger and older subjects, for 5 mL and 10 mL bolus volumes. Conclusions On average, a highly viscous liquid bolus crosses the pharynx faster in older subjects (56-77 years old than in younger subjects (19-55 years old, which suggested an adaptation to the aging process to maintain a safe swallow.

  16. The effect of food bolus location on jaw movement smoothness and masticatory efficiency.

    Science.gov (United States)

    Molenaar, W N B; Gezelle Meerburg, P J; Luraschi, J; Whittle, T; Schimmel, M; Lobbezoo, F; Peck, C C; Murray, G M; Minami, I

    2012-09-01

    Masticatory efficiency in individuals with extensive tooth loss has been widely discussed. However, little is known about jaw movement smoothness during chewing and the effect of differences in food bolus location on movement smoothness and masticatory efficiency. The aim of this study was to determine whether experimental differences in food bolus location (anterior versus posterior) had an effect on masticatory efficiency and jaw movement smoothness. Jaw movement smoothness was evaluated by measuring jerk-cost (calculated from acceleration) with an accelerometer that was attached to the skin of the mentum of 10 asymptomatic subjects, and acceleration was recorded during chewing on two-colour chewing gum, which was used to assessed masticatory efficiency. Chewing was performed under two conditions: posterior chewing (chewing on molars and premolars only) and anterior chewing (chewing on canine and first premolar teeth only). Jerk-cost and masticatory efficiency (calculated as the ratio of unmixed azure colour to the total area of gum, the unmixed fraction) were compared between anterior and posterior chewing with the Wilcoxon signed rank test (two-tailed). Subjects chewed significantly less efficiently during anterior chewing than during posterior chewing (P = 0·0051). There was no significant difference in jerk-cost between anterior and posterior conditions in the opening phase (P = 0·25), or closing phase (P = 0·42). This is the first characterisation of the effect of food bolus location on jaw movement smoothness at the same time as recording masticatory efficiency. The data suggest that anterior chewing decreases masticatory efficiency, but does not influence jerk-cost. © 2012 Blackwell Publishing Ltd.

  17. Differential Response Pattern of Oropharyngeal Pressure by Bolus and Dry Swallows.

    Science.gov (United States)

    Hasegawa, Mana; Kurose, Masayuki; Okamoto, Keiichiro; Yamada, Yoshiaki; Tsujimura, Takanori; Inoue, Makoto; Sato, Taisuke; Narumi, Takatsune; Fujii, Noritaka; Yamamura, Kensuke

    2018-02-01

    The aim of this study was to determine if bolus and dry swallow showed similar pressure changes in the oropharynx using our newly developed device. A unique character of it includes that baropressure can be measured with the sensor being placed in the balloon and can assess the swallowing mechanics in terms of pressure changes in the oropharynx with less influences of direct contacts of boluses and oropharyngeal structures during swallow indirectly. Fifteen healthy subjects swallowed saliva (dry), 15 ml of water, 45 ml of water, and 15 ml of two different types of food in terms of viscosity (potage soup-type and mayonnaise-type foods). Suprahyoid muscle activity was recorded simultaneously. Three parameters, area under the curve (AUC), peak amplitude, and duration of pressure, were analyzed from each swallow. Almost all of the bolus swallowing events had biphasic baropressure responses consisting of an early phase and late phase (99%), whereas 90% of the saliva swallowing events had a single phase. AUC, peak, and duration displayed greater effects during the late phase than during the early phase. Baropressure of the early phase, but not of the late phase, significantly increased with increasing volume; however, small but significant viscosity effects on pressure were seen during both phases. Peak pressure of the late phase was preceded by maximum muscle activity, whereas that of the early phase was seen when muscle activity displayed a peak response. These findings indicated that our device with the ability to measure baropressure has the potential to provide additional parameter to assess the swallow physiology, and biphasic baropressure responses in the early and late phases could reflect functional aspects of the swallowing reflexes.

  18. Optimum bolus wizard settings in insulin pumps in children with Type 1 diabetes

    DEFF Research Database (Denmark)

    Andersen, A J B; Ostenfeld, A; Pipper, C B

    2016-01-01

    : Optimum insulin pump settings at pump initiation depend on both insulin requirements and use of the pump. Settings need to be individualized because the standardized calculation factors are not constant for children. There is a need to develop specific age- and insulin dose-dependent calculation factors.......AIM: To evaluate current insulin pump settings in an optimally regulated paediatric population using bolus wizard. METHODS: We used a retrospective study design to analyse data from 124 children on insulin pump therapy who had optimum HbA1c levels [

  19. SU-F-T-442: Dose Distribution Comparison for Post-Laryngectomy Stoma Area Between Conventional AP and VMAT Plans with Or Without Bolus

    Energy Technology Data Exchange (ETDEWEB)

    Lee, B [University of California, Los Angeles, Los Angeles, CA (United States); Zhang, J; Cho-Lim, J [VA Long Beach Healthcare System, Long Beach, CA (United States); University of California, Irvine, Orange, CA (United States); Leu, M [VA Greater Los Angeles Healthcare System, Los Angeles, CA (United States); Inouye, W [VA Long Beach Healthcare System, Long Beach, CA (United States); Lorentz, W [University of California, Los Angeles, Los Angeles, CA (United States); VA Greater Los Angeles Healthcare System, Los Angeles, CA (United States); Lee, S [University of California, Los Angeles, Los Angeles, CA (United States); VA Long Beach Healthcare System, Long Beach, CA (United States); VA Greater Los Angeles Healthcare System, Los Angeles, CA (United States)

    2016-06-15

    Purpose: To compare dose distributions of conventional AP vs. VMAT treatment plans with or without bolus around post-laryngectomy stoma. Methods: Radiation dose coverage for post-laryngectomy stoma was analyzed using a set of real-case CT-simulation images. After meticulous contouring of the catheter cuff, stoma lumen, peri-stoma skin and subclinical tumor bed at the larynx, the resulting dosimetry plans were analyzed with or without a 5 mm bolus placement. Wet gauze was used to minimize the effect of any air gap. Four plans were generated: AP superclavicular (SCV) plan with or without bolus, and VMAT plan with or without bolus. A dose of 60Gy in 30 fractions was prescribed at 3 cm depth for AP SCV plan, and to 95% of the PTV volume for VMAT plan. Results: For the conventional AP SCV plan, the peri-stoma skin dose is sensitive to bolus placement as well as air gap compensation by wetted gauze (V95% of 20.7%, 33.0% and 94.8% for no bolus, bolus without and with air gap compensation, respectively). For stoma lumen, the dose drops off rapidly in depth. The catheter cuff may have certain dose-buildup effect, but air gap around it and under the bolus placed can pose a more serious problem. The dose distributions of the two VMAT plans are moderately different for peri-stoma skin (V95% of 95.0% with bolus and air gap compensation, and 82.3% without bolus), but nearly identical for stoma lumen (V95% of 91.5% and 92.0%, respectively). VMAT allows beamlets with different angles of incidence that helped achieve such dose distribution around the stoma even without bolus placement. Conclusion: Overall, the dose coverage around the stoma in the VMAT plan is better than the conventional AP SCV plan. To achieve optimal dose distribution, it is still recommended to place physical bolus and reduce the air gaps.

  20. Evaluation of the Eclipse eMC algorithm for bolus electron conformal therapy using a standard verification dataset.

    Science.gov (United States)

    Carver, Robert L; Sprunger, Conrad P; Hogstrom, Kenneth R; Popple, Richard A; Antolak, John A

    2016-05-08

    The purpose of this study was to evaluate the accuracy and calculation speed of electron dose distributions calculated by the Eclipse electron Monte Carlo (eMC) algorithm for use with bolus electron conformal therapy (ECT). The recent com-mercial availability of bolus ECT technology requires further validation of the eMC dose calculation algorithm. eMC-calculated electron dose distributions for bolus ECT have been compared to previously measured TLD-dose points throughout patient-based cylindrical phantoms (retromolar trigone and nose), whose axial cross sections were based on the mid-PTV (planning treatment volume) CT anatomy. The phantoms consisted of SR4 muscle substitute, SR4 bone substitute, and air. The treatment plans were imported into the Eclipse treatment planning system, and electron dose distributions calculated using 1% and processors (Intel Xeon E5-2690, 2.9 GHz) on a framework agent server (FAS). In comparison, the eMC was significantly more accurate than the pencil beam algorithm (PBA). The eMC has comparable accuracy to the pencil beam redefinition algorithm (PBRA) used for bolus ECT planning and has acceptably low dose calculation times. The eMC accuracy decreased when smoothing was used in high-gradient dose regions. The eMC accuracy was consistent with that previously reported for accuracy of the eMC electron dose algorithm and shows that the algorithm is suitable for clinical implementation of bolus ECT.

  1. The influence of a slow-release multi-trace element ruminal bolus on trace element status, number of ovarian follicles and pregnancy outcomes in synchronized Afshari ewes

    Science.gov (United States)

    Abdollahi, E.; Kohram, H.; Shahir, M. H.; Nemati, M. H.

    2015-01-01

    Published data on the effects of ruminal bolus on the number of ovulatory follicles in ewes does not exist. The present study determined the effects of a ruminal bolus on trace element status, follicular dynamics and reproductive performance in ewes. Eighty Afshari cycling ewes were synchronized during breeding season using CIDR for 14 days and assigned to 4 groups (n=20); group 1 received a single Ferrobloc bolus four weeks prior to CIDR insertion following 400 IU eCG on CIDR removal, group 2 received two boluses four weeks prior to CIDR insertion following 400 IU eCG on CIDR removal, group 3 received only 400 IU eCG on CIDR removal and group 4 (control) received no bolus and no eCG. Transrectal ultrasonography was done to monitor the ovarian follicles on the day of CIDR removal and a day later. Results showed that boluses increased the status of copper, selenium and iodine on mating day and days 90 to 100 of gestation. Ruminal bolus did not significantly increase the number of different classes of ovarian follicles in ewes fed a diet meeting all trace mineral requirements. All ewes eventually became pregnant with 1 or 2 boluses but the multiple births rate (80%) was higher (P<0.05) after 2 boluses compared to the other groups. PMID:27175153

  2. O ensaio como narrativa

    Directory of Open Access Journals (Sweden)

    Pedro Duarte

    2016-02-01

    Full Text Available O artigo tenta demonstrar que todos os textos, mesmo aqueles cuja natureza é teórica, têm alguma forma de narrativa. Nem sempre são personagens que os ocupam, podem ser ideias, mas mesmo assim há um enredo conceitual que se passa. Modernamente, a forma dessa narrativa foi sobretudo o sistema, com a pretensão totalizadora presente, por exemplo, na filosofia de Hegel. Contemporaneamente, porém, a forma do ensaio – surgida ainda na era moderna – ganha destaque por sua forma descontínua de narrar. O objetivo do artigo é apontar que, se o ensaio é uma forma, como explicitaram Lukács, Benjamin e Adorno, ele é também uma forma de narrar – ainda que de narrar conceitualmente objetos da cultura.

  3. La Justicia como virtud

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    Martínez-Sicluna y Sepúlveda, Consuelo

    2003-07-01

    Full Text Available El sentimiento de la justicia representa el hábito de conducta por el que nos vemos obligados, en cualquier relación, a dar a cada uno lo suyo. Ahora bien, esta disposición del espíritu se inscribe en las coordenadas que definen al hombre: verdad, libertad y bien. El hombre como ser racional y por tanto libre: el único ser que se determina a sí mismo y que alcanza en el bien el sentido de su proyección personal, esto es, la perfección. Dar a cada uno lo suyo es dar al sujeto el reconocimiento de este fundamento ontológico.

  4. Como comunicar la Alegria

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    Pablo Portales

    2015-01-01

    Full Text Available Se ofrece un amplio análisis sobre la industria electoral, recordando que un candidato a presidente es "un producto para la venta". Se Desmenuzan las estrategias utilizadas en el plebiscito chileno,las elecciones norteamericanas con el NO a BUSH. El Mercadeo Social es una nueva metodología utilizada en proyectos de desarrollo a nivel de campo por ello se hace un esclarecimiento y clarifica el vínculo con la comunicación. Se agrega temas como: Los modelos de recepción de mensajes cuyos marcos conceptuales y metodologías aún no se han adaptado al potencial de esta línea de trabajo.Se analiza la agonía de las radios mineras en Bolivia en la que 42 años de historia y heroísmo se desmoronan.

  5. El inquisidor como profesor

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    Adriano PROSPERI

    2009-12-01

    Full Text Available Giovanni Botero, en una célebre página de su Ragion di stato, se detuvo sobre el tema de la fuerza de la religión en los gobiernos. Esta función de la religión cristiana —para Botero, católica— es garante del orden público y se presenta también como opuesta a la generadora de desorden de Lutero y Calvino, quienes siembran por todo cizañas y revoluciones de estados y ruinas de los reinos. Estamos en los orígenes del esquema historiografía de la periodización de la Edad Moderna que confió precisamente a la Reforma el papel de nodriza de las revoluciones que nacieron en Europa.

  6. Contrast timing in computed tomography: Effect of different contrast media concentrations on bolus geometry

    International Nuclear Information System (INIS)

    Mahnken, Andreas H.; Jost, Gregor; Seidensticker, Peter; Kuhl, Christiane; Pietsch, Hubertus

    2012-01-01

    Objective: To assess the effect of low-osmolar, monomeric contrast media with different iodine concentrations on bolus shape in aortic CT angiography. Materials and methods: Repeated sequential computed tomography scanning of the descending aorta of eight beagle dogs (5 male, 12.7 ± 3.1 kg) was performed without table movement with a standardized CT scan protocol. Iopromide 300 (300 mg I/mL), iopromide 370 (370 mg I/mL) and iomeprol 400 (400 mg I/mL) were administered via a foreleg vein with an identical iodine delivery rate of 1.2 g I/s and a total iodine dose of 300 mg I/kg body weight. Time-enhancement curves were computed and analyzed. Results: Iopromide 300 showed the highest peak enhancement (445.2 ± 89.1 HU), steepest up-slope (104.2 ± 17.5 HU/s) and smallest full width at half maximum (FWHM; 5.8 ± 1.0 s). Peak enhancement, duration of FWHM, enhancement at FWHM and up-slope differed significantly between iopromide 300 and iomeprol 400 (p 0.05). Conclusions: Low viscous iopromide 300 results in a better defined bolus with a significantly higher peak enhancement, steeper up-slope and smaller FWHM when compared to iomeprol 400. These characteristics potentially affect contrast timing.

  7. Direct bolus imaging of cervical blood vessels by means of MRI

    International Nuclear Information System (INIS)

    Satoh, Toshihiko; Fujioka, Mutsuhisa; Watari, Tsutomu; Nishimura, Gen; Matsumoto, Toshihiko; Washiya, Sumio; Inoue, Kiyoshi; Horita, Masatoshi; Shimizu, Kohji.

    1991-01-01

    Direct bolus imaging (DBI) is one of the non-invasive method for flow measurements which is based on the bolus tracking technique. DBI permits the direct visualization of flow velocity profiles and vessel band width. We performed screening for cervical vessel disease in patients with vertigo by means of DBI. MR system used here was 0.5 T superconducting imager-SMT-50A (Shimazu Co. Ltd). Pulse sequence parameters were TR= 60 ms, TE= 50 ms, NEX= 1, acquisition matrix; 128 x 256, slice thickness= 5 mm, with cardiac gating. Pulse sequence employed a slice selective RF pulse at the level of C5 vertebral body to tag a disk of fluid perpendicular to the direction of flow, followed by a gradient reforcussed echo. We evaluated each peak high and band width of the common-carotid arteries and the vertebral arteries. Seventy nine of 83 cases had optimal examinations. Abnormal findings of DBI were seen in 15 of 79 cases, (including 2 of subclavian steal syndrome, 1 of carotid obstruction, 5 of vertebral obstruction, 1 of basilar artery obstruction, and 6 of hypoplasia of vertebral artery). The abnormal findings of DBI were well correlated with those of angiographic examinations. We concluded that DBI was suitable to the screening for cervical vessel diseases in patients with vertigo, and should be added to the routine MR studies. (author)

  8. Bolus effect to reduce skin dose of the caontralateral breast during breast cancer radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Won, Young Jin [Dept. of Radiation Oncology, InJe University Ilsan Paik Hospital, Goyang (Korea, Republic of); Kim, Jong Won; Kim, Jung Hoon [Dept. of Radiology, Radiation Oncology, KonYang University Hospital, Daejeon (Korea, Republic of)

    2017-06-15

    The aim of this study was to evaluate the dose comparison using Radon phantom with 5 mm and 10 mm tissue equivalent materials, FIF, Wedge(15, 30 angle) and IMRT, to reduce the skin dose of the contralateral breast during breast cancer radiation therapy(Total dose: 50.4Gy). The dose was measured for each treatment plan by attaching to the 8 point of the contralateral breast of the treated region using a optical-stimulated luminance dosimeter(OSLD) as a comparative dose evaluation method. Of the OSLD used in the study, 10 were used with reproducibility within 3%. As a result, the average reduction rates of 5 mm and 10 mm in the FIF treatment plan were 37.23 cGy and 41.77 cGy, respectively, and the average reduction rates in the treatment plan using Wedge 15 degrees were 70.69 cGy and 87.57 cGy, respectively. The IMRT showed a reduction of 67.37 cGy and 83.17 cGy, respectively. The results of using bolus showed that as the thickness of the bolus increased in all treatments, the dose reduction increased. We concluded that mastectomy as well as general radiotherapy for breast cancer would be very effective for patients who are more likely to be exposed to scattered radiation due to a more demanding or complex treatment plan.

  9. The Effect of Bolus Volume on Hyoid Kinematics in Healthy Swallowing

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    Ahmed Nagy

    2014-01-01

    Full Text Available Hyoid movement in swallowing is biomechanically linked to closure of the laryngeal vestibule for airway protection and to opening of the upper esophageal sphincter. Studies suggest that the range of hyoid movement is highly variable in the healthy population. However, other aspects of hyoid movement such as velocity remain relatively unexplored. In this study, we analyze data from a sample of 20 healthy young participants (10 male to determine whether hyoid movement distance, duration, velocity, and peak velocity vary systematically with increases in thin liquid bolus volume from 5 to 20 mL. The temporal correspondence between peak hyoid velocity and laryngeal vestibule closure was also examined. The results show that maximum hyoid position and peak velocity increase significantly for 20 mL bolus volumes compared to smaller volumes, and that the timing of peak velocity is closely linked to achieving laryngeal vestibule closure. This suggests that generating hyoid movements with increased power is a strategy for handling larger volumes.

  10. Ocular dynamics of Garcinia cola (Heckel on healthy volunteers following bolus ingestion

    Directory of Open Access Journals (Sweden)

    S. A. Igwe

    2007-12-01

    Full Text Available Garcinia cola Heckel, an angiospermae belonging to the  family Guttiferae, is known in commerce as bitter cola. It is a plant found in the West African subregion, mostly in moist conditions, and often in association with Cola acuminata. The seeds are highly valued ingredients in African ethonomedicine. The seeds have several social uses and applications in folk medicine. These seeds are ordinarily chewed by the local people without prescription or restriction. In an in vivo case control study, the effects of Garcinia cola on some visual functions: pupil diameter, near point of convergence (NPC, amplitude of accommodation (AA, intraocular pressure (IOP, visual acuity (VA and habitual phoria; following bolus ingestion of 20 g was undertaken using healthy visually active volunteers. Results showed that bolus ingestion of Garcinia cola constricted the pupil by 68%, reduced the NPC by 28%, increased the AA by 17.8% at peak effect and decreased the intraocular pressure by 31% without affecting the distance and near VA. The lateral phoria at far and near tended towards esophoria. Possibly the miotic effect and reduction in IOP could be of benefit to patients with raised IOP where conventional drugs may not be effective. Also it is possible that the effects on phoria could be exploited in oculomotor function in combination with visual training.

  11. Study of the usefulness on liver CT using intermittent bolus injection method

    International Nuclear Information System (INIS)

    Hayashi, Hideo

    1990-01-01

    Usefulness on the liver CT using intermittent bolus injection method of contrast media (IM-CE) was studied in 108 hepatic space occupying lesions, particularly to analyze hepatocellular carcinoma (HCC). Scans were obtained before, 20∼30 (arterial phase) and 60 seconds (parenchymal phase) after intravenous bolus injection of 65%-diatrizoate (angiografin) or 300 mg I-iopamidol (iopamiron 300), and in case of necessity, added 3∼15 minutes (late phase) after all injections of contrast media. These scans imaging the features of hepatic mass provided us much useful information. Early enhancement of the arterial phase, and early wash out of the parenchymal phase and delayed ring enhancement of the capsule improved the rates of detection to 96%, 60%, and 49% respectively in case of HCC. Especially. at the small HCC (less than 2cm in diameter), these rates were 89%, 50%, and 28% respectively. Combination of these 3 findings suggested the possibility of HCC in comparison with other hepatic mass. The rate of accurate diagnosis of HCC by this IM-CE was 81%. Thus IM-CE CT provides the useful information in diagnosis of hepatic mass and should be considered as the routine examination of hepatic mass. (author)

  12. ANALGESIC EFFECT OF INTRATHECAL BACLOFEN BOLUS ON NEUROPATHIC PAIN IN SPINAL CORD INJURY PATIENTS.

    Science.gov (United States)

    Kumru, Hatice; Benito-Penalva, Jesus; Kofler, Markus; Vidal, Joan

    2018-05-18

    GABA-ergic neurons are widely distributed throughout the central nervous system, including the spinal cord which is important for the transmission of pain impulses to the brain. Here we hypothesized that intrathecal baclofen (ITB) which is a GABA analogue might exert analgesic effects on neuropathic pain, which could be related to subtypes of pain in spinal cord injury (SCI). SCI patients with a cervical or thoracic lesion and neuropathic pain were randomized to receive either a single ITB bolus or placebo. Numerical Rating Scale (NRS), Neuropathic Pain Symptom Inventory (NPSI), and Brief Pain Inventory (BPI) were obtained for assessment of neuropathic pain. Spasticity was assessed using Modified Ashworth Scale and visual analogue scale. Evaluations were performed at baseline, and 4, 8, and 24 hours after application of ITB or placebo. Eight patients received ITB, 5 placebo. Neuropathic pain improved significantly in the ITB group based on NRS, BPI, and NPSI, which revealed an effect on all subtypes of pain. Spasticity declined significantly. In the placebo group, there was neither significant change in pain nor in spasticity. An ITB bolus exerted a significant analgesic effect on all subtypes of neuropathic pain in SCI patients. ITB has analgesic effects on all subtypes of neuropathic pain and can improve interference of neuropathic pain with activities of daily living. ITB might be a promising analgesic treatment to control neuropathic pain. Copyright © 2018. Published by Elsevier Inc.

  13. Enteral nutrition for preterm infants: by bolus or continuous? An update

    Directory of Open Access Journals (Sweden)

    Valentina Bozzetti

    2017-06-01

    Full Text Available Optimization of nutritional management of preterm infants is crucial for achievement of their long-term health. Enteral nutrition is preferred to total parenteral nutrition (TPN because the former avoids complications related to vascular catheterization, sepsis, adverse effects of TPN, and fasting. Due to the lack of ability of preterm infants to coordinate suckling, swallowing, and breathing, tube feeding is necessary for most infants less than 1500 g to ensure sufficient feeding tolerance, to support optimal growth and to reduce the risk of aspiration. Therefore, feeding by orogastric or nasogastric tube using either continuous or intermittent bolus delivery of formula or human milk is common practice for these infants. Theoretical risks and benefits of both continuous nasogastric milk feeding and intermittent bolus milk feeding have been proposed. According to the literature, continuous nutrition could be preferred in smaller infants (as those with a birthweight below 1250 g or hemodynamically impaired infants; in stable growing infants nutrition can be administered intermittently as in healthy term infants.

  14. Evaluation of reconstruction parameters of electrical impedance tomography on aorta detection during saline bolus injection

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    Thürk Florian

    2016-09-01

    Full Text Available An accurate detection of anatomical structures in electrical impedance tomography (EIT is still at an early stage. Aorta detection in EIT is of special interest, since it would favor non-invasive assessment of hemodynamic processes in the body. Here, diverse EIT reconstruction parameters of the GREIT algorithm were systematically evaluated to detect the aorta after saline bolus injection in apnea. True aorta position and size were taken from computed tomography (CT. A comparison with CT showed that the smallest error for aorta displacement was attained for noise figure nf = 0.7, weighting radius rw = 0.15, and target size ts = 0.01. The spatial extension of the aorta was most precise for nf = 0.7, rw = 0.25, and ts = 0.07. Detection accuracy (F1-score was highest with nf = 0.6, rw = 0.15, and ts = 0.04. This work provides algorithm-related evidence for potentially accurate aorta detection in EIT after injection of a saline bolus.

  15. Bolus timing in high-pitch CT angiography of the aorta

    International Nuclear Information System (INIS)

    Beeres, Martin; Loch, Matthias; Schulz, Boris; Kerl, Matthias; Al-Butmeh, Firas; Bodelle, Boris; Herrmann, Eva; Gruber-Rouh, Tatjana; Lee, Clara; Jacobi, Volkmar; Vogl, Thomas J.

    2013-01-01

    Objective: To investigate the bolus geometry in high-pitch CT angiography (CTA) of the aorta without ECG synchronisation in comparison to single-source CT. Methods: Overall 160 consecutive patients underwent CTA either in conventional single-source mode with a pitch of 1.2 (group 1), or in dual-source mode with a pitch of 3.0 (groups 2, 3 and 4) using different contrast media timings with bolus triggering at 140 HU (5 s, group 1; 10 s, group 2; 12 s, group 3; 14 s, group 4). Contrast material, saline flush, flow rate and kV/mAs settings were kept equal for optimum comparability. Aortic attenuation was measured along the z-axis of the patient at different anatomic landmarks and subjective image quality was compared. Results: The most homogeneous enhancement of the aorta was reached with a delay of 10 s after reaching the trigger threshold. The imaging length was not significantly different, but the examination time was significantly (p < 0.001) shorter in the high-pitch group (7.7 s vs. 1.7 s for group 1 vs. 2, 3 and 4). Conclusion: In high-pitch CT angiography using a start delay of 10 s after a trigger threshold of 140 HU in the descending aorta is reached, a homogenous contrast along the z-axis is accomplished

  16. "The relationship between pharmacokinetic variables and pharmacodynamic profiles of bolus versus continuous infusion of furosemide in critically ill patients"

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    "Mojtaba Mojtahedzadeh

    2005-05-01

    Full Text Available In this investigation, the pharmacokinetic variables of continuous infusion and intermittent bolus injection of furosemide and the possible relationship between its pharmacokinetic characteristics and pharmacodynamic profile among intensive care unit (ICU patients were studied. In this prospective, randomized, clinical trial, twelve patients received IV bolus of 20 mg of the drug during 3 hours period and, the drug dose was doubled, when the urine output was less than 1 ml/kg/h (group 1. The other nine patients received a continuous intravenous furosemide infusion at the rate of 0.1 mg/kg/h (group 2. The amount of furosemide in serum was measured by high performance liquid chromatography (HPLC. Results showed a positive correlation between plasma clearance of furosemide and its diuretic activity (P=0.01. The pharmacokinetic parameters such as Vd (l, CL (ml/min, Ke (min-1 and t½ (min in continuous infusion patients were not significantly differed from the bolus patients (P-values 0.5, 0.9, 0.9,0.9, respectively. Nevertheless the observed plasma clearance of drug in the continuous infusion group was clinically higher than bolus injection group and as a result the cumulative urine output per hour per mg of furosemide in a continuous infusion was observed to be higher than bolus(P=0.2. Changes in serum sodium and potassium were similar for both groups, but bolus injection patients were associated with higher potassium depletion (P=0.001. Therefore, continuous infusion seems to be better means of diuretic therapy in critically ill patients.

  17. Optimization of a beam shaping bolus for superficial microwave hyperthermia waveguide applicators using a finite element method

    International Nuclear Information System (INIS)

    Kumaradas, J Carl; Sherar, Michael D

    2003-01-01

    Temperature inhomogeneity in hyperthermia treatments often limits the total thermal dose that can be delivered to the tumour region. To reduce such inhomogeneities, a prototype dynamically modifiable square array of saline-filled patches which attenuate microwave energy was developed for superficial treatments that use external microwave applicators. The array was situated inside the coupling water bolus that is often used with external applicators. The prototype has been previously tested clinically with promising results. A more complete theoretical analysis of the performance of this new bolus design and improvements to its design by modelling are presented here. The analysis was performed by performing five iterative simulations of the SAR pattern produced inside a tissue structure by a waveguide applicator with a water bolus containing the dynamic patch array attached. Between iterations the patch array configuration was modified in an attempt to improve the ability of the bolus to confine heating to an 'L'-shaped tumour region. These simulations were performed using the finite element method. The steady-state temperature profile was then computed using a finite element method based simulation of heat transfer that assumed a given applicator power level and water bolus temperature. Several iterations of these heat transfer simulations were performed with varying applicator power level and water bolus temperature to improve the confinement of heating to the target region. The analysis showed that the dynamic patch array should be capable of conforming heating to an 'L'-shaped target tumour region while limiting the heating to the surrounding normal tissue to an acceptable level

  18. The velocity of a radioactive bolus in the oesophagus evaluated by means of an image segmentation algorithm

    International Nuclear Information System (INIS)

    Miquelin, Charlie A; Dantas, Roberto O; Oliveira, Ricardo B; Braga, Francisco Jos H. N

    2002-01-01

    Classical scintigraphic evaluation of a radioactive bolus through the oesophagus is based on regions of interest and time/activity curves, which only gives information about the total time required for it to cross the organ. Instantaneous parameters can be obtained if the exact position (centroid) of the bolus is known. For that, one needs to know the co-ordinates of the centre of mass of the bolus radioactivity distribution. From this, one can obtain velocity at each time. Obtaining such a new parameter would be important, to try to determine whether the anatomical differences among the 3 thirds of the oesophagus have a functional correspondence or not. We have studied 5 normal volunteers (4 males, 1 female, 33-68 yo). Each volunteer swallowed (unique swallowing) 40 MBq of 99mTc-phytate in 10 ml water. Eighty frames (0.3 sec) were acquired in a scintillation camera. External marks were used to separate the pharynx from the oesophagus. Images were transformed into bitmap by means of a Sophy Medical processing module and analysed by means of the algorithm, which determines the co-ordinates of the centroid (horizontal and vertical) for each frame and instant velocities through the organ. Different velocities were found in typical evaluations. Curves representing the different positions of the bolus C and the correspondent different Vs were obtained. Different velocities of the bolus were detected during the pharyngeal phase, and proximal, mid and distal parts of the oesophagus. Larger studies are necessary, but it seems that the velocity of a radioactive bolus changes in the different parts of the oesophagus. It is reasonable to say that there is a functional correspondence to the anatomical differences in the organ (Au)

  19. Rapid Bolus Administration Does not Increase The Extravasation Rate of Albumin: A Randomized Controlled Trial in The Endotoxemic Pig.

    Science.gov (United States)

    von Seth, Magnus; Lipcsey, Miklós; Engström, Peter; Larsson, Anders; Hillered, Lars; Maripuu, Enn; Widström, Charles; Sjölin, Jan

    2017-04-01

    Some experimental data suggest that rapid bolus administration of albumin causes less plasma-expanding effects than slow, continuous infusion. To determine whether rapid bolus administration, in comparison with slow infusion, results in greater extravasation of albumin in experimental septic shock we performed a randomized controlled trial with 32 endotoxemic pigs. The animals were monitored and ventilated with standard intensive care equipment and given 10 mL × kg 5% albumin labeled with Technetium-99m, either as a rapid 15-min bolus (Bolus group, n = 16) or as a 2-h infusion (Infusion group, n = 16). Radioactivity was monitored in plasma, extracellular microdialysate, and urine for 6 h. Physiological parameters were monitored hourly. Radioactivity in the liver, spleen, kidney, and lung was analyzed post mortem.The plasma area under the curve activity0-6 h was 4.4 ± 0.9 × 10 in the Bolus group and 4.4 ± 1.1 × 10 counts × min × mL × h in the Infusion group. Blood hemoglobin levels increased in both groups, suggesting severe capillary leakage. Yet, there were no group differences in albumin radioactivity in plasma, muscle tissue, urine, or in the post-mortem analysis of the organs. Following albumin administration, circulatory and respiratory parameters were similar in the two groups.In conclusion, the present results suggest that albumin might be given as a bolus without leading to increased extravasation of albumin, in contrast to previous animal experiments in rodents.

  20. The application of DSA bolus chase technology in diagnosing the vascular disorders of lower extremities due to diabetes mellitus

    International Nuclear Information System (INIS)

    Ren Chongyang; Di Zhenhai; Mao Xuequn; Zou Rong; Zhang Jian; Wang Meirong; Li Quan

    2010-01-01

    Objective: To retrospectively evaluate the digital subtraction angiography (DSA) bolus chase technology in diagnosing the vascular disorders of lower extremities due to diabetes mellitus. Methods: From January 2004 to March 2010, DSA was performed in forty-five diabetes patients with suspicious vascular diseases of lower extremities. Among them, 24 cases (31 lower limbs)were examined with DSA bolus chase technology and the remaining 21 cases (21 lower limbs)were examined with traditional segmentational technique. The contrast dosage used in angiography, the total exposure time, the examination time and the imaging value for making diagnosis were analyzed and compared between two techniques. Results: For DSA bolus chase technology group, the contrast dosage used in angiography, the total exposure time and the examination time were 25.26 ml, 13.23 s and 37.26 min, respectively,with an average exposure of 101.65 pictures. For traditional segmentational technique group, the contrast dosage used in angiography, the total exposure time and the examination time were 130.00 ml, 52.38 s and 50.48 min, respectively, with an average exposure of 118.33 pictures. The percentage of high quality images in bolus chase technology group and in traditional segmentational technique group were 90.3% and 90.5%, respectively. All the images could meet the requirements for making a reliable diagnosis. Conclusion: Digital subtraction angiography by using bolus-chase technology can well demonstrate the vascular pathology of lower extremities caused by diabetes mellitus, obtain sufficient imaging information necessary for making a reliable diagnosis. DSA bolus chase technology is superior to traditional segmentational technique in shortening procedure time, reducing contrast medium dosage and decreasing radiation dose. (authors)

  1. Bolus and continuous infusion mitoxantrone in newly diagnosed adult acute lymphoblastic leukemia: results of two consecutive phase II clinical studies.

    Science.gov (United States)

    Koc, Y; Akpek, G; Kansu, E; Kars, A; Tekuzman, G; Baltali, E; Güler, N; Barista, I; Güllü, I; Ozisik, Y; Firat, D

    1998-01-01

    Two consecutive phase II clinical studies were designed to evaluate the efficacy and safety of bolus and continuous infusion (CI) mitoxantrone (MTZ) in 39 patients with newly diagnosed acute lymphocytic leukemia (ALL). MTZ was used as part of the classical ALL induction regimen. Twenty patients were treated with bolus MTZ (10 mg/m2 for 3 days) combined with vincristine and prednisone. The same regimen was given to a second set of 19 patients, except that MTZ was administered as a 24-hr CI. Both groups received bimonthly intensifications with vincristine and prednisone for 3 years, along with oral maintenance therapy. Patients in the CI-MTZ study arm received additional MTZ on the first day of intensification cycles. Seventeen patients (85%) in the bolus arm and 15 patients (79%) in the CI arm achieved complete remission (CR). Median disease-free survivals (DFS) in the bolus and CI groups were 11 and 15 months after median follow-ups of 16 (3.5-96) and 13 (2.3-32) months, respectively. At 2.5 years, DFS rates were 29.4% and 34.4% in the bolus and CI groups (p > 0.05). There were no significant differences between two groups in rates of early death, degree of organ toxicity, or duration of neutropenia and thrombocytopenia. Significant cardiac toxicity was not observed in either group. Bolus or CI administration of MTZ was equally effective and was well tolerated. Neither the mode of administration nor increasing the dose intensity of MTZ by incorporating intensification cycles reduced relapse rates. Development of new antileukemia agents and novel treatment approaches are still needed to improve the high relapse rates in adult ALL once a complete response is achieved.

  2. La persona como creatura

    Directory of Open Access Journals (Sweden)

    Emmanuel Housset

    2010-01-01

    Full Text Available El artículo de Emmanuel Housset implica un esfuerzo de rehabilitación del concepto «persona» para la filosofía contemporánea y la fenomenología. Para ello el autor busca mostrar cómo poco a poco «persona» tomó otra significación que la de «personaje» o sujeto de derecho. Es en autores como san Agustín y santo Tomás de Aquino que se halla un acceso diferente que pone el énfasis más bien en su carácter relacional y responsivo de la persona, antes que en su dimensión autónoma y autotélica. Tal dimensión aparece, según Housset, junto con la idea de persona como creatura y en oposición a la de individuo racional dueño de sí. La dimensión afectiva, la personalidad despertada por las diversas figuras de la alteridad son algunas de las dimensiones de la persona que examina el autor a partir del examen de la carne, las pasiones, la memoria, la historicidad y el amor alteridad.Emmanuel Housset's paper is an effort to revitalize the concept of 'person' for contemporary philosophy and phenomenology To this end the author looks to show how little by little the understanding of 'person' took on a different meaning to that of 'character' or "right bearing individual". It is in authors such as St. Augustine and St. Thomas Aquinas that a different approach is found, one that puts emphasis on the relational and responsive character of a person, rather than on the autonomous and auto telic dimension. According to Housset, such a dimension appears together with the idea of the person as a creation, and in opposition to the idea of the rational individual, that is his own master. The emotional dimension and the personality that is awoken by the many figures of alterity are some of the dimensions of the person that the author analyzes, based on examining the flesh, passions, memory historicity and love.

  3. Onset and effectiveness of rocuronium for rapid onset of paralysis in patients with major burns: priming or large bolus

    Science.gov (United States)

    Han, T.-H.; Martyn, J. A. J.

    2009-01-01

    Background Burn injury leads to resistance to the effects of non-depolarizing muscle relaxants. We tested the hypothesis that a larger bolus dose is as effective as priming for rapid onset of paralysis after burns. Methods Ninety adults, aged 18–59 yr with 40 (2)% [mean (se)] burn and 30 (2) days after injury, received rocuronium as a priming dose followed by bolus (0.06+0.94 mg kg−1), or single bolus of either 1.0 or 1.5 mg kg−1. Sixty-one non-burned, receiving 1.0 mg kg−1 as a primed (0.06+0.94 mg kg−1) or full bolus dose, served as controls. Acceleromyography measured the onset times. Results Priming when compared with 1.0 mg kg−1 bolus in burned patients shortened the time to first appearance of twitch depression (30 vs 45 s, P<0.05) and time to maximum twitch inhibition (135 vs 210 s, P<0.05). The onset times between priming and higher bolus dose (1.5 mg kg−1) were not different (30 vs 30 s for first twitch depression and 135 vs 135 s for maximal depression, respectively). The onset times in controls, however, were significantly (P<0.05) faster than burns both for priming and for full bolus (15 and 15 s, respectively, for first twitch depression and 75 and 75 s for maximal depression). Priming caused respiratory distress in 10% of patients in both groups. Intubating conditions in burns were significantly better with 1.5 mg kg−1 than with priming or full 1.0 mg kg−1 bolus. Conclusions A dose of 1.5 mg kg−1 not only produces an initial onset of paralysis as early as 30 s, which we speculate could be a reasonable onset time for relief of laryngospasm, but also has an onset as fast as priming with superior intubating conditions and no respiratory side-effects. PMID:19029093

  4. El signo como emblema

    Directory of Open Access Journals (Sweden)

    Sáez, Carlos

    2003-06-01

    Full Text Available The aim of this article is to study the signs and symbols that appear in the hispanic medieval documents and manuscripts. These signs and symbols have usually been considered simply as mere elements to validate the charters. However, these alements were useful as a mean of visual communication between the high classes, able to generate charters, and the rest of medieval society—the majority illiterate— who received those charters. Because of their inability of understand an alphabetical code, they needed the graphic help to comprehend the message. Besides this, the article deals with non diplomatic signs and their function.

    Este artículo se centra en los signos o símbolos presentes en los documentos y manuscritos medievales hispanos, que habitualmente han sido tratados como meros elementos de validación de los diplomas. Pero estos elementos servían también de nexos de comunicación visual entre las clases poderosas, capaces de producir escritos, y los demás miembros de la sociedad medieval, receptores y destinatarios de tales escritos, en su mayoría analfabetos. Precisamente por esta razón, su incapacidad de descifrar un código alfabético, necesitan de auxilio gráfico para acercarse a la comprensión del mensaje. Asimismo, tratamos de los signos no diplomáticos y de su función.

  5. O analista como testemunha

    Directory of Open Access Journals (Sweden)

    Jô Gondar

    2016-04-01

    Full Text Available Resumo A proposta deste artigo é pensar o lugar da testemunha como um lugar terceiro que o analista, na clínica do traumático, é capaz de sustentar. Nos sonhos traumáticos, segundo Ferenczi, já existe a convocação de um terceiro. Não se trata da testemunha da esfera do Direito, tampouco do lugar do pai ou da Lei simbólica. Trata-se de um terceiro espaço que pode ser chamado de potencial, espaço intersticial, indeterminado e informe no qual circula - e aos poucos ganha forma -, algo que a princípio seria incomunicável. Esse espaço permite e suporta a literalidade da narrativa testemunhal, seus titubeios, paradoxos e silêncios. Mais do que uma teoria do trauma, a noção de espaço potencial seria a grande contribuição da psicanálise às pesquisas teóricas e clínicas com sobreviventes de campos de extermínio, de situações de tortura e de violência.

  6. Arte como espelho

    Directory of Open Access Journals (Sweden)

    Pedro Süssekind

    2016-12-01

    Full Text Available Este artigo tem como ponto de partida o exemplo da relação espelhada entre um livro e uma pintura de mesmo nome: o retrato que Lucian Freud fez do crítico de arte Martin Gayford e o diário que esse crítico escreveu sobre seu retratista, ambas as obras chamadas Homem com cachecol azul. A partir do exemplo, discuto a metáfora do espelho para caracterizar a arte, recorrendo para isso à teoria da representação artísticas elaborada pelo filósofo norte-americano Arthur Danto no artigo “O mundo da arte”, de 1964, e no primeiro capítulo do livro A transfiguração do lugar-comum, de 1981. Recorro, por fim, a dois exemplos artísticos de espelhamento na representação analisados por Danto em O abuso da beleza, de 2003, um quadro holandês do século dezessete e um poema de Rainer Maria Rilke.

  7. El riesgo como oportunidad

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    Daniela Gargantini

    2003-01-01

    Full Text Available Durante los últimos años el crecimiento mundial de catástrofes naturales ha ido en franco aumento. Sin embargo, desde un enfoque sistémico puede verificarse que la gran mayoría de los desastres se origina en los países en desarrollo (entre ellos los latinoamericanos, siendo las pérdidas en ellos significativamente más altas que en los países industrializados. Bajo esta postura los desastres no son sólo naturales sino socio- naturales, enfatizando la estrecha relación de causalidad entre modelos de desarrollo y urbanización y procesos de generación de riesgos, al incrementar la vulnerabilidad de los sectores más desprotegidos. El desastre pone en evidencia así una situación (la pobreza y segregación urbana ya existente, pero no considerada hasta el momento de la catástrofe. Frente a este panorama el desastre aparece como oportunidad que precipita tres catalizadores de políticas habitacionales: tierra, asistencia técnica y financiamiento, incrementando la celeridad y la creatividad de las respuestas. El interrogante que surge es por qué esperar el desastre para ponerlos en marcha, cuando ninguno de ellos es estrictamente dependiente de la situación de riesgo, sino sujeto de luchas de poder.

  8. Endomarketing: como diferencial competitivo

    Directory of Open Access Journals (Sweden)

    Karin Birck

    2013-05-01

    Full Text Available Atualmente, com a profissionalização das empresas e com a grande concorrência no mercado, observa-se uma demanda cada vez maior de gestores comprometidos com o bem-estar pessoal e profissional de seus colaboradores. E, com esse intuito, de apresentar algumas idéias básicas de gestão voltadas à aplicação nas mais diversas técnicas de Endomarketing. Demonstra assim, a importância da utilização de feedback, tanto por parte dos colaboradores quanto dos gestores, destacando a importância de trabalhos de motivação, do clima organizacional favorável e de uma comunicação interna eficaz e a necessidade ímpar de tratar o colaborador como o diferencial dentro de uma empresa. Desta forma, foi realizada uma pesquisa bibliográfica que auxiliará e dará subsídios que lhe permitam retribuir em ações e atitudes de sucesso e, também, fazer um confronto de idéias, onde os autores apresentam suas mais diversas opiniões. Contudo, valendo-se, muitas vezes, de narrativas de experiências de outros gestores e até mesmo de suas próprias, tirando cada um suas próprias conclusões.

  9. Triphasic contrast enhanced CT simulation with bolus tracking for pancreas SBRT target delineation.

    Science.gov (United States)

    Godfrey, Devon J; Patel, Bhavik N; Adamson, Justus D; Subashi, Ergys; Salama, Joseph K; Palta, Manisha

    Bolus-tracked multiphasic contrast computed tomography (CT) is often used in diagnostic radiology to enhance the visibility of pancreas tumors, but is uncommon in radiation therapy pancreas CT simulation, and its impact on gross tumor volume (GTV) delineation is unknown. This study evaluates the lesion conspicuity and consistency of pancreas stereotactic body radiation therapy (SBRT) GTVs contoured in the different contrast phases of triphasic CT simulation scans. Triphasic, bolus-tracked planning CT simulation scans of 10 consecutive pancreas SBRT patients were acquired, yielding images of the pancreas during the late arterial (LA), portal venous (PV), and either the early arterial or delayed phase. GTVs were contoured on each phase by a gastrointestinal-specialized radiation oncologist and reviewed by a fellowship-trained abdominal radiologist who specializes in pancreatic imaging. The volumes of the registered GTVs, their overlap ratio, and the 3-dimensional margin expansions necessary for each GTV to fully encompass GTVs from the other phases were calculated. The contrast difference between tumor and normal pancreas was measured, and 2 radiation oncologists rank-ordered the phases according to their value for the lesion-contouring task. Tumor-to-pancreas enhancement was on average much larger for the LA and PV than the delayed phase or early arterial phases; the LA and PV phases were also consistently preferred by the radiation oncologists. Enhancement differences among the phases resulted in highly variable GTV volumes with no observed trends. Overlap ratios ranged from 18% to 75% across all 3 phases, improving to 43% to 91% when considering only the preferred LA and PV phases. GTV expansions necessary to encompass all GTVs ranged from 0.3 to 1.8 cm for all 3 phases, improving slightly to 0.1 to 1.4 cm when considering just the LA and PV phases. For pancreas SBRT, we recommend combining the GTVs from a multiphasic CT simulation with bolus-tracking, including

  10. Ouabaina como Hormona

    Directory of Open Access Journals (Sweden)

    J. Hernando Ordoñez

    1996-04-01

    Full Text Available

    Comentario sobre su origen endógeno y sus aplicaciones terapéuticas

    Pocas drogas han sido más estudiadas que el grupo de los digitálicos, estrofantinas y ouabaina, cuyo estudio es objeto del presente trabajo.

    La ouabaina empezó a ser estudiada desde el siglo pasado. La primera referencia conocida corresponde a Pelikan, 1865 (1, como veneno que empleaban para las flechas en Gabón (Africa. (.

    (. Vinieron luego los trabajos de Fraser, 1869, (2, 3, 6, Polaillon, 1871 (4, Amaud, 1888 (5, Vaquez y Lutembacher, 1917 (7, Stoll, 1939 (8, Lapicque, 1929 (9, Wiggers, 1927 (10, Ytantos otros (11, 12, 13. En la obra de Kisch (14 aparecen más de 700 referencias bibliográficas sobre el particular.

    Ouabaina de origen endógeno. Purificación
    Durante muchos años se conoció la ouabaina como de origen vegetal, elaborada por las plantas Strophanthus Glaber(k-estrofantina,AcocantheraOuabaio(Ouabaina yStrophanthus Kombe (k-estrofantina y kestrofantósido. Una propiedad común a todos los digitálicos, estrofantina y ouabaina es que todos son inhibidores de la bomba de Na-K, encargada de regular la salida de Na y la entrada de K celular.

    Estudiando los inhibido res de esta bomba han encontrado en años recientes resultados extraordinarios en relación con el origen endógeno de algunos de estos inhibidores, entre ellos la ouabaina. Por considerarlos de extrema importancia y actualidad científica me permito citar algunos de ellos. Hamlyn y Manunta (15, 16, 17, 18, Y 19 hicieron estudios sobre el particular y lograron identificar en el plasma humano un compuesto igual a la ouabaina. Estos hallazgos fueron confirmados después por otros autores (20, 21, 22, 23 Y24.

    Ham bl yn (19 da varios argumentos que ponen en evidencia que el compuesto químico encontrado es ouabaina pura, y, lo que es más interesante, que tiene un origen endógeno. a Por espectroscopia de alta resoluci

  11. O direito como imperativo

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    Cloter Miglioriani

    1988-08-01

    Full Text Available We have examined one of the facets which Law presents to society, looking at the theme through a brief history of Law, in which Roman Law stands out, up to modem times, comparing current juridical systems such as the Continental System, Common Law, and Soviet Law. We have looked at Law from the viewpoint of society 's need to have basic mies for living together, with the juridical ruZe being one of the most important. We have highlighted the views of Hart and Kelsen on the foundations of the validity of Law. We have also considered the obligatoriness of Law; giving the point of view of tadbruch who, explaining his ''Theory of the Obligatoriness of Law ", concluded that the obligatoriness of Law can only be withdraw when there is a Clash between morals, law, use and social conventions. We have looked at the notion of the imperativeness of Law the central theme of the work -drawing on the views of Miguel Reale, for whom the juridical nonn cannot be reduced to a "command of a volitional nature", but rather the obligatory character of the juridical nonn arises from the pressure of social values. Del Vecchio, who is also quoted, recognized that imperativeness exists in the juridical norm, whether it is preceptive (a positive command or permissive. Also mentioned is the opinion of Tercio Sampaio Ferraz, for whom the juridical norm has imperativeness to the extent that the imposition of behaviour is unconditionally guaranteed. Foi feita a abordagem de uma das facetas com que o Direito se apresenta à sociedade, enfocando o tema a partir de um brevíssimo histórico do Direito, onde revela a fase romana, até os períodos modernos, com comparações dos sistemas jurídicos hodiernos, como o sistema continental, o da Commum Law e o soviético. Foi enfocado o Direito em face da necessidade sociedade em ter básicas de convivência, despontando a regra jurídica como das mais importantes. Foi dado destaque às posições de Hart e Kelsen, sobre os

  12. Anxiety can significantly explain bolus perception in the context of hypotensive esophageal motility: Results of a large multicenter study in asymptomatic individuals.

    Science.gov (United States)

    Cisternas, D; Scheerens, C; Omari, T; Monrroy, H; Hani, A; Leguizamo, A; Bilder, C; Ditaranto, A; Ruiz de León, A; Pérez de la Serna, J; Valdovinos, M A; Coello, R; Abrahao, L; Remes-Troche, J; Meixueiro, A; Zavala, M A; Marin, I; Serra, J

    2017-09-01

    Previous studies have not been able to correlate manometry findings with bolus perception. The aim of this study was to evaluate correlation of different variables, including traditional manometric variables (at diagnostic and extreme thresholds), esophageal shortening, bolus transit, automated impedance manometry (AIM) metrics and mood with bolus passage perception in a large cohort of asymptomatic individuals. High resolution manometry (HRM) was performed in healthy individuals from nine centers. Perception was evaluated using a 5-point Likert scale. Anxiety was evaluated using Hospitalized Anxiety and Depression scale (HAD). Subgroup analysis was also performed classifying studies into normal, hypotensive, vigorous, and obstructive patterns. One hundred fifteen studies were analyzed (69 using HRM and 46 using high resolution impedance manometry (HRIM); 3.5% swallows in 9.6% of volunteers were perceived. There was no correlation of any of the traditional HRM variables, esophageal shortening, AIM metrics nor bolus transit with perception scores. There was no HRM variable showing difference in perception when comparing normal vs extreme values (percentile 1 or 99). Anxiety but not depression was correlated with perception. Among hypotensive pattern, anxiety was a strong predictor of variance in perception (R 2 up to .70). Bolus perception is less common than abnormal motility among healthy individuals. Neither esophageal motor function nor bolus dynamics evaluated with several techniques seems to explain differences in bolus perception. Different mechanisms seem to be relevant in different manometric patterns. Anxiety is a significant predictor of bolus perception in the context of hypotensive motility. © 2017 John Wiley & Sons Ltd.

  13. The reliability and validity of passive leg raise and fluid bolus to assess fluid responsiveness in spontaneously breathing emergency department patients

    DEFF Research Database (Denmark)

    Duus, Nicolaj; Shogilev, Daniel J; Skibsted, Simon

    2015-01-01

    PURPOSE: We investigated the reproducibility of passive leg raise (PLR) and fluid bolus (BOLUS) using the Non-Invasive Cardiac Output Monitor (NICOM; Cheetah Medical, Tel Aviv, Israel) for assessment of fluid responsiveness (FR) in spontaneously breathing emergency department (ED) patients. METHODS...

  14. Radiotherapy in differentiated thyroid cancer: Optimal dose distribution using a wax bolus

    International Nuclear Information System (INIS)

    Mayer, R.; Stucklschweiger, G.; Oechs, A.; Pakish, B.; Hackl, A.; Preidler, K.; Szola, D.

    1994-01-01

    The study includes 53 patients with differentiated thyroid cancer, who underwent surgical and radioiodine therapy as well as hormone therapy. Postoperative radiotherapy was performed in all patients in 'mini-mantle-technique' with parallel opposed fields, followed by an anterior boost-field with electrons up to 60-64 Gy, using a wax bolus for optimal dose distribution in the target volume sparing out the spinal cord as much as possible. The dose to the spinal cord did not exceed 44 Gy in any case. The study shows that radiotherapy with doses up to 60-64 Gy plays an important role in postsurgical therapeutic management. Therefore nonradical surgery is a less important prognostic factor for survival and local recurrence in patients with differentiated thyroid cancer than histological diagnosis in combination with age and lymph node involvement

  15. Comparison of /sup 133/Xe washout curves after bolus inhalation, perfusion, and equilibration

    Energy Technology Data Exchange (ETDEWEB)

    Devos, P; Demedts, M; Vandecruys, A; Cosemans, J; De Roo, M

    1978-01-01

    In 6 healthy subjects and 13 patients with chronic obstructive lung disease, /sup 133/Xe washout curves after bolus inhalation, perfusion and equilibration were compared, using a gamma camera and computerized data handling. In healthy subjects the washout after equilibration was significantly slower than after the two other procedures. As this phenomenon occurred at the basal zones, it was attributed to the presence of airway closure in some units. In patients, the three washouts were significantly different from each other. This indicated the existence of intraregional inhomogeneity in ventilation, perfusion and ventilation-perfusion ratio. Our conclusion is that comparison of these different washout methods yields valuable information not only on absolute values of pulmonary function but also on the intraregional distribution, which cannot be obtained by other examinations.

  16. Intratracheal Milrinone Bolus Administration During Acute Right Ventricular Dysfunction After Cardiopulmonary Bypass.

    Science.gov (United States)

    Gebhard, Caroline Eva; Desjardins, Georges; Gebhard, Cathérine; Gavra, Paul; Denault, André Y

    2017-04-01

    To evaluate intratracheal milrinone (tMil) administration for rapid treatment of right ventricular (RV) dysfunction as a novel route after cardiopulmonary bypass. Retrospective analysis. Single-center study. The study comprised 7 patients undergoing cardiac surgery who exhibited acute RV dysfunction after cardiopulmonary bypass. After difficult weaning caused by cardiopulmonary bypass-induced acute RV dysfunction, milrinone was administered as a 5-mg bolus inside the endotracheal tube. RV function improvement, as indicated by decreasing pulmonary artery pressure and changes of RV waveforms, was observed in all 7 patients. Adverse effects of tMil included dynamic RV outflow tract obstruction (2 patients) and a decrease in systemic mean arterial pressure (1 patient). tMil may be an effective, rapid, and easily applicable therapeutic alternative to inhaled milrinone for the treatment of acute RV failure during cardiac surgery. However, sufficiently powered clinical trials are needed to confirm these findings. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Factors predicting incremental administration of antihypertensive boluses during deep brain stimulator placement for Parkinson's disease.

    Science.gov (United States)

    Rajan, Shobana; Deogaonkar, Milind; Kaw, Roop; Nada, Eman Ms; Hernandez, Adrian V; Ebrahim, Zeyd; Avitsian, Rafi

    2014-10-01

    Hypertension is common in deep brain stimulator (DBS) placement predisposing to intracranial hemorrhage. This retrospective review evaluates factors predicting incremental antihypertensive use intraoperatively. Medical records of Parkinson's disease (PD) patients undergoing DBS procedure between 2008-2011 were reviewed after Institutional Review Board approval. Anesthesia medication, preoperative levodopa dose, age, preoperative use of antihypertensive medications, diabetes mellitus, anxiety, motor part of the Unified Parkinson's Disease Rating Scale score and PD duration were collected. Univariate and multivariate analysis was done between each patient characteristic and the number of antihypertensive boluses. From the 136 patients included 60 were hypertensive, of whom 32 were on angiotensin converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB), told to hold on the morning of surgery. Antihypertensive medications were given to 130 patients intraoperatively. Age (relative risk [RR] 1.01; 95% confidence interval [CI] 1.00-1.02; p=0.005), high Joint National Committee (JNC) class (p10 years (RR 1.2; 95%CI 1.1-1.3; p=0.001) were independent predictors for antihypertensive use. No difference was noted in the mean dose of levodopa (p=0.1) and levodopa equivalent dose (p=0.4) between the low (I/II) and high severity (III/IV) JNC groups. Addition of dexmedetomidine to propofol did not influence antihypertensive boluses required (p=0.38). Intraoperative hypertension during DBS surgery is associated with higher age group, hypertensive, diabetic patients and longer duration of PD. Withholding ACEI or ARB is an independent predictor of hypertension requiring more aggressive therapy. Levodopa withdrawal and choice of anesthetic agent is not associated with higher intraoperative antihypertensive medications. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Discounting the duration of bolus exposure in impedance testing underestimates acid reflux.

    Science.gov (United States)

    Vikneswaran, Namasivayam; Murray, Joseph A

    2016-06-08

    Combined impedance-pH testing (MII) allows for detection of reflux episodes regardless of pH. However impedance-based diagnosis of reflux may not routinely account for duration of the reflux episode. We hypothesize that impedance testing may be less sensitive than pH-testing in detecting acid reflux off therapy as a result of discounting duration of exposure. Baseline characteristics and reflux parameters of MII studies performed off-anti-secretory medications were analyzed. Studies on acid suppressive medication and those with recording times less than 20 h or low baseline impedance were excluded. A total of 73 consecutive MII studies were analyzed of which 31 MII studies had elevated acid exposure while 16 were abnormal by impedance criteria. MII testing off-therapy was more likely to be abnormal by pH criteria (percent time pH reflux):[42 vs 22 % (p =0.02)]. Acid exposure (percent time pH acid reflux episodes [42 vs 34 % (p acid clearance time (pH-detected) was significantly longer than median bolus clearance time (impedance-detected) in the total [98.7 s vs 12.6 s (p acid clearance time (pH-detected) and the median bolus clearance time (impedance-detected) was significantly higher in the recumbent position compared to the upright position [11. vs 5.3 (p = 0.01)]. Ambulatory impedance testing underestimates acid reflux compared to esophageal acid exposure by discounting the prolonged period of mucosal contact with each acid reflux episode, particularly in the recumbent position.

  19. Appropriateness of Bolus Antihypertensive Therapy for Elevated Blood Pressure in the Emergency Department.

    Science.gov (United States)

    Miller, Joseph B; Arter, Andrew; Wilson, Suprat S; Janke, Alexander T; Brody, Aaron; Reed, Brian P; Levy, Phillip D

    2017-08-01

    While moderate to severely elevated blood pressure (BP) is present in nearly half of all emergency department (ED) patients, the incidence of true hypertensive emergencies in ED patients is low. Administration of bolus intravenous (IV) antihypertensive treatment to lower BP in patients without a true hypertensive emergency is a wasteful practice that is discouraged by hypertension experts; however, anecdotal evidence suggests this occurs with relatively high frequency. Accordingly, we sought to assess the frequency of inappropriate IV antihypertensive treatment in ED patients with elevated BP absent a hypertensive emergency. We performed a retrospective cohort study from a single, urban, teaching hospital. Using pharmacy records, we identified patients age 18-89 who received IV antihypertensive treatment in the ED. We defined treatment as inappropriate if documented suspicion for an indicated cardiovascular condition or acute end-organ injury was lacking. Data abstraction included adverse events and 30-day readmission rates, and analysis was primarily descriptive. We included a total of 357 patients over an 18-month period. The mean age was 55; 51% were male and 93% black, and 127 (36.4%) were considered inappropriately treated. Overall, labetalol (61%) was the most commonly used medication, followed by enalaprilat (18%), hydralazine (18%), and metoprolol (3%). There were no significant differences between appropriate and inappropriate BP treatment groups in terms of clinical characteristics or adverse events. Hypotension or bradycardia occurred in three (2%) patients in the inappropriate treatment cohort and in two (1%) patients in the appropriately treated cohort. Survival to discharge and 30-day ED revisit rates were equivalent. More than one in three patients who were given IV bolus antihypertensive treatment in the ED received such therapy inappropriately by our definition, suggesting that significant resources could perhaps be saved through education of

  20. Appropriateness of Bolus Antihypertensive Therapy for Elevated Blood Pressure in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Joseph B. Miller

    2017-07-01

    Full Text Available Introduction: While moderate to severely elevated blood pressure (BP is present in nearly half of all emergency department (ED patients, the incidence of true hypertensive emergencies in ED patients is low. Administration of bolus intravenous (IV antihypertensive treatment to lower BP in patients without a true hypertensive emergency is a wasteful practice that is discouraged by hypertension experts; however, anecdotal evidence suggests this occurs with relatively high frequency. Accordingly, we sought to assess the frequency of inappropriate IV antihypertensive treatment in ED patients with elevated BP absent a hypertensive emergency. Methods: We performed a retrospective cohort study from a single, urban, teaching hospital. Using pharmacy records, we identified patients age 18–89 who received IV antihypertensive treatment in the ED. We defined treatment as inappropriate if documented suspicion for an indicated cardiovascular condition or acute end-organ injury was lacking. Data abstraction included adverse events and 30-day readmission rates, and analysis was primarily descriptive. Results: We included a total of 357 patients over an 18-month period. The mean age was 55; 51% were male and 93% black, and 127 (36.4% were considered inappropriately treated. Overall, labetalol (61% was the most commonly used medication, followed by enalaprilat (18%, hydralazine (18%, and metoprolol (3%. There were no significant differences between appropriate and inappropriate BP treatment groups in terms of clinical characteristics or adverse events. Hypotension or bradycardia occurred in three (2% patients in the inappropriate treatment cohort and in two (1% patients in the appropriately treated cohort. Survival to discharge and 30-day ED revisit rates were equivalent. Conclusion: More than one in three patients who were given IV bolus antihypertensive treatment in the ED received such therapy inappropriately by our definition, suggesting that significant

  1. Factors Influencing ACT After Intravenous Bolus Administration of 100 IU/kg of Unfractionated Heparin During Cardiac Catheterization in Children.

    Science.gov (United States)

    Muster, Ileana; Haas, Thorsten; Quandt, Daniel; Kretschmar, Oliver; Knirsch, Walter

    2017-10-01

    Anticoagulation using intravenous bolus administration of unfractionated heparin (UFH) aims to prevent thromboembolic complications in children undergoing cardiac catheterization (CC). Optimal UFH dosage is needed to reduce bleeding complications. We analyzed the effect of bolus UFH on activated clotting time (ACT) in children undergoing CC focusing on age-dependent, anesthesia-related, or disease-related influencing factors. This retrospective single-center study of 183 pediatric patients receiving UFH during CC analyzed ACT measured at the end of CC. After bolus administration of 100 IU UFH/kg body weight, ACT values between 105 and 488 seconds were reached. Seventy-two percent were within target level of 160 to 240 seconds. Age-dependent differences were not obtained ( P = .407). The ACT values were lower due to hemodilution (total fluid and crystalloid administration during CC, both P ACT values but occurred more frequently in children between 1 month and 1 year of age (91%). In conclusion, with a bolus of 100 IU UFH/kg, an ACT target level of 160 to 240 seconds can be achieved during CC in children in 72%, which is influenced by hemodilution and anticoagulant and antiplatelet premedication but not by age.

  2. Changes in basal rates and bolus calculator settings in insulin pumps during pregnancy in women with type 1 diabetes

    DEFF Research Database (Denmark)

    Mathiesen, Jonathan M; Secher, Anna L; Ringholm, Lene

    2014-01-01

    OBJECTIVE: To explore insulin pump settings in a cohort of pregnant women with type 1 diabetes on insulin pump therapy with a bolus calculator. METHODS: Twenty-seven women with type 1 diabetes on insulin pump therapy were included in this study. At 8, 12, 21, 27 and 33 weeks, insulin pump setting...

  3. Taste enhancement in food gels: Effect of fracture properties on oral breakdown, bolus formation and sweetness intensity

    NARCIS (Netherlands)

    Mosca, A.C.; Velde, van de F.; Bult, J.H.F.; Boekel, van M.A.J.S.; Stieger, M.A.

    2015-01-01

    This study investigates the effects of fracture strain and fracture stress on oral breakdown, bolus formation and sweetness intensity of semi-solid food gels containing sucrose heterogeneously distributed in layers. The sweetness intensity of gels was mainly affected by the total surface area of gel

  4. Relationship between esophageal contraction patterns and clearance of swallowed liquid and solid boluses in healthy controls and patients with dysphagia

    NARCIS (Netherlands)

    Bogte, A.; Bredenoord, A. J.; Oors, J.; Siersema, P. D.; Smout, A. J. P. M.

    2012-01-01

    Background Non-obstructive dysphagia patients prove to be a difficult category for clinical management. Esophageal high-resolution manometry (HRM) is a novel method, used to analyze dysphagia. However, it is not yet clear how findings on HRM relate to bolus transport through the esophagus. Methods

  5. The Impact of Injector-Based Contrast Agent Administration on Bolus Shape and Magnetic Resonance Angiography Image Quality

    Directory of Open Access Journals (Sweden)

    Gregor Jost

    2017-04-01

    Full Text Available Objective: To compare injector-based contrast agent (CA administration with hand injection in magnetic resonance angiography (MRA. Methods: Gadobutrol was administered in 6 minipigs with 3 protocols: (a hand injection (one senior technician, (b hand injection (6 less-experienced technicians, and (c power injector administration. The arterial bolus shape was quantified by test bolus measurements. A head and neck MRA was performed for quantitative and qualitative comparison of signal enhancement. Results: A significantly shorter time to peak was observed for protocol C, whereas no significant differences between protocols were found for peak height and bolus width. However, for protocol C, these parameters showed a much lower variation. The MRA revealed a significantly higher signal-to-noise ratio for injector-based administration. A superimposed strong contrast of the jugular vein was found in 50% of the hand injections. Conclusions: Injector-based CA administration results in a more standardized bolus shape, a higher vascular contrast, and a more robust visualization of target vessels.

  6. The measurement of fringing fields in a radio-frequency hyperthermia array with emphasis on bolus size

    NARCIS (Netherlands)

    Wiersma, J.; van Dijk, J. D.; Sijbrands, J.; Schneider, C. J.

    1998-01-01

    The limited aperture size through which the em-field of the applicator is emanated and the constraining of this em-field near the bolus' edge is related to the appearance of superficial 'hot spot' phenomena in radiative hyperthermia. Regarding systems based on the concept of the annular phased array

  7. Use of 3D printers to create a patient‐specific 3D bolus for external beam therapy

    Science.gov (United States)

    Baker, Jamie; Hsia, An Ting; Xu, Zhigang

    2015-01-01

    The purpose of this paper is to demonstrate that an inexpensive 3D printer can be used to manufacture patient‐specific bolus for external beam therapy, and to show we can accurately model this printed bolus in our treatment planning system for accurate treatment delivery. Percent depth‐dose measurements and tissue maximum ratios were used to determine the characteristics of the printing materials, acrylonitrile butadiene styrene and polylactic acid, as bolus material with physical density of 1.04 and 1.2 g/cm3, and electron density of 3.38×1023electrons/cm3 and 3.80×1023 electrons/cm3, respectively. Dose plane comparisons using Gafchromic EBT2 film and the RANDO phantom were used to verify accurate treatment planning. We accurately modeled a printing material in Eclipse treatment planning system, assigning it a Hounsfield unit of 260. We were also able to verify accurate treatment planning using gamma analysis for dose plane comparisons. With gamma criteria of 5% dose difference and 2 mm DTA, we were able to have 86.5% points passing, and with gamma criteria of 5% dose difference and 3 mm DTA, we were able to have 95% points passing. We were able to create a patient‐specific bolus using an inexpensive 3D printer and model it in our treatment planning system for accurate treatment delivery. PACS numbers: 87.53.Jw, 87.53.Kn, 87.56.ng PMID:26103485

  8. Myocardial oxygen extraction fraction measured using bolus inhalation of 15O-oxygen gas and dynamic PET

    NARCIS (Netherlands)

    Lubberink, Mark; Wong, YY; Raijmakers, P. G.; Huisman, Marc C.; Schuit, Robert C.; Luurtsema, Geert; Boellaard, Ronald; Knaapen, P; Vonk-Noordegraaf, Anton; Lammertsma, Adriaan A.

    Abstract The aim of this study was to determine the accuracy of oxygen extraction fraction (OEF) measurements using a dynamic scan protocol after bolus inhalation of 15O2. The method of analysis was optimized by investigating potential reuse of myocardial blood flow (MBF), perfusable tissue

  9. Europa como cultura

    Directory of Open Access Journals (Sweden)

    Javier San Martín

    2012-02-01

    Full Text Available El presente texto tiene un origen muy concreto. El día 15 de marzo de 2002, con motivo de la Cumbre Europea de Barcelona, Jorge Semprún reflexionaba, en las páginas de un conocido diario madrileño, sobre el significado que para él tenía ser europeo. Para ello emprendía tres "viajes intelectuales" a Viena, Praga y Buchenwald, los tres de gran significado histórico y cultural. Dado el interés del texto y del momento, me pareció entonces oportuno glosar algunos aspectos de aquel artículo, primero, para subrayar el valor de la aportación de Semprún, luego para corregir alguna inexactitud de carácter biográfico, debida posiblemente a la rapidez de la traducción, y, tercero, para ampliar con algún comentario la valiosa contribución de Sempnín, sobre todo en lo que concierne al sentido de Europa. En este texto se toma aquel comentario como punto de partida.The origins of this text are very specific. On 15 March 2002, on the occasion of the European Summit in Barcelona, and on the pages of a well-known Madrid newspaper, Jorge Semprún reflected on the meaning that being European had for him. To do this, he embarked on three "intellectual journeys" to Vienna, Prague and Buchenwald, all three of great historical and cultural significance. Given the interest of the text and of the moment, I considered it appropriate to comment on aspects of the article -firstly, to underline the value of Semprún's contribution; secondly, to correct certain biographical inaccuracies, possibly due to a hasty translation; and thirdly, to complement Semprún's valuable contribution, essentially concerning the meaning of Europe. This text takes that comment as its starting point.

  10. Implementation of a split-bolus single-pass CT protocol at a UK major trauma centre to reduce excess radiation dose in trauma pan-CT

    International Nuclear Information System (INIS)

    Leung, V.; Sastry, A.; Woo, T.D.; Jones, H.R.

    2015-01-01

    Aim: To quantify the dose reduction and ensure that the use of a split-bolus protocol provided sufficient vascular enhancement. Materials and methods: Between 1 January 2014 and 31 May 2014, both split bolus and traditional two-phase scans were performed on a single CT scanner (SOMATOM Definition AS+, Siemens Healthcare) using a two-pump injector (Medrad Stellant). Both protocols used Siemens' proprietary tube current and tube voltage modulation techniques (CARE dose and CARE kV). The protocols were compared retrospectively to assess the dose–length product (DLP), aortic radiodensity at the level of the coeliac axis and radiodensity of the portal vein. Results: There were 151 trauma CT examinations during this period. Seventy-eight used the split-bolus protocol. Seventy-one had traditional two-phase imaging. One patient was excluded as they were under the age of 18 years. The radiodensity measurements for the portal vein were significantly higher (p<0.001) in the split-bolus protocol. The mean aortic enhancement in both protocols exceeded 250 HU, although the traditional two-phase protocol gave greater arterial enhancement (p<0.001) than the split-bolus protocol. The split-bolus protocol had a significantly lower (p<0.001) DLP with 43.5% reduction in the mean DLP compared to the traditional protocol. Conclusion: Split-bolus CT imaging offers significant dose reduction for this relatively young population while retaining both arterial and venous enhancement. -- Highlights: •We implemented a split bolus pan-CT protocol for trauma CT. •We compared the radiation dose and vascular enhancement of the split bolus protocol to a traditional two phase protocol. •The split bolus protocol had a 43.5% reduction in mean DLP

  11. Care-bolus tracking systems in multislice-helical computed tomography - a new method in the screening of cardiovascular failure?

    International Nuclear Information System (INIS)

    Stueckle, C.A.; Kickuth, R.; Kirchner, E.M.; Liermann, D.; Kirchner, J.

    2002-01-01

    Purpose. Recently bolus tracking systems were developed to improve the timing of intravenous contrast media application in helical computed tomography. We investigated the benefit of this new method as a parameter of the cardiac function.Material and methods. Retrospective analysis of 64 patients which incidentally underwent bolus triggered contrast enhanced helical CT and invasive investigation of the heart within one week. All examinations were performed on the CT scanner Somatom Plus 4 Volume Zoom (Siemens Corp., Forchheim, Germany) using the C.A.R.E. trademark Bolus software. This performs repetitive low- dose test scans (e.g. for the abdomen: 140 kV, 20 mA, TI 0,5 s) and measures the Hounsfield attenuation (increase over the baseline) in a preselected region of interest. The displayed increase of vascular density over the time after peripheral contrast media injection (75 ml Iopromid (300 mg/ml), 2 ml/s) was categorised to three types: (a) rapid increase, (b) deceleration before a 100 HE threshold was reached and (c) one or more peaks. The findings of the invasive investigation of the heart were correlated to the findings of the bolus-tracking measurements.Results. The examinations were categorized as follows: 19 type A, 34 type B, 11 type C. We found a high significant correlation between the type of the Hounsfield attenuation and systolic pressure in the left ventricle. There was no correlation between the type of the Hounsfield attenuation and the diastolic pressure in the left ventricle, the pressures related to the right ventricle or the ejection fraction. The bolus- tacking system showed a sensitivity of 53, a specificity of 82, an accuracy of 70%, a positive predictive value of 70% and a negative predictive value of 70% in detection of left heart failure.Conclusion. The bolus tracking system C.A.R.E.-bolus copyright often shows atypical Hounsfield attenuation in cases of cardiac failure but is not suitable as a screening method of the cardiopulmonary

  12. Poster - 38: On the physical and dosimetric properties of 3D printed electron bolus fabricated using polylactic acid

    Energy Technology Data Exchange (ETDEWEB)

    Sasaki, David; Jensen, Martin; Rickey, Daniel W; Dubey, Arbind; Harris, Chad; McCurdy, Boyd [CancerCare Manitoba, CancerCare Manitoba, CancerCare Manitoba, CancerCare Manitoba, CancerCare Manitoba, CancerCare Manitoba (Canada)

    2016-08-15

    Purpose: 3D printing technology could simplify and improve electron bolus fabrication. The purpose of this study was to characterize the density, dimensional accuracy, uniformity, and attenuation of PLA boluses fabricated with a low-cost 3D printer. Methods: Several solid square slabs were printed with specific requested dimensions and 100% infill using different fill patterns. These pieces were imaged using an x-ray flat panel imager in order to check for uniformity of the prints. Percentage depth doses (PDDs) were measured downstream of the slabs in solid water using a parallel plate chamber and compared to measurements in water in order to characterize attenuation. The dimensions of the PLA slabs were measured using digital calipers. The slabs were also weighed to find their density. Results: The fill pattern used to create boluses can affect the attenuation of the bolus. Fill patterns should be chosen carefully and quality assurance should be done for each printed piece. PLA causes the electron PDD to shift towards shallower depths, compared to water, by 1.7 mm for each centimeter of PLA. Agreement with design dimensions was within 1 mm in the plane of the printer bed, and within 1/3 of a millimeter (roughly the thickness of a single layer), perpendicular to the printer bed. Average density was in the range 1.20 – 1.22. Conclusions: 3D printing shows great promise for use in fabricating electron bolus. This work indicates that printed PLA can be a suitable material provided the increased attenuation is properly accounted for.

  13. SU-F-T-86: Electron Dosimetric Effects of Bolus and Lens Shielding in Treating Superficial Eye Lesions

    Energy Technology Data Exchange (ETDEWEB)

    Young, L [University of Washington Medical Center, Seattle, WA (United States); Wootton, L [University of Washington School of Medicine, Seattle, WA (United States); Gopan, O; Liao, J [University of Washington, Seattle, WA (United States)

    2016-06-15

    Purpose: Electron therapy for the treatment of ocular lymphomas requires the lens to be shielded to prevent secondary cataracts. This work evaluates the dosimetry under a suspended eyeshield with and without bolus for low energy electron fields. Methods: Film (GafChromic EBT3) dosimetry and relative output factors were measured for 6, 8, and 10 MeV electron energies. A customized 5 cm diameter circle electron orbital cutout was constructed for a 6×6 cm applicator with a lens shield, 1 cm diameter Cerrobend cylinder with 2.2 cm length, suspended from an XV film covering the open field. Relative output factors were measured using a Scanditronix electron diode in a solid water phantom. Depth dose profiles were collected for bolus thicknesses of 0, 3, and 5 mm in solid water at a source to surface distance (SSD) of 100 cm. These measurements were repeated in a Rando phantom. Results: At 5 mm, the approximate distance of the lens from the surface of the cornea, the estimated dose in solid water under the suspended lens shield was reduced to 16%, 14%, and 13% of the unblocked dose at the same depth, for electron energies of 6, 8, and 10 MeV, respectively. Applying bolus increased estimated doses under the block to 22% for 3-mm and 32% for 5-mm thicknesses for a 6 MeV incident electron beam. This effect is reduced for higher energies where the corresponding values were 15.5% and 18% for 3-mm and 5-mm for an 8 MeV electron beam. Conclusion: The application of bolus to treat superficial eye lesions of the conjunctiva increases lens dose at a depth of 5-mm under the shielding block with decreasing electron energy. Careful selection of electron energy is needed to account for electron scatter under the lens shield with the application of bolus in order to prevent cataracts.

  14. Poster - 38: On the physical and dosimetric properties of 3D printed electron bolus fabricated using polylactic acid

    International Nuclear Information System (INIS)

    Sasaki, David; Jensen, Martin; Rickey, Daniel W; Dubey, Arbind; Harris, Chad; McCurdy, Boyd

    2016-01-01

    Purpose: 3D printing technology could simplify and improve electron bolus fabrication. The purpose of this study was to characterize the density, dimensional accuracy, uniformity, and attenuation of PLA boluses fabricated with a low-cost 3D printer. Methods: Several solid square slabs were printed with specific requested dimensions and 100% infill using different fill patterns. These pieces were imaged using an x-ray flat panel imager in order to check for uniformity of the prints. Percentage depth doses (PDDs) were measured downstream of the slabs in solid water using a parallel plate chamber and compared to measurements in water in order to characterize attenuation. The dimensions of the PLA slabs were measured using digital calipers. The slabs were also weighed to find their density. Results: The fill pattern used to create boluses can affect the attenuation of the bolus. Fill patterns should be chosen carefully and quality assurance should be done for each printed piece. PLA causes the electron PDD to shift towards shallower depths, compared to water, by 1.7 mm for each centimeter of PLA. Agreement with design dimensions was within 1 mm in the plane of the printer bed, and within 1/3 of a millimeter (roughly the thickness of a single layer), perpendicular to the printer bed. Average density was in the range 1.20 – 1.22. Conclusions: 3D printing shows great promise for use in fabricating electron bolus. This work indicates that printed PLA can be a suitable material provided the increased attenuation is properly accounted for.

  15. TU-H-CAMPUS-TeP1-05: Fast Processed 3D Printing-Aided Urethane Resin (PUR) Bolus in Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, B; Chiu, T; Gu, X; Lee, H; Nedzi, L; Jiang, S [UT Southwestern Medical Center, Dallas, TX (United States)

    2016-06-15

    Purpose: 3D printed custom bolus is regularly used in radiation therapy clinic as a compensator. However, usual method of bolus printing with 100% filling is very time-consuming. The purpose of this study is to evaluate the feasibility and benefit of 3D printed bolus filled with UR. Methods: Two boluses were designed on nose (9e electrons) and ear (6× photons) for a head phantom in treatment planning system (TPS) to achieve dose coverage to the skin. The bolus structures (56–167cc) were converted to STereoLithographic (STL) model using an in-house developed algorithm and sent to a commercial fused deposition modeling (FDM) printer. Only shells were printed with polylactic acid (PLA) material. Liquid UR was then placed in a vacuum pump and slowly poured into the hollow bolus from its top opening. Liquid UR hardened in around half an hour. The phantom was rescanned with custom boluses attached and the dosimetry was compared with original design in TPS. Basic CT and dose properties were investigated. GaF films were irradiated to measure dose profile and output of several open photon and electron beams under solid water and UR slabs of same thicknesses. Results: CT number was 11.2±7.3 and 65.4±7.8, respectively for solid water(∼1.04g/cc) and UR(∼1.08g/cc). The output measurement at dmax for 6× was within 2% for the two materials. The relative dose profiles of the two materials above dmax show 94–99% Gamma analysis passing rates for both photons and electrons. Dose distributions with 3D PUR boluses maintained great coverage on the intended skin regions and resembled that with computer generated boluses. Manufacturing 3D PUR boluses was 3–4 times faster than 100% printed boluses. The efficiency significantly improves for larger boluses. Conclusion: The study suggests UR has similar dose responses as solid water. Making custom bolus with UR greatly increases clinical workflow efficiency.

  16. TU-H-CAMPUS-TeP1-05: Fast Processed 3D Printing-Aided Urethane Resin (PUR) Bolus in Radiation Therapy

    International Nuclear Information System (INIS)

    Zhao, B; Chiu, T; Gu, X; Lee, H; Nedzi, L; Jiang, S

    2016-01-01

    Purpose: 3D printed custom bolus is regularly used in radiation therapy clinic as a compensator. However, usual method of bolus printing with 100% filling is very time-consuming. The purpose of this study is to evaluate the feasibility and benefit of 3D printed bolus filled with UR. Methods: Two boluses were designed on nose (9e electrons) and ear (6× photons) for a head phantom in treatment planning system (TPS) to achieve dose coverage to the skin. The bolus structures (56–167cc) were converted to STereoLithographic (STL) model using an in-house developed algorithm and sent to a commercial fused deposition modeling (FDM) printer. Only shells were printed with polylactic acid (PLA) material. Liquid UR was then placed in a vacuum pump and slowly poured into the hollow bolus from its top opening. Liquid UR hardened in around half an hour. The phantom was rescanned with custom boluses attached and the dosimetry was compared with original design in TPS. Basic CT and dose properties were investigated. GaF films were irradiated to measure dose profile and output of several open photon and electron beams under solid water and UR slabs of same thicknesses. Results: CT number was 11.2±7.3 and 65.4±7.8, respectively for solid water(∼1.04g/cc) and UR(∼1.08g/cc). The output measurement at dmax for 6× was within 2% for the two materials. The relative dose profiles of the two materials above dmax show 94–99% Gamma analysis passing rates for both photons and electrons. Dose distributions with 3D PUR boluses maintained great coverage on the intended skin regions and resembled that with computer generated boluses. Manufacturing 3D PUR boluses was 3–4 times faster than 100% printed boluses. The efficiency significantly improves for larger boluses. Conclusion: The study suggests UR has similar dose responses as solid water. Making custom bolus with UR greatly increases clinical workflow efficiency.

  17. El CO2 como disolvente y como reactivo

    OpenAIRE

    La Franca Pitarresi, Vincenzo Rosario

    2016-01-01

    Existen numerosas ventajas asociada con el uso de CO2 , tanto como disolvente que como reactivo, y todas se pueden resumir en cuatro categorías generales: beneficios ambiental, beneficios de salud y seguridad, beneficios en el procedimiento y beneficios químicos. Los procesos que implican el CO2 como disolvente no aumentaría las emisiones de CO2, más bien proporcionaría una oportunidad para el reciclaje de CO2 residual. Además, los esfuerzos para secuestrar el CO2 producido de los gases de co...

  18. Utilization of hair and nails as bio-indicators of contamination by heavy and toxic metals in industrial workers; Utilizacao de cabelos e unhas como bioindicadores de contaminacao por metais pesados e toxicos em trabalhadores de industrias

    Energy Technology Data Exchange (ETDEWEB)

    Vilhena Schayer Sabino, Claudia de; Silva, Ascanio Barros F.E.; Fernandes, Marcio Prado; Amaral, Angela Maria; Franco, Milton Batista; Guedes, Joao Bosco; Francisco, Dovenir; Castro de Assis, Adilson de

    1996-03-01

    Instrumental neutron activation analysis and atomic absorption spectrometry were performed on scalp hair and fingernail samples collected from a group of heavily exposed healthy mail industrial workers. The concentration of trace elements (As, Cd, Cr, Hg, Ni, Pb and Sb) were evaluated and compared for scalp and fingernails. Comparative studies demonstrated that concentration of certain elements were greater than those corresponding to non-exposed workers. (author). 4 refs., 6 tabs.

  19. The use of gamma radiation aiming to post harvest conservation of Cantaloupe melon (Cucumis melo L. var. Cantaloupensis);Utilizacao de radiacao gama em meloes cantaloupe (Cucumis melo L. var. Cantaloupensis) como tecnica de conservacao pos-colheita

    Energy Technology Data Exchange (ETDEWEB)

    Siqueira, Alessandra Aparecida Zilio Cozzo de

    2007-07-01

    Although Brazilian fruit culture has been growing in the international market, the fruit quality and the post harvest technology have not been improved properly. In Brazil, fruit nutritional factors are very important because of their potential to provide suitable nutrients for a significant part of the Country population. Some post harvest technologies, such as ionizing radiation, can keep the physical, chemical, nutritional and sensorial characteristics of the natural fruit, improving the quality of the fruits in the market. This work evaluated the effects of Cobalt 60 irradiation in Cantaloupe melon, aiming the post harvest conservation during 7 days of storage, at a temperature ranging from 20 to 22 deg C. The doses of irradiation were set to 0, 150, 300, 450, 600, 750 and 900 Gy, based on the multiple of 150 Gy quarantine dose, aiming to establish the lowest, the highest and the ideal doses. Afterwards, physical, chemical and nutritional characteristics of irradiated fruit were checked and, finally, the sensorial characteristics through acceptability test. Results indicated that the doses higher than 450 Gy affected firmness, pulp yield and color (L and a{sup *}) parameters. Nevertheless, analyzing physical, chemical and nutritional parameters, doses of 450 and 900 Gy kept pH, tetrable acidity, soluble solids, color (a{sup *} and b{sup *}), chlorophyll and carotenoids, phenolic compounds, respiratory rate and ethylene level. The storage period was the most important factor that affected the quality of the fruit, despite of the radiation doses. Based on the acceptability test, the best evaluated fruits were from the treatments of 450 and 900 Gy. This work allowed to conclude that fruit radiation is an appropriate technology for Cantaloupe melon post harvest conservation, but it is necessary to be used in combination with other technologies, especially to fungi control. (author)

  20. Study of Cesium and Strontium sorption in Brazilian clays for their use as a barrier in repositories of radioactive wastes; Estudo de sorcao de cesio e estroncio em argilas nacionais para sua utilizacao como barreira em repositorios de rejeitos radioativos

    Energy Technology Data Exchange (ETDEWEB)

    Freire, Carolina Braccini

    2007-07-01

    Wastes in general should be properly treated and stored. Then the radioactive wastes also require suitable and safe management beginning in their generation until the storage in repository. The main purpose of the radioactive waste management is to preserve the human beings and the environment. The objective of this research was to characterize some Brazilian clays in order to evaluate the viability of their use in the backfill layer, one of the radioactive waste repository barriers. The main function of this barrier is to contribute in the delay of the radionuclides movement, and to prevent their release into the environment. Four clays provided by national suppliers were selected for the research: Ca-Montmorillonite (Dol 01), Na-Montmorillonite (Dol 02), Kaolinite (Ind 01) and Vermiculite (Ubm 04). Their physical, chemical and mineralogical characteristics were determined, and also their sorption potential of Cesium and Strontium cations. It was confirmed through these results a direct relationship among their specific surface (SS), the capacity of cationic exchange (CCE) and pH. The CCE results followed this increasing order: Ind 01, Dol 01, and Dol 02. In accordance with the models of Freundlich (KJ) and Langmuir (M), the clays Dol 01 and Dol 02 were the best sorbers of Sr{sup 2+}. The Ind 01 and Ubm 04 were the best ones in the case of Cs{sup +}. The Gibbs free energy change ({delta}G deg) was calculated for the sorption reactions between the clays and the cations, and it was negative for all clays, confirming the sorption reaction spontaneity. (author)

  1. Conversion of cycle Diesel engines to Otto aiming the methane utilization as alternative fuel; Conversao de motores do ciclo diesel para Otto visando a utilizacao do metano como combustivel alternativo

    Energy Technology Data Exchange (ETDEWEB)

    Torres, J F; Venanzi, D [Sao Paulo Univ., Sao Carlos, SP (Brazil). Escola de Engenharia

    1988-12-31

    A diesel engine was converted in Otto engine for use methane as fuel, by modifications on compression ratio and on the induction system, and inclusion of a spark ignition system. The performance of dynamometer essays results in both cycles are compared and presented in overlapped curves. (author). 5 refs., 2 figs., 2 tabs

  2. Use of wasted foundry sand (WFS) as a partial substitute for silica in a soda lime glass; Utilizacao de areia descartada de fundicao (ADF) como substituinte parcial da silica em um vidro soda-cal

    Energy Technology Data Exchange (ETDEWEB)

    Martin, A.C.; Ueno, O.K.; Folgueras, M.V., E-mail: amandacarolinemartin@gmail.com [Universidade do Estado de Santa Catarina (CCT/UDESC), Joinville, SC (Brazil). Centro de Ciencias Tecnologicas

    2016-07-01

    The waste foundry sand (WFS) is the main waste generates in foundry industries. Studies in the literature suggest the use of WFS in different materials, such as concrete, brick or asphalt. This work aims to partially replace the silica of a soda-lime glass by the WFS. The waste foundry sand has in its composition elements such as iron and aluminum that can affect the glass quality, which justifies the residue processing to reduce the impurity content. The treatments, that included mechanical agitation and thermal treatment, resulted in a slight decrease in the percent of iron with consequent increase of the silica content. After treatment, some sands were incorporated into the glass, that showed green color but with lower absorption intensity for the sand with less iron content. It was observed that it's possible to obtain glasses using WFS, however, there is difficulty in color controlling. (author.

  3. Evaluation of the potentiality of the use of high-carbon microsilica as a pozzolanic material; Avaliacao da potencialidade da utilizacao de microssilica de alto teor de carbono como material pozolanico

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, R.L.S.; Pederneiras, C.M.; Costa, T.C.S.; Silva, C.H.R.B., E-mail: ruan_landolfo@hotmail.com [Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN (Brazil); Anjos, M.A.S. [Instituto Federal da Paraiba (IFPB), PB (Brazil); Nobrega, A.K. [Universidade Federal Rural do Semi-Arido (UFERSA), Mossoro, RN (Brazil)

    2016-07-01

    Supplementary Cementitious Materials reduce the production of clinker, which minimizes the environmental impact of cement production and the generation of industrial waste, also improve mechanical behavior and durability. Thus, this article aims to evaluate the potential use of microsilica with high content of carbon as pozzolanic material, based on the requirements of ISO 12653 (ABNT, 2015). The techniques of X-ray fluorescence (XRF), X-ray diffraction (XRD) and compressive strength of mortar of lime and cement (at 7 and 28 days, respectively) were used to evaluate the pozzolanic of the microsilica as a mineral addition. The results indicated that the microsilica has a high amorphous silicon dioxide percentage structure. In the DRX could be possible to analyze the formation of CSH, justifying the good results of mechanical strength, especially with cement. Thus, the mineral admixture used in this research can be considered as a pozzolanic material. (author)

  4. Implementation and testing of the use of vegetable oils as fuel diesel generators in the Amazon isolated communities; Implantacao e testes de utilizacao de oleo vegetal como combustivel para diesel geradores em comunidades isoladas da Amazonia

    Energy Technology Data Exchange (ETDEWEB)

    Coelho, Suani Teixeira; Silva, Orlando Cristiano da; Gonzalez Velaquez, Silvia Maria Stortini; Monteiro, Maria Beatriz C.A.; Silotto, Carlos Eduardo Grassi [Centro Nacional de Referencia em Biomassa (CENBIO), Sao Paulo, SP (Brazil)

    2004-07-01

    The project PROVEGAM 'Implantation and test of a unit demonstration of energetic utilization of vegetable oil', tested in operational conditions of field, the functioning of a conventional diesel engine, adapted to operate with palm oil 'in natura' in the community of Vila Soledade, city of Moju, Para State. The Vila Soledade is an isolated community that has, approximately, 700 inhabitants and it's located at one hundred kilometers from the city hall by car and more 30 minutes by boat. The electric energy of this community was previously generated, by a conventional diesel engine, obsolete and very expensive to the community, because the fuel price and the transport of the diesel oil from the city to the community. The PROVEGAM project, installed an electric generation group, MWM TD229, manufactured in Brazil, adapted with a conversion kit to operate with 'in natura' palm oil, working 6 hours per day. Because of the viscosity of the palm oil and its combustion point, it was necessary to heat the vegetable oil before its injection into the engine. The operation begins and finishes with diesel oil, in order to heat the palm oil and to clean possible residues deposited in the interior of the engine. The use of the palm oil justifies itself for being produced in the region, which means that it doesn't have to be imported. Currently, the generating group is working in the community during 5 hours per day with palm oil, and 1 hour per day with diesel oil and it already has more than 1600 hours of testing. The results of this project, so far, have confirmed the conceived premises, and this electric model of generating energy is already recommended to be implemented in other communities in the Amazon region. (author)

  5. Feasibility analysis of the use of sugar cane bagasse ash as mineral addition to cementitious mortars; Analise da viabilidade de utilizacao da cinza do bagaco de cana-de-acucar como adicao mineral em argamassas cimenticias

    Energy Technology Data Exchange (ETDEWEB)

    Fazzan, J.V.; Pereira, A.M.; Moraes, M.J.B. de; Akasaki, J.L.; Sanches, A.O.; Malmonge, J. A., E-mail: jvfazzan@hotmail.com [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Ilha Solteira, SP (Brazil). Faculdade de Engenharia. Departamento de Fisica e Quimica

    2014-07-01

    Currently, Brazil is experiencing an expansion of sugarcane plantations, which makes the country the world's largest producer of sugarcane. With the bagasse generated during the process, is generated the bagasse ash cane sugar (CBC) which consists mainly of silicon dioxide (SiO{sub 2}) and presents as potential alternative raw material for the production of cement composites. In this context, the objective of this study is to evaluate the reactivity of the CBC through physical and chemical analysis, for the production of mortars. The study of the CBC was performed by means of XRF testing, XRD, SEM and ADL. Mortar specimens with different percentages of CBC in partial replacement of Portland cement, for analysis of compressive strength were also produced. Despite the mixtures with additions have lower resistance to conventional mortars, the results showed the potential of the CBC as reactive mineral addition. (author)

  6. Implementation and testing of the use of vegetable oils as fuel diesel generators in the Amazon isolated communities; Implantacao e testes de utilizacao de oleo vegetal como combustivel para diesel geradores em comunidades isoladas da Amazonia

    Energy Technology Data Exchange (ETDEWEB)

    Coelho, Suani Teixeira; Silva, Orlando Cristiano da; Gonzalez Velaquez, Silvia Maria Stortini; Monteiro, Maria Beatriz C.A.; Silotto, Carlos Eduardo Grassi [Centro Nacional de Referencia em Biomassa (CENBIO), Sao Paulo, SP (Brazil)

    2004-07-01

    The project PROVEGAM 'Implantation and test of a unit demonstration of energetic utilization of vegetable oil', tested in operational conditions of field, the functioning of a conventional diesel engine, adapted to operate with palm oil 'in natura' in the community of Vila Soledade, city of Moju, Para State. The Vila Soledade is an isolated community that has, approximately, 700 inhabitants and it's located at one hundred kilometers from the city hall by car and more 30 minutes by boat. The electric energy of this community was previously generated, by a conventional diesel engine, obsolete and very expensive to the community, because the fuel price and the transport of the diesel oil from the city to the community. The PROVEGAM project, installed an electric generation group, MWM TD229, manufactured in Brazil, adapted with a conversion kit to operate with 'in natura' palm oil, working 6 hours per day. Because of the viscosity of the palm oil and its combustion point, it was necessary to heat the vegetable oil before its injection into the engine. The operation begins and finishes with diesel oil, in order to heat the palm oil and to clean possible residues deposited in the interior of the engine. The use of the palm oil justifies itself for being produced in the region, which means that it doesn't have to be imported. Currently, the generating group is working in the community during 5 hours per day with palm oil, and 1 hour per day with diesel oil and it already has more than 1600 hours of testing. The results of this project, so far, have confirmed the conceived premises, and this electric model of generating energy is already recommended to be implemented in other communities in the Amazon region. (author)

  7. Use of the CoFe{sub 2}O{sub 4} ferrospinel as catalyst in the WGSR process; Utilizacao do ferroespinelio CoFe{sub 2}O{sub 4} como catalisador no processo de WGSR

    Energy Technology Data Exchange (ETDEWEB)

    Lima, M.S.; Dantas, J.; Costa, A.C.F.M., E-mail: joeldadantas@yahoo.com.br [Universidade Federal de Campina Grande (LabSMaC/UFCG), PB (Brazil). Departamento de Engenharia de Materiais. Laboratorio de Sintese de Materiais Ceramicos; Sazaki, J.M. [Universidade Federal do Ceara (UFC), Fortaleza, CE (Brazil). Departamento de Fisica; Andrade, H.M.C. [Universidade Federal da Bahia (UFBA), Salvador, BA (Brazil). Departamento de Quimica Geral e Inorganica. Lab. de Catalise e Materiais

    2014-07-01

    This work investigates the use of ferrospinel CoFe{sub 2}O{sub 4} as a catalyst in water gas shift reactions (WGSR). The ferrospinel was synthesized by combustion reaction using the following heating conditions: ceramic base, resistive muffle oven, and microwave oven. The samples were characterized by XRD, FTIR, textural analysis and SEM. The catalytic tests were carried out on a bench scale using mixed CO/N{sub 2} (5% CO mol.mol) to the reaction flow 30mL.min{sup -1}, molar ratio H{sub 2}O/CO of 0.3. The results showed that for all heating conditions there was the monophasic formation of CoFe{sub 2}O{sub 4}, with crystallite size ranging from 38 to 40 nm. Samples showed mesoporous characteristics with type II isotherm and hysteresis loop H3. The sample synthesized in the muffle furnace showed the highest conversion rate of 56.0% and the sample synthesized in the ceramic base showed higher selectivity with 90.19% for the WGRS process. (author)

  8. Use of the 3DVH Software as a complementary method of IMRT pretreatment evaluation; Utilizacao do Software 3DVH como metodo complementar de avaliacao de pre-tratamento de IMRT

    Energy Technology Data Exchange (ETDEWEB)

    Lyra, Jesse G.P.; Bruning, Fabio F.; Funchal, Melissa; Toledo, Hugo V.; Bornatto, Pricila; Fernandes, Tatiane C.O., E-mail: jesse_lyra@hotmail.com [Hospital Erasto Gaertner / Liga Paranaense de Combate ao Cancer (LPCC), Departamento de Radioterapia, Curitiba, PR (Brazil)

    2013-04-15

    The aim of this study is to compare the method of treatment planning evaluation for IMRT using the gamma index to the method of the 3DVH Software. The 3DVH Software was used with the MapCheck2 detector 2D array under a 6MV x-ray beam of linear accelerator equipped with 120 leafs MLC. Nine treatment plans of prostate patients chose randomly and fully anonimatize were performed in the Eclipse planning system, using the AAA calculation algorithm in IMRT sliding window technique. These plans were approved and treated according to the gamma analysis criteria of the institution. The comparisons were made in absolute dose and normalized at maximum dose for each field and then with the 3DVH Software the Dmax, Dmean, D15%, D25%, D35% and D50% parameters for the bladder and rectum, Dmean for the bulb, Dmax for the femur and D95% for the PTV were evaluated. In the planar analysis by field, the plans studied had a minimum of 97.5% approval. The PTV-related differences have relative variation from 1.3 to 2.2%, that is, greater coverage than expected for this structure. For the organs at risk, the relative differences observed were between -5.3 to 25.8%, which could result in a non-approved plan if these variations are close to the clinical tolerances of the OAR. The results show that even a plan compatible with greater than or equal to 95% of the points, the gamma analysis does not give enough information if this plan can or cannot be approved for treatment and that there is a need for more detailed verification of the plan which considers not only the planar evaluation, but also the evaluation of the DVH measured, and the 3DVH Software proved be adequate for this analysis. (author)

  9. Thermal activation and characterization of clay aiming their use as sorbent in fixed bed columns to remove cadmium; Ativacao termica e caracterizacao da argila visando sua utilizacao como adsorvente em colunas de leito fixo para a remocao de cadmio

    Energy Technology Data Exchange (ETDEWEB)

    Silva, M.M. da; Rodrigues, M.G.F. [Universidade Federal de Campina Grande (UFCG), PB (Brazil); Silva, M.L.P. [Universidade Federal Rural do Semi-Arido (UFERSA), RN (Brazil); Kleinübing, S.J.; Silva, M.G.C., E-mail: marciliomaximo@yahoo.com.br [Universidade Estadual de Campinas (UNICAMP), SP (Brazil)

    2011-07-01

    In this work we studied the removal of cadmium in a synthetic wastewater using clay of Pernambuco - Brazil, in systems of fixed bed column. Clay was thermally activated at 500 °C. The materials were characterized using X-ray Fluorescence (XRF), X-ray Diffraction (XRD) and nitrogen adsorption (BET method). For tests in fixed bed column, we applied a factorial design 2{sup 2} and found that increasing the flow adversely affects the process of removing cadmium concentration while acting positively. The studies showed these materials as promising for the removal of Cd{sup 2+} ions in synthetic wastewater containing low levels of this metal. (author)

  10. Effect of synthesis method on the preparation of lanthanum chromite for using as ceramic pigment; Influencia do metodo de sintese na preparacao de cromita de lantanio para utilizacao como pigmento ceramico

    Energy Technology Data Exchange (ETDEWEB)

    Dantas, G.C.B.; Ferreira, K.M.B.; Pimentel, P.M., E-mail: gerbeson_dantas@hotmail.com [Universidade Federal Rural do Semi-Arido (UFERSA), Mossoro, RN (Brazil); Melo, D.M.A.; Gomes, D.K.S.; Costa, A.F. [Universidade Federal do Rio Grande do Norte (UFRN), RN (Brazil)

    2016-07-01

    In this paper, LaCrO3 perovskites were synthesized by two synthesis methods, in order to compare these methods in function of microstructure and optical properties. The synthesis routes employed were a method that use gelatin as organic precursor and microwave assisted auto-combustion. The resulting powders were calcined at 800 ° C and 1000 ° C for obtaining the perovskite phase. Then, they were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM); UV-Visible spectroscopy and colorimetric analysis for color identification. No significant changes were observed in the powders synthesized by two routes. The oxides presented orthorhombic perovskite structure. The powders synthesized by the gelatin method were single phase. Chromite lanthanide presented grayish hue being darker in perovskites calcined at higher temperatures. (author)

  11. The utilization of induction generators working with PATs (pumps working as turbines) in electric energy generation; A utilizacao de geradores de inducao acionados por BFTs (bombas funcionando como turbinas) na geracao de energia eletrica

    Energy Technology Data Exchange (ETDEWEB)

    Viana, Augusto Nelson Carvalho; Rezek, Angelo Jose Junqueira; Medeiros, Daniel de Macedo [Universidade Federal de Itajuba (UNIFEI), MG (Brazil). Programa de Pos-graduacao em Engenharia da Energia], e-mail: augusto@unifei.edu.br, e-mail: rezek@iee.efei.br, e-mail: macedo@unifei.edu.br

    2004-07-01

    The utilization of the Pumps working as Turbines (PATs) in micro hydro-energy resources to replace the conventional turbines as Pelton, Francis and Propeller have been used in countries as USA, Germany and France. In the mean time, in Brazil this practice and the utilization of induction generators working with PATs is still in the scope of the laboratory experiments. This work, based on experimental results carried on in Laboratory of Hydromechanics for Small Hydro Power Plants (Laboratorio Hidromecanico para Pequenas Centrais Hidroeletricas - LHPCH - UNIFEI), (VIANA, 1987), (VIANA e NOGUEIRA, 1990), propose the utilization of asynchronous generator groups operating with PATs. To show the investment cost decrease in micro hydro power plants (MHPs), is showed the Boa Esperanca MPH example, in which is presented a comparison between the synchronous generator group cost working with a Michell-Banki turbine and a asynchronous generator group operating with a PAT. (author)

  12. Use of residues proceeding from marbles and granites finishing and manufacturing processes as raw material for structural ceramic; Utilizacao do residuo proveniente do acabamento e manufatura de marmores e granitos como materia-prima em ceramica vermelha

    Energy Technology Data Exchange (ETDEWEB)

    Mello, Roberta Monteiro de

    2006-07-01

    In order to decrease environmental impact, caused by mud discarding and clay extraction in the ceramic industry, it was used residual mud from marble and granite companies for structural ceramic. Samples were collected in twelve different marble companies located at the metropolitan region of Sao Paulo. However, only four samples were selected, based on its different characteristics. Clay stone was the raw material chosen to prepare the structural ceramic, considering its high use in this segment. Samples and clay stone were both analysed by the following procedures: granulometric analysis, x-rays fluorescent chemical analysis and x-rays diffraction mineralogical analysis, besides, tests in the samples were conducted following NBR 10004 standards. Once raw materials were characterized, the plasticity test was conducted. Test specimen were molded with different levels of mud, then burned and submitted to technological tests, such as: mechanical resistance, water absorption, porosity, specific gravity and retraction, material dilation before burning process and scanning electron microscopy. The final results have shown the viability of using this kind of mud, and pointed some advantages on its usage, but taking in consideration some previous conditions to be adopted. (author)

  13. The use of lichens as bioindicators of atmospheric contamination by natural radionuclides and metals in a region impacted by TENORM; Utilizacao de liquens como bioindicadores de contaminacao atmosferica por radionuclideos naturais e metais em regiao impactada por TENORM

    Energy Technology Data Exchange (ETDEWEB)

    Leonardo, Lucio

    2010-07-01

    The main aim of this thesis is to study the possibility of using lichen as bioindicator of atmospheric pollution in regions contaminated by radionuclides, metals and rare earth elements. Two regions were chosen, one in Pirapora do Bom Jesus, where a tin and lead industry is located, and a second one in Cubatao, where a phosphate fertilizer industrial complex is located. The two industries chosen are considered as TENORM - Technologically Enhanced Naturally Occurring Radioactive Material, since they can cause a significant increase in the natural radionuclides concentration in the industrial process, and consequently a potential increase in the radiation exposure in products, byproducts and residue. To achieve this aim, the radionuclides {sup 238}U, {sup 226}Ra, {sup 210}Pb, {sup 2'}3{sup 2}Th and {sup 228}Ra, rare earth elements and metals were analyzed in samples of raw material and residues from the installations, lichens and soils. Lichens and soil samples were analyzed by instrumental neutron activation analysis for the determination of uranium, thorium, rare earth elements and metals. The radionuclides {sup 226}Ra, {sup 228}Ra and {sup 2}'1{sup 0}Pb in soil samples were determined by gamma spectrometry and in lichen sample by radiochemical separation and gross alpha and beta counting on a gas flow proportional counter. The concentrations of {sup 238}U (from 19 to 473 Bq kg{sup -1}), {sup 226}Ra (from 21 to 265 Bq kg{sup -1}), {sup 210}Pb (from 401 to 1461 Bq kg{sup -1}), {sup 232}Th (from 15 to 574 Bq kg{sup -1}), {sup 228}Ra (from 176 to 535 Bq kg'-{sup 1}), rare earth elements, Hf and Ta determined in lichen samples around the tin and lead industry show an enrichment in these elements. Therefore, the lichens can be used as a fingerprint of the atmospheric contamination. The results obtained for the lichen samples, in the Cubatao region, present a fingerprint mainly of {sup 210}Pb, from industries of the region. The results obtained in this study showed that the lichens can be used as bioindicators of atmospheric pollution by radionuclides and trace elements. (author)

  14. Evaluation of Cortaderia selloana (Capim-dos-pampas) blankets as sorbent materials for oil spills in simulated hydro equipment; Estudo do desempenho de tecidos e mantas para utilizacao como sorventes para petroleo

    Energy Technology Data Exchange (ETDEWEB)

    Bonetti, T.F.; Sydenstricker, T.H.D. [Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil)], e-mail: thais@demec.ufpr.br; Amico, S.C. [Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS (Brazil)

    2006-07-01

    Oil spills in aquatic environments may cause serious economy losses and severe environmental impact which both drive the development of commercial systems (e.g. sorbents) to control these accidents. One way of using sorbents is to encapsulate them with an involucre or cover, i.e. producing blankets. The focus of this research is to evaluate the key characteristics of interest (aerial density, water and oil sorption, mechanical strength and cost) of different materials to use as covers for blankets and to prepare blankets and compare their performance when made with various core materials, such as Cortaderia selloana fibers and different commercial sorbents. A simulated aqueous body with stream was used for the sorption experiments, where the oil and water phases were circulated and forced to pass under the blankets. On the sorption tests, the fibers of Cortaderia selloana reached a performance lower to that of commercial sorbents, mainly due to their low density and high volume (difficult packing), nevertheless a clear trend was noted, heavier blankets with higher sorption periods lead to higher sorption. (author)

  15. Bee waxes: a model of characterization for using as base simulator tissue in teletherapy with photons; Ceras de abelha: um modelo de caracterizacao para sua utilizacao como tecido simulador base em teleterapia com fotons

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Rogerio Matias Vidal da; Souza, Divanizia do Nascimento

    2011-10-26

    This paper presents a model of characterization and selection of bee waxes which makes possible to certify the usage viability of that base simulator tissue in the manufacture of appropriated objects for external radiotherapy with mega volt photon beams. The work was divide into three stages, where was evaluated physical and chemical properties besides the aspects related to the capacity of beam attenuation. All the process was carefully accompanied related to the wax origin such as the bee specimen and the flora surrounding the beehives. The chemical composition of the waxes is similar to others simulators usually used in radiotherapy. The behavior of mass attenuation coefficient in the radiotherapeutic energy range is comparable to other simulators, and consequently to the soft tissue. The proposed model is efficient and allows the affirmative that the usage of determined bee wax as base simulator tissue is convenient

  16. The use of compressed natural gas as a strategy of development of natural gas industry; Utilizacao do GNC (Gas Natural Comprimido) como estrategia de desenvolvimento da industria do gas natural

    Energy Technology Data Exchange (ETDEWEB)

    Bock, Jucemara [Companhia de Gas do Estado do Rio Grande do Sul (Sulgas), Porto Alegre, RS (Brazil). Coordenacao de Segmento Veicular; Rickmann, Cristiano [Companhia de Gas do Estado do Rio Grande do Sul (Sulgas), Porto Alegre, RS (Brazil). Gerencia de Novos Negocios; Maestri, Juares [Companhia de Gas do Estado do Rio Grande do Sul (Sulgas), Porto Alegre, RS (Brazil). Gerencia de Mercado de Grandes Consumidores

    2008-07-01

    This work emphasizes the Compressed Natural Gas (CNG) as modal of transport, used by the Company of Gas of the State of Rio Grande do Sul - Sulgas, through experience in pioneering project in Brazil: the introduction of the technology of Compressed Natural Gas (CNG) to assist areas where there is not the infrastructure of pipeline for the transport. The article offers a display of the project of expansion of the Natural gas in Rio Grande do Sul, through the supply of CNG to the company Tramontina in Carlos Barbosa's city in the year of 2002. The last aspect focused by this article demonstrates as the use of this transport technology impelled the development of the transport market in the State and it has been used as an important strategy for the development of the market of Natural Gas Vehicle (NGV) in the state. (author)

  17. Polymer matrices obtained by ionizing radiation for using in controlled drug delivery systems; Matrizes polimericas obtidas mediante radiacao ionizante para sua utilizacao como sistemas de liberacao controlada de farmacos

    Energy Technology Data Exchange (ETDEWEB)

    Martellini, Flavia

    1998-07-01

    Two kinds of controlled drug delivery system were obtained by gamma radiation induced polymerization. One of the system was obtained from an acrylic derivative of acetaminophen (40-hydroxyacetanilide), by copolymerization of 4-(acryloyloxy) acetanilide and N,N-dimethylacrylamide (DMAA) in dimethylformamide solution with 0,16 kGy/h dose rate and 54 Gy dose. The values of reactivity rate, r-D{sub MAA} = 0,31 {+-} 0,02 e r{sub AOA} -0,07 {+-} 0,12, were determined by Fineman-Ross method. The acetaminophen hydrolysis was carried out in alkaline and enzymatic (trypsin) media. Another kind of drug delivery system studied was solvent controlled type, being the drug immobilized in the hydrogel,. The hydrogels prepared by radiation polymerization of acryloyl-L-propine methylester (A-Pro-OMe) with 10 Gy dose, showed thermosensible property, swelling or shrinking in water with decreased or increased temperatures. The hydrogels were obtained with different crosslink density, trimethylolpropane trimethacrylate, and the monomers N, N-dimethyl acrylamide (DMAA) and 2-cyanoethyl acrylate to study the influence of the composition in the drug delivery rate. It was verified that the porous size besides being a characteristic of the matrix composition, it was also temperature dependent (thermosensible). The analgesic drug acetaminophen was immobilized by entrapment and by physical adsorption into the hydrogels matrices for 'in vitro' study. The insulin was immobilized by adsorption for 'in vivo' study. (author)

  18. Use of biogas generated from swine manure as preliminary agent in the feasibility construction of natural gas networks; Utilizacao do biogas gerado a partir de dejetos suinos como agente preliminar na viabilizacao da construcao de redes de gas natural

    Energy Technology Data Exchange (ETDEWEB)

    Machado, Antonio Rogerio; Ferraz, Andre; Rocha, Ivan; Azevedo, Jorge; Oshiro, Hugo K.; Konishi, Ricardo; Piazza, Walter; Lehmkuhl, Willian [Companhia de Gas de Santa Catarina (SCGAS), Florianopolis, SC (Brazil)

    2011-12-21

    Santa Catarina state has over 800 km of natural gas distributed along the coast line, however, has an area of 95.700 km{sup 2}. Due to mountainous relief, constructing pipeline that will supply natural gas to remote areas will prove difficult. Supplying gas to remote areas through biogas from pig manure is a feasible alternative to building a gas pipeline to these regions. Using data from the IBGE and by aid of computer programs it was found that Santa Catarina has a potential to generate biogas from 900.000 m{sup 3}/day which are located predominantly in the western region of state. Thus, through the provision of biogas in this region a market that uses natural gas as an energy source can stimulate. As result the pay-back time and the feasibility risk of a network gas project can be reduced. It was found that only in the west there is an energy potential to be shifted to natural gas equivalent of 389.583 m{sup 3}/day and as expected output is estimated to reach 16.728 m{sup 3}/day. This helps anticipate the building of a natural gas network that links the coast with outskirts of the state, while the environmental impact of swine as methane emissions and waste are reduced. (author)

  19. Utilization of rice husk ash as filler for polyamide 6 and ionizing radiation effect studies on this composite;Utilizacao da cinza da casca de arroz como carga em matriz de poliamida 6 submetida a radiacao ionizante

    Energy Technology Data Exchange (ETDEWEB)

    Ferro, Waldir Pedro

    2009-07-01

    In order to improve the dimensional stability, as well as, electrical, mechanical and thermal properties of polymers, new filler to this purpose has been developed. The mos applied filler to propitiate the features previously mentioned are the glass and carbon fibers, the mineral filler as the calcium carbonate, the talc and the micro glass sphere. The main aim of this work was to study the rice husk ash as filler for polyamide 6 and ionizing radiation effect studies on this composite, irradiated by electron beam at different doses, since it is constituted of at least 90% of silicon dioxide, and compared with the talc which is the most applied mineral filler. This comparison was made from a compound made through the refined rice husk ash and the polyamide 6 (PA 6), which is one of the main engineering plastic with applications in several productive areas. The samples were injected and irradiated in a electron accelerator. Afterwards, their mechanical and thermal properties were measured. It was also inject automotive parts to verify the processing of the PA 6 with CCA. The results showed that the use of the rice husk ash as filler for polyamide 6 composite is technically and economically viable. The irradiation of the studied composite (PA 6 with 30% of rice husk ash) did not provide any improvement for the mechanical and thermal properties previously appraised. (author)

  20. Project, construction and characterization of ionization chambers for use as standard systems in X and gamma radiation beams; Projeto, construcao e caracterizacao de camaras de ionizacao para utilizacao como sistemas padroes em feixes de radiacao X e gama

    Energy Technology Data Exchange (ETDEWEB)

    Perini, Ana Paula

    2013-07-01

    Ionization chambers present some advantages in relation to other dosimeters: easiness of handling, low energy dependence and high precision. The advantages associated to ionization chambers and the large number of diagnostic radiology exams and therapeutic treatments motivated the development of this PhD program. In this project ionization chambers were developed and characterized to be applied in diagnostic radiology and therapy beam dosimetry, with high precision and performance, in compliance with international recommendations. They were assembled in a simple way, utilizing low-cost national materials, so they can be reproduced and applied at calibration laboratories. The project of these ionization chambers presents some differences in relation to commercial ionization chambers, as the materials utilized and geometrical arrangements. Besides the development of the ionization chambers to be utilized in standard X-ray beam dosimetry as work standard systems, two graphite parallel-plate ionization chambers were developed and characterized to be applied as reference standard systems for determining the air kerma rates of gamma radiation sources. Comparing the air kerma rates determined with the reference standard of the Calibration Laboratory of IPEN, a Farmer ionization chamber, with the values of the air kerma rates obtained with the graphite ionization chambers, the maximum differences obtained were only 1.7% and 1.2% for the G1 and G2 graphite ionization chambers, respectively. Moreover, these ionization chambers presented correction factors close to 1.000, which is ideal for an ionization chamber be characterized as a reference standard system. (author)

  1. Radiation dermatitis caused by a bolus effect from an abdominal compression device

    Energy Technology Data Exchange (ETDEWEB)

    Connor, Michael; Wei, Randy L.; Yu, Suhong; Sehgal, Varun [Department of Radiation Oncology, University of California, Irvine Medical Center, Orange, CA (United States); Klempner, Samuel J. [Department of Medicine, Division of Hematology/Oncology, University of California, Orange, CA (United States); Daroui, Parima, E-mail: pdaroui@uci.edu [Department of Radiation Oncology, University of California, Irvine Medical Center, Orange, CA (United States)

    2016-10-01

    American Association of Physicists in Medicine (AAPM) Task Group 176 evaluated the dosimetric effects caused by couch tops and immobilization devices. The report analyzed the extensive physics-based literature on couch tops, stereotactic body radiation therapy (SBRT) frames, and body immobilization bags, while noting the scarcity of clinical reports of skin toxicity because of external devices. Here, we present a clinical case report of grade 1 abdominal skin toxicity owing to an abdominal compression device. We discuss the dosimetric implications of the utilized treatment plan as well as post hoc alternative plans and quantify differences in attenuation and skin dose/build-up between the device, a lower-density alternative device, and an open field. The description of the case includes a 66-year-old male with HER2 amplified poorly differentiated distal esophageal adenocarcinoma treated with neoadjuvant chemo-radiation and the use of an abdominal compression device. Radiation was delivered using volumetric modulated arc therapy (VMAT) with 2 arcs using abdominal compression and image guidance. The total dose was 50.4 Gy delivered over 40 elapsed days. With 2 fractions remaining, the patient developed dermatitis in the area of the compression device. The original treatment plan did not include a contour of the device. Alternative post hoc treatment plans were generated, one to contour the device and a second with anterior avoidance. In conclusion, replanning with the device contoured revealed the bolus effect. The skin dose increased from 27 to 36 Gy. planned target volume (PTV) coverage at 45 Gy was reduced to 76.5% from 95.8%. The second VMAT treatment plan with an anterior avoidance sector and more oblique beam angles maintained PTV coverage and spared the anterior wall, however at the expense of substantially increased dose to lung. This case report provides an important reminder of the bolus effect from external devices such as abdominal compression. Special

  2. Radiation dermatitis caused by a bolus effect from an abdominal compression device

    International Nuclear Information System (INIS)

    Connor, Michael; Wei, Randy L.; Yu, Suhong; Sehgal, Varun; Klempner, Samuel J.; Daroui, Parima

    2016-01-01

    American Association of Physicists in Medicine (AAPM) Task Group 176 evaluated the dosimetric effects caused by couch tops and immobilization devices. The report analyzed the extensive physics-based literature on couch tops, stereotactic body radiation therapy (SBRT) frames, and body immobilization bags, while noting the scarcity of clinical reports of skin toxicity because of external devices. Here, we present a clinical case report of grade 1 abdominal skin toxicity owing to an abdominal compression device. We discuss the dosimetric implications of the utilized treatment plan as well as post hoc alternative plans and quantify differences in attenuation and skin dose/build-up between the device, a lower-density alternative device, and an open field. The description of the case includes a 66-year-old male with HER2 amplified poorly differentiated distal esophageal adenocarcinoma treated with neoadjuvant chemo-radiation and the use of an abdominal compression device. Radiation was delivered using volumetric modulated arc therapy (VMAT) with 2 arcs using abdominal compression and image guidance. The total dose was 50.4 Gy delivered over 40 elapsed days. With 2 fractions remaining, the patient developed dermatitis in the area of the compression device. The original treatment plan did not include a contour of the device. Alternative post hoc treatment plans were generated, one to contour the device and a second with anterior avoidance. In conclusion, replanning with the device contoured revealed the bolus effect. The skin dose increased from 27 to 36 Gy. planned target volume (PTV) coverage at 45 Gy was reduced to 76.5% from 95.8%. The second VMAT treatment plan with an anterior avoidance sector and more oblique beam angles maintained PTV coverage and spared the anterior wall, however at the expense of substantially increased dose to lung. This case report provides an important reminder of the bolus effect from external devices such as abdominal compression. Special

  3. WE-F-16A-05: Use of 3D-Printers to Create a Tissue Equivalent 3D-Bolus for External Beam Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Burleson, S; Baker, J; Hsia, A; Xu, Z [Stony Brook Medicine, Stony Brook, NY (United States)

    2014-06-15

    Purpose: The purpose of this project is to demonstrate that a non-expensive 3D-printer can be used to manufacture a 3D-bolus for external beam therapy. The printed bolus then can be modeled in our treatment planning system to ensure accurate dose delivery to the patient. Methods: We developed a simple method to manufacture a patient-specific custom 3Dbolus. The bolus is designed using Eclipse Treatment Planning System, contoured onto the patients CT images. The bolus file is exported from Eclipse to 3D-printer software, and then printed using a 3D printer. Various tests were completed to determine the properties of the printing material. Percent depth dose curves in this material were measured with electron and photon beams for comparison to other materials. In order to test the validity of the 3D printed bolus for treatment planning, a custom bolus was printed and tested on the Rando phantom using film for a dose plane comparison. We compared the dose plane measured on the film to the same dose plane exported from our treatment planning system using Film QA software. The gamma-dose distribution tool was used in our film analysis. Results: We compared point measurements throughout the dose plane and were able to achieve greater than 95% passing rate at 3% dose difference and 3 mm distance to agreement, which is our departments acceptable gamma pixel parameters. Conclusion: The printed 3D bolus has proven to be accurately modeled in our treatment planning system, it is more conformal to the patient surface and more durable than other bolus currently used (wax, superflab etc.). It is also more convenient and less costly than comparable bolus from milling machine companies.

  4. WE-F-16A-05: Use of 3D-Printers to Create a Tissue Equivalent 3D-Bolus for External Beam Therapy

    International Nuclear Information System (INIS)

    Burleson, S; Baker, J; Hsia, A; Xu, Z

    2014-01-01

    Purpose: The purpose of this project is to demonstrate that a non-expensive 3D-printer can be used to manufacture a 3D-bolus for external beam therapy. The printed bolus then can be modeled in our treatment planning system to ensure accurate dose delivery to the patient. Methods: We developed a simple method to manufacture a patient-specific custom 3Dbolus. The bolus is designed using Eclipse Treatment Planning System, contoured onto the patients CT images. The bolus file is exported from Eclipse to 3D-printer software, and then printed using a 3D printer. Various tests were completed to determine the properties of the printing material. Percent depth dose curves in this material were measured with electron and photon beams for comparison to other materials. In order to test the validity of the 3D printed bolus for treatment planning, a custom bolus was printed and tested on the Rando phantom using film for a dose plane comparison. We compared the dose plane measured on the film to the same dose plane exported from our treatment planning system using Film QA software. The gamma-dose distribution tool was used in our film analysis. Results: We compared point measurements throughout the dose plane and were able to achieve greater than 95% passing rate at 3% dose difference and 3 mm distance to agreement, which is our departments acceptable gamma pixel parameters. Conclusion: The printed 3D bolus has proven to be accurately modeled in our treatment planning system, it is more conformal to the patient surface and more durable than other bolus currently used (wax, superflab etc.). It is also more convenient and less costly than comparable bolus from milling machine companies

  5. The influence of carbon monoxide bolus on the measurement of total haemoglobin mass using the optimized CO-rebreathing method

    International Nuclear Information System (INIS)

    Turner, G; Richardson, A J; Maxwell, N S; Pringle, J S M; Ingham, S A; Fudge, B W

    2014-01-01

    The optimized carbon monoxide (CO) rebreathing method (oCOR-method) is routinely used to measure total haemoglobin mass (tHbmass). The tHbmass measure is subject to a test-retest typical error of ∼2%, mostly from the precision of carboxyhaemoglobin (HbCO) measurement. We hypothesized that tHbmass would be robust to differences in the bolus of CO administered during the oCOR-method. Twelve participants (ten males and two females; age 27 ± 6 yr, height 177 ± 11 cm and mass 73.9 ± 12.1 kg) completed the oCOR-method on four occasions. Different bolus of CO were administered (LOW: 0.6 ml kg −1 ; MED 1 : 1.0 ml kg −1  and HIGH: 1.4 ml kg −1 ); to determine the reliability of MED 1 , a second trial was conducted (MED 2 ). tHbmass was found to be significantly less from the HIGH CO bolus (776 ± 148 g) when compared to the LOW CO (791 ± 149 g) or MED 1  CO (788 ± 149 g) trials. MED 2  CO was 785 ± 150 g. The measurement of tHbmass is repeatable to within 0.8%, but a small and notable difference was seen when using a HIGH CO bolus (1.4 to 1.9% less), potentially due to differences in CO uptake kinetics. Previously, an improved precision of the oCOR-method was thought to require a higher bolus of CO (i.e. larger ▵%HbCO), as commercial hemoximeters only estimate %HbCO levels to a single decimal place (usually ± 0.1%). With the new hemoximeter used in this study, a bolus of 1.0 ml kg −1  allows adequate precision with acceptable safety. (note)

  6. Continuous versus bolus intragastric tube feeding for preterm and low birth weight infants with gastro-oesophageal reflux disease.

    Science.gov (United States)

    Richards, Robyn; Foster, Jann P; Psaila, Kim

    2014-07-17

    Gastro-oesophageal reflux disease is a particularly common condition in preterm and low birth weight infants. These infants are also more likely to have excessive regurgitation, as they do not have a fully developed antireflux mechanism. Preterm and low birth weight infants who are unable to suck oral feeds are required to be fed via an intragastric tube for varying lengths of time. Intragastric tube feeding can be delivered by the intermittent bolus or continuous feeding method. Use of continuous or intermittent bolus intragastric feeding may have a positive or negative effect on the incidence or severity of gastro-oesophageal reflux disease. To determine whether continuous or intermittent bolus intragastric tube feeding reduces the number of episodes and the duration of gastro-oesophageal reflux disease (GORD) in preterm and low birth weight infants.We intended to perform subgroup analyses for gestational age; birth weight; age in days from birth at full enteral feeding via intragastric tube (breast vs bottle); frequency of intermittent bolus feed; and type of medication for treatment of GORD (only if medication prescribed and given similarly to both intervention groups). We used the standard search strategy of the Cochrane Neonatal Group as described in The Cochrane Library (www.thecochranelibrary.com) to search for randomised controlled trials (RCTs) in the Cochrane Central Register of Controlled Trials (CENTRAL) (2013, Issue 9), MEDLINE (1966 to September 2013), EMBASE (1980 to September 2013) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to September 2013). We also searched previous reviews, including cross-references, abstracts and conference and symposia proceedings of the Perinatal Society of Australia and New Zealand and the Pediatric Academic Societies (American Pediatric Society/Society for Pediatric Research and European Society for Paediatric Research) from 1990 to 2012. Published and unpublished RCTs and quasi

  7. A condicionalidade como zona conceitual

    Directory of Open Access Journals (Sweden)

    Taísa Peres de OLIVEIRA

    Full Text Available RESUMO Neste trabalho avaliam-se diferentes padrões de construções condicionais no português a partir dos parâmetros de condicionalidade. O objetivo principal é mostrar como a categoria está internamente organizada não apenas em termos de um núcleo prototípico, mas mostrando como os exemplares mais periféricos se relacionam a ele. As bases teóricas deste trabalho assentam-se sobre concepções funcional-cognitivistas, nos termos de Bybee (2010 e Dancygier (1998, especialmente considerando a relativa instabilidade da gramática e a fluidez da categoria. As reflexões principais apontam a condicionalidade como uma categoria bastante complexa que serve de/como abrigo de múltiplas construções.

  8. Dosimetry characterization and clinical application of Exa skin: Bolus of high of high density for use with photons; Caracterizacion dosimetrica y aplicacion clinica de Exaskin: bolus de alta densidad para uso con fotones

    Energy Technology Data Exchange (ETDEWEB)

    Ortiz Seidel, M.; Velazquez Miranda, S.

    2013-07-01

    Bolus of high density eXaSkin of density 1.6 g/cm{sub 3} is calculated correctly in the planning systems, is easy to use and generates optimum coupling with the radiation area, at the same time which is easily reproducible in their placement, avoiding the use of electron beams. On the other hand its behavior varies very slightly with the presence of air gaps. (Author)

  9. The Effect of Rheological Properties of Foods on Bolus Characteristics After Mastication

    Science.gov (United States)

    Hwang, Junah; Bae, Jung Hyun; Kang, Si Hyun; Seo, Kyung Mook; Kim, Byong Ki; Lee, Sook Young

    2012-01-01

    Objective To evaluate the effects of physical properties of foods on the changes of viscosity and mass as well as the particle size distribution after mastication. Method Twenty subjects with no masticatory disorders were recruited. Six grams of four solid foods of different textures (banana, tofu, cooked-rice, cookie) were provided, and the viscosity and mass after 10, 20, and 30 cycles of mastication and just before swallowing were measured. The physical properties of foods, such as hardness, cohesiveness, and adhesiveness, were measured with a texture analyzer. Wet sieving and laser diffraction were used to determine the distribution of food particle size. Results When we measured the physical characteristics of foods, the cookie was the hardest food, and the banana exhibited marked adhesiveness. Tofu and cooked-rice exhibited a highly cohesive nature. As the number of mastication cycles increased, the masses of all foods were significantly increased (pmastication (pmastication process and food bolus formation were affected by the physical properties of the food. PMID:23342309

  10. MnDPDP enhancement in rabbit liver after intravenous bolus injection and slow infusion

    International Nuclear Information System (INIS)

    Thorstensen, Oe.; Isberg, B.; Jorulf, H.; Westman, L.; Svahn, U.; Venizelos, N.

    1997-01-01

    Purpose: To investigate the MR-enhancing effect of mangafodipir trisodium (MnDPDP, Teslascan) in the rabbit liver in relation to dose, mode of administration and imaging window. Material and Methods: MnDPDP was administered to 18 rabbits at a dose of 10 μmol/kg or 20 μmol/kg, as a bolus injection or infusion. MR imaging of the liver was performed at different time intervals. Results: Peak liver enhancement was typically observed 10-30 min after administration and the enhancement declined with a half-time of about 5 h. This pattern was observed in all sequences (SE 400/15, FLASH, and SE 132/10), with both doses and with both rates of administration. The peak enhancement was greater, though not significantly so after 20 μmol/kg than after 10 μmol/kg. A higher relative peak signal was observed with SE 132/10 than with FLASH or SE 400/15. (orig./AJ)

  11. Optimizing computed tomography pulmonary angiography using right atrium bolus monitoring combined with spontaneous respiration

    Energy Technology Data Exchange (ETDEWEB)

    Min, Wang; Jian, Li; Rui, Zhai [Jining No. 1 People' s Hospital, Department of Computed Tomography, Jining City, ShanDong Province (China); Wen, Li [Jining No. 1 People' s Hospital, Department of Gastroenterology, Jining, ShanDong (China); Dai, Lun-Hou [Shandong Chest Hospital, Department of Radiology, Jinan, ShanDong (China)

    2015-09-15

    CT pulmonary angiography (CTPA) aims to provide pulmonary arterial opacification in the absence of significant pulmonary venous filling. This requires accurate timing of the imaging acquisition to ensure synchronization with the peak pulmonary artery contrast concentration. This study was designed to test the utility of right atrium (RA) monitoring in ensuring optimal timing of CTPA acquisition. Sixty patients referred for CTPA were divided into two groups. Group A (n = 30): CTPA was performed using bolus triggering from the pulmonary trunk, suspended respiration and 70 ml of contrast agent (CA). Group B (n = 30): CTPA image acquisition was triggered using RA monitoring with spontaneous respiration and 40 ml of CA. Image quality was compared. Subjective image quality, average CT values of pulmonary arteries and density difference between artery and vein pairs were significantly higher whereas CT values of pulmonary veins were significantly lower in group B (all P < 0.05). There was no significant difference between the groups in the proportion of subjects where sixth grade pulmonary arteries were opacified (P > 0.05). RA monitoring combined with spontaneous respiration to trigger image acquisition in CTPA produces optimal contrast enhancement in pulmonary arterial structures with minimal venous filling even with reduced doses of CA. (orig.)

  12. Bolus versus continuous low dose of enalaprilat in congestive heart failure with acute refractory decompensation.

    Science.gov (United States)

    Podbregar, M; Voga, G; Horvat, M; Zuran, I; Krivec, B; Skale, R; Pareznik, R

    1999-01-01

    The first dose of angiotensin-converting enzyme (ACE) inhibitors may trigger a considerable fall of blood pressure in chronic heart failure. The response may be dose-related. To determine hemodynamic and systemic oxygenation effects of low-dose enalaprilat, we administered intravenous enalaprilat (0.004 mg/kg) as bolus (group B) or continuous 1-hour infusion (group C) in 20 patients with congestive heart failure due to ischemic heart disease with acute decompensation refractory to inotropic, vasodilator and diuretic therapy. Hemodynamic and systemic oxygenation variables were recorded at baseline (+0 min), +30, +60, +120, +180, and +360 min after the start of intervention. Mean arterial pressure (MAP) (p < 0. 001), mean pulmonary artery pressure (MPAP) (p < 0.001), pulmonary artery occlusion pressure (PAOP) (p < 0.001), oxygen extraction ratio (ER) (p < 0.026) decreased regardless of enalaprilat application. Compared to group B, there was in group C prolonged decrease of MAP, MPAP, PAOP, ER and increase of pulmonary artery oxyhemoglobin saturation in regard to baseline values. Cardiac index, heart rate, central venous pressure and oxygen consumption index did not change. A low dose of intravenous enalaprilat (0.004 mg/kg) can be used to safely improve hemodynamics and systemic oxygenation in congestive heart failure due to ischemic heart disease with acute refractory decompensation.

  13. Thoracic pathologies on scout views and bolus tracking slices for computed tomographic cerebral angiography

    Energy Technology Data Exchange (ETDEWEB)

    Groth, M.; Fiehler, J.; Buhk, J.H. [University Medical Center Hamburg-Eppendorf (Germany). Dept. of Diagnostic and Interventional Neuroradiology; Henes, F.O. [University Medical Center Hamburg-Eppendorf (Germany). Dept. of Diagnostic and Interventional Radiology

    2015-08-15

    To evaluate the incidence of additional thoracic pathologic findings (TPF) detected on scout views and corresponding bolus tracking slices (SVBT) for computed tomographic cerebral angiography (CTCA) and to test the reliability and accuracy of these findings. The study collective included 505 consecutive patients who underwent multidetector CTCA. Appendant SVBT of all patients were reviewed for any pathologic findings and patient medical reports were analyzed, if any medical treatment was initiated for the detected pathologic findings. In 18 patients thoracic CT scans were performed in the same session. These were additionally reviewed by two blinded observers to test for intra- and interobserver reliability as well as for accuracy of detecting thoracic pathologies on SVBT. TPF were detected in 165 (33 %) SVBT. The five most common pathologic findings were: pleural effusion, 12 %; pneumonia, 8 %; atelectasis/dystelecatsis, 6 %; pericardial effusion, 2 % and elevated diaphragm, 1 %. For 48 % of these findings medical treatment was initiated. SVBT showed a sensitivity of 53 %, a specificity of 99 %, a positive predictive value of 89 %, a negative predictive value of 94 % and accuracy of 94 % for the detection of TPF. The intraobserver reliability was very good and the interobserver reliability showed moderate agreement. SVBT for CTCA should be reviewed with care by radiologists, since additional TPF can affect patient management. Nevertheless, despite a high specificity of SVBT for detecting TPF, an only moderate sensitivity has to be taken into account.

  14. Effects of advanced carbohydrate counting guided by an automated bolus calculator in Type 1 diabetes mellitus (StenoABC)

    DEFF Research Database (Denmark)

    Hommel, E; Schmidt, S; Vistisen, D

    2017-01-01

    -centre, investigator-initiated clinical study. We enrolled advanced carbohydrate counting-naïve adults with Type 1 diabetes and HbA1c levels 64-100 mmol/mol (8.0-11.3%), who were receiving multiple daily insulin injection therapy. In a 1:1-ratio, participants were randomized to receive training in either advanced......AIMS: To test whether concomitant use of an automated bolus calculator for people with Type 1 diabetes carrying out advanced carbohydrate counting would induce further improvements in metabolic control. METHODS: We conducted a 12-month, randomized, parallel-group, open-label, single...... carbohydrate counting using mental calculations (MC group) or advanced carbohydrate counting using an automated bolus calculator (ABC group) during a 3.5-h group training course. For 12 months after training, participants attended a specialized diabetes centre quarterly. The primary outcome was change in HbA1c...

  15. Development of a bolus injection system for regional deposition studies of nanoparticles in the human respiratory system

    International Nuclear Information System (INIS)

    Koujalagi, V; Semple, S; Ayres, J G; Ramesh, S L; Gunarathne, G P P

    2009-01-01

    This study presents the work carried out in developing a precision bolus injection system in order to understand the regional deposition of nanoparticles (NP) in human lung. A real-time control system has been developed that is capable of storing graphite NP, assessing human breathing pattern and delivering a bolus of the stored NP at a pre-determined instance of the inhalation phase of breathing. This will form the basis for further development of a system to deliver radioactive nanoparticles to enable 3-dimensional lung imaging using techniques such as positron emission tomography (PET). The system may then be used to better understand the actual regional deposition in human lung, which could validate or challenge the current computational lung models such as that published by the International Commission for Radiation Protection (ICRP-1994). A dose related response to inhaled PM can possibly be shown, which can be used to review the current workplace exposure limits (WELs).

  16. Development of a bolus injection system for regional deposition studies of nanoparticles in the human respiratory system

    Science.gov (United States)

    Koujalagi, V.; Ramesh, S. L.; Gunarathne, G. P. P.; Semple, S.; Ayres, J. G.

    2009-02-01

    This study presents the work carried out in developing a precision bolus injection system in order to understand the regional deposition of nanoparticles (NP) in human lung. A real-time control system has been developed that is capable of storing graphite NP, assessing human breathing pattern and delivering a bolus of the stored NP at a pre-determined instance of the inhalation phase of breathing. This will form the basis for further development of a system to deliver radioactive nanoparticles to enable 3-dimensional lung imaging using techniques such as positron emission tomography (PET). The system may then be used to better understand the actual regional deposition in human lung, which could validate or challenge the current computational lung models such as that published by the International Commission for Radiation Protection (ICRP-1994). A dose related response to inhaled PM can possibly be shown, which can be used to review the current workplace exposure limits (WELs).

  17. Doxorubicin: Comparison between 3-h continuous and bolus intravenous administration paradigms on cardio-renal axis, mitochondrial sphingolipids and pathology

    International Nuclear Information System (INIS)

    Kamendi, Harriet; Zhou, Ying; Crosby, Meredith; Keirstead, Natalie; Snow, Debra; Bentley, Patricia; Patel, Nilaben; Barthlow, Herbert; Luo, Wenli; Dragan, Yvonne; Bialecki, Russell

    2015-01-01

    Doxorubicin (DOX) is a potent and effective broad-spectrum anthracycline antitumor agent, but its clinical usefulness is restricted by cardiotoxicity. This study compared pharmacokinetic, functional, structural and biochemical effects of single dose DOX bolus or 3-h continuous iv infusion (3-h iv) in the Han–Wistar rat to characterize possible treatment-related differences in drug safety over a 72 h observation period. Both DOX dosing paradigms significantly altered blood pressure, core body temperature and QA interval (indirect measure of cardiac contractility); however, there was no recovery observed in the bolus iv treatment group. Following the 3-h iv treatment, blood pressures and QA interval normalized by 36 h then rose above baseline levels over 72 h. Both treatments induced biphasic changes in heart rate with initial increases followed by sustained decreases. Cardiac injury biomarkers in plasma were elevated only in the bolus iv treatment group. Tissue cardiac injury biomarkers, cardiac mitochondrial complexes I, III and V and cardiac mitochondrial sphingolipids were decreased only in the bolus iv treatment group. Results indicate that each DOX dosing paradigm deregulates sinus rhythm. However, slowing the rate of infusion allows for functional compensation of blood pressure and may decrease the likelihood of cardiac myocyte necrosis via a mechanism associated with reduced mitochondrial damage. - Highlights: • Despite damaging cardiomyocytes, continuous iv doxorubicin improves cardiovascular outcomes. • This study supports administration of doxorubicin via slow continuous iv infusion limits acute cardio-toxicity. • This study supports use of metabolomic-derived lipid biomarkers for improved quantification of cardiovascular risk. • This study supports systems-based physiological approach to generate a data that can greatly inform risk assessments.

  18. Optimized enhancement in helical CT: Experiences with a real-time bolus tracking system in 628 patients

    International Nuclear Information System (INIS)

    Kirchner, J.; Kickuth, R.; Laufer, U.; Noack, M.; Liermann, D.

    2000-01-01

    AIMS: Ultrafast detector technology enables bolus-triggered application of contrast media. In a prospective study we investigated the benefit of this new method with the intention of optimizing enhancement during examination of the chest and abdomen. MATERIALS AND METHODS: In total, we examined 548 patients under standardized conditions. All examinations were performed on a Somatom Plus 4 Power CT system (Siemens Corp., Forchheim, Germany) using the CARE-Bolus software. This produces repetitive low-dose test images (e.g. for the lung: 140 kV, 43 mA, TI 0.5 s) and measures the Hounsfield attenuation in a pre-selected region of interest. After exceeding a defined threshold, a diagnostic spiral CT examination was begun automatically. The data obtained from 321 abdominal CT and 179 lung CT examinations were correlated with different parameters such as age, weight and height of the patients and parameters of vascular access. In a group of 80 patients, the injection of contrast medium was stopped after reaching a pre-defined threshold of an increase of 100 HU over the baseline. Then, we assessed the maximal enhancement of liver, pulmonal artery trunk and aortic arch. RESULTS: There was no correlation between bolus geometry and age, body surface or weight. In helical CT of the abdomen the threshold was reached after a mean trigger time of 27 s (range 13-67 s) and only 65 ml (range 41-105 ml) of contrast medium were administered. In helical CT of the lung the threshold was reached after 21 s (range 12-48 s) and the mean amount of administered contrast medium was 48 ml (range 38-71 ml). CONCLUSION: Bolus triggering allows optimized enhancement of the organs and reduces the dose of contrast material required compared with standard administration. Kirchner, J. (2000). Clinical Radiology 55, 368-373

  19. Optimized enhancement in helical CT: experiences with a real-time bolus tracking system in 628 patients.

    Science.gov (United States)

    Kirchner, J; Kickuth, R; Laufer, U; Noack, M; Liermann, D

    2000-05-01

    Ultrafast detector technology enables bolus-triggered application of contrast media. In a prospective study we investigated the benefit of this new method with the intention of optimizing enhancement during examination of the chest and abdomen. In total, we examined 548 patients under standardized conditions. All examinations were performed on a Somatom Plus 4 Power CT system (Siemens Corp., Forchheim, Germany) using the CARE-Bolus software. This produces repetitive low-dose test images (e.g. for the lung: 140 kV, 43 mA, TI 0.5 s) and measures the Hounsfield attenuation in a pre-selected region of interest. After exceeding a defined threshold, a diagnostic spiral CT examination was begun automatically. The data obtained from 321 abdominal CT and 179 lung CT examinations were correlated with different parameters such as age, weight and height of the patients and parameters of vascular access. In a group of 80 patients, the injection of contrast medium was stopped after reaching a pre-defined threshold of an increase of 100 HU over the baseline. Then, we assessed the maximal enhancement of liver, pulmonal artery trunk and aortic arch. There was no correlation between bolus geometry and age, body surface or weight. In helical CT of the abdomen the threshold was reached after a mean trigger time of 27 s (range 13-67 s) and only 65 ml (range 41-105 ml) of contrast medium were administered. In helical CT of the lung the threshold was reached after 21 s (range 12-48 s) and the mean amount of administered contrast medium was 48 ml (range 38-71 ml). Bolus triggering allows optimized enhancement of the organs and reduces the dose of contrast material required compared with standard administration. Copyright 2000 The Royal College of Radiologists.

  20. Feasibility of test-bolus DCE-MRI using CAIPIRINHA-VIBE for the evaluation of pancreatic malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Huh, Jimi; Seo, Nieun; Kim, Bohyun [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul (Korea, Republic of); Choi, Yoonseok; Woo, Dong-Cheol; Lee, Chang Kyung [Asan Medical Center, Bioimaging Center, Asan Institute for Life Sciences, Seoul (Korea, Republic of); Kim, In Seong [Siemens Healthcare, Seoul (Korea, Republic of); Nickel, Dominik [Siemens Healthcare, Erlangen (Germany); Kim, Kyung Won [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul (Korea, Republic of); Asan Medical Center, Bioimaging Center, Asan Institute for Life Sciences, Seoul (Korea, Republic of)

    2016-11-15

    To evaluate the feasibility of test-bolus dynamic contrast-enhanced (DCE) MRI with CAIPIRINHA-VIBE for pancreatic malignancies. Thirty-two patients underwent DCE-MRI with CAIPIRINHA-VIBE after injection of 2 mL gadolinium. From the resulting time-intensity curve (TIC), we estimated the arterial (AP) and portal venous phase (PVP) scan timing for subsequent multiphasic MRI. DCE-MRI perfusion maps were generated, and perfusion parameters were calculated. The image quality was rated on a 5-point scale (1: poor, 5: excellent). Goodness-of-fit of the TIC was evaluated by Pearson's χ{sup 2} test. Test-bolus DCE-MRIs with high temporal (3 s) and spatial resolution (1 x 1 x 4 mm{sup 3}) were acquired with good-quality perfusion maps of Ktrans and iAUC (mean score 4.313 ± 0.535 and 4.125 ± 0.554, respectively). The mean χ{sup 2} values for fitted TICs were 0.115 ± 0.082 for the pancreatic parenchyma and 0.784 ± 0.074 for pancreatic malignancies, indicating an acceptable goodness-of-fit. Test-bolus DCE-MRI was highly accurate in estimating the proper timing of AP (90.6 %) and PVP (100 %) of subsequent multiphasic MRI. Between pancreatic adenocarcinomas and neuroendocrine tumours, there were significant differences in the Ktrans (0.073 ± 0.058 vs. 0.308 ± 0.062, respectively; p = 0.007) and iAUC (1.501 ± 0.828 vs. 3.378 ± 0.378, respectively; p = 0.045). Test-bolus DCE-MRI using CAIPIRINHA-VIBE is feasible for incorporating perfusion analysis of pancreatic tumours into routine multiphasic MRI. (orig.)

  1. Three-dimensional printer-aided casting of soft, custom silicone boluses (SCSBs) for head and neck radiation therapy.

    Science.gov (United States)

    Chiu, Tsuicheng; Tan, Jun; Brenner, Mathew; Gu, Xuejun; Yang, Ming; Westover, Kenneth; Strom, Tobin; Sher, David; Jiang, Steve; Zhao, Bo

    Custom tissue compensators provide dosimetric advantages for treating superficial or complex anatomy, but currently available fabrication technology is expensive or impractical for most clinical operations and yields compensators that are difficult for patients to tolerate. We aimed to develop an inexpensive, clinically feasible workflow for generating patient-specific, soft, custom silicone boluses (SCSBs) for head-and-neck (HN) radiation therapy. We developed a method using 3-dimensional printed parts for generating SCSBs for the treatment of HN cancers. The clinical workflow for generation of SCSBs was characterized inclusive of patient simulation to treatment in terms of resource time and cost. Dosimetric properties such as percentage depth dose and dose profiles were measured for SCSBs using GaF films. Comprehensive measurements were also conducted on an HN phantom. SCSBs were generated and used for electron or photon based radiation treatments of 7 HN patients with lesions at nose, cheek, eye, or ears. In vivo dose measurements with optically simulated luminescence dosimeters were performed. Total design and fabrication time from patient simulation to radiation treatment start required approximately 1 week, with fabrication constituting 1 to 2 working days depending on bolus surface area, volume, and complexity. Computed tomography and dosimetric properties of the soft bolus were similar to water. In vivo dose measurements on 7 treated patients confirmed that the dose deposition conformed to planned doses. Material costs were lower than currently available hard plastic boluses generated with 3-dimensional printing technology. All treated patients tolerated SCSBs for the duration of therapy. Generation and use of SCSBs for clinical use is feasible and effective for the treatment of HN cancers. Copyright © 2017 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

  2. Doxorubicin: Comparison between 3-h continuous and bolus intravenous administration paradigms on cardio-renal axis, mitochondrial sphingolipids and pathology

    Energy Technology Data Exchange (ETDEWEB)

    Kamendi, Harriet, E-mail: harriet_kamendi@kandih.com [Drug Safety and Metabolism, AstraZeneca, Waltham, MA 02451 (United States); Zhou, Ying, E-mail: yingzhou526@gmail.com [Oncology Innovative Medicines and Early Development, AstraZeneca, Waltham, MA 02451 (United States); Crosby, Meredith, E-mail: Meredith.crosby@astrazeneca.com [Drug Safety and Metabolism, AstraZeneca, Waltham, MA 02451 (United States); Keirstead, Natalie, E-mail: Nkeirstead@alnylam.com [Drug Safety and Metabolism, AstraZeneca, Waltham, MA 02451 (United States); Snow, Debra, E-mail: Debra.snow@astrazeneca.com [Drug Safety and Metabolism, AstraZeneca, Waltham, MA 02451 (United States); Bentley, Patricia, E-mail: patricia.bentley@abbvie.com [Drug Safety and Metabolism, AstraZeneca, Waltham, MA 02451 (United States); Patel, Nilaben, E-mail: patelnilaben@yahoo.com [Drug Safety and Metabolism, AstraZeneca, Waltham, MA 02451 (United States); Barthlow, Herbert, E-mail: Herbert.barthlow@astrazeneca.com [Drug Safety and Metabolism, AstraZeneca, Waltham, MA 02451 (United States); Luo, Wenli, E-mail: Wenli.luo@astrazeneca.com [Discovery Sciences, Innovative Medicines, AstraZeneca, Waltham, MA 02451 (United States); Dragan, Yvonne, E-mail: Yvonne.P.Dragan@takeda.com [Drug Safety and Metabolism, AstraZeneca, Waltham, MA 02451 (United States); Bialecki, Russell, E-mail: russell.bialecki@astrazeneca.com [Drug Safety and Metabolism, AstraZeneca, Waltham, MA 02451 (United States)

    2015-12-15

    Doxorubicin (DOX) is a potent and effective broad-spectrum anthracycline antitumor agent, but its clinical usefulness is restricted by cardiotoxicity. This study compared pharmacokinetic, functional, structural and biochemical effects of single dose DOX bolus or 3-h continuous iv infusion (3-h iv) in the Han–Wistar rat to characterize possible treatment-related differences in drug safety over a 72 h observation period. Both DOX dosing paradigms significantly altered blood pressure, core body temperature and QA interval (indirect measure of cardiac contractility); however, there was no recovery observed in the bolus iv treatment group. Following the 3-h iv treatment, blood pressures and QA interval normalized by 36 h then rose above baseline levels over 72 h. Both treatments induced biphasic changes in heart rate with initial increases followed by sustained decreases. Cardiac injury biomarkers in plasma were elevated only in the bolus iv treatment group. Tissue cardiac injury biomarkers, cardiac mitochondrial complexes I, III and V and cardiac mitochondrial sphingolipids were decreased only in the bolus iv treatment group. Results indicate that each DOX dosing paradigm deregulates sinus rhythm. However, slowing the rate of infusion allows for functional compensation of blood pressure and may decrease the likelihood of cardiac myocyte necrosis via a mechanism associated with reduced mitochondrial damage. - Highlights: • Despite damaging cardiomyocytes, continuous iv doxorubicin improves cardiovascular outcomes. • This study supports administration of doxorubicin via slow continuous iv infusion limits acute cardio-toxicity. • This study supports use of metabolomic-derived lipid biomarkers for improved quantification of cardiovascular risk. • This study supports systems-based physiological approach to generate a data that can greatly inform risk assessments.

  3. Pathological bolus exposure may define gastro-esophageal reflux better than pathological acid exposure in patients with globus.

    Science.gov (United States)

    Sinn, Dong Hyun; Kim, Beom Jin; Son, Hee Jung; Kim, Jae J; Rhee, Jong Chul; Rhee, Poong-Lyul

    2012-01-01

    Conventionally, pathological acid exposure (PAE), defined by acid reflux only, is used to identify gastro-esophageal reflux disease (GERD). However, weak acid reflux or non-acid reflux also induces reflux symptoms. Defining abnormal reflux based on all reflux episodes may better identify GERD and would be more useful among patients with atypical GERD symptoms, such as globus. Impedance-pHmetry results of 31 globus patients, off acid suppressants, were analysed. A median of 24 episodes of reflux were observed. Of the reflux episodes, 54% were non-acid reflux and 50% reached the proximal extent. PAE was observed in 6 patients (19%). For 5 patients (16%) without PAE, there was evidence of increased bolus exposure compared to normal controls (an intraesophageal bolus exposure for more than 1.4% of the recording time, defined as pathological bolus exposure, PBE). When GERD was defined by PAE or esophagitis, the prevalence of GERD was 29%. When GERD was defined by PBE, PAE or esophagitis, the prevalence was 42%. PBE identified 13% of the patients who otherwise would have been missed. A significant proportion of patients without PAE had evidence of PBE. PBE may be a more useful definition for identifying patients with abnormal increase in reflux in patients with globus. Further studies are warranted.

  4. Comparison of Power Versus Manual Injection in Bolus Shape and Image Quality on Contrast-Enhanced Magnetic Resonance Angiography: An Experimental Study in a Swine Model.

    Science.gov (United States)

    Tsuboyama, Takahiro; Jost, Gregor; Pietsch, Hubertus; Tomiyama, Noriyuki

    2017-09-01

    The aim of this study was to compare power versus manual injection in bolus shape and image quality on contrast-enhanced magnetic resonance angiography (CE-MRA). Three types of CE-MRA (head-neck 3-dimensional [3D] MRA with a test-bolus technique, thoracic-abdominal 3D MRA with a bolus-tracking technique, and thoracic-abdominal time-resolved 4-dimensional [4D] MRA) were performed after power and manual injection of gadobutrol (0.1 mmol/kg) at 2 mL/s in 12 pigs (6 sets of power and manual injections for each type of CE-MRA). For the quantitative analysis, the signal-to-noise ratio was measured on ascending aorta, descending aorta, brachiocephalic trunk, common carotid artery, and external carotid artery on the 6 sets of head-neck 3D MRA, and on ascending aorta, descending aorta, brachiocephalic trunk, abdominal aorta, celiac trunk, and renal artery on the 6 sets of thoracic-abdominal 3D MRA. Bolus shapes were evaluated on the 6 sets each of test-bolus scans and 4D MRA. For the qualitative analysis, arterial enhancement, superimposition of nontargeted enhancement, and overall image quality were evaluated on 3D MRA. Visibility of bolus transition was assessed on 4D MRA. Intraindividual comparison between power and manual injection was made by paired t test, Wilcoxon rank sum test, and analysis of variance by ranks. Signal-to-noise ratio on 3D MRA was statistically higher with power injection than with manual injection (P < 0.001). Bolus shapes (test-bolus, 4D MRA) were represented by a characteristic standard bolus curve (sharp first-pass peak followed by a gentle recirculation peak) in all the 12 scans with power injection, but only in 1 of the 12 scans with manual injection. Standard deviations of time-to-peak enhancement were smaller in power injection than in manual injection. Qualitatively, although both injection methods achieved diagnostic quality on 3D MRA, power injection exhibited significantly higher image quality than manual injection (P = 0.001) due to

  5. TU-F-CAMPUS-I-01: Investigation of the Effective Dose From Bolus Tracking Acquisitions at Different Anatomical Locations in the Chest for CT

    Energy Technology Data Exchange (ETDEWEB)

    Nowik, P; Bujila, R; Merzan, D [Dept. of Medical Physics, Karolinska University Hospital, Stockholm (Sweden)

    2015-06-15

    Purpose: Stationary table acquisitions (Bolus tracking) in X-ray Computed Tomography (CT) can Result in dose length products (DLP) comparable to spiral scans. It is today unclear whether or not the effective dose (E) for Bolus Tracking can be approximated using target region specific conversion factors (E/DLP). The purpose of this study was to investigate how E depends on the anatomical location of the Bolus Tracking in relation to Chest CT scans with the same DLP. Methods: Effective doses were approximated for the ICRP 110 adult Reference Male (AM) and adult Reference Female (FM) computational voxel phantoms using software for CT dose approximations (pre-simulated MC data). The effective dose was first approximated for a Chest CT scan using spiral technique and a CTDIvol (32 cm) of 6 mGy. The effective dose from the spiral scan was then compared to E approximated for contiguous Bolus Tracking acquisitions (1 cm separation), with a total collimation of 1 cm, over different locations of the chest of the voxel phantoms. The number of rotations used for the Bolus Tracking acquisitions was adjusted to yield the same DLP (32 cm) as the spiral scan. Results: Depending on the anatomical location of the Bolus Tracking, E ranged by factors of 1.3 to 6.8 for the AM phantom and 1.4 to 3.3 for the AF phantom, compared to the effective dose of the spiral scans. The greatest E for the Bolus Tracking acquisitions was observed for anatomical locations coinciding with breast tissue. This can be expected as breast tissue has a high tissue weighting factor in the calculation of E. Conclusion: For Chest CT scans, the effective dose from Bolus Tracking is highly dependent on the anatomical location where the scan is administered and will not always accurately be represented using target region specific conversion factors.

  6. Intravenous Bolus versus Continuous Infusion of Famotidine or Ranitidine on 24 H Intragastric Acidity in Fasting Healthy Volunteers

    Directory of Open Access Journals (Sweden)

    ABR Thomson

    1995-01-01

    Full Text Available Infusions of H2-receptor antagonists may be clinically indicated to maintain intragastric pH above 4 to reduce acute gastric mucosal lesions or to treat patients with bleeding peptic ulcers. Eight fasting healthy volunteers were randomly assigned to receive ranitidine infusion alone (150 mg/day, ranitidine infusion plus 50 mg bolus injection of ranitidine (total of 200 mg/day, famotidine infusion alone (40 mg/day or famotidine infusion plus 40 mg bolus injection of famotidine (total of 80 mg/day. Gastric fluid contents were aspirated for 24 h and collected as half-hourly samples in which pH measurements were made. Measures analyzed were mean and median pH, percentage pH at or below 3, 4 or 5 for the 24 h period, daytime, evening and nighttime. The data for each of the variables were analyzed as a Latin square crossover design of variance therapy; base pH before treatment administration in each crossover phase was employed as the covariant. Significant differential treatment means were tested by Newman-Keul’s multiple range test at the 5% level of significance. The mean and median evening pH were higher after famotidine than after ranitidine infusion, but all other pH readings were similar when using these doses. The addition of an initial loading bolus of 50 mg ranitidine to the ranitidine infusion did not result in any added differences in pH, whereas the addition of an initial loading bolus of 40 mg famotidine to the famotidine infusion resulted in a higher 24 h median pH, as well as a lower percentage of pH values of 4 or below, 16.6% versus 28.5%, P<0.05. However, the loading doses of ranitidine and famotidine were not equivalent in potency, and studies are needed to compare the potency of equivalent doses of ranitidine and famotidine when given by bolus plus infusion. Also the clinical relevance of these findings needs to be explored further in the type of individuals potentially requiring intravenous H2-receptor antagonists.

  7. Open-loop glucose control: Automatic IOB-based super-bolus feature for commercial insulin pumps.

    Science.gov (United States)

    Rosales, Nicolás; De Battista, Hernán; Vehí, Josep; Garelli, Fabricio

    2018-06-01

    Although there has been significant progress towards closed-loop type 1 diabetes mellitus (T1DM) treatments, most diabetic patients still treat this metabolic disorder in an open-loop manner, based on insulin pump therapy (basal and bolus insulin infusion). This paper presents a method for automatic insulin bolus shaping based on insulin-on-board (IOB) as an alternative to conventional bolus dosing. The methodology presented allows the pump to generate the so-called super-bolus (SB) employing a two-compartment IOB dynamic model. The extra amount of insulin to boost the bolus and the basal cutoff time are computed using the duration of insulin action (DIA). In this way, the pump automatically re-establishes basal insulin when IOB reaches its basal level. Thus, detrimental transients caused by manual or a-priori computations are avoided. The potential of this method is illustrated via in-silico trials over a 30 patients cohort in single meal and single day scenarios. In the first ones, improvements were found (standard treatment vs. automatic SB) both in percentage time in euglycemia (75g meal: 81.9 ± 15.59 vs. 89.51 ± 11.95, ρ ≃ 0; 100g meal: 75.12 ± 18.23 vs. 85.46 ± 14.96, ρ ≃ 0) and time in hypoglecymia (75g meal: 5.92 ± 14.48 vs. 0.97 ± 4.15, ρ=0.008; 100g meal: 9.5 ± 17.02 vs. 1.85 ± 7.05, ρ=0.014). In a single day scenario, considering intra-patient variability, the time in hypoglycemia was reduced (9.57 ± 14.48 vs. 4.21 ± 6.18, ρ=0.028) and improved the time in euglycemia (79.46 ± 17.46 vs. 86.29 ± 11.73, ρ=0.007). The automatic IOB-based SB has the potential of a better performance in comparison with the standard treatment, particularly for high glycemic index meals with high carbohydrate content. Both glucose excursion and time spent in hypoglycemia were reduced. Copyright © 2018 Elsevier B.V. All rights reserved.

  8. Comparison between intravenous boluses versus infusion of tranexamic acid (TXA) to reduce bleeding in paediatric cyanotic congenital heart disease (CHD) surgeries

    International Nuclear Information System (INIS)

    Junejo, F.; Irfan, M.; Akhtar, M.I.; Hamid, M.; Ahmed, S.S.

    2018-01-01

    To compare the intravenous boluses and intravenous continuous infusion of tranexamic acid (TXA) to reduce postoperative bleeding in cyanotic congenital heart disease surgeries. Study Design:Single-blinded randomised clinical trial. Place and Duration of Study:Anaesthesia Department, The Aga Khan University Hospital, Karachi, from July 2016 to April 2017. Methodology:Sixty patients of cyanotic congenital heart disease, undergoing either palliative or corrective surgery involving cardiopulmonary bypass (CPB), were recruited. These 60 patients were divided randomly into two groups. The infusion group received intravenous infusion of TXA at 5 mg/kg/hour while the bolus group received three intravenous boluses of 10 mg/kg after induction, after going to bypass and after protamine reversal. Data was collected through predesigned proforma. There were two primary outcomes: postoperative bleeding in the first 24 hours, and chest closure time. Results:Postoperative bleeding was 13.94 (10.27-20.18) ml/kg in the first 24 hours in infusion group and 15.05 (9.04-23.50) ml/kg in the bolus group. Chest closure time was 38.5 (25-45) in infusion group and 30 (20-46.25) minutes in the bolus group. There was no statistically significant and clinical difference between both groups regarding postoperative bleeding in the first 24 hours and chest closure time. Conclusion:These infusion and bolus groups had comparable postoperative bleeding and chest closure time. (author)

  9. Montagem e Imagem como Paradigma

    Directory of Open Access Journals (Sweden)

    Cesar Huapaya

    2016-01-01

    Full Text Available O pensar como montagem e imagem tornou-se um método revelador nos processos de estudos práticos e teóricos do artista e dos pesquisadores nos séculos XX e XXI. Este artigo procura articular três formas de pensar por montagem: nas obras de Bertolt Brecht, Sergei Eisenstein e Georges DidiHuberman. O filósofo e historiador da arte Georges Didi-Huberman reinaugura o debate e o exercício de pensar a antropologia da imagem e a montagem como metalinguagem e forma de conhecimento.

  10. Magnetic Resonance angiography with bolus contrast agent in abdominal aortic aneurysms

    International Nuclear Information System (INIS)

    Di Cesare, E.; Cerone, G.; Giordano, A.V.; Marsili, L.; Barile, A.; Michelini, O.; Masciocchi, C.; Spartera, C.

    2000-01-01

    Purpose of this paper is to investigate the potentials of 3D breath-hold contrast-enhanced Magnetic Resonance Angiography (MRA) in the diagnosis, follow-up and treatment planning of abdominal aortic aneurysms. Twenty-four patients with infrarenal aortic aneurysm underwent MRA. It was used a 1.5 T unit (GE Horizon, Echospeed 8.2), a phased array surface coil and 3D Fast SPGR T1-weighted sequences acquired on the coronal plane during patient breath-hold and after contrast agent i.v. administration. A bolus-test was done before angiography to optimize imaging delay time. After 3D MRA a Fast-SPGR T1-weighted sequence was acquired on the axial plane. The 3D MRA source images were processed with the MIP algorithm. Qualitative and quantitative analyses were carried out. Helical CT was performed in 6 cases and DSA in 7 cases. Surgery was the reference standard in 15 patients. MRA depicted aneurysm thrombosis in 22 cases, carrefour involvement in 18 cases and iliac arteries involvement in 3 cases. Accessory renal arteries were shown in 4 cases; iliac artery stenosis was associated in 5 cases. There was agreement between MR and Helical CT and DSA findings: surgery confirmed MRA results in 15/15 cases. 3D contrast-enhanced MRA can be considered the method of choice in the follow-up and treatment planning of abdominal aortic aneurysms, because it provides both angiographic and tomographic images: this allows to obtain more information, noninvasively and without the use of ionizing radiations [it

  11. La ciudad como ecosistema urbano

    OpenAIRE

    Higueras García, Esther

    2013-01-01

    LA CIUDAD COMO ECOSISTEMA URBANO .- La ecología y los ecosistemas .- El ecosistema urbano, definición, alcance y oportunidad .- El metabolismo urbano .- Los síntomas de la patología urbana .- Los objetivos del nuevo ecosistema urbano .- Las aportaciones de los ecobarrios

  12. LA CUESTIÓN AGRARIA COMO ENFOQUE Y COMO PROBLEMA

    Directory of Open Access Journals (Sweden)

    Carlos Salgado

    2000-01-01

    Full Text Available Este ensayo trata de llamar la atención sobre los problemas del agro hoy, colocando especial énfasis en la disrupción entre las razones tecnológicas -que se asumen como ideológicas-, económicas y políticas que han inspirado el desarrollo del agro, o mejor, sobre las cuales se han basado las políticas de crecimiento agropecuario.

  13. A randomized phase III multicenter trial comparing irinotecan in combination with the Nordic bolus 5-FU and folinic acid schedule or the bolus/infused de Gramont schedule (Lv5FU2) in patients with metastatic colorectal cancer

    DEFF Research Database (Denmark)

    Glimelius, B; Sørbye, H; Balteskard, L

    2008-01-01

    not differ (4% versus 6%, P = 0.3). Grade 3/4 neutropenia (11% versus 5%, P = 0.01) and grade 2 alopecia (18% versus 9%, P = 0.002) were more common in the FLIRI group. The 60-day mortality was 2.4% versus 2.1%. CONCLUSIONS: Irinotecan with the bolus Nordic schedule (FLIRI) is a convenient treatment with PFS...... and OS comparable to irinotecan with the Lv5FU2 schedule. Neutropenia and alopecia are more prevalent, but both regimens are equally well tolerated....

  14. Low contrast volume run-off CT angiography with optimized scan time based on double-level test bolus technique – feasibility study

    International Nuclear Information System (INIS)

    Baxa, Jan; Vendiš, Tomáš; Moláček, Jiří; Štěpánková, Lucie; Flohr, Thomas; Schmidt, Bernhard; Korporaal, Johannes G.; Ferda, Jiří

    2014-01-01

    Purpose: To verify the technical feasibility of low contrast volume (40 mL) run-off CT angiography (run-off CTA) with the individual scan time optimization based on double-level test bolus technique. Materials and methods: A prospective study of 92 consecutive patients who underwent run-off CTA performed with 40 mL of contrast medium (injection rate of 6 mL/s) and optimized scan times on a second generation of dual-source CT. Individual optimized scan times were calculated from aortopopliteal transit times obtained on the basis of double-level test bolus technique – the single injection of 10 mL test bolus and dynamic acquisitions in two levels (abdominal aorta and popliteal arteries). Intraluminal attenuation (HU) was measured in 6 levels (aorta, iliac, femoral and popliteal arteries, middle and distal lower-legs) and subjective quality (3-point score) was assessed. Relations of image quality, test bolus parameters and arterial circulation involvement were analyzed. Results: High mean attenuation (HU) values (468; 437; 442; 440; 342; 274) and quality score in all monitored levels was achieved. In 91 patients (0.99) the sufficient diagnostic quality (score 1–2) in aorta, iliac and femoral arteries was determined. A total of 6 patients (0.07) were not evaluable in distal lower-legs. Only the weak indirect correlation of image quality and test-bolus parameters was proved in iliac, femoral and popliteal levels (r values: −0.263, −0.298 and −0.254). The statistically significant difference of the test-bolus parameters and image quality was proved in patients with occlusive and aneurysmal disease. Conclusion: We proved the technical feasibility and sufficient quality of run-off CTA with low volume of contrast medium and optimized scan time according to aortopopliteal transit time calculated from double-level test bolus

  15. Dextrose boluses versus burette dextrose infusions in prevention of hypoglycemia among preterms admitted at Mulago Hospital: an open label randomized clinical trial.

    Science.gov (United States)

    Kutamba, E; Lubega, S; Mugalu, J; Ouma, J; Mupere, E

    2014-09-01

    Hypoglycemia is a major cause of morbidity and mortality among preterm infants and its management remains a challenge in resource limited settings. Use of dextrose infusion by the recommended infusion pumps is not feasible in our environment due to their high costs and yet the current use of mini dextrose boluses with syringes as adapted at Mulago national referral and tertiary teaching hospital has unknown efficacy in prevention of hypoglycemia. We determined the efficacy of dextrose infusions by burettes versus two hourly dextrose boluses in prevention of hypoglycemia among preterms admitted in the first 72 hours at Special Care Unit, Mulago Hospital. One hundred and forty preterms aged 0 to 24 hours of life were randomized to receive 10% IV dextrose either as mini boluses or by infusion using burettes in an open label clinical trial. Blood glucose was measured at 0, two hourly for next 6 hours, 6 hourly for next 12 hours and thereafter 12 hourly until end of 72 hours following admission. Primary end point was incidence of hypoglycemia (random blood sugar (RBS) dextrose infusion was computed using 1-RR. From February 2012 to April 2012, 68 preterms in the bolus arm and 72 in the infusion arm were studied. Hypoglycemia was detected in 34% (48/140). The incidence of hypoglycemia in the bolus arm was 59% (40/68) compared to 11% (8/72) in the infusion arm (RR; 0.19, 95% CI; 0.09-0.37). Efficacy (1-RR) of infusion by burettes versus boluses in prevention of hypoglycemia among preterms was 0.81 (95% CI; 0.63-0.90). Continuous 10% dextrose infusion by burettes reduced the incidence of hypoglycemia by 81% in the first 72 hours of admission compared to two hourly 10% mini dextrose boluses among preterms admitted at Special Care Unit, Mulago Hospital. (ClinicalTrials.gov Identifier: NCT01688674).

  16. [Observing the density increase curve after intravenous contrast medium administration using a bolus triggering system: a method for detection cardiovascular disorders?].

    Science.gov (United States)

    Stückle, C A; Kickuth, R; Kirchner, E M; Liermann, D; Kirchner, J

    2002-06-01

    Recently bolus tracking systems were developed to improve the timing of intravenous contrast media application in helical computed tomography. We investigated the benefit of this new method as a parameter of the cardiac function. Retrospective analysis of 64 patients which incidentally underwent bolus triggered contrast enhanced helical CT and invasive investigation of the heart within one week. All examinations were performed on the CT scanner Somatom Plus 4 Volume Zoom (Siemens Corp., Forchheim, Germany) using the C.A.R.E. Bolus software. This performs repetitive low-dose test scans (e.g. for the abdomen: 140 kV, 20 mA, Tl 0.5 s) and measures the Hounsfield attenuation (increase over the baseline) in a preselected region of interest. The displayed increase of vascular density over the time after peripheral contrast media injection (75 ml lopromid (300 mg/ml), 2 ml/s) was categorised to three types: (a) rapid increase, (b) deceleration before a 100 HE threshold was reached and (c) one or more peaks. The findings of the invasive investigation of the heart were correlated to the findings of the bolus-tracking measurements. The examinations were categorized as follows: 19 type A, 34 type B, 11 type C. We found a high significant correlation between the type of the Hounsfield attenuation and systolic pressure in the left ventricle. There was no correlation between the type of the Hounsfield attenuation and the diastolic pressure in the left ventricle, the pressures related to the right ventricle or the ejection fraction. The bolus-tacking system showed a sensitivity of 53, a specificity of 82, an accuracy of 70%, a positive predictive value of 70% and a negative predictive value of 70% in detection of left heart failure. The bolus tracking system C.A.R.E.-bolus often shows atypical Hounsfield attenuation in cases of cardiac failure but is not suitable as a screening method of the cardiopulmonary function.

  17. The cost-effectiveness and budget impact of stepwise addition of bolus insulin in the treatment of type 2 diabetes: evaluation of the FullSTEP trial.

    Science.gov (United States)

    Saunders, Rhodri; Lian, Jean; Karolicki, Boris; Valentine, William

    2014-12-01

    Abstract Background and aims: Intensification of basal insulin-only therapy in type 2 diabetes is often achieved through addition of bolus insulin 3-times daily. The FullSTEP trial demonstrated that stepwise addition (SWA) of bolus insulin aspart was non-inferior to full basal-bolus (FBB) therapy and reduced the rate of hypoglycemia. Here the cost-effectiveness and budget impact of SWA is evaluated. Cost-effectiveness and budget impact models were developed to assess the cost and quality-of-life (QoL) implications of intensification using SWA compared with FBB in the US setting. At assessment, SWA patients added one bolus dose to their current regimen if the HbA1c target was not met. SWA patients reaching three bolus doses used FBB event rates. Outcomes were evaluated at trial end and projected annually up to 5 years. Models captured hypoglycemic events, the proportion meeting HbA1c target, and self-measured blood glucose. Event rates and QoL utilities were taken from trial data and published literature. Costs were evaluated from a healthcare-payer perspective, reported in 2013 USD, and discounted (like clinical outcomes) at 3.5% annually. This analysis applies to patients with HbA1c 7.0-9.0% and body mass index Budget impact analysis estimated that, by moving from FBB to SWA, a health plan with 77,000 patients with type 2 diabetes, of whom 7.8% annually intensified to basal-bolus therapy, would save USD 1304 per intensifying patient over the trial period. SWA of bolus insulin should be considered a beneficial and cost-saving alternative to FBB therapy for the intensification of treatment in type 2 diabetes.

  18. Alfaxalone for maintenance of anaesthesia in ponies undergoing field castration: continuous infusion compared with intravenous boluses.

    Science.gov (United States)

    Deutsch, Julia; Ekiri, Abel; de Vries, Annemarie

    2017-07-01

    To compare alfaxalone as continuous intravenous (IV) infusion with intermittent IV injections for maintenance of anaesthesia in ponies undergoing castration. Prospective, randomized, 'blinded' clinical study. A group of 33 entire male Welsh ponies undergoing field castration. After preanaesthetic medication with IV detomidine (10 μg kg -1 ) and butorphanol (0.05 mg kg -1 ), anaesthesia was induced with IV diazepam (0.05 mg kg -1 ) followed by alfaxalone (1 mg kg -1 ). After random allocation, anaesthesia was maintained with either IV alfaxalone 2 mg kg -1  hour -1 (group A; n = 16) or saline administered at equal volume (group S; n = 17). When necessary, additional alfaxalone (0.2 mg kg -1 ) was administered IV. Ponies were breathing room air. Using simple descriptive scales, surgical conditions and anaesthesia recovery were scored. Total amount of alfaxalone, ponies requiring additional alfaxalone and time to administration, time from induction to end of infusion and end of infusion to standing were noted. Indirect arterial blood pressure, pulse and respiratory rates, end-expiratory carbon dioxide partial pressure and arterial haemoglobin oxygen saturation were recorded every 5 minutes. Data were analysed using Student t, Mann-Whitney U and chi-square tests, where appropriate (p < 0.05). Total amount of alfaxalone administered after induction of anaesthesia (0.75 ± 0.27 versus 0.17 ± 0.23 mg kg -1 ; p < 0.0001) and time to standing (14.8 ± 4 versus 11.6 ± 4 minutes; p = 0.044) were higher in group A compared to group S. Ponies requiring additional alfaxalone boluses [four (group A) versus seven (group S)] and other measured variables were similar between groups; five ponies required oxygen supplementation [three (group A) versus two (group S)]. Continuous IV infusion and intermittent administration of alfaxalone provided similar anaesthesia quality and surgical conditions in ponies undergoing field castration. Less alfaxalone

  19. Computer simulations suggest that acute correction of hyperglycaemia with an insulin bolus protocol might be useful in brain FDG PET

    International Nuclear Information System (INIS)

    Buchert, R.; Brenner, W.; Apostolova, I.; Mester, J.; Clausen, M.; Santer, R.; Silverman, D.H.S.

    2009-01-01

    FDG PET in hyperglycaemic subjects often suffers from limited statistical image quality, which may hamper visual and quantitative evaluation. In our study the following insulin bolus protocol is proposed for acute correction of hyperglycaemia (> 7.0 mmol/l) in brain FDG PET. (i) Intravenous bolus injection of short-acting insulin, one I.E. for each 0.6 mmol/l blood glucose above 7.0. (ii) If 20 min after insulin administration plasma glucose is ≤ 7.0 mmol/l, proceed to (iii). If insulin has not taken sufficient effect step back to (i). Compute insulin dose with the updated blood glucose level. (iii) Wait further 20 min before injection of FDG. (iv) Continuous supervision of the patient during the whole scanning procedure. The potential of this protocol for improvement of image quality in brain FDG PET in hyperglycaemic subjects was evaluated by computer simulations within the Sokoloff model. A plausibility check of the prediction of the computer simulations on the magnitude of the effect that might be achieved by correction of hyperglycaemia was performed by retrospective evaluation of the relation between blood glucose level and brain FDG uptake in 89 subjects in whom FDG PET had been performed for diagnosis of Alzheimer's disease. The computer simulations suggested that acute correction of hyperglycaemia according to the proposed bolus insulin protocol might increase the FDG uptake of the brain by up to 80%. The magnitude of this effect was confirmed by the patient data. The proposed management protocol for acute correction of hyperglycaemia with insulin has the potential to significantly improve the statistical quality of brain FDG PET images. This should be confirmed in a prospective study in patients. (orig.)

  20. One year results of preoperative single bolus ATG-Fresenius induction therapy in sensitized renal transplant recipients.

    Science.gov (United States)

    Wang, D; Chen, J H; Wu, W Z; Yang, S L; Wu, G J; Wang, H; Tan, J M

    2007-01-01

    Sensitization in kidney transplantation is associated with more acute rejections, inferior graft survival, and an increase in delayed graft function. This study was designed to evaluate the efficacy and safety of preoperative single bolus antithymocyte globulin (ATG) induction therapy in sensitized renal transplant recipients. Fifty-six cadaveric donor kidney transplant recipients were divided into two groups: Group I (nonsensitized group, n = 30) and group II (sensitized group, PRA>10%, n = 26). ATG was given as a single preoperative bolus induction therapy to group II (ATG IV; 9 mg/kg). The group I patients were treated with mycophenolate mofetil preoperatively as induction therapy. The basic immunosuppressive regimen included tacrolimus (FK-506) or cyclosporine, mycophenolate mofetil, and prednisolone. After hospital discharge, patients were followed on a routine outpatient basis for 12 months. Acute rejection episodes (ARE) occurred in 20% (6/30) of group I and 15.38% (4/26) of group II patients (P = NS). Infections occurred in eight patients (26.7%) as 11 episodes (36.7%), averaging 1.4 episodes per infected patient in group 1, and 6 patients (23.1%) for a total of 10 episodes (38.5%), averaging 1.7 episodes per infected patient, in group II (P = NS). Occurrence of side effects and hospital stay were almost comparable in the two groups. No delayed graft function was observed in either group. The 12-month actuarial patient and graft survival were 100% in Group I and II. A preoperative single bolus ATG induction therapy was an effective and safe therapeutic measure, yielding an acceptable acute rejection rate in presensitized renal transplant recipients.

  1. Computer simulations suggest that acute correction of hyperglycaemia with an insulin bolus protocol might be useful in brain FDG PET

    Energy Technology Data Exchange (ETDEWEB)

    Buchert, R.; Brenner, W.; Apostolova, I.; Mester, J.; Clausen, M. [University Medical Center Hamburg-Eppendorf (Germany). Dept. of Nuclear Medicine; Santer, R. [University Medical Center Hamburg-Eppendorf (Germany). Center for Gynaecology, Obstetrics and Paediatrics; Silverman, D.H.S. [David Geffen School of Medicine at UCLA, Los Angeles, CA (United States). Dept. of Molecular and Medical Pharmacology

    2009-07-01

    FDG PET in hyperglycaemic subjects often suffers from limited statistical image quality, which may hamper visual and quantitative evaluation. In our study the following insulin bolus protocol is proposed for acute correction of hyperglycaemia (> 7.0 mmol/l) in brain FDG PET. (i) Intravenous bolus injection of short-acting insulin, one I.E. for each 0.6 mmol/l blood glucose above 7.0. (ii) If 20 min after insulin administration plasma glucose is {<=} 7.0 mmol/l, proceed to (iii). If insulin has not taken sufficient effect step back to (i). Compute insulin dose with the updated blood glucose level. (iii) Wait further 20 min before injection of FDG. (iv) Continuous supervision of the patient during the whole scanning procedure. The potential of this protocol for improvement of image quality in brain FDG PET in hyperglycaemic subjects was evaluated by computer simulations within the Sokoloff model. A plausibility check of the prediction of the computer simulations on the magnitude of the effect that might be achieved by correction of hyperglycaemia was performed by retrospective evaluation of the relation between blood glucose level and brain FDG uptake in 89 subjects in whom FDG PET had been performed for diagnosis of Alzheimer's disease. The computer simulations suggested that acute correction of hyperglycaemia according to the proposed bolus insulin protocol might increase the FDG uptake of the brain by up to 80%. The magnitude of this effect was confirmed by the patient data. The proposed management protocol for acute correction of hyperglycaemia with insulin has the potential to significantly improve the statistical quality of brain FDG PET images. This should be confirmed in a prospective study in patients. (orig.)

  2. Contrast agent bolus tracking with a fixed threshold or a manual fast start for coronary CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Stenzel, Fabian; Rief, Matthias; Zimmermann, Elke; Greupner, Johannes; Richter, Felicitas; Dewey, Marc [Charite - Universitaetsmedizin Berlin, Department of Radiology, Berlin (Germany)

    2014-06-15

    Comparison of bolus tracking with a fixed threshold versus a manual fast start for coronary CT angiography. We retrospectively analysed 320-row coronary CT angiography of 50 patients with suspected or known coronary artery disease. Twenty-five examinations were initiated by a bolus tracking method (group 1), 25 examinations with a manual fast surestart (group 2). Mean attenuation values in the ascending aorta were 519 ± 111 Hounsfield units (HU) in group 1 and 476 ± 65 HU in group 2 (p = 0.10). Assessable vessel lengths were 171 ± 44 mm vs 172 ± 29 mm for the right coronary artery (p = 0.91), 11 ± 4 mm vs 12 ± 4 mm for the left main (p = 0.9), 163 ± 28 mm vs 151 ± 26 mm for the left anterior descending coronary artery (p = 0.11) and 125 ± 41 mm vs 110 ± 37 mm for the left circumflex coronary artery (p = 0.18). Image quality for all coronary arteries was not significantly different between the groups (p > 0.41). The attenuation ratio between the left and right ventricle was 2.8 ± 0.7 vs 3.6 ± 1.0 (p = 0.003). Significantly less contrast agent was used in group 2 (64 ± 6 ml vs 80 ± 0 ml; p < 0.001). Bolus tracking with a fixed threshold and with a manual fast start are both suitable methods; the fast start allowed a reduction of contrast agent volumes. (orig.)

  3. Therapeutic efficacy and toxicity of bolus application of chemotherapy protocol in the treatment of metastatic colorectal cancer.

    Science.gov (United States)

    Šišić, Ibrahim; Pojskić, Belma; Mekić Abazović, Alma; Kovčin, Vladimir

    2015-08-01

    To compare efficacy and toxicity of bolus application of chemotherapy protocol, oxaliplatin, fluorouracil (bolus), leucovorin (folfox) between two groups of patients in the therapy of metastatic colorectal carcinoma (mCRC). A total of 63 patients were treated for mCRC in the period January 2009 - January 2010 at the Department of Oncology of the Cantonal Hospital Zenica, Bosnia and Herzegovina (first group, 30 patients) and at the Department of Oncology of the Clinical Hospital Centre Bežanijska kosa in Belgrade, Serbia, in the period January 2005 - January 2006 (second group, 33 patients). The patients were treated according the same protocol, i.v. bolus infusion, but in different day intervals (D), 1, 8, 15/28 days or D1-D5/28 days, respectively. In all patients the following factors were analyzed: tumor response, overall survival (OS), progression free survival, hematological and non-hematological toxicity . Colon was the primary localization in almost two thirds of patients. There was no statistically significant difference between the groups according to the age, hematological and non-hematological toxicity, as well as in achieved OS. Progression free survival expressed in months was in average 5 months though with a large range between minimal and maximal survival time. Both groups have shown equivalent efficacy to applied chemotherapy protocols. Overall survival in the two groups matched data from the literature. Further research should confirm success of the combination of chemotherapy protocols and their combination with the biological therapy. Copyright© by the Medical Assotiation of Zenica-Doboj Canton.

  4. Therapeutic efficacy and toxicity of bolus application of chemotherapy protocol in the treatment of metastatic colorectal cancer

    Directory of Open Access Journals (Sweden)

    Ibrahim Šišić

    2015-08-01

    Full Text Available Aim To compare efficacy and toxicity of bolus application of chemotherapy protocol, oxaliplatin, fluorouracil (bolus, leucovorin (folfox between two groups of patients in the therapy of metastatic colorectal carcinoma (mCRC. Methods A total of 63 patients were treated for mCRC in the period January 2009 – January 2010 at the Department of Oncology of the Cantonal Hospital Zenica, Bosnia and Herzegovina (first group, 30 patients and at the Department of Oncology of the Clinical Hospital Centre Bežanijska kosa in Belgrade, Serbia, in the period January 2005 – January 2006 (second group, 33 patients. The patients were treated according the same protocol, i.v. bolus infusion, but in different day intervals (D, 1, 8, 15/28 days or D1-D5/28 days, respectively. In all patients the following factors were analyzed: tumor response, overall survival (OS, progression free survival, hematological and non-hematological toxicity. Results Colon was the primary localization in almost two thirds of patients. There was no statistically significant difference between the groups according to the age, hematological and non-hematological toxicity, as well as in achieved OS. Progression free survival expressed in months was in average 5 months though with a large range between minimal and maximal survival time. Conclusion Both groups have shown equivalent efficacy to applied chemotherapy protocols. Overall survival in the two groups matched data from the literature. Further research should confirm success of the combination of chemotherapy protocols and their combination with the biological therapy.

  5. Los ancianos como actores sociales

    Directory of Open Access Journals (Sweden)

    Mª PIA ARENYS

    1996-01-01

    Full Text Available En este artículo se recogen las discusiones de grupo que se realizaron durante cuatro meses en Barcelona como preparación del "II congreso de la gent gran" (II congreso de ancianos de esta ciudad, en noviembre de 1993. las discusiones se llevaron a cabo en las sedes de cada distrito, previa presentación de la ponencia por parte de un técnico. los componentes de los grupos son personas mayores sensibilizadas y comprometidas que forman parte del consejo de bienestar social del ayuntamiento de Barcelona. la metodología utilizada es cualitativa para el análisis del discurso, que se ha estructurado en los siguientes puntos: bajo el epígrafe "los ancianos como ciudadanos de derechos y obligaciones" se recogen los temas de valoración de la vejez, la familia, la jubilación, las implicaciones de los ancianos como ciudadanos de derechos y deberes y las funciones sociales de los ancianos.-- sobre estos temas, los mayores expresaron sus opiniones, que se vertieron, resumidamente, en la redacción final de la ponencia. aquí se recogen y se han analizado los materiales que ofrecen una versión de primera mano sobre lo que opinan los ancianos respecto al tema de "la valoración de la vejez".

  6. Efficacy, distribution and faecal excretion of copper oxide wire particles in a novel bolus in red deer (Cervus elaphus).

    Science.gov (United States)

    Castillo-Alcala, F; Wilson, P R; Molenaar, R; Lopez-Villalobos, N

    2007-04-01

    To determine the efficacy of a novel copper oxide wire particle (COWP) formulation in elevating concentrations of copper (Cu) in the liver and serum of red deer (Cervus elaphus), and to investigate the distribution of particles in the gastrointestinal tract and the rate of their excretion in faeces. Mixed-age red deer hinds were allocated to three groups (n=10 per group) on the basis of pre-treatment liver Cu concentrations. Groups 1 and 2 were treated orally with a 10-g COWP bolus on Days 0 and 30, respectively, while the remaining group served as an untreated control. Animals were slaughtered on Day 60, when blood and liver samples were collected for determination of Cu concentrations. An additional group of 18-month-old red deer hinds (n=20) were treated orally with a 10-g COWP bolus, and four were slaughtered on each of Days 1, 5, 15, 30 and 60 after treatment. The gastrointestinal tract was secured between compartments below the oesophagus and contents rinsed until sedimentation of particles was complete. The sediment was oven-dried and COWP were separated and weighed. Faeces were collected continuously from four additional animals held in metabolism cages for 4 days after treatment, sub-sampled daily, and COWP recovered. Mean liver Cu concentrations at slaughter were 80, 597 and 447 micromol/kg for controls and hinds treated 30, and 60 days previously, respectively. Corresponding mean serum Cu concentrations were 7.7, 12.9 and 11.9 micromol/L, respectively. Liver and serum Cu concentrations were higher in both treatment groups than in untreated control animals (p<0.001). COWP were found in all compartments of the gastrointestinal tract measured, for at least 15 days, and in the rumen/reticulum and abomasum for at least 60 days post-administration. The highest rate of recovery overall was from the rumen/reticulum. Mean weight of COWP recovered from faeces was 0.09 g during the first 24 h and 0.94 g over the first 4 days following administration. The COWP bolus

  7. Comparison of Two Methods of Bolus and Infusion of Tranexamic Acid in Reduction of Blood Loss in Total Knee Arthroplasty

    OpenAIRE

    Mohammadreza Moshari; Bahman Malek; Mohammadreza Minator-Sajjadi; Maryam Vosoghian; Mastaneh Dahi; Mahshid Ghasemi; Razieh Shekari

    2018-01-01

    AbstractBackground: So far, many studies have been performed to determine the optimal dose and regimen of tranexamic acid to reduce preoperative and postoperative blood loss in primary total knee arthroplasty. In the present study, two different methods of administration (bolus and infusion), were compared.Materials and Methods: Forty patients were randomized in the two groups (A and B) of 20 patients each. All patients received 500 mg tranexamic acid before inflation of tourniquet. Group A (...

  8. La proyección como proceso y como mecanismo

    OpenAIRE

    Brusset, Bernard

    2001-01-01

    La proyección es a la vez un mecanismo elemental testimonio de la fragilidad de la organización defensiva y un proceso cuyo rol es fundamental en el funcionamiento psíquico. En este doble aspecto, la proyección guarda especificidades diferentes en la neurosis y en la psicosis al punto que se las deba considerar como fundamentalmente diferentes? O bien las diferencias de contexto, del nivel del funcionamiento psíquico, de lugar, de función pueden explicar las diferencias clínicas justificando ...

  9. Precision flow-controlled Rb-82 generator for bolus or constant-infusion studies of the heart and brain

    International Nuclear Information System (INIS)

    Yano, Y.; Cahoon, J.L.; Budinger, T.F.

    1981-01-01

    A precision flow-controlled rubidium-82 generator has been constructed to deliver 76-sec Rb-82 at either fast or slow flow rates for bolus or constant-infusion studies. A stepping motor drive is interfaced to a microprocessor for pulsed control of flow rate to deliver the saline eluant solution from a large-volume (150 ml) machined pumping syringe through an alumina column that retains the 25-day Sr-82 parent. The generator system delivers 70-90% of the maximum Rb-82 activity in a 20-25 ml bolus elution of 2% NaCl. The Sr-82/Sr-85 breakthrough is 10 -7 - 10 -6 . Both yield and breakthrough are functions of column length and flow rate. Six separate Sr-82 loadings of the generator were evaluated over a period of nearly 2 yr in studies of myocardial blood perfusion and permeability changes in the blood-brain barrier. Sterility and apyrogenicity of the Rb-82 eluate were maintained during multiple elutions and long-term use of 3-4 mo for each generator loading

  10. [Simultaneous determination of five effective components in Sijunzi bolus using high performance liquid chromatography-evaporation light scattering detection].

    Science.gov (United States)

    Li, Chunying; Zhang, Xiaojun

    2010-01-01

    A high performance liquid chromatographic (HPLC) method was developed for the simultaneous determination of lobetyolin, pachymic acid, glycyrrhizic acid, atractylenoide III and atractylenolide I in Sijunzi bolus. The separation was performed on an HIQ SIL C18 V column (250 mm x 4.6 mm, 5 microm) with 0.5% acetic acid-methanol as the mobile phase of gradient elution at a flow rate of 1.0 mL/min. The detection was performed with an evaporation light scattering detector (ELSD) and the sample volume was 10 microL. The temperature of drift tube and heating grade of nebulizer was respectively set at 55 degrees C and 60% at 0.2 MPa of pressure. Nitrogen gas was used as carrier gas. Under the optimized conditions, there were good linear relationships between the logarithm values of mass concentration and the peak areas of lobetyolin, pachymic acid, glycyrrhizic acid, atractylenoide III and atractylenolide I in the ranges of 0.076 - 1.21, 0.048 -0.76, 0.153 - 2.45, 0.045 - 0.72 and 0.098 - 1.56 g/L, respectively. The recoveries of the five components were between 97.13% and 100.25%, the relative standard deviations (RSDs) were between 1.23% and 2.44%. This method is simple, rapid, accurate and suitable for the quality control of Sijunzi bolus.

  11. Split-bolus CT-urography using dual-energy CT: Feasibility, image quality and dose reduction

    Energy Technology Data Exchange (ETDEWEB)

    Takeuchi, Mitsuru, E-mail: m2rbimn@gmail.com [Nagoya City University Graduate School of Medical Sciences, Department of Radiology, 1 Kawasumi Mizuho-cho, Mizuho-ku, Nagoya, 467-8601 (Japan); Kawai, Tatsuya; Ito, Masato; Ogawa, Masaki [Nagoya City University Graduate School of Medical Sciences, Department of Radiology, 1 Kawasumi Mizuho-cho, Mizuho-ku, Nagoya, 467-8601 (Japan); Ohashi, Kazuya [Nagoya City University Hospital, Department of Radiology, 1 Kawasumi Mizuho-cho, Mizuho-ku, Nagoya, 467-8601 (Japan); Hara, Masaki; Shibamoto, Yuta [Nagoya City University Graduate School of Medical Sciences, Department of Radiology, 1 Kawasumi Mizuho-cho, Mizuho-ku, Nagoya, 467-8601 (Japan)

    2012-11-15

    Purpose: To prospectively evaluate the feasibility of dual-energy (DE) split-bolus CT-urography (CTU) and the quality of virtual non-enhanced images (VNEI) and DE combined nephrographic-excretory phase images (CNEPI), and to estimate radiation dose reduction if true non-enhanced images (TNEI) could be omitted. Patients and methods: Between August and September 2011, 30 consecutive patients with confirmed or suspected urothelial cancer or with hematuria underwent DE CT. Single-energy TNEI and DE CNEPI were obtained. VNEI was reconstructed from CNEPI. Image quality of CNEPI and VNEI was evaluated using a 5-point scale. The attenuation of urine in the bladder on TNEI and VNEI was measured. The CT dose index volume (CTDI (vol)) of the two scans was recorded. Results: The mean image quality score of CNEPI and VNEI was 4.7 and 3.3, respectively. The mean differences in urine attenuation between VNEI and TNEI were 14 {+-} 15 [SD] and -16 {+-} 29 in the anterior and posterior parts of the bladder, respectively. The mean CTDI (vol) for TNEI and CNEPI was 11.8 and 10.9 mGy, respectively. Omission of TNEI could reduce the total radiation dose by 52%. Conclusion: DE split-bolus CTU is technically feasible and can reduce radiation exposure; however, an additional TNEI scan is necessary when the VNEI quality is poor or quantitative evaluation of urine attenuation is required.

  12. Pharmacokinetics of Perfluorobutane after Intra-Venous Bolus Injection of Sonazoid in Healthy Chinese Volunteers.

    Science.gov (United States)

    Li, Pengfei; Hoppmann, Susan; Du, Ping; Li, Huiling; Evans, Paul M; Moestue, Siver A; Yu, Weiyue; Dong, Fang; Liu, Hongchuan; Liu, Lihong

    2017-05-01

    Sonazoid is an ultrasound contrast agent based on microbubbles (MB) containing perfluorobutane (PFB) gas. Sonazoid is approved in Japan, Korea and Norway for contrast-enhanced ultrasonography of focal liver lesions and focal breast lesions (Japan only). The objective of this study was to determine the pharmacokinetics (PKs) and safety of Sonazoid in Chinese healthy volunteers (HVs) and to evaluate the potential for ethnic differences in PKs between Chinese and Caucasian HVs. Sonazoid was administered as an intra-venous bolus injection at the clinical dose of 0.12 μL or 0.60 μL MB/kg body weight to two groups of eight Chinese HVs. Expired air and blood samples were collected and analyzed using a validated gas chromatographic tandem mass spectrometry method, and the main PK parameters were calculated. The highest PFB concentrations in blood were observed shortly after intra-venous administration of Sonazoid, and elimination of PFB was rapid. In the 0.12 μL MB/kg body weight cohort, PFB concentrations above the limit of quantification were observed for only 10 to 15 min post-injection. In the 0.60 μL MB/kg body weight cohort, PFB concentrations above the limit of quantification were observed for 60 min post-injection, and the shape of the elimination curve suggested a biphasic elimination profile. The maximum observed concentration (C max ) values of PFB in blood were 2.3 ± 1.1 and 19.1 ± 9.2 ng/g for the 0.12 and 0.60 μL MB/kg body weight dose groups (mean ± standard deviation). Area under the curve values were 10.1 ± 2.7 and 90.1 ± 38.3 ng × min/g for the 0.12 and 0.60 μL MB/kg body weight dose groups. C max values of PFB in exhaled air were 0.35 ± 0.2 and 2.4 ± 0.7 ng/mL for the 0.12 and 0.60 μL MB/kg body weight dose groups. Assessment of laboratory parameters, vital signs, oxygen saturation and electrocardiograms revealed no changes indicative of a concern. The PK profile and safety data generated in the Chinese

  13. Dynamic computed tomography after bolus injection and infusion of perfluorooctylbromide (PFOB). Computertomographische Untersuchungen zur Dichtekinetik nach Bolusinjektion und Infusion von Perfluorooctylbromid (PFOB). Tierexperimentelle Untersuchungen

    Energy Technology Data Exchange (ETDEWEB)

    Adam, G.; Guenther, R.W.; Goertz, H.; Schiffer, C. (Technische Hochschule Aachen (Germany). Klinik fuer Radiologische Diagnostik); Prescher, A. (Technische Hochschule Aachen (Germany). Inst. fuer Anatomie); Bruchmueller, K. (Technische Hochschule Aachen (Germany). Inst. fuer Versuchstierkunde); Limmer, J. (Boehringer Ingelheim GmbH (Germany))

    1992-05-01

    We investigated the enhancement of the liver, the spleen, and of induced abscesses and the abdominal vessels after administration of 3 g/kg bodyweight Perfluoroocytlbromide (PFOB) on an animal model. Twenty-one rabbits each received the contrast medium as bolus injection and as slow infusion over half an hour. CT was performed between 2 and 48 hours after contrast medium application. Peak enhancement of the liver, the spleen and the liver abscess membrane was found between 24 and 48 hours after PFOB administration, independently of the application mode. Peak enhancement of the abdominal aorta and the IVC was observed within two hours after bolus injection. In this rabbit model PFOB permits best delineation of the vessels after bolus injection within the first two hours, while CT imaging of the liver, the spleen and the liver abscess membrane is best between 24 and 48 hours after contrast medium application, independent of the injection velocity. (orig.).

  14. El dictado como tarea comunicativa

    Directory of Open Access Journals (Sweden)

    Daniel Cassany

    2004-01-01

    Full Text Available El artículo explora las utilidades didácticas del dictado (la práctica comunicativa de oralizar o leer en voz alta un escrito para el aprendizaje funcional de una lengua materna o extranjera, en los diversos niveles de enseñanza. Después de criticar el uso tradicional de este ejercicio lingüístico, presentamos once formas diferentes de desarrollar un dictado en clase, con sus particulares contenidos, objetivos y metodologías. También analizamos con detalle la técnica más tradicional del dictado magistral, en la que el docente dicta palabra por palabra un texto al alumnado, poniendo énfasis en la ortografía; ofrecemos algunas orientaciones para incrementar el componente comunicativo de esta propuesta. Las conclusiones finales proponen entender esta técnica como un recurso metodológico variado, rico y sugerente, adaptado a cada situación de aprendizaje —y no como una práctica obligatoria y fosilizada.

  15. SU-E-T-71: A Radiochromic Film Based Quantitative Assessment of Thermoplastic Mask Bolus Effect in Head and Neck IMRT/VMAT

    Energy Technology Data Exchange (ETDEWEB)

    Kalavagunta, C; Lin, M; Snider, J; Xu, H; Schrum, A; Vadnais, P; Marter, K; Suntharalingam, M; Prado, K [University of Maryland School of Medicine, Baltimore, MD (United States)

    2015-06-15

    Purpose: To quantify the factors leading to thermoplastic mask bolus-associated-increased skin dose in head and neck IMRT/VMAT using EBT2 film. Methods: EBT2 film placed beneath a dual layer 3-point ORFIT head, neck and shoulder mask was used to test the effect of mask thickness, beam modulation, air gap, and beam obliquity on bolus effect. Mask thickness was varied based on the distribution of 1.6mm Orfilight layer on top of 2 mm Efficast layer. Beam modulation was varied by irradiating the film with an open field (no beam modulation) and a step and shoot field (beam modulation). Air gap between mask and film was varied from 0 to 5mm. Beam obliquity was varied by irradiating the film at gantry angles of 0°, 35°, and 70°.Finally, film strips placed on a Rando phantom under an Orfit mask, in regions of expected high dose, were irradiated using 5 IMRT and 5 VMAT plans with various modulation levels (modulation factor 2 to 5) and the results were compared with those obtained placing OSLDs at the same locations. Results: An 18–34% increase in mask bolus effect was observed for three factors where the effect of beam obliquity ≥ beam modulation > mask thickness. No increase in mask bolus effect was observed for change in air gap. A 6–13% increase in dose due to mask bolus effect was observed on film strips. Conclusion: This work underlines the role of beam obliquity and beam modulation combined with thermoplastic mask thickness in increasing mask bolus-associated skin dose in head and neck IMRT/VMAT. One possible method of dose reduction, based on knowledge gained from this work, is inclusion of skin as an avoidance structure in treatment planning. Another approach is to design a mask with the least amount of thermoplastic material necessary for immobilization.

  16. SU-E-T-71: A Radiochromic Film Based Quantitative Assessment of Thermoplastic Mask Bolus Effect in Head and Neck IMRT/VMAT

    International Nuclear Information System (INIS)

    Kalavagunta, C; Lin, M; Snider, J; Xu, H; Schrum, A; Vadnais, P; Marter, K; Suntharalingam, M; Prado, K

    2015-01-01

    Purpose: To quantify the factors leading to thermoplastic mask bolus-associated-increased skin dose in head and neck IMRT/VMAT using EBT2 film. Methods: EBT2 film placed beneath a dual layer 3-point ORFIT head, neck and shoulder mask was used to test the effect of mask thickness, beam modulation, air gap, and beam obliquity on bolus effect. Mask thickness was varied based on the distribution of 1.6mm Orfilight layer on top of 2 mm Efficast layer. Beam modulation was varied by irradiating the film with an open field (no beam modulation) and a step and shoot field (beam modulation). Air gap between mask and film was varied from 0 to 5mm. Beam obliquity was varied by irradiating the film at gantry angles of 0°, 35°, and 70°.Finally, film strips placed on a Rando phantom under an Orfit mask, in regions of expected high dose, were irradiated using 5 IMRT and 5 VMAT plans with various modulation levels (modulation factor 2 to 5) and the results were compared with those obtained placing OSLDs at the same locations. Results: An 18–34% increase in mask bolus effect was observed for three factors where the effect of beam obliquity ≥ beam modulation > mask thickness. No increase in mask bolus effect was observed for change in air gap. A 6–13% increase in dose due to mask bolus effect was observed on film strips. Conclusion: This work underlines the role of beam obliquity and beam modulation combined with thermoplastic mask thickness in increasing mask bolus-associated skin dose in head and neck IMRT/VMAT. One possible method of dose reduction, based on knowledge gained from this work, is inclusion of skin as an avoidance structure in treatment planning. Another approach is to design a mask with the least amount of thermoplastic material necessary for immobilization

  17. Como Lo Hago Yo: Myelomeningocele

    Science.gov (United States)

    Lazareff, Jorge

    2014-01-01

    Fortificación con ádico fólico es efectiva, pero aún falta conciencia en los jóvenes. La legalidad del aborto aumenta la importancia de la consulta prenatal. Realizo la cirugía bajo microcoscopio por razones didácticas. Irrigación continua para reducir la temperatura del tejido. Trato a la plaqueta como tejido viable. No suturo la plaqueta. No cierro músculo. ATB por una semana después de cirugía. Hidrocefalia: Válvula en todos los casos de ventriculomegalia. Médula anclada: Desanclar una sola vez. Chiari II: Revisar la válvula. Incluir en el seguimiento rendimiento escolar, puede indicar obstrucción de la válvula o médula anclada. PMID:24791217

  18. The Efficacy of Programmed Intermittent Epidural Bolus for Postoperative Analgesia after Open Gynecological Surgery: A Randomized Double-Blinded Study

    Directory of Open Access Journals (Sweden)

    Shiho Satomi

    2018-01-01

    Full Text Available Background. It is well known that the programmed intermittent epidural bolus (PIEB technique effectively provides epidural anesthesia in labor. This randomized double-blind trial compared the postoperative analgesic efficacy of PIEB with that of continuous epidural infusion (CEI in patients undergoing gynecological surgery under combined general-epidural anesthesia. Methods. Patients undergoing open gynecological surgery under combined general-epidural anesthesia were randomized at a 1 : 1 ratio to receive PIEB or CEI. In the PIEB group, the pump delivered 4 mL ropivacaine 0.2% plus fentanyl 2 μg/mL every hour. In the CEI group, the pump delivered the same solution at a rate of 4 mL/h. In both groups, additional 4 mL boluses of ropivacaine 0.2% plus fentanyl 2 μg/mL were provided, when necessary, by patient-controlled epidural analgesia after surgery. The primary outcome was the total ropivacaine dose 40 hours after surgery. The secondary outcomes were the number of PCEA boluses and postoperative pain (evaluated on an 11-point numerical rating scale 3, 24, and 48 hours after surgery. Results. In total, 57 patients were randomized (n=28 and 29 in the PIEB and CEI groups, resp.. The two groups differ significantly in terms of the total ropivacaine dose 40 hours after surgery (mean (standard deviation: 155.38 (4.55 versus 159.73 (7.87 mL, P=0.016. Compared to the CEI group, the PIEB group had significantly lower numerical rating scale scores 3 hours (median [lower–upper quartiles]: 0 [0–0.5] versus 3 [0–5.5], P=0.002, 24 hours (1 [0–2] versus 3 [1–4], P=0.003, and 48 hours (1 [0–2] versus 2 [2–3.5], P=0.002 after surgery. Conclusion. PIEB was better than CEI in terms of providing postoperative analgesia after open gynecological surgery under combined general-epidural anesthesia.

  19. El investigador como educador musical y como divulgador

    Directory of Open Access Journals (Sweden)

    Suárez-Pajares, Javier

    2000-05-01

    Full Text Available La presente ponencia trataba de plantear en la Mesa redonda "Investigación aplicada a la educación musical" una serie de problemas que surgen no tanto a quienes se dedican profesionalmente a la educación musical, sino a quienes, dedicados a la investigación y al estudio de temas relacionados con la historia de la música desde perspectivas diversas, tienen finalmente que transmitirlos a una audiencia determinada, ya sea otros colegas, alumnos de universidad, u otros públicos en los que se centra el concepto "divulgación" aludido en el título.Se incide particularmente en los problemas de la educación musical universitaria para no especialistas y en la divulgación científica aplicada a la música, un campo casi yermo sobre el que hay mucho que reflexionar: desde las nuevas posibilidades para la explicación de la música que ofrecen soportes nuevos como el CD-Rom, hasta las tradicionales formas de relación con un público melómano a través de notas a programas y críticas de conciertos.

  20. Model of the Glucose-Insulin-Glucagon Dynamics after Subcutaneous Administration of a Glucagon Rescue Bolus in Healthy Humans

    DEFF Research Database (Denmark)

    Wendt, Sabrina Lyngbye; Møller, Jan Kloppenborg; Haidar, Ahmad

    In healthy individuals, insulin and glucagon work in a complex fashion to maintain blood glucose levels within a narrow range. This regulation is distorted in patients with diabetes. The hepatic glucose response due to an elevated glucagon level depends on the current insulin concentration and thus...... endogenous glucose production (EGP) can not be modelled without knowledge of the concentration of both hormones in plasma. Furthermore, literature suggests an upper limit to EGP irrespective of glucagon levels. We build a simulation model of the glucose-insulin-glucagon dynamics in man including saturation...... effect of EGP. Ten healthy subjects received a 1 mg subcutaneous (SC) glucagon bolus (GlucaGen®). Plasma samples were collected until 300 minutes post dose and analyzed for glucagon, insulin, and glucose concentrations. All observations were used to fit a physiological model of the glucose...

  1. GH receptor signaling in skeletal muscle and adipose tissue in human subjects following exposure to an intravenous GH bolus

    DEFF Research Database (Denmark)

    Jørgensen, Jens O L; Jessen, Niels; Pedersen, Steen Bønløkke

    2006-01-01

    Growth hormone (GH) regulates muscle and fat metabolism, which impacts on body composition and insulin sensitivity, but the underlying GH signaling pathways have not been studied in vivo in humans. We investigated GH signaling in biopsies from muscle and abdominal fat obtained 30 (n = 3) or 60 (n...... was measured by in vitro phosphorylation of PI. STAT5 DNA binding activity was assessed with EMSA, and the expression of IGF-I and SOCS mRNA was measured by real-time RT-PCR. GH induced a 52% increase in circulating FFA levels with peak values after 155 min (P = 0.03). Tyrosine-phosphorylated STAT5...... tended to increase after GH in muscle and fat, respectively. We conclude that 1) STAT5 is acutely activated in human muscle and fat after a GH bolus, but additional downstream GH signaling was significant only in fat; 2) the direct GH effects in muscle need further characterization; and 3) this human...

  2. A qualitative feasibility study to inform a randomised controlled trial of fluid bolus therapy in septic shock.

    Science.gov (United States)

    O'Hara, Caitlin B; Canter, Ruth R; Mouncey, Paul R; Carter, Anjali; Jones, Nicola; Nadel, Simon; Peters, Mark J; Lyttle, Mark D; Harrison, David A; Rowan, Kathryn M; Inwald, David; Woolfall, Kerry

    2018-01-01

    The Fluids in Shock (FiSh) Trial proposes to evaluate whether restrictive fluid bolus therapy (10 mL/kg) is more beneficial than current recommended practice (20 mL/kg) in the resuscitation of children with septic shock in the UK. This qualitative feasibility study aimed to explore acceptability of the FiSh Trial, including research without prior consent (RWPC), potential barriers to recruitment and participant information for a pilot trial. Qualitative interview study involving parents of children who had presented to a UK emergency department or been admitted to a paediatric intensive care unit with severe infection in the previous 3 years. Twenty-one parents (seven bereaved) were interviewed 16 (median) months since their child's hospital admission (range: 1-41). All parents said they would have provided consent for the use of their child's data in the FiSh Trial. The majority were unfamiliar with RWPC, yet supported its use. Parents were initially concerned about the change from currently recommended treatment, yet were reassured by explanations of the current evidence base, fluid bolus therapy and monitoring procedures. Parents made recommendations about the timing of the research discussion and content of participant information. Bereaved parents stated that recruiters should not discuss research immediately after a child's death, but supported a personalised postal 'opt-out' approach to consent. Findings show that parents whose child has experienced severe infection supported the proposed FiSh Trial, including the use of RWPC. Parents' views informed the development of the pilot trial protocol and site staff training. ISRCTN15244462-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. Prolonged infusion versus intermittent boluses of β-lactam antibiotics for treatment of acute infections: a meta-analysis.

    Science.gov (United States)

    Teo, Jocelyn; Liew, Yixin; Lee, Winnie; Kwa, Andrea Lay-Hoon

    2014-05-01

    The clinical advantages of prolonged (extended/continuous) infusion remain controversial. Previous studies and reviews have failed to show consistent clinical benefits of extending the infusion time. This meta-analysis sought to determine whether prolonged β-lactam infusions were associated with a reduction in mortality and improvement in clinical success. A search of PubMed, EMBASE and The Cochrane Library for randomised controlled trials (RCTs) and observational studies comparing prolonged infusion with intermittent bolus administration of the same antibiotic in hospitalised adult patients was conducted. Primary outcomes evaluated were mortality and clinical success. A total of 29 studies with 2206 patients (18 RCTs and 11 observational studies) were included in the meta-analysis. Compared with intermittent boluses, use of prolonged infusion appeared to be associated with a significant reduction in mortality [pooled relative risk (RR) = 0.66, 95% confidence interval (CI) 0.53-0.83] and improvement in clinical success (RR = 1.12, 95% CI 1.03-1.21). Statistically significant benefit was supported by non-randomised studies (mortality, RR = 0.57, 95% CI 0.43-0.76; clinical success, RR = 1.34, 95% CI 1.02-1.76) but not by RCTs (mortality, RR = 0.83, 95% CI 0.57-1.21; clinical success, RR = 1.05, 95% CI 0.99-1.12). The positive results from observational studies, especially in the face of increasing antibiotic resistance, serve to justify the imperative need to conduct a large-scale, well-designed, multicentre RCT involving critically ill patients infected with high minimum inhibitory concentration pathogens to clearly substantiate this benefit. Copyright © 2014 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  4. A qualitative feasibility study to inform a randomised controlled trial of fluid bolus therapy in septic shock

    Science.gov (United States)

    O’Hara, Caitlin B; Canter, Ruth R; Mouncey, Paul R; Carter, Anjali; Jones, Nicola; Nadel, Simon; Peters, Mark J; Lyttle, Mark D; Harrison, David A; Rowan, Kathryn M; Inwald, David; Woolfall, Kerry

    2018-01-01

    Objective The Fluids in Shock (FiSh) Trial proposes to evaluate whether restrictive fluid bolus therapy (10 mL/kg) is more beneficial than current recommended practice (20 mL/kg) in the resuscitation of children with septic shock in the UK. This qualitative feasibility study aimed to explore acceptability of the FiSh Trial, including research without prior consent (RWPC), potential barriers to recruitment and participant information for a pilot trial. Design Qualitative interview study involving parents of children who had presented to a UK emergency department or been admitted to a paediatric intensive care unit with severe infection in the previous 3 years. Participants Twenty-one parents (seven bereaved) were interviewed 16 (median) months since their child’s hospital admission (range: 1–41). Results All parents said they would have provided consent for the use of their child’s data in the FiSh Trial. The majority were unfamiliar with RWPC, yet supported its use. Parents were initially concerned about the change from currently recommended treatment, yet were reassured by explanations of the current evidence base, fluid bolus therapy and monitoring procedures. Parents made recommendations about the timing of the research discussion and content of participant information. Bereaved parents stated that recruiters should not discuss research immediately after a child’s death, but supported a personalised postal ‘opt-out’ approach to consent. Conclusions Findings show that parents whose child has experienced severe infection supported the proposed FiSh Trial, including the use of RWPC. Parents’ views informed the development of the pilot trial protocol and site staff training. Trial registration number ISRCTN15244462—results. PMID:28847877

  5. Activity and toxicity of oxaliplatin and bolus fluorouracil plus leucovorin in pretreated colorectal cancer patients: a phase 2. study

    Energy Technology Data Exchange (ETDEWEB)

    Ferraresi, V.; Buccilli, A.; Giannarelli, D.; Ciccarese, M. [Regina Elena Cancer Institute, Rome (Italy). Dept. of Medical Oncology; Giampaolo, M.A.; Gabriele, A.; Buccilli, A.; Gamucci, T. [Azienda Sanitaria Locale, Frosinone (Italy). Complex Operative Unit of Medical Oncology

    2005-06-15

    The aim of the current study was to evaluate the activity and toxicity of a combination of oxaliplatin with bolus fluorouracil and leucovorin in colorectal cancer (CRC) patients pretreated for advanced disease with various schedules including continuous fluorouracil infusion. Thirty consecutive patients with pretreated advanced CRC received oxaliplatin 130 mg/m{sup 2} by 2-h infusion dl, leucovorin 100 mg/m{sup 2} by 1-h infusion followed by fluorouracil 425 mg/m{sup 2} i.v. bolus from day 1 to 3 every 3 weeks for a maximum of 6 cycles. The best overall response rate in an intent-to-treat analysis was 13% (2 complete responses and 2 partial responses) (95% CI, 1.2-25.5%) and 37% of patients obtained stable disease with a tumor growth control rate of 50% (95% CI, 32.1-67.9%). The median progression-free survival was 4.0 months (95% CI, 1.4-6.5 months) and median overall survival was 12.0 months (95% CI, 9.9-14.1 months). The independent prognostic factors for improved overall survival were a good performance status and a response/stabilization of disease to chemotherapy. Severe neutropenia was quite common (43.3% of patients and 14.4% of cycles), although complicated by fever only in one case (3.3% of patients). There was one toxic death. In conclusion, the study combination showed an interesting rate of tumor growth control in a cohort of patients previously treated for advanced disease with various schedules including continuous fluorouracil infusion.

  6. Ultrasound-mediated gene delivery of naked plasmid DNA in skeletal muscles: a case for bolus injections.

    Science.gov (United States)

    Sanches, Pedro Gomes; Mühlmeister, Mareike; Seip, Ralf; Kaijzel, Eric; Löwik, Clemens; Böhmer, Marcel; Tiemann, Klaus; Grüll, Holger

    2014-12-10

    Localized gene delivery has many potential clinical applications. However, the nucleic acids (e.g. pDNA and siRNA) are incapable of passively crossing the endothelium, cell membranes and other biological barriers which must be crossed to reach their intracellular targets. A possible solution is the use of ultrasound to burst circulating microbubbles inducing transient permeabilization of surrounding tissues which mediates nucleic acid extravasation and cellular uptake. In this study we report on an optimization of the ultrasound gene delivery technique. Naked pDNA (200 μg) encoding luciferase and SonoVue® microbubbles were co-injected intravenously in mice. The hindlimb skeletal muscles were exposed to ultrasound from a non-focused transducer (1 MHz, 1.25 MPa, PRI 30s) and injection protocols and total amounts as well as ultrasound parameters were systemically varied. Gene expression was quantified relative to a control using a bioluminescence camera system at day 7 after sonication. Bioluminescence ratios in sonicated/control muscles of up to 101× were obtained. In conclusion, we were able to specifically deliver genetic material to the selected skeletal muscles and overall, the use of bolus injections and high microbubble numbers resulted in increased gene expression reflected by stronger bioluminescence signals. Based on our data, bolus injections seem to be required in order to achieve transient highly concentrated levels of nucleic acids and microbubbles at the tissue of interest which upon ultrasound exposure should lead to increased levels of gene delivery. Thus, ultrasound mediated gene delivery is a promising technique for the clinical translation of localized drug delivery. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Multidetector computed tomography with triple-bolus contrast medium administration protocol for preoperative anatomical and functional assessment of potential living renal donors

    International Nuclear Information System (INIS)

    Knox, Matthew K.; Rivers-Bowerman, Michael D.; Bardgett, Harry P.; Cowan, Nigel C.

    2010-01-01

    To evaluate multidetector computed tomography (MDCT) with a triple-bolus contrast administration protocol for preoperative anatomical and functional assessment of living renal donors. Fifty-five potential living renal donors underwent MDCT of which 27 proceeded to donor nephrectomy. A triple-bolus contrast administration protocol was used for simultaneous acquisition of arterial, nephrographic, and excretory phases. MDCT images were independently reviewed in random order by two radiologists blinded to surgical anatomy findings. Diagnostic accuracy for anatomical variants was quantified by sensitivity and specificity. Differential renal function (DRF) was derived from MDCT for 54 patients and compared with technetium-99 m dimercaptosuccinic acid renography (Tc-99 m DMSA). All triple-bolus MDCT examinations were technically adequate. Accessory renal arteries and veins were identified at surgery in 33% (n = 9/27) and 22% (n = 6/27) of donor kidneys. The mean difference between MDCT-derived DRF and DMSA was 0.8% (95% CI 0.1-1.6) with 95% limits of agreement of -4.6% (95% CI -3.3 to -5.9) to 6.3% (95% CI 5.0-7.6). MDCT delivered a mean (SD, range) radiation dose of 9.5 (3.6, 3.6-17.3) mSv. MDCT with a triple-bolus contrast administration provides accurate anatomical and functional evaluation of living renal donors. (orig.)

  8. Multidetector computed tomography with triple-bolus contrast medium administration protocol for preoperative anatomical and functional assessment of potential living renal donors

    Energy Technology Data Exchange (ETDEWEB)

    Knox, Matthew K. [University of Calgary, Faculty of Medicine, UME Office, Health Sciences Centre, Calgary, Alberta (Canada); Rivers-Bowerman, Michael D. [University of British Columbia, Faculty of Medicine, MD Undergraduate Program, Diamond Health Care Centre, Vancouver, British Columbia (Canada); Bardgett, Harry P. [Bradford Teaching Hospitals, Department of Radiology, Bradford (United Kingdom); Cowan, Nigel C. [The Churchill Hospital, Department of Radiology, Oxford (United Kingdom)

    2010-11-15

    To evaluate multidetector computed tomography (MDCT) with a triple-bolus contrast administration protocol for preoperative anatomical and functional assessment of living renal donors. Fifty-five potential living renal donors underwent MDCT of which 27 proceeded to donor nephrectomy. A triple-bolus contrast administration protocol was used for simultaneous acquisition of arterial, nephrographic, and excretory phases. MDCT images were independently reviewed in random order by two radiologists blinded to surgical anatomy findings. Diagnostic accuracy for anatomical variants was quantified by sensitivity and specificity. Differential renal function (DRF) was derived from MDCT for 54 patients and compared with technetium-99 m dimercaptosuccinic acid renography (Tc-99 m DMSA). All triple-bolus MDCT examinations were technically adequate. Accessory renal arteries and veins were identified at surgery in 33% (n = 9/27) and 22% (n = 6/27) of donor kidneys. The mean difference between MDCT-derived DRF and DMSA was 0.8% (95% CI 0.1-1.6) with 95% limits of agreement of -4.6% (95% CI -3.3 to -5.9) to 6.3% (95% CI 5.0-7.6). MDCT delivered a mean (SD, range) radiation dose of 9.5 (3.6, 3.6-17.3) mSv. MDCT with a triple-bolus contrast administration provides accurate anatomical and functional evaluation of living renal donors. (orig.)

  9. Comparison of Intermittent and Bolus Enteral Feeding Methods on Enteral Feeding Intolerance of Patients with Sepsis: A Triple-blind Controlled Trial in Intensive Care Units.

    Science.gov (United States)

    Nasiri, Morteza; Farsi, Zahra; Ahangari, Mojtaba; Dadgari, Fahimeh

    2017-10-01

    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.

  10. Split-bolus single-phase cardiac multidetector computed tomography for reliable detection of left atrial thrombus. Comparison to transesophageal echocardiography

    Energy Technology Data Exchange (ETDEWEB)

    Staab, W.; Zwaka, P.A.; Sohns, J.M.; Schwarz, A.; Lotz, J. [University Medical Center Goettingen Univ. (Germany). Inst. for Diagnostic and Interventional Radiology; Sohns, C.; Vollmann, D.; Zabel, M.; Hasenfuss, G. [Goettingen Univ. (Germany). Dept. of Cardiology and Pneumology; Schneider, S. [Goettingen Univ. (Germany). Dept. of Medical Statistics

    2014-11-15

    Evaluation of a new cardiac MDCT protocol using a split-bolus contrast injection protocol and single MDCT scan for reliable diagnosis of LA/LAA thrombi in comparison to TEE, optimizing radiation exposure and use of contrast agent. A total of 182 consecutive patients with drug refractory AF scheduled for PVI (62.6% male, mean age: 64.1 ± 10.2 years) underwent routine diagnostic work including TEE and cardiac MDCT for the evaluation of LA/LAA anatomy and thrombus formation between November 2010 and March 2012. Contrast media injection was split into a pre-bolus of 30 ml and main bolus of 70 ml iodinated contrast agent separated by a short time delay. In this study, split-bolus cardiac MDCT identified 14 of 182 patients with filling defects of the LA/LAA. In all of these 14 patients, abnormalities were found in TEE. All 5 of the 14 patients with thrombus formation in cardiac MDCT were confirmed by TEE. MDCT was 100% accurate for thrombus, with strong but not perfect overall results for SEC equivalent on MDCT.

  11. Effect of Admission Oral Diuretic Dose on Response to Continuous versus Bolus Intravenous Diuretics in Acute Heart Failure: An Analysis from DOSE-AHF

    Science.gov (United States)

    Shah, Ravi V.; McNulty, Steven; O'Connor, Christopher M.; Felker, G. Michael; Braunwald, Eugene; Givertz, Michael M.

    2014-01-01

    Background Results from the Diuretic Optimization Strategies in Acute Heart Failure (DOSE-AHF) study suggest that an initial continuous infusion of loop diuretics is not superior to bolus dosing with regard to clinical endpoints in AHF. We hypothesized that outpatient furosemide dose was associated with congestion and poorer renal function, and explored the hypothesis that a continuous infusion may be more effective in patients on higher outpatient diuretic doses. Methods DOSE-AHF randomized 308 patients within 24 hours of admission to high vs. low initial intravenous diuretic dose given as either a continuous infusion or bolus. We compared baseline characteristics and assessed associations between mode of administration (bolus vs. continuous) and outcomes in patients receiving high-dose (≥120 mg furosemide equivalent, n=177) versus low-dose (diuretics. Results Patients on higher doses of furosemide were less frequently on renin-angiotensin system inhibitors (P=.01), and had worse renal function and more advanced symptoms. There was a significant interaction between outpatient dose and mode of therapy (P=0.01) with respect to net fluid loss at 72 hours after adjusting for creatinine and intensification strategy. Admission diuretic dose was associated with an increased risk of death or rehospitalization at 60 days (adjusted HR=1.08 per 20-mg increment in dose, 95% CI 1.01–1.16, P=.03). Conclusions In acute HF, patients on higher diuretic doses have greater disease severity, and may benefit from an initial bolus strategy. PMID:23194486

  12. Associations between bolus infusion of hydrocortisone, glycemic variability and insulin infusion rate variability in critically Ill patients under moderate glycemic control

    NARCIS (Netherlands)

    van Hooijdonk, Roosmarijn T. M.; Binnekade, Jan M.; Bos, Lieuwe D. J.; Horn, Janneke; Juffermans, Nicole P.; Abu-Hanna, Ameen; Schultz, Marcus J.

    2015-01-01

    We retrospectively studied associations between bolus infusion of hydrocortisone and variability of the blood glucose level and changes in insulin rates in intensive care unit (ICU) patients. 'Glycemic variability' and 'insulin infusion rate variability' were calculated from and expressed as the

  13. Impaired bolus clearance in combined high-resolution esophageal manometry and impedance measurement helps to differentiate between esophagogastric junction outflow obstruction and achalasia.

    Science.gov (United States)

    Zizer, Eugen; Seufferlein, Thomas; Hänle, Mark Martin

    2017-02-01

    Introduction and aims  High-resolution esophageal manometry (HRM) has improved the diagnostic work-up of esophageal motility disorders. Simultaneous evaluation of bolus clearance delivers useful information about the function of tubular esophagus. We assessed bolus clearance in a combined HRM-impedance examination for esophagogastric junction outflow obstruction (EGJOO) in comparison to achalasia patients. The collected data were assessed in a retrospective analysis. Patients and methods  After gastroscopy excluded a mechanical esophageal or gastric obstruction, 142 consecutive patients underwent combined HRM-impedance examination. The assessment and interpretation of the manometry results were done according to the Chicago Classification of esophageal motility disorders v3.0. After classifying the motility disorder, the evaluation of bolus clearance was done according to published studies. Results  All patients with achalasia (n = 24) showed a significantly impaired bolus clearance (achalasia cases. This might be helpful as an additional tool to differentiate between achalasia and EGJOO patients. Furthermore, the role of the combined impedance-HRM investigation for early diagnosis of achalasia in "pre-achalasia" condition or in evaluation of potential progress of EGJOO to achalasia should be evaluated in a prospective study. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Optimization of initial propofol bolus dose for EEG Narcotrend Index-guided transition from sevoflurane induction to intravenous anesthesia in children.

    Science.gov (United States)

    Dennhardt, Nils; Boethig, Dietmar; Beck, Christiane; Heiderich, Sebastian; Boehne, Martin; Leffler, Andreas; Schultz, Barbara; Sümpelmann, Robert

    2017-04-01

    Sevoflurane induction followed by intravenous anesthesia is a widely used technique to combine the benefits of an easier and less traumatic venipuncture after sevoflurane inhalation with a recovery with less agitation, nausea, and vomiting after total intravenous anesthesia (TIVA). Combination of two different anesthetics may lead to unwanted burst suppression in the electroencephalogram (EEG) during the transition phase. The objective of this prospective clinical observational study was to identify the optimal initial propofol bolus dose for a smooth transition from sevoflurane induction to TIVA using the EEG Narcotrend Index (NI). Fifty children aged 1-8 years scheduled for elective pediatric surgery were studied. After sevoflurane induction and establishing of an intravenous access, a propofol bolus dose range 0-5 mg·kg -1 was administered at the attending anesthetist's discretion to maintain a NI between 20 and 64, and sevoflurane was stopped. Anesthesia was continued as TIVA with a propofol infusion dose of 15 mg·kg -1 ·h -1 for the first 15 min, followed by stepwise reduction according to McFarlan's pediatric infusion regime, and remifentanil 0.25 μg·kg -1 ·min -1 . Endtidal concentration of sevoflurane, NI, and hemodynamic data were recorded during the whole study period using a standardized case report form. Propofol plasma concentrations were calculated using the paedfusor dataset and a TIVA simulation program. Median endtidal concentration of sevoflurane at the time of administration of the propofol bolus was 5.1 [IQR 4.7-5.9] Vol%. The median propofol bolus dose was 1.2 [IQR 0.9-2.5] mg·kg -1 and median NI thereafter was 33 [IQR 23-40]. Nine children presented with a NI 13-20 and three children with burst suppression in the EEG (NI 0-12); all of them received an initial propofol bolus dose >2 mg·kg -1 . Regression equation demonstrated that NI 20-64 was achieved with a 95% probability when using a propofol bolus dose of 1 mg·kg -1 after

  15. SU-E-T-356: Accuracy of Eclipse Electron Macro Monte Carlo Dose Algorithm for Use in Bolus Electron Conformal Therapy

    International Nuclear Information System (INIS)

    Carver, R; Popple, R; Benhabib, S; Antolak, J; Sprunger, C; Hogstrom, K

    2014-01-01

    Purpose: To evaluate the accuracy of electron dose distribution calculated by the Varian Eclipse electron Monte Carlo (eMC) algorithm for use with recent commercially available bolus electron conformal therapy (ECT). Methods: eMC-calculated electron dose distributions for bolus ECT have been compared to those previously measured for cylindrical phantoms (retromolar trigone and nose), whose axial cross sections were based on the mid-PTV CT anatomy for each site. The phantoms consisted of SR4 muscle substitute, SR4 bone substitute, and air. The bolus ECT treatment plans were imported into the Eclipse treatment planning system and calculated using the maximum allowable histories (2×10 9 ), resulting in a statistical error of <0.2%. Smoothing was not used for these calculations. Differences between eMC-calculated and measured dose distributions were evaluated in terms of absolute dose difference as well as distance to agreement (DTA). Results: Results from the eMC for the retromolar trigone phantom showed 89% (41/46) of dose points within 3% dose difference or 3 mm DTA. There was an average dose difference of −0.12% with a standard deviation of 2.56%. Results for the nose phantom showed 95% (54/57) of dose points within 3% dose difference or 3 mm DTA. There was an average dose difference of 1.12% with a standard deviation of 3.03%. Dose calculation times for the retromolar trigone and nose treatment plans were 15 min and 22 min, respectively, using 16 processors (Intel Xeon E5-2690, 2.9 GHz) on a Varian Eclipse framework agent server (FAS). Results of this study were consistent with those previously reported for accuracy of the eMC electron dose algorithm and for the .decimal, Inc. pencil beam redefinition algorithm used to plan the bolus. Conclusion: These results show that the accuracy of the Eclipse eMC algorithm is suitable for clinical implementation of bolus ECT

  16. SU-E-T-356: Accuracy of Eclipse Electron Macro Monte Carlo Dose Algorithm for Use in Bolus Electron Conformal Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Carver, R [Mary Bird Perkins Cancer Center, Baton Rouge, LA (United States); Popple, R; Benhabib, S [UniversityAlabama Birmingham, Birmingham, AL (United Kingdom); Antolak, J [Mayo Clinic, Rochester, MN (United States); Sprunger, C [Louisiana State University, Baton Rouge, LA (United States); Hogstrom, K [Mary Bird Perkins Cancer Center, Baton Rouge, LA (United States); Louisiana State University, Baton Rouge, LA (United States)

    2014-06-01

    Purpose: To evaluate the accuracy of electron dose distribution calculated by the Varian Eclipse electron Monte Carlo (eMC) algorithm for use with recent commercially available bolus electron conformal therapy (ECT). Methods: eMC-calculated electron dose distributions for bolus ECT have been compared to those previously measured for cylindrical phantoms (retromolar trigone and nose), whose axial cross sections were based on the mid-PTV CT anatomy for each site. The phantoms consisted of SR4 muscle substitute, SR4 bone substitute, and air. The bolus ECT treatment plans were imported into the Eclipse treatment planning system and calculated using the maximum allowable histories (2×10{sup 9}), resulting in a statistical error of <0.2%. Smoothing was not used for these calculations. Differences between eMC-calculated and measured dose distributions were evaluated in terms of absolute dose difference as well as distance to agreement (DTA). Results: Results from the eMC for the retromolar trigone phantom showed 89% (41/46) of dose points within 3% dose difference or 3 mm DTA. There was an average dose difference of −0.12% with a standard deviation of 2.56%. Results for the nose phantom showed 95% (54/57) of dose points within 3% dose difference or 3 mm DTA. There was an average dose difference of 1.12% with a standard deviation of 3.03%. Dose calculation times for the retromolar trigone and nose treatment plans were 15 min and 22 min, respectively, using 16 processors (Intel Xeon E5-2690, 2.9 GHz) on a Varian Eclipse framework agent server (FAS). Results of this study were consistent with those previously reported for accuracy of the eMC electron dose algorithm and for the .decimal, Inc. pencil beam redefinition algorithm used to plan the bolus. Conclusion: These results show that the accuracy of the Eclipse eMC algorithm is suitable for clinical implementation of bolus ECT.

  17. La lengua inglesa como neolengua

    Directory of Open Access Journals (Sweden)

    Fernando BELTRÁN LLAVADOR

    2009-11-01

    Full Text Available RESUMEN: El artículo examina algunos usos y abusos de la lengua inglesa en la actualidad en el contexto de la globalización. Se define la neolengua, se ofrecen similitudes de la misma en el lenguaje publicitario en España, se trazan sus orígenes y se apuntan algunos antecedentes en la historia de la literatura inglesa, al tiempo que se ilustran ejemplos de variantes contemporáneas de la misma bajo la denominación de «nukespeak», especialmente abundantes en el discurso de los conflictos bélicos. La lengua inglesa está indisociablemente unida a complejos factores de orden económico, tecnológico y cultural que afectan a su misma morfología. Por otra parte, la presencia ubicua de la lengua inglesa, como idioma global, opera sobre las estructuras de sentimiento, pensamiento y acción de los ciudadanos en todo el mundo. Para los profesionales de la enseñanza del idioma inglés, ello comporta la obligación de discernir y resistir sus efectos potencialmente perversos al tiempo que siguen promoviendo sus valiosos beneficios culturales.ABSTRACT: Contemporary uses and abuses of the English language are examined in the context of complex issues and globalization trends. The term «newspeak» is defined, similitudes of it are found today in the language of advertising in Spain, its origins are traced back and antecedents are located in the history of English literature, while the presence of new modalities of the Orwellian reductionist language, such as «nukespeak», is illustrated within the language of warfare. The English language is inextricably bound up with economical, technological and cultural factors which affect its very morphology just as much as the pervasive influence of English as a global language affects the structures of feeling, thought and action of citizens all over the world, which poses an obligation on the part of EFL teachers to discern and resist its ill effects while they promote its still highly valuable cultural

  18. Como responder ao momento presente?

    Directory of Open Access Journals (Sweden)

    Maria Filomena Molder

    2013-12-01

    Full Text Available http://dx.doi.org/10.5007/1984-784X.2013v13n19p13 Foi com esta pergunta — já um efeito de um primeiro encontro entre Irene Pimentel e eu própria — que decidimos desafiar colegas, estudantes e funci­onários da nossa Faculdade, FCSH (Faculdade de Ciências Sociais e Huma­nas, de outras Faculdades da Universidade Nova de Lisboa, de outras Uni­versidades e todos os interessados em con­siderar e discutir em comum aquilo que se passava em Portugal e que no anúncio da Jornada de 6 de De­zembro de 2012 se descrevia como um “processo de desmantela­mento social, económico e cultural sem precedentes — pese embora tantas compara­ções, baseadas na premissa da ‘eterna repetição’ — e cujas consequências não param de exceder as previsões dos responsáveis por esse desmantelamento”. Acedendo com todo o empenho e gratidão ao convite que me foi dirigido por Humberto Brito para fazer uma resenha da Jornada a publicar no primeiro número de Forma de Vida (saúdo a revista e o título, decidi-me, no entanto, a pôr de lado a resenha, que sob a forma de “Editorial” será em breve publi­cada no blogue Responder ao Momento Presente, entre­tanto criado, conjuntamente com os textos escritos pelos nossos convidados, com as parti­cipações de pessoas que corresponderam ao nosso apelo e ainda com contri­bui­ções que se alargaram para lá da Jornada; a que se juntará uma gravação em video, também disponível no Youtube.   Texto publicado originalmente em Forma de Vida, Lisboa, n.1, fev. 2013. Agrade­cemos à autora por permitir a republicação neste número do Boletim. [N.E.

  19. Enhancing automatic closed-loop glucose control in type 1 diabetes with an adaptive meal bolus calculator - in silico evaluation under intra-day variability.

    Science.gov (United States)

    Herrero, Pau; Bondia, Jorge; Adewuyi, Oloruntoba; Pesl, Peter; El-Sharkawy, Mohamed; Reddy, Monika; Toumazou, Chris; Oliver, Nick; Georgiou, Pantelis

    2017-07-01

    Current prototypes of closed-loop systems for glucose control in type 1 diabetes mellitus, also referred to as artificial pancreas systems, require a pre-meal insulin bolus to compensate for delays in subcutaneous insulin absorption in order to avoid initial post-prandial hyperglycemia. Computing such a meal bolus is a challenging task due to the high intra-subject variability of insulin requirements. Most closed-loop systems compute this pre-meal insulin dose by a standard bolus calculation, as is commonly found in insulin pumps. However, the performance of these calculators is limited due to a lack of adaptiveness in front of dynamic changes in insulin requirements. Despite some initial attempts to include adaptation within these calculators, challenges remain. In this paper we present a new technique to automatically adapt the meal-priming bolus within an artificial pancreas. The technique consists of using a novel adaptive bolus calculator based on Case-Based Reasoning and Run-To-Run control, within a closed-loop controller. Coordination between the adaptive bolus calculator and the controller was required to achieve the desired performance. For testing purposes, the clinically validated Imperial College Artificial Pancreas controller was employed. The proposed system was evaluated against itself but without bolus adaptation. The UVa-Padova T1DM v3.2 system was used to carry out a three-month in silico study on 11 adult and 11 adolescent virtual subjects taking into account inter-and intra-subject variability of insulin requirements and uncertainty on carbohydrate intake. Overall, the closed-loop controller enhanced by an adaptive bolus calculator improves glycemic control when compared to its non-adaptive counterpart. In particular, the following statistically significant improvements were found (non-adaptive vs. adaptive). Adults: mean glucose 142.2 ± 9.4vs. 131.8 ± 4.2mg/dl; percentage time in target [70, 180]mg/dl, 82.0 ± 7.0vs. 89.5 ± 4

  20. Plasma amino acids and metabolic profiling of dairy cows in response to a bolus duodenal infusion of leucine.

    Science.gov (United States)

    Sadri, Hassan; von Soosten, Dirk; Meyer, Ulrich; Kluess, Jeannette; Dänicke, Sven; Saremi, Behnam; Sauerwein, Helga

    2017-01-01

    Leucine (Leu), one of the three branch chain amino acids, acts as a signaling molecule in the regulation of overall amino acid (AA) and protein metabolism. Leucine is also considered to be a potent stimulus for the secretion of insulin from pancreatice β-cells. Our objective was to study the effects of a duodenal bolus infusion of Leu on insulin and glucagon secretion, on plasma AA concentrations, and to do a metabolomic profiling of dairy cows as compared to infusions with either glucose or saline. Six duodenum-fistulated Holstein cows were studied in a replicated 3 × 3 Latin square design with 3 periods of 7 days, in which the treatments were applied at the end of each period. The treatments were duodenal bolus infusions of Leu (DIL; 0.15 g/kg body weight), glucose (DIG; at Leu equimolar dosage) or saline (SAL). On the day of infusion, the treatments were duodenally infused after 5 h of fasting. Blood samples were collected at -15, 0, 10, 20, 30, 40, 50, 60, 75, 90, 120, 180, 210, 240 and 300 min relative to the start of infusion. Blood plasma was assayed for concentrations of insulin, glucagon, glucose and AA. The metabolome was also characterized in selected plasma samples (i.e. from 0, 50, and 120 min relative to the infusion). Body weight, feed intake, milk yield and milk composition were recorded throughout the experiment. The Leu infusion resulted in significant increases of Leu in plasma reaching 20 and 15-fold greater values than that in DIG and SAL, respectively. The elevation of plasma Leu concentrations after the infusion led to a significant decrease (Pcows were reduced (Pinsulin were not affected by Leu. In DIG, insulin and glucose concentrations peaked at 30-40 and 40-50 min after the infusion, respectively. Insulin concentrations were greater (Pcows were compared with the DIG and SAL cows at 50 and 120 min after the infusion. By using this analysis, several metabolites, mainly acylcarnitines, methionine sulfoxide and components from the

  1. SU-E-T-541: Bolus Effect of Thermoplastic Masks in IMRT and VMAT Head and Neck Treatments

    International Nuclear Information System (INIS)

    Zhen, H; Nedzi, L; Chen, S; Jiang, S; Zhao, B

    2014-01-01

    Purpose: To quantitatively evaluate the bolus effect of thermoplalstic mask on patient skin dose during multi-field IMRT and VMAT treatment. Methods: The clinically approved target contours for five head and neck patients were deformably registered to an anthropomorphic Rando phantom. Two plans: Multifield IMRT plan with 7-9 beams and VMAT plan with 2-4 arcs were created for each patient following same dose constraints. 3mm skin was excluded from PTVs but not constrained during optimization. The prescription dose was 200-220 cGy/fraction. A thermoplastic head and shoulder mask was customized for the Rando phantom. Each plan was delivered to the phantom twice with and without mask. During each delivery, two rectangular strips of EBT3 films (1cm x 6.8cm) were placed across the anterior upper and lower neck near PTVs to measure the surface dose. For consistency films were positioned at same locations for same patient. A total of 8 film strips were obtained for each patient. Film dose was calibrated in the range of 0-400cGy on the day of plan delivery. For dose comparison 3 regions of interests (ROIs) of 1×1 cm 2 were selected at left, right and middle part of each film, resulting in 6 point doses at each plan delivery. Results: The films without mask show relatively uniform dose distribution while those with mask clearly show mesh pattern of mask, usually indicating an increase in skin dose. On average the increase in skin dose over all ROIs with mask was 31.9%(±14.8%) with a range of 11.4%- 58.4%. There is no statistically significant difference (p=0.44) between skin dose increase in VMAT (30.8%±15.3%) and IMRT delivery (33.0%±14.9%). Conclusion: Thermoplastic immobilization masks increase surface dose for HN patient by around 30%. The magnitude is comparable between multi-field IMRT and VMAT. Radiochromic EBT3 film serves as an effective tool to quantify bolus effect

  2. Analysis of factors influencing the integrated bolus peak timing in contrast-enhanced brain computed tomographic angiography

    International Nuclear Information System (INIS)

    Son, Soon Yong; Choi, Kwan Woo; Jeong, Hoi Woun; Jang, Seo Goo; Jung, Jae Young; Yun, Jung Soo; Kim, Ki Won; Lee, Young Ah; Son, Jin Hyun; Min, Jung Whan

    2016-01-01

    The objective of this study was to analyze the factors influencing integrated bolus peak timing in contrast- enhanced computed tomographic angiography (CTA) and to determine a method of calculating personal peak time. The optimal time was calculated by performing multiple linear regression analysis, after finding the influence factors through correlation analysis between integrated peak time of contrast medium and personal measured value by monitoring CTA scans. The radiation exposure dose in CTA was 716.53 mGy·cm and the radiation exposure dose in monitoring scan was 15.52 mGy (2 - 34 mGy). The results were statistically significant (p < .01). Regression analysis revealed, a -0.160 times decrease with a one-step increase in heart rate in male, and -0.004, -0.174, and 0.006 times decrease with one-step in DBP, heart rate, and blood sugar, respectively, in female. In a consistency test of peak time by calculating measured peak time and peak time by using the regression equation, the consistency was determined to be very high for male and female. This study could prevent unnecessary dose exposure by encouraging in clinic calculation of personal integrated peak time of contrast medium prior to examination

  3. Knowledge Translation to Optimize Adult Inpatient Glycemic Management with Basal Bolus Insulin Therapy and Improve Patient Outcomes.

    Science.gov (United States)

    Helmle, Karmon E; Chacko, Sunita; Chan, Trevor; Drake, Alison; Edwards, Alun L; Moore, Glenda E; Philp, Leta C; Popeski, Naomi; Roedler, Rhonda L; Rogers, Edwin J R; Zimmermann, Gabrielle L; McKeen, Julie

    2017-12-27

    To develop and evaluate a Basal Bolus Insulin Therapy (BBIT) Knowledge Translation toolkit to address barriers to adoption of established best practice with BBIT in the care of adult inpatients. This study was conducted in 2 phases and focused on the hospitalist provider group across 4 acute care facilities in Calgary. Phase 1 involved a qualitative evaluation of provider and site specific barriers and facilitators, which were mapped to validated interventions using behaviour change theory. This informed the co-development and optimization of the BBIT Knowledge Translation toolkit, with each tool targeting a specific barrier to improved diabetes care practice, including BBIT ordering. In Phase 2, the BBIT Knowledge Translation toolkit was implemented and evaluated, focusing on BBIT ordering frequency, as well as secondary outcomes of hyperglycemia (patient-days with BG >14.0 mmol/L), hypoglycemia (patient-days with BG Knowledge Translation toolkit resulted in a significant 13% absolute increase in BBIT ordering. Hyperglycemic patient-days were significantly reduced, with no increase in hypoglycemia. There was a significant, absolute 14% reduction in length of stay. The implementation of an evidence-informed, multifaceted BBIT Knowledge Translation toolkit effectively reduced a deeply entrenched in-patient diabetes care gap. The resulting sustained practice change improved patient clinical and system resource utilization outcomes. This systemic approach to implementation will guide further scale and spread of glycemic optimization initiatives. Copyright © 2018 Diabetes Canada. Published by Elsevier Inc. All rights reserved.

  4. Green Tea Increases the Concentration of Total Mercury in the Blood of Rats following an Oral Fish Tissue Bolus

    Directory of Open Access Journals (Sweden)

    Elsa M. Janle

    2015-01-01

    Full Text Available Fish has many health benefits but is also the most common source of methylmercury. The bioavailability of methylmercury in fish may be affected by other meal components. In this study, the effect of green tea on the bioavailability of methylmercury from an oral bolus of fish muscle tissue was studied in rats and compared to a water treated control group and a group treated with meso-2,3-dimercaptosuccinic acid (DMSA, a compound used medically to chelate mercury. Rats were given a single oral dose of fish tissue via gavage and one of the treatments. Rats were given access to food for 3 h at 12 h intervals. They were dosed with each of the treatments with each meal. Blood samples were collected for 95 hours. Green tea significantly increased the concentration of total mercury in blood relative to the control, whereas DMSA significantly decreased it. In addition, feeding caused a slight increase in blood mercury for several meals following the initial dose.

  5. Comparison of first pass bolus AIFs extracted from sequential 18F-FDG PET and DSC-MRI of mice

    International Nuclear Information System (INIS)

    Evans, Eleanor; Sawiak, Stephen J.; Ward, Alexander O.; Buonincontri, Guido; Hawkes, Robert C.; Adrian Carpenter, T.

    2014-01-01

    Accurate kinetic modelling of in vivo physiological function using positron emission tomography (PET) requires determination of the tracer time–activity curve in plasma, known as the arterial input function (AIF). The AIF is usually determined by invasive blood sampling methods, which are prohibitive in murine studies due to low total blood volumes. Extracting AIFs from PET images is also challenging due to large partial volume effects (PVE). We hypothesise that in combined PET with magnetic resonance imaging (PET/MR), a co-injected bolus of MR contrast agent and PET ligand can be tracked using fast MR acquisitions. This protocol would allow extraction of a MR AIF from MR contrast agent concentration–time curves, at higher spatial and temporal resolution than an image-derived PET AIF. A conversion factor could then be applied to the MR AIF for use in PET kinetic analysis. This work has compared AIFs obtained from sequential DSC-MRI and PET with separate injections of gadolinium contrast agent and 18 F-FDG respectively to ascertain the technique′s validity. An automated voxel selection algorithm was employed to improve MR AIF reproducibility. We found that MR and PET AIFs displayed similar character in the first pass, confirmed by gamma variate fits (p<0.02). MR AIFs displayed reduced PVE compared to PET AIFs, indicating their potential use in PET/MR studies

  6. Capillary permeability of 99mTc-DTPA in canine myocardium determined by intracoronary bolus injection and residue detection

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Efsen, F; Haunsø, S

    1989-01-01

    chest dogs (group A) these indicators were administered separately as bolus injections into a cannulated diagonal branch of the left anterior descending coronary artery (LAD) and the curve of the response function was recorded by external activity registration. In further experiments on closed and open...... chest dogs (group B) 99mTc-DTPA was injected via a coronary angiography catheter into the ostium of the left coronary artery and the response curve was obtained by external registration. Regional myocardial perfusion coefficients were determined by the local 133xenon washout technique and from kinetic...... by local 133Xe washout technique. Mean values of the extraction fractions (E) were 0.463 and 0.475 for 99mTc-DTPA and 51Cr-EDTA, and the permeability-surface area products (PdS) were 52.8 and 57.5 ml.min-1.100 g-1 respectively. At the conventional capillary surface area estimate of 500 cm2.g-1...

  7. Regional cerebral blood flow measurement with intravenous [15O]water bolus and [18F]fluoromethane inhalation

    International Nuclear Information System (INIS)

    Herholz, K.; Pietrzyk, U.; Wienhard, K.; Hebold, I.; Pawlik, G.; Wagner, R.; Holthoff, V.; Klinkhammer, P.; Heiss, W.D.

    1989-01-01

    In 20 patients with ischemic cerebrovascular disease, classic migraine, or angiomas, we compared paired dynamic positron emission tomographic measurements of regional cerebral blood flow using both [ 15 O]water and [ 18 F]fluoromethane as tracers. Cerebral blood flow was also determined according to the autoradiographic technique with a bolus injection of [ 15 O]water. There were reasonable overall correlations between dynamic [ 15 O]water and [ 18 F]fluoromethane values for cerebral blood flow (r = 0.82) and between dynamic and autoradiographic [ 15 O]water values for cerebral blood flow (r = 0.83). We found a close correspondence between abnormal pathologic findings and visually evaluated cerebral blood flow tomograms obtained with the two tracers. On average, dynamic [ 15 O]water cerebral blood flow was 6% lower than that measured with [ 18 F]fluoromethane. There also was a general trend toward a greater underestimation with [ 15 O]water in high-flow areas, particularly in hyperemic areas, probably due to incomplete first-pass extraction of [ 15 O]water. Underestimation was not detected in low-flow areas or in the cerebellum. Absolute cerebral blood flow values were less closely correlated between tracers and techniques than cerebral blood flow patterns. The variability of the relation between absolute flow values was probably caused by confounding effects of the variation in the circulatory delay time. The autoradiographic technique was most sensitive to this type error

  8. Comparative study of intravenous urographic bolus (I.U.B.) and intravenous urographic infusion (I.U.I.) in dogs

    International Nuclear Information System (INIS)

    Thibaut L, Julio; Ditzel, G.; Vargas, L; Born, R; Deppe G, Rodolfo

    1996-01-01

    Two urographic methods were compared: the intravenous urographic bolus (i.u.b.) and the intravenous urographic infusion (i.u.i.). In both methods, two groups of seven healthy adult dogs of both sexes, weighing7.0 to 16.5 kg were used and were anaesthesized with 2% thiopentone sodium in doses of 20 mg/kg via cephalica. In the i.u.b., meglumine diatrizoate (Hypaque-M, 60%) was injected via saphena with a concentration of 282 mg of iodine per mi in doses of 564 mg of iodine per kg. In the i.u.i., meglumine diatrizoate was injected via saphena by drip infusion with a concentration of 200 mg of iodine per mi in doses of 500 mg of iodine per kg. Three series of two X-rays each were taken in ventrodorsal projection 1, 4 and 8 min and left lateral recumbency 30 sec after administering the contrast medium. The X-ray plates obtained were analyzed and compared intra and inter group considering the advance speed of the contrast medium, the radiographic density and outline, and kidney size. The advance speed of the contrast medium was higher in the i.u.i., reaching the kidney, ureter and bladder 1 min after administration in both projections; in ventrodorsal projections in the i.u.b. only the kidneys were reached while in the left lateral recumbency, the kidney and ureters were reached [es

  9. A feasibility study of a 3-day basal-bolus insulin delivery device in individuals with type 2 diabetes.

    Science.gov (United States)

    Mader, Julia K; Lilly, Leslie C; Aberer, Felix; Korsatko, Stefan; Strock, Ellie; Mazze, Roger S; Damsbo, Peter; Pieber, Thomas R

    2014-05-01

    This study tested the feasibility of transition from multiple daily injections (MDI) to a 3-day, basal-bolus insulin delivery device (PaQ) for type 2 diabetes (T2D). Twenty MDI-treated individuals with T2D with HbA(1c) ≤9% (75 mmol/mol) were enrolled in a single-center, single-arm pilot study, lasting three 2-week periods: baseline (MDI), transition to PaQ, and PaQ therapy. Feasibility of use, glycemic control, safety, and patient satisfaction were assessed. Nineteen participants transitioned to PaQ treatment and demonstrated competency in assembling, placing, and using the device. Self-monitored blood glucose and blinded continuous glucose-monitoring data showed glycemic control similar to MDI. Study participants reported high satisfaction and device acceptance. PaQ treatment is both feasible and acceptable in individuals with T2D. Transition from MDI is easy and safe. PaQ treatment might lead to better therapy adherence and improvements in glycemic control and clinical outcomes.

  10. Mapping water exchange rates in rat tumor xenografts using the late-stage uptake following bolus injections of contrast agent.

    Science.gov (United States)

    Bailey, Colleen; Moosvi, Firas; Stanisz, Greg J

    2014-05-01

    To map the intra-to-extracellular water exchange rate constant in rat xenografts using a two-compartment model of relaxation with water exchange and a range of contrast agent concentrations and compare with histology. MDA-MB-231 cells were xenografted into six nude rats. Three bolus injections of gadodiamide were administered. When uptake in the tumor demonstrated a steady-state, T1 data were acquired by spoiled gradient recalled acquisitions at four flip angles. A global fit of data to a two-compartment model incorporating exchange was performed, assuming a distribution volume of 20% of the rat. Voxels that did not reach steady-state and were excluded from parametric maps tended to be in large necrotic areas. TUNEL-negative (nonapoptotic) regions tended to have well-defined error bounds, with an average intra-to-extracellular exchange rate constant of 0.6 s(-1) . Apoptotic regions had higher exchange, but poorly determined upper bounds, with goodness of fit similar to that for a model assuming infinitely fast exchange. A lower bound of >3 s(-1) was used to establish voxels where the exchange rate constant was fast despite a large upper bound. Water exchange rates were higher in apoptotic regions, but examination of statistical errors was an important step in the mapping process. Copyright © 2013 Wiley Periodicals, Inc.

  11. Dual-energy CT iodine maps as an alternative quantitative imaging biomarker to abdominal CT perfusion: determination of appropriate trigger delays for acquisition using bolus tracking.

    Science.gov (United States)

    Skornitzke, Stephan; Fritz, Franziska; Mayer, Philipp; Koell, Marco; Hansen, Jens; Pahn, Gregor; Hackert, Thilo; Kauczor, Hans-Ulrich; Stiller, Wolfram

    2018-05-01

    Quantitative evaluation of different bolus tracking trigger delays for acquisition of dual energy (DE) CT iodine maps as an alternative to CT perfusion. Prior to this retrospective analysis of prospectively acquired data, DECT perfusion sequences were dynamically acquired in 22 patients with pancreatic carcinoma using dual source CT at 80/140 kV p with tin filtration. After deformable motion-correction, perfusion maps of blood flow (BF) were calculated from 80 kV p image series of DECT, and iodine maps were calculated for each of the 34 DECT acquisitions per patient. BF and iodine concentrations were measured in healthy pancreatic tissue and carcinoma. To evaluate potential DECT acquisition triggered by bolus tracking, measured iodine concentrations from the 34 DECT acquisitions per patient corresponding to different trigger delays were assessed for correlation to BF and intergroup differences between tissue types depending on acquisition time. Average BF measured in healthy pancreatic tissue and carcinoma was 87.6 ± 28.4 and 38.6 ± 22.2 ml/100 ml min -1 , respectively. Correlation between iodine concentrations and BF was statistically significant for bolus tracking with trigger delay greater than 0 s (r max = 0.89; p alternative to CT perfusion measurements of BF. Advances in knowledge: After clinical validation, DECT iodine maps of pancreas acquired using bolus tracking with appropriate trigger delay as determined in this study could offer an alternative quantitative imaging biomarker providing functional information for tumor assessment at reduced patient radiation exposure compared to CT perfusion measurements of BF.

  12. Evaluation of a bolus/infusion protocol for 11C-ABP688, a PET tracer for mGluR5

    International Nuclear Information System (INIS)

    Burger, Cyrill; Deschwanden, Alexandra; Ametamey, Simon; Johayem, Anass; Mancosu, Bruno; Wyss, Matthias; Hasler, Gregor; Buck, Alfred

    2010-01-01

    11 C-ABP-688 is a selective tracer for the mGluR5 receptor. Its kinetics is fast and thus favourable for an equilibrium approach to determine receptor-related parameters. The purpose of this study was to test the hypothesis that the pattern of the 11 C-ABP688 uptake using a bolus-plus-infusion (B/I) protocol at early time points corresponds to the perfusion and at a later time point to the total distribution volume. Methods: A bolus and a B/I study (1 h each) was performed in five healthy male volunteers. With the B/I protocol, early and late scans were normalized to gray matter, cerebellum and white matter. The same normalization was done on the maps of the total distribution volume (Vt) and K 1 which were calculated in the study with bolus only injection and the Logan method (Vt) and a two-tissue compartment model (K 1 ). Results: There was an excellent correlation close to the identity line between the pattern of the late uptake in the B/I study and Vt of the bolus-only study for all three normalizations. The pattern of the early uptake in the B/I study correlated well with the K 1 maps, but only when normalized to gray matter and cerebellum, not to white matter. Conclusion: It is demonstrated that with a B/I protocol the 11 C-ABP688 distribution in late scans reflects the pattern of the total distribution volume and is therefore a measure for the density pattern of mGluR5. The early scans following injection are related to blood flow, although not in a fully quantitative manner. The advantage of the B/I protocol is that no arterial blood sampling is required, which is advantageous in clinical studies.

  13. Lung disease severity in idiopathic pulmonary fibrosis is more strongly associated with impedance measures of bolus reflux than pH parameters of acid reflux alone.

    Science.gov (United States)

    Gavini, S; Borges, L F; Finn, R T; Lo, W-K; Goldberg, H J; Burakoff, R; Feldman, N; Chan, W W

    2017-05-01

    Gastroesophageal reflux (GER) has been associated with idiopathic pulmonary fibrosis (IPF). Pathogenesis may be related to chronic micro-aspiration. We aimed to assess objective measures of GER on multichannel intraluminal impedance and pH study (MII-pH) and their relationship with pulmonary function testing (PFT) results, and to compare the performance of pH/acid reflux parameters vs corresponding MII/bolus parameters in predicting pulmonary dysfunction in IPF. This was a retrospective cohort study of IPF patients undergoing prelung transplant evaluation with MII-pH off acid suppression, and having received PFT within 3 months. Patients with prior fundoplication were excluded. Severe pulmonary dysfunction was defined using diffusion capacity of the lung for carbon monoxide (DLCO) ≤40%. Six pH/acid reflux parameters with corresponding MII/bolus reflux measures were specified a priori. Multivariate analyses were applied using forward stepwise logistic regression. Predictive value of each parameter for severe pulmonary dysfunction was calculated by area-under-the-receiver-operating-characteristic-curve or c-statistic. Forty-five subjects (67% M, age 59, 15 mild-moderate vs 30 severe) met criteria for inclusion. Patient demographics and clinical characteristics were similar between pulmonary dysfunction groups. Abnormal total reflux episodes and prolonged bolus clearance time were significantly associated with pulmonary dysfunction severity on univariate and multivariate analyses. No pH parameters were significant. The c-statistic of each pH parameter was lower than its MII counterpart in predicting pulmonary dysfunction. MII/bolus reflux, but not pH/acid reflux, was associated with pulmonary dysfunction in prelung transplant patients with IPF. MII-pH may be more valuable than pH testing alone in characterizing GER in IPF. © 2016 John Wiley & Sons Ltd.

  14. La sabidur?a como competencia gerencial

    OpenAIRE

    Pinzon-Barrios, Ana-Maria; Cort?s Zapata, Gabriela

    2012-01-01

    Aunque el concepto de sabidur?a ha sido ampliamente estudiado por expertos de ?reas como la filosof?a, la religi?n y la psicolog?a, a?n enfrenta limitaciones en cuanto a su definici?n y evaluaci?n. Por esto, el presente trabajo tiene como objetivo, formular una definici?n del concepto de sabidur?a que permita realizar una propuesta de evaluaci?n del concepto como competencia en los gerentes. Para esto, se realiz? un an?lisis documental de tipo cualitativo. De esta manera, se analizaron divers...

  15. Los ritmos como terapia para la impulsividad

    Directory of Open Access Journals (Sweden)

    Mónica Triviño

    2012-10-01

    Full Text Available Investigaciones recientes muestran que el uso de patrones rítmicos facilita la respuesta óptima en el tiempo, por lo que el entrenamiento mediante ritmos podría proponerse como terapia novedosa ante problemas como la impulsividad. Esto podría beneficiar a pacientes con daño prefrontal o personas con trastorno por déficit de atención e hiperactividad (TDAH, que suelen mostrar conductas impulsivas, así como dificultad para estimar el paso del tiempo.

  16. La transparencia como objetivo del desarrollo sostenible

    OpenAIRE

    Juan José Gilli

    2017-01-01

    El presente trabajo tiene por propósito precisar el significado de la transparencia en la gestión pública como una exigencia de carácter ético relacionada con la información que los agentes deben dar en el ámbito sus funciones, reconociendo al ciudadano como el dueño de la información que producen y guardan. La transparencia tiene un especial valor como herramienta para combatir la corrupción y, de esa forma, contribuir a la meta de lograr instituciones inclusivas y efectivas para el desarrol...

  17. La universidad como organización

    Directory of Open Access Journals (Sweden)

    Luis Aurelio Ordoñez Burbano

    2001-07-01

    Full Text Available El presente artículo versa sobre la unviersidad como organización y tiene como objetivo hacer una reflexión sobre la misión de la universidad colombiana en el marco de diversos entornos. Como punto de partida, se propone una precisión sobre la misión de la universidad moderna y la investigación, a diferencia de la universidad colonial y decimonónica limitada a la divulgación de conocimientos preexistentes.

  18. Carolee Schneemann. El cine como autobiografía, la artista como actriz, el cuerpo como pincel

    Directory of Open Access Journals (Sweden)

    María Barbaño González-Moreno

    2017-10-01

    Full Text Available Este trabajo analiza la relación de cine y mujer a partir de la obra fílmica de Carolee Schneemann, principalmente de su obra autobiográfica Fuses (1964-1966. Desde ella, se plantea el papel de la artista como productora, directora y protagonista principal de todas sus obras. Reflexionamos así sobre el rol del creador-director como actor que derivaría en la consecución de una obra cinematográfica de tintes necesariamente autobiográficos. Asumiendo la visión vanguardista del cine como diario personal/Entendido el cine como diario personal, Schneemann va a explorar en su obra diferentes aspectos de la identidad y la sexualidad de la mujer en un cine artístico, alternativo y de tendencia política feminista. Entendido/Asumido su cine como elemento plástico, la artista explorará de forma paralela la experimentación matérica y física a través de los cuerpos filmados así como de la propia materialidad de la película, excluyendo toda posibilidad narrativa, dramática e ilusoria de proyección del espectador en el espacio cinematográfico y el espacio privado del creador.

  19. Evaluation of a commercially available molybdate formulation and zinc oxide boluses in preventing hepatic copper accumulation and thus enzootic icterus in sheep

    Directory of Open Access Journals (Sweden)

    C.J. Botha

    2001-07-01

    Full Text Available The efficacy of a molybdate formulation and a zinc oxide bolus as prophylactic agents for enzootic icterus was evaluated in sheep. Before copper loading, liver biopsies were performed on 12 male, 6-month-old, Mutton Merino sheep to determine hepatic copper (Cu and zinc (Zn concentrations. The animals were restrictively randomised according to liver copper concentrations to 3 treatment groups (n = 4 to achieve similar mean liver copper concentrations per group. All sheep received 4 m /kg of a 0.5 %aqueous solution of CuSO4·5H2O intraruminally 7 days per week for 10 weeks. On Day 0 the sheep in the Mo-group were injected subcutaneously with 42 mg molybdenum (Mo contained in a commercial molybdate formulation. The animals in the Zn-group each received a zinc oxide bolus, containing 43 g zinc oxide, via a rumen cannula. Treatment was repeated on Day 42. Four animals served as untreated controls. Urinary copper excretion, plasma copper concentration, haematocrit and glutamate dehydrogenase (GLDH activity were determined throughout the trial. The animals were sacrificed after 10 weeks and liver samples were submitted for histopathological examination. Liver and kidney copper and zinc concentrations were determined. Neither the molybdate treatment nor the zinc oxide boluses prevented hepatic copper accumulation. The urinary copper excretion, plasma copper concentration, haematocrit and GLDH activity were not significantly different (P > 0.05 from the controls.

  20. El videojuego como material educativo: La Odisea

    Directory of Open Access Journals (Sweden)

    Belén Mainer Blanco

    2012-04-01

    Full Text Available La investigación se basa en la función educativa que pueden cumplir los videojuegos, un campo que consideramos inexplorado por tres motivos principalmente: su reciente incorporación, su impopularidad educativa (el rechazo el videojuego como herramienta de aprendizaje y considerado, por el contrario, como una distracción, y la incompleta incorporación de las nuevas tecnologías de información y comunicación (TIC en el ámbito familiar y educativo. En una segunda parte, se ha realizado una aplicación práctica tomando como referencia la gran obra universal “La Odisea”, cuya intención es mostrar la utilidad del videojuego como complemento educativo.

  1. El Derecho como argumentación

    Directory of Open Access Journals (Sweden)

    Atienza, Manuel

    1999-11-01

    Full Text Available Not available

    Frente a las concepciones del Derecho como norma, como hecho o como valor (que caracterizan, respectivamente, al norrnativismo, al realismo jurídico y al iusnaturalismo, se propone aquí un cuarto enfoque que consiste en ver el Derecho como argumentación (y que cohra especial relevancia en las sociedades democráticas. Sin embargo, no hay una única forma de entender la argumentación jurídica. Aunque conectadas entre sí, en el trabajo se distinguen tres concepciones: la formal, la material y la pragmática o dialéctica; muchas cuestiones que se plantean en el ámbito de la teoría de la argumentación jurídica pueden resolverse -o aclararse- teniendo en cuenta esa triple perspectiva.

  2. La sangre como espectáculo.

    Directory of Open Access Journals (Sweden)

    Rubén Darío Buitrón

    2015-01-01

    Full Text Available El autor asevera que cuando la información es concebida y tratada como una mercancía y no como un bien social, la avidez por el lucro la degenera en productos abyectos donde la sangre es espectáculo que sirve para exacerbar el morbo social, incrementar las ventas y los ingresos publicitarios. Señala que lamentablemente en el Ecuador este tipo de periodismo es una plaga muy bien vendida.

  3. An additional bolus of rapid-acting insulin to normalise postprandial cardiovascular risk factors following a high-carbohydrate high-fat meal in patients with type 1 diabetes: A randomised controlled trial.

    Science.gov (United States)

    Campbell, Matthew D; Walker, Mark; Ajjan, Ramzi A; Birch, Karen M; Gonzalez, Javier T; West, Daniel J

    2017-07-01

    To evaluate an additional rapid-acting insulin bolus on postprandial lipaemia, inflammation and pro-coagulation following high-carbohydrate high-fat feeding in people with type 1 diabetes. A total of 10 males with type 1 diabetes [HbA 1c 52.5 ± 5.9 mmol/mol (7.0% ± 0.5%)] underwent three conditions: (1) a low-fat (LF) meal with normal bolus insulin, (2), a high-fat (HF) meal with normal bolus insulin and (3) a high-fat meal with normal bolus insulin with an additional 30% insulin bolus administered 3-h post-meal (HFA). Meals had identical carbohydrate and protein content and bolus insulin dose determined by carbohydrate-counting. Blood was sampled periodically for 6-h post-meal and analysed for triglyceride, non-esterified-fatty acids, apolipoprotein B48, glucagon, tumour necrosis factor alpha, fibrinogen, human tissue factor activity and plasminogen activator inhibitor-1. Continuous glucose monitoring captured interstitial glucose responses. Triglyceride concentrations following LF remained similar to baseline, whereas triglyceride levels following HF were significantly greater throughout the 6-h observation period. The additional insulin bolus (HFA) normalised triglyceride similarly to low fat 3-6 h following the meal. HF was associated with late postprandial elevations in tumour necrosis factor alpha, whereas LF and HFA was not. Fibrinogen, plasminogen activator inhibitor-1 and tissue factor pathway levels were similar between conditions. Additional bolus insulin 3 h following a high-carbohydrate high-fat meal prevents late rises in postprandial triglycerides and tumour necrosis factor alpha, thus improving cardiovascular risk profile.

  4. Las leyendas regionales como intangibles territoriales

    Directory of Open Access Journals (Sweden)

    Eloy Martos Núñez

    2015-01-01

    Full Text Available El artículo examina el concepto de leyenda como intangible territorial en diversas escalas, desde la local a la regional o nacional, y su relación con la construcción de mitos étnicos y la emergencia de tradiciones translocales. Para ello, se revisan la metodología de los estudios corográficos y las nociones de ecotipo y de paisaje cultural, así como la etnografía de los territorios simbólicos a la luz de conceptos como el clásico «témenos» y modernos como el «mytho-moteur» (Abadal, 1958. Se aplican estudios de casos que evidencian cómo es el Imaginario, en interacción con factores geohistóricos del lugar, el que a menudo acota y perimetrea un territorio a través de cauces como la fabulación legendaria y los ritos paralitúgicos, como procesiones o peregrinaciones. La conclusión es que las leyendas y los arquetipos de origen étnico y genealógico reescriben tradiciones que crean identidades y se pueden proyectar en ámbitos diferentes de la vida política o recreativa, con perfiles igualmente diferentes.

  5. MO-B-BRD-03: Principles, Pitfalls and Techniques of 3D Printing for Bolus and Compensators

    International Nuclear Information System (INIS)

    Baker, J.

    2015-01-01

    This session is designed so that the learning objectives are practical. The intent is that the attendee may take home an understanding of not just the technology, but also the logistical steps necessary to execute these 3D printing techniques in the clinic. Four practical 3D printing topics will be discussed: (i) Creating bolus and compensators for photon machines; (ii) tools for proton therapy; (iii) clinical applications in imaging; (iv) custom phantom design for clinic and research use. The use of 3D printers within the radiation oncology setting is proving to be a useful tool for creating patient specific bolus and compensators with the added benefit of cost savings. Creating the proper protocol is essential to ensuring that the desired effect is achieved and modeled in the treatment planning system. The critical choice of printer material (since it determines the interaction with the radiation) will be discussed. Selection of 3D printer type, design methods, verification of dose calculation, and the printing process will be detailed to give the basis for establishing your own protocol for electron and photon fields. A practical discussion of likely obstacles that may be encountered will be included. The diversity of systems and techniques in proton facilities leads to different facilities having very different requirements for beam modifying hardware and quality assurance devices. Many departments find the need to design and fabricate facility-specific equipment, making 3D printing an attractive technology. 3D printer applications in proton therapy will be discussed, including beam filters and compensators, and the design of proton therapy specific quality assurance tools. Quality control specific to 3D printing in proton therapy will be addressed. Advantages and disadvantages of different printing technology for these applications will also be discussed. 3D printing applications using high-resolution radiology-based imaging data will be presented. This data

  6. MO-B-BRD-03: Principles, Pitfalls and Techniques of 3D Printing for Bolus and Compensators

    Energy Technology Data Exchange (ETDEWEB)

    Baker, J. [Stony Brook University Medical Center (United States)

    2015-06-15

    This session is designed so that the learning objectives are practical. The intent is that the attendee may take home an understanding of not just the technology, but also the logistical steps necessary to execute these 3D printing techniques in the clinic. Four practical 3D printing topics will be discussed: (i) Creating bolus and compensators for photon machines; (ii) tools for proton therapy; (iii) clinical applications in imaging; (iv) custom phantom design for clinic and research use. The use of 3D printers within the radiation oncology setting is proving to be a useful tool for creating patient specific bolus and compensators with the added benefit of cost savings. Creating the proper protocol is essential to ensuring that the desired effect is achieved and modeled in the treatment planning system. The critical choice of printer material (since it determines the interaction with the radiation) will be discussed. Selection of 3D printer type, design methods, verification of dose calculation, and the printing process will be detailed to give the basis for establishing your own protocol for electron and photon fields. A practical discussion of likely obstacles that may be encountered will be included. The diversity of systems and techniques in proton facilities leads to different facilities having very different requirements for beam modifying hardware and quality assurance devices. Many departments find the need to design and fabricate facility-specific equipment, making 3D printing an attractive technology. 3D printer applications in proton therapy will be discussed, including beam filters and compensators, and the design of proton therapy specific quality assurance tools. Quality control specific to 3D printing in proton therapy will be addressed. Advantages and disadvantages of different printing technology for these applications will also be discussed. 3D printing applications using high-resolution radiology-based imaging data will be presented. This data

  7. Dosing of Milrinone in Preterm Neonates to Prevent Postligation Cardiac Syndrome: Simulation Study Suggests Need for Bolus Infusion.

    Science.gov (United States)

    Hallik, Maarja; Tasa, Tõnis; Starkopf, Joel; Metsvaht, Tuuli

    2017-01-01

    Milrinone has been suggested as a possible first-line therapy for preterm neonates to prevent postligation cardiac syndrome (PLCS) through decreasing systemic vascular resistance and increasing cardiac contractility. The optimal dosing regimen, however, is not known. To model the dosing of milrinone in preterm infants for prevention of PLCS after surgical closure of patent ductus arteriosus (PDA). Milrinone time-concentration profiles were simulated for 1,000 subjects using the volume of distribution and clearance estimates based on one compartmental population pharmacokinetic model by Paradisis et al. [Arch Dis Child Fetal Neonatal Ed 2007;92:F204-F209]. Dose optimization was based on retrospectively collected demographic data from neonates undergoing PDA ligation in Estonian PICUs between 2012 and 2014 and existing pharmacodynamic data. The target plasma concentration was set at 150-200 ng/ml. The simulation study used demographic data from 31 neonates who underwent PDA ligation. The median postnatal age was 13 days (range: 3-29) and weight was 760 g (range: 500-2,351). With continuous infusion of milrinone 0.33 μg/kg/min, the proportion of subjects within the desired concentration range was 0% by 3 h, 36% by 6 h, and 61% by 8 h; 99% of subjects exceeded the range by 18 h. The maximum proportion of total simulated concentrations in the target range was attained with a bolus infusion of 0.73 μg/kg/min for 3 h followed by a 0.16-μg/kg/min maintenance infusion. Mathematical simulations suggest that in preterm neonates the plasma time-concentration profile of milrinone can be optimized with a slow loading dose followed by maintenance infusion. © 2016 S. Karger AG, Basel.

  8. MDMA ‘ecstasy’ increases cerebral cortical perfusion determined by bolus-tracking arterial spin labelling (btASL) MRI

    Science.gov (United States)

    Rouine, J; Gobbo, O L; Campbell, M; Gigliucci, V; Ogden, I; McHugh Smith, K; Duffy, P; Behan, B; Byrne, D; Kelly, M E; Blau, C W; Kerskens, C M; Harkin, A

    2013-01-01

    Background and Purpose The purpose of this study was to assess cerebral perfusion changes following systemic administration of the recreational drug 3,4-methylendioxymethamphetamine (MDMA ‘ecstasy’) to rats. Experimental Approach Cerebral perfusion was quantified using bolus-tracking arterial spin labelling (btASL) MRI. Rats received MDMA (20 mg·kg−1; i.p.) and were assessed 1, 3 or 24 h later. Rats received MDMA (5 or 20 mg·kg−1; i.p.) and were assessed 3 h later. In addition, rats received MDMA (5 or 10 mg·kg−1; i.p.) or saline four times daily over 2 consecutive days and were assessed 8 weeks later. Perfusion-weighted images were generated in a 7 tesla (7T) MRI scanner and experimental data was fitted to a quantitative model of cerebral perfusion to generate mean transit time (MTT), capillary transit time (CTT) and signal amplitude. Key Results MDMA reduces MTT and CTT and increases amplitude in somatosensory and motor cortex 1 and 3 h following administration, indicative of an increase in perfusion. Prior exposure to MDMA provoked a long-term reduction in cortical 5-HT concentration, but did not produce a sustained effect on cerebral cortical perfusion. The response to acute MDMA challenge (20 mg·kg−1; i.p.) was attenuated in these animals indicating adaptation in response to prior MDMA exposure. Conclusions and Implications MDMA provokes changes in cortical perfusion, which are quantifiable by btASL MRI, a neuroimaging tool with translational potential. Future studies are directed towards elucidation of the mechanisms involved and correlating changes in cerebrovascular function with potential behavioural deficits associated with drug use. PMID:23517012

  9. Observation of the CSF pulsatile flow in the aqueduct using cine MRI with presaturation bolus tracking, 3

    International Nuclear Information System (INIS)

    Nakajima, Satoshi

    1992-01-01

    The to-and-fro motion patterns of the CSF flow in the aqueduct in ten normal adults, ten patients with secondary normal-pressure hydrocephalus (NPH), and fourteen patients with idiopathic ventriculomegaly were analyzed using cine MRI with presaturation bolus tracking. The to-and-fro motion patterns of the CSF flow in the aqueduct were thus classified into four types according to their maximum velocity and the relative time duration of their flow in the rostral and caudal directions. The correlation between the clinical symptoms, the CT findings, the RI-cisternography findings, the results of the ICP monitorings, and the CSF pulsatile-flow patterns were then analyzed. In secondary NPH disclosing frequent B waves on ICP monitoring, the maximum velocity of the CSF flow in the aqueduct was over 15 mm/sec, and the duration of the CSF flow was longer in the caudal direction than in the rostral direction. Furthermore, the faster the maximum velocity of the CSF flow, the larger the ventricular size on CT and the more severe the CSF malabsorption on cisternography. In idiopathic ventriculomegaly, only two cases demonstrated the same CSF flow pattern as was shown in secondary NPH; the other cases demonstrated other CSF flow patterns, which were considered to indicate hydrocephalus ex vacuo or arrested hydrocephalus. The CSF pulsatile-flow pattern was assumed to change according to the degree of the CSF circulatory disorder, its compensatory process, and the plasticity of the brain. The investigation of the CSF pulsatile flow gives important information for the evaluation of various hydrocephalic conditions. (author)

  10. A Review of Basal-Bolus Therapy Using Insulin Glargine and Insulin Lispro in the Management of Diabetes Mellitus.

    Science.gov (United States)

    Candido, Riccardo; Wyne, Kathleen; Romoli, Ester

    2018-04-13

    Basal-bolus therapy (BBT) refers to the combination of a long-acting basal insulin with a rapid-acting insulin at mealtimes. Basal insulin glargine 100 U/mL and prandial insulin lispro have been available for many years and there is a substantial evidence base to support the efficacy and safety of these agents when they are used in BBT or basal-plus therapy for patients with type 1 or type 2 diabetes mellitus (T1DM, T2DM). With the growing availability of alternative insulins for use in such regimens, it seems timely to review the data regarding BBT with insulin glargine 100 U/mL and insulin lispro. In patients with T1DM, BBT with insulin glargine plus insulin lispro provides similar or better glycemic control and leads to less nocturnal hypoglycemia compared to BBT using human insulin as the basal and/or prandial component, and generally provides similar glycemic control and rates of severe hypoglycemia to those achieved with insulin lispro administered by continuous subcutaneous insulin infusion (CSII). Studies evaluating BBT with insulin glargine plus insulin lispro in patients with T2DM also demonstrate the efficacy and safety of these insulins. Available data suggest that BBT with insulin glargine and insulin lispro provides similar levels of efficacy and safety in pediatric and adult populations with T1DM and in adult patients and those aged more than 65 years with T2DM. These insulin preparations also appear to be safe and effective for controlling T2DM in people of different ethnicities and in patients with T1DM or T2DM and comorbidities. Eli Lilly and Company.

  11. Basal-bolus insulin therapy reduces maternal triglycerides in gestational diabetes without modifying cholesteryl ester transfer protein activity.

    Science.gov (United States)

    Olmos, Pablo R; Borzone, Gisella R

    2017-09-01

    Macrosomia in the offspring of overweight/obese mothers with glucose-controlled gestational diabetes mellitus (GDM) is due to excessive rise of maternal triglycerides (TG). We aimed to ascertain whether basal-bolus insulin therapy (BBIT), or other components of the treatment, could reduce TG in GDM. We studied the records of 131 singleton pregnancies with GDM, using stepwise multiple linear regression, Mann-Whitney, χ 2 , and Jonckheere-Terpstra tests. As maternal TG increased steadily during normal pregnancy, these were transformed as z-scores. The atherogenic index of plasma (AIP) was calculated as a measure of cholesteryl ester transfer protein activity. Multiple regression showed that only BBIT (but neither limitation of weight gain nor metformin) reduced maternal TG z-scores (P = 0.011). When the 131 pregnancies were split into two groups - without BBIT (n = 58; HbA1c = 5.3 ± 0.3%) and with BBIT (n = 73; HbA1c = 5.4 ± 0.6; P = 0.2005) - we observed that BBIT (n = 73) reduced maternal TG z-scores in a dose-related fashion (Jonckheere-Terpstra P = 0.03817). The atherogenic index of plasma remained within normal range in both groups. BBIT (but not weight gain control nor metformin) reduced maternal TG in mothers with glucose-controlled GDM. This beneficial effect of BBIT was not related to changes in the cholesteryl ester transfer protein activity. © 2017 Japan Society of Obstetrics and Gynecology.

  12. Single bolus dose of epidural magnesium prolongs the duration of analgesia in cardiac patients undergoing vascular surgeries

    Directory of Open Access Journals (Sweden)

    Amarja Sachin Nagre

    2017-01-01

    Full Text Available Background and Aims: Magnesium, a physiological antagonist of calcium and N-methyl-d-aspartate, has a role in the prevention of pain in patients undergoing surgery for peripheral vascular diseases with cardiac comorbidities such as ischaemic heart disease and coronary artery disease. The objective of our study was assessment of effects of epidural magnesium in cardiac patients undergoing vascular surgery. Methods: Sixty patients of either sex American Society of Anesthesiologists physical status III undergoing surgeries for peripheral vascular diseases were enrolled. The control group had 30 patients who received levobupivacaine 0.25% 10 ml with fentanyl 50 μg while 30 patients in study group received levobupivacaine 0.25% 10 ml with fentanyl 50 μg and magnesium 100 mg. The primary outcome was duration of analgesia. Sedation score, pain assessment using visual analogue scale (VAS, systolic blood pressure (SBP and diastolic blood pressure (DBP, heart rate (HR, respiratory rate (RR and fentanyl consumption were also recorded. Statistical analyses were performed using Minitab 15 statistical software. Results: Both groups were similar demographically and with respect to baseline HR, SBP, DBP and RR. In the study group, compared to the control group, duration of analgesia was 4.17 ± 1.07 h versus 1.55 ± 0.47 h (P < 0.01, sedation score were\\ better (P = 0.003 and the VAS scores was lower (P < 0.01. sConclusion: Epidural magnesium, added to levobupivacaine and fentanyl as a single bolus dose effectively prolongs the duration of analgesia in high-risk cardiac patients undergoing peripheral vascular surgery.

  13. La realidad como materia novelable: Alejo Carpentier

    Directory of Open Access Journals (Sweden)

    Raquel Arias Careaga

    2007-12-01

    Full Text Available Desde que en 1897 Benito Pérez Galdós defendiera como materia prima legítima de la literatura «la vida misma, de donde el artista saca las ficciones que nos instruyen y embelesan» (Pérez Galdós, 1990: 159, el realismo como instrumento de indagación y análisis de la sociedad no ha dejado de crecer y expandirse. Realismo crítico, como este de Galdós, que implica una ampliación del concepto chato de «realidad», incluyendo en ella «recuerdos, sueños, imaginación, locura, símbolos» para contribuir a la formación de un «realismo total» (Rodríguez Puértolas, 2000, II: 93, al que se une también la asimilación de enseñanzas esenciales como la que representa la narrativa de Cervantes: La novelística de Galdós hunde sus raíces en el mejor Cervantes, como puede verse en su peculiar sentido del humor y de la ironía, en la concepción perspectivista de la realidad y en tantas otras cosas, algunas de ellas en verdad fundamentales. Así el concepto de la Naturaleza y sus relaciones dialécticas con el ser humano; así el Amor como elemento vital y animador del orden cósmico, muy alejado del idealismo vulgar romántico (Ibid., 93.

  14. A Imagem como Ruína

    Directory of Open Access Journals (Sweden)

    Míriam Volpe

    2001-12-01

    Full Text Available O dialogismo ente o filme Citizen Kane, de Orson Welles, e o poema “Kubla Khan”, de S.T. Coleridgé, é analisado, sendo evidenciados não só o tema em comum – o mito do Paraíso perdido – como também a similariedade na organização do disurso na justaposição das images, como fragmentos da memória a serem preservados.

  15. Los rincones como contextos significativos de aprendizaje

    OpenAIRE

    Sánchez Molero, María Luisa

    2016-01-01

    En el presente trabajo se pretende hacer un estudio sobre los rincones de trabajo en el aula de Educación Infantil, describiéndolos como modelo de organización del espacio y como estrategia metodológica que aboga por un aprendizaje socioconstructivista. El estudio se completa con la descripción y el análisis de los rincones de un aula específica de un centro escolar, incorporando diversas propuestas de mejora fundamentadas en el previo estudio teórico

  16. PARP-1 como regulador del ciclo celular

    OpenAIRE

    Iglesias Vázquez, Pablo

    2015-01-01

    En el presente estudio hemos querido investigar las implicaciones biológicas de la interacción PARP-1/E2F-1 en escenarios en los que el factor de transcripción E2F-1 resulta de gran importancia como son el desarrollo embrionario y la oncogénesis. En este respecto, hemos demostrado que tanto PJ34, inhibidor de la actividad enzimática de PARP, como gosipol, inhibidor de las interacciones proteína-proteína, son capaces de reducir la actividad transcripcional de E2F-1 y la proli...

  17. Dibujo infantil como medio de diagnostico

    OpenAIRE

    González Hernando, Elisa

    2015-01-01

    Con este documento se pretende demostrar la importancia que tiene el dibujo infantil en el correcto desarrollo integral de las personas. Se estudia la importancia del dibujo y su valor a la hora de utilizarlo como método de diagnóstico ante determinados aspectos que pueden determinar la vida de una persona. En definitiva lo que se desarrolla en este trabajo de Fin de Grado es el papel que juega el dibujo como herramienta para el seguimiento del desarrollo de los individuos centrándonos ...

  18. La fatiga como estado motivacional subjetivo

    OpenAIRE

    D. Cárdenas; J. Conde-González; J.C. Perales

    2017-01-01

    Actualmente no existe consenso sobre los factores que determinan la aparición de la fatiga. Hay factores que se derivan exclusivamente del esfuerzo físico, otros que dependen del esfuerzo mental que este lleva aparejado, y otros de los resultados de la tarea que se está realizando. Como consecuencia, se han desarrollado diferentes modelos explicativos que pretenden aunar las diferentes razones de su aparición. No obstante, la tendencia actual es entender la fatiga como un estado motivacion...

  19. Quitina y carboximetilquitosana como agentes desintegrantes

    OpenAIRE

    Sol A Fernández Monagas; María D Rodríguez Albadalejo; Ofelia Bilbao Revoredo; Olga M Nieto Acosta

    1998-01-01

    Se realizó un estudio comparativo de la quitina y la carboximetilquitosana como agentes desintegrantes, y se evaluó la influencia ejercida por el método empleado en la elaboración de las tabletas sobre la actividad desintegrante de ambos polímeros. La quitina presentó buenas características como agente desintegrante independientemente del método utilizado en la elaboración de las tabletas, mientras que la actividad desintegrante de la carboximetilquitosana fue afectada por el proceso de granu...

  20. Measurement of apolipoprotein E and amyloid β clearance rates in the mouse brain using bolus stable isotope labeling

    Science.gov (United States)

    2012-01-01

    Background Abnormal proteostasis due to alterations in protein turnover has been postulated to play a central role in several neurodegenerative diseases. Therefore, the development of techniques to quantify protein turnover in the brain is critical for understanding the pathogenic mechanisms of these diseases. We have developed a bolus stable isotope-labeling kinetics (SILK) technique coupled with multiple reaction monitoring mass spectrometry to measure the clearance of proteins in the mouse brain. Results Cohorts of mice were pulse labeled with 13 C6-leucine and the brains were isolated after pre-determined time points. The extent of label incorporation was measured over time using mass spectrometry to measure the ratio of labeled to unlabeled apolipoprotein E (apoE) and amyloid β (Aβ). The fractional clearance rate (FCR) was then calculated by analyzing the time course of disappearance for the labeled protein species. To validate the technique, apoE clearance was measured in mice that overexpress the low-density lipoprotein receptor (LDLR). The FCR in these mice was 2.7-fold faster than wild-type mice. To demonstrate the potential of this technique for understanding the pathogenesis of neurodegenerative disease, we applied our SILK technique to determine the effect of ATP binding cassette A1 (ABCA1) on both apoE and Aβ clearance. ABCA1 had previously been shown to regulate both the amount of apoE in the brain, along with the extent of Aβ deposition, and represents a potential molecular target for lowering brain amyloid levels in Alzheimer's disease patients. The FCR of apoE was increased by 1.9- and 1.5-fold in mice that either lacked or overexpressed ABCA1, respectively. However, ABCA1 had no effect on the FCR of Aβ, suggesting that ABCA1 does not regulate Aβ metabolism in the brain. Conclusions Our SILK strategy represents a straightforward, cost-effective, and efficient method to measure the clearance of proteins in the mouse brain. We expect that

  1. Comparison of Two Methods of Bolus and Infusion of Tranexamic Acid in Reduction of Blood Loss in Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Mohammadreza Moshari

    2018-01-01

    Full Text Available AbstractBackground: So far, many studies have been performed to determine the optimal dose and regimen of tranexamic acid to reduce preoperative and postoperative blood loss in primary total knee arthroplasty. In the present study, two different methods of administration (bolus and infusion, were compared.Materials and Methods: Forty patients were randomized in the two groups (A and B of 20 patients each. All patients received 500 mg tranexamic acid before inflation of tourniquet. Group A (mean age, 64± 6.1 years received 500 mg tranexamic acid 10 minutes before loosening of tourniquet and group B (mean age, 63.5 ± 7.7 years received 500 mg tranexamic acid through IV infusion during 6 hours from the time of tourniquet loosening (total dose of TA, 1 g in both groups. Intraoperative blood loss,postoperative drainage (in 6 and 12 hours, blood transfusion (in 48 hours, and decrease in hematocrit and hemoglobin (6 and 12 hours later, were compared between the two groups.Results: The patients in group B had lower intra- and postoperative blood loss in 6 and 12 hours and also had lower decrease in hemoglobin, and their packed cell transfusion rate was significantly lower compared to the group A.Conclusion: The findings of this study indicated that infusion administration of tranexamic acid in primary total knee arthroplasty, was more effective in the reduction of perioperative blood loss as well as need for blood transfusion in 48 hours.

  2. Saline Flush After Rocuronium Bolus Reduces Onset Time and Prolongs Duration of Effect: A Randomized Clinical Trial.

    Science.gov (United States)

    Ishigaki, Sayaka; Masui, Kenichi; Kazama, Tomiei

    2016-03-01

    Circulatory factors modify the onset time of neuromuscular-blocking drugs. Therefore, we hypothesized that infusion of a saline flush immediately after rocuronium administration would shorten the onset time without influencing the duration of the rocuronium effect. Forty-eight patients were randomly allocated to the control or saline flush group. Anesthesia was induced and maintained with propofol and remifentanil, and all patients received 0.6 mg/kg rocuronium in 10 mL of normal saline. In the saline flush group, 20 mL normal saline was immediately infused after rocuronium administration. Neuromuscular blockade was assessed using acceleromyography at the adductor pollicis muscle with train-of-four (TOF) stimulation. The neuromuscular indices for rocuronium were calculated as follows: the latent onset time, defined as the time from the start of rocuronium infusion until first occurrence of depression of the first twitch of the TOF (T1) ≥5%; onset time, defined as the time from the start of rocuronium infusion until first occurrence of depression of the T1 ≥95%; clinical duration, defined as the time from the start of rocuronium administration until T1 recovered to 25% of the final T1 value; recovery index, defined as the time for recovery of T1 from 25% to 75% of the final T1 value; and the total recovery time, defined as the time from the start of rocuronium administration until reaching a TOF ratio of 0.9. Significance was designated at P rocuronium bolus by 17%, 24%, and 14%, respectively. In addition, the recovery phase was significantly prolonged in the saline flush group. The mean clinical duration (5th-95th percentile range) in the saline flush group and control group was 35 minutes (27-63 minutes) and 31 minutes (19-48 minutes; P = 0.032), respectively; the recovery index was 13 minutes (8-25 minutes) and 10 minutes (7-19 minutes; P = 0.019), respectively; and the total recovery time was 61 minutes (44-108 minutes) and 50 minutes (35-93 minutes; P = 0

  3. Heidegger E A Técnica Moderna Como Perigo E Como Salvação

    Directory of Open Access Journals (Sweden)

    Robson Costa Cordeiro

    2014-04-01

    Full Text Available O mundo contemporâneo é marcado por uma compreensão de técnica que se ergue como tal a partir de um sentido próprio e autônomo. Este sentido pode ser caracterizado como um logos que se constitui a partir de sua própria natureza e se manifesta como tecnologia no decorrer da história. Compreender esse sentido e assumi-lo como condição de nossa existência no mundo é comprender a técnica como nossa herança e nosso envio. Nesse sentido, compreender a essência da técnica é fundamental para o mundo contemporâneo, assumindo que, nesse processo, consiste o perigo e a salvação da espécie.

  4. Comparison of treatment with continuous subcutaneous insulin infusion versus multiple daily insulin injections with bolus calculator in patients with type 1 diabetes.

    Science.gov (United States)

    Pérez-García, L; Goñi-Iriarte, M J; García-Mouriz, M

    2015-01-01

    A study of the glycemic control, quality of life, and fear and perception of hypoglycemia by comparing continuous subcutaneous insulin infusion (CSII) group with multiple daily inyections (MDI) with bolus calculator group. This is a retrospective cohort study with following up during the first 12 months that CSII group (n=30) begins the use of "bolus wizard" and the MDI-calculator (n=30) group begins the use of the bolus calculator (Accu-Chek(®) Aviva Expert). HbA1c (3, 6 and 12 months). Questionnaires used: EsDQOL (quality of life), FH-15 (fear of hypoglycemia), and Clarke (perception of hypoglycemia). T Student and nonparametric tests. The average reduction in HbA1c during the study was significantly higher in CSII group (-0.56±0.84%) compared with the MDI group (0.097±0.94%), P=.028. The average basal insulin dose was significantly higher in the MDI group (at baseline, 6 and 12 months). No significant differences were found between the 2 treatment groups after analyzing the EsDQOL, FH-15 and Clarke questionnaires. In the CSII group, perceived quality of life assessed by the EsDQOL questionnaire was found to be better at the end of the study than at the beginning of using the insulin pump. The average reduction in HbA1c was significantly higher in the CSII group. In the CSII group, perceived quality of life was better at the end of the study than at the beginning. Copyright © 2014 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  5. Closed-loop double-vasopressor automated system vs manual bolus vasopressor to treat hypotension during spinal anaesthesia for caesarean section: a randomised controlled trial.

    Science.gov (United States)

    Sng, B L; Tan, H S; Sia, A T H

    2014-01-01

    Hypotension necessitating vasopressor administration occurs commonly during caesarean section under spinal anaesthesia. We developed a novel vasopressor delivery system that automatically administers phenylephrine or ephedrine based on continuous non-invasive arterial pressure monitoring. A phenylephrine bolus of 50 μg was given at 30-s intervals when systolic blood pressure fell manual boluses of either phenylephrine 100 μg or ephedrine 8 mg, administered at 1-min intervals based on the same thresholds for systolic pressure and heart rate. This randomised, controlled, double-blinded trial involved 213 healthy women who underwent elective caesarean delivery under spinal anaesthesia using 11 mg hyperbaric bupivacaine with 15 μg fentanyl and 100 μg morphine. The automated vasopressor group had better systolic pressure control, with 37/106 (34.9%) having any beat-to-beat systolic pressure reading 120% of baseline, with 8/106 (7.5%) in the automated vasopressor group vs 14/107 (13.1%) in the control group, or total dose of vasopressors. The automated vasopressor group had lower median absolute performance error of 8.5% vs control of 9.8% (p = 0.013), and reduced incidence of nausea (1/106 (0.9%) vs 11/107 (10.3%), p = 0.005). Neonatal umbilical cord pH, umbilical lactate and Apgar scores were similar. Hence, our system afforded better control of maternal blood pressure and reduced nausea with no increase in reactive hypertension when compared with manual boluses. © 2013 The Association of Anaesthetists of Great Britain and Ireland.

  6. Comparison of bolus and continuous infusion of esmolol on hemodynamic response to laryngoscopy, endotracheal intubation and sternotomy in coronary artery bypass graft

    Directory of Open Access Journals (Sweden)

    Esra Mercanooglu Efe

    2014-07-01

    Full Text Available BACKGROUND AND OBJECTIVE: The aim of this randomized, prospective and double blinded study is to investigate effects of different esmolol use on hemodynamic response of laryngoscopy, endotracheal intubation and sternotomy in coronary artery bypass graft surgery. METHODS: After approval of local ethics committee and patients' written informed consent, 45 patients were randomized into three groups equally. In Infusion Group; from 10 min before intubation up to 5th minute after sternotomy, 0.5 mg/kg/min esmolol infusion, in Bolus Group; 2 min before intubation and sternotomy 1.5 mg/kg esmolol IV bolus and in Control Group; %0.9 NaCl was administered. All demographic parameters were recorded. Heart rate and blood pressure were recorded before infusion up to anesthesia induction in every minute, during endotracheal intubation, every minute for 10 minutes after endotracheal intubation and before, during and after sternotomy at first and fifth minutes. RESULTS: While area under curve (AUC (SAP × time was being found more in Group B and C than Group I, AUC (SAP × T int and T st and AUC (SAP × T2 was found more in Group B and C than Group I (p < 0.05. Moreover AUC (HR × T st was found less in Group B than Group C but no significant difference was found between Group B and Group I. CONCLUSION: This study highlights that esmolol infusion is more effective than esmolol bolus administration on controlling systolic arterial pressure during endotracheal intubation and sternotomy in CABG surgery.

  7. Reducing the radiation dose to the eye lens region during CT brain examination: the potential beneficial effect of the combined use of bolus and a bismuth shield

    International Nuclear Information System (INIS)

    Lai, C.W.K.; Chan, T.P.; Cheung, H.Y.; Wong, T.H.

    2015-01-01

    Objective: Computed Tomography (CT) is the leading contributor to medical exposure to ionizing radiation. Although the use of CT brain scans for patients with head injuries and convulsions has shown a tremendous growth, it has raised substantial concerns in the general public because of the risk of radiation-induced cataracts: the current available strategies to reduce the radiation dose to the eye lens region are limited. Therefore, the present research project was initiated with the aim of evaluating the potential benefit of the combined use of bolus and a bismuth shield on reducing the radiation dose to the eye lens region during CT brain examination. Materials and methods: We conducted a series of phantom studies to measure the entrance surface dose (ESD) that is delivered to the eye lens region during CT brain examination under the effect of different scanning and shielding setups. Results: Our results indicated, during CT brain examination: (1) a drastic reduction of 92.5% in the ESD to the eye lens region was found when the CT gantry was tilted from 0 deg. (overall ESD = 30.7 mGy) to 30 deg. cranially (overall ESD = 2.4 mGy), and (2) when the CT gantry was positioned at 0 deg. (the common practice in the clinical setting), the setups with the application of a) a bismuth shield, b) a bismuth shield with a face shield (air gap), c) a bismuth shield with bolus, and d) a bismuth shield with bolus and an air gap can result in an acceptable level of image quality with a smaller overall ESD delivered to the eye lens region (overall ESD = 23.2 mGy, 24 mGy, 21 mGy and 19.9 mGy, respectively) than the setup without the bismuth shield applied (overall ESD = 30.7 mGy). Conclusion: When the primary beam scanning through the eye lens region is unavoidable during CT brain examination, the combined use of a bismuth shield with bolus and a face shield is an easy-to-use and inexpensive shielding setup to reduce the radiation dose delivered to the eye lens region while

  8. Bolus dose response characteristics of single chain urokinase plasminogen activator and tissue plasminogen activator in a dog model of arterial thrombosis.

    Science.gov (United States)

    Badylak, S F; Voytik, S; Klabunde, R E; Henkin, J; Leski, M

    1988-11-15

    Tissue plasminogen activator (t-PA) and single chain urokinase-plasminogen activator (scu-PA) are relatively "fibrin-specific" thrombolytic drugs with short plasma half lives of 6-8 minutes. Most treatment regimens with these agents utilize a bolus injection followed by continuous drug infusion, usually combined with anticoagulant therapy. The purpose of this study was to establish the dose-response characteristics for scu-PA and t-PA, when given as a single intravenous bolus injection, in a dog model of arterial thrombosis. Eight groups of 6 dogs each were given one of the following doses of scu-PA (mg/kg): 0.20, 0.50, 1.00, 2.00; or t-PA: 0.05, 0.10, 0.20; or an equivalent amount of saline (control group). All doses were given as a single bolus injection 60 minutes after formation of a totally occlusive femoral artery thrombus. Thrombolysis was measured by monitoring the continuous decrement of 125I activity from a radiolabelled thrombus. Ninety minutes after drug injection, all scu-PA treated dogs showed greater thrombolysis (30%, 45%, 56%, and 67%, respectively) than the control group (15%, p less than 0.01). The 0.10 and 0.20 mg/kg t-PA treated dogs showed greater thrombolysis (35% and 49%, respectively) than the control group (15%, p less than 0.01). Both scu-PA and t-PA caused a partial and dose-dependent decrease in alpha 2-antiplasmin activity but scu-PA caused a greater depletion (72% vs. 18%, respectively, p less than 0.05) at 60 minutes after the highest dose of drug administration. Both drugs showed a longer than expected thrombolytic effect based upon the known half lives. Neither drug caused significant changes in the prothrombin time, activated partial thromboplastin time, thrombin time, hematocrit, platelet count, or fibrin degradation product concentration. Single bolus injections of scu-PA and t-PA produce safe and effective thrombolysis in this dog model of arterial thrombosis.

  9. La biblioteca como editora de contenidos

    Directory of Open Access Journals (Sweden)

    Alonso-Arévalo, Julio

    2015-12-01

    Full Text Available Una de las características más innovadoras de la biblioteca del siglo 21 tiene que ver con la toma de una postura activa frente a la gestión y generación de contenidos. Con la llegada de la Web 2.0 las bibliotecas no sólo siguen salvaguardando y difundiendo información como han venido realizando a lo largo de su historia, también cada vez con más frecuencia crean nueva información con el objetivo de prestar los mejores servicios a sus ciudadanos, a través de recursos y servicios tales como la elaboración guías de investigación, boletines de alerta y novedades, recursos web, información a través de sus blogs, y como administradores de contenidos a través de repositorios y revistas de acceso abierto. Un paso más allá en esta dinámica tienen que ver con la biblioteca como editora y distribuidora de libros, especialmente en el ámbito local, siendo la impulsora, formadora, dinamizador y difusoras de las obras de los autores de su comunidad.

  10. A rota como memória

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    Patrick Fraysse

    Full Text Available No contexto de estudo do patrimônio por um ponto de vista comunicacional, este artigo permitiu-nos visualisar um objeto de comunicação por excelência « a estrada » como portador de informação a decifrar e a interpretar um documento, mas também como um repositário da memória coletiva, quer dizer um monumento. Paralelamente, a patrimonialização dos monumentos, dos conjuntos arquiteturais e sobretudo dos itinerários que os religam, dito de outra maneira, da estrada, assim como a sua documentarização (relatos de viagens, guias, bancos de dados participam de uma nova institucionalização da memória integrante também das estradas míticas como o caminho de São Tiago na França ou a famosa estrada 66 nos Estados-Unidos.

  11. La medicina tradicional como medicina ecocultural

    OpenAIRE

    Aparicio Mena, Alfonso Julio

    2005-01-01

    Los sistemas terap??uticos tradicionales responden a las culturas de los pueblos en los que surgen. En ellos, se concibe la naturaleza ??ntimamente ligada a la tradici??n. Salud es, para los miembros de las culturas tradicionales, bienestar como equilibrio entre el ser humano, la naturaleza, las creencias y la sociedad.

  12. Los patrones de asentamiento como recurso patrimonial

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    Antonio Lista Martín

    2012-12-01

    Full Text Available Los patrones de asentamiento son las pautas con las que distribuyen los diferentes elementos construidos, como casas, caminos, campos, espacios públicos o fábricas, y son una expresión cultural de la sociedad que los construye. Tanto el tipo de elementos, su número como su distribución, dependen del nivel tecnológico, de la estructura social y de su bagaje cultural. Se puede decir, por tanto, que en los patrones estaría reflejado el conocimiento que la sociedad tenia del medio, así como sus anhelos, prioridades e, incluso, sus malas prácticas. La presente comunicación propone que estos patrones puedan servir de base para el planeamiento territorial actual, no sólo preservando aquello que realmente tenga valor, sino incluso recreándolos o reproduciéndolos a otras escalas siempre que puedan aportar un valor añadido al territorio. El escrito plantea una pregunta: ¿Qué se debe mantener de los patrones tradicionales y qué se puede, o incluso se debe, cambiar?, y para responderla en la primera parte se analizan someramente algunos asentamientos-tipo y en la segunda se indican pautas de actuación que han aparecido como propuestas en planes de ordenación territorial en los últimos años.

  13. EL PERIODISMO CIVICO COMO COMUNICACION POLITICA

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    Ana María Miralles C.

    1998-01-01

    Full Text Available La autora retoma el ejercicio del periodismo cívico como el espacio en el cual la formación de la opinión pública adquiere características de un proyecto político dinámico en el que el ciudadano es el ente fundamental.

  14. Evaluation of the effect of bolus administration of 50% dextrose solution on measures of electrolyte and energy balance in postpartum dairy cows.

    Science.gov (United States)

    Wagner, Sarah A; Schimek, Daniel E

    2010-09-01

    To determine the effect of IV administration of a bolus of 50% dextrose solution on electrolyte and energy balance and effect of blood collection site on serum electrolyte values in postparturient dairy cows. 24 clinically normal multiparous cows. A bolus of 50% dextrose solution (0.5 L [n=8 cows]), 50% dextrose solution (1.0 L [8]), or saline (0.9% NaCl) solution (1.0 L, control treatment [8]) was administered via jugular venipuncture 5 to 10 days after parturition. Pretreatment and posttreatment blood samples were analyzed for concentrations of calcium, magnesium, phosphorus, potassium, glucose, insulin, beta-hydroxybutyric acid (BHBA), and nonesterified fatty acids. Coccygeal vessel and jugular vein blood samples were obtained prior to treatment, and electrolyte concentrations were compared. Treatment with 50% dextrose decreased phosphorus concentration in serum, compared with the control treatment. Suppression of BHBA and nonesterified fatty acid concentrations following dextrose treatment lasted for dextrose solution may be at risk for hypophosphatemia, and 1 treatment with 0.5 or 1 L of 50% dextrose solution is unlikely to prevent or resolve acetonemia (ketosis). The risk of hypophosphatemia may be underestimated when coccygeal vessel blood samples are used for diagnosis.

  15. Usefulness of the Bolus-Tracking Baseline Scan for the Diagnosis of Hepatic Steatosis in Abdominal Computed Tomography: A Feasibility Study

    International Nuclear Information System (INIS)

    Gossner, J.; Schäfer, S.

    2013-01-01

    Nonalcoholic fatty liver disease (NAFLD) is a common pathology in western societies. Unenhanced computed tomography (CT) of the liver is a valuable tool in determining the presence of steatosis hepatis, but in most departments standard CT protocols of abdomen often do not include unenhanced scans anymore. In a small series of 22 patients the liver density was measured in the acquired low-dose baseline scan for bolus tracking and was compared to the measurement in a regular unenhanced CT scan of the upper abdomen. The mean difference between the unenhanced CT scan and the low-dose baseline scan was 3.4 HU (range 0.2–8.6 HU); the difference between these two scans was 5 HU or smaller in 82% of the patients. There was a significant difference between the two used CT scanners; this has to be kept in mind before implementing this approach into daily practice. All but one patient with fatty liver disease on unenhanced CT were diagnosed using the baseline scan. The baseline scan for bolus tracking may be useful for the diagnosis or in the followup of fatty liver disease

  16. Development and Clinical Implementation of a Universal Bolus to Maintain Spot Size During Delivery of Base of Skull Pencil Beam Scanning Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Both, Stefan, E-mail: Stefan.Both@uphs.upenn.edu [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Shen, Jiajian [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Department of Radiation Oncology, Mayo Clinic, Phoenix, Arizona (United States); Kirk, Maura; Lin, Liyong; Tang, Shikui; Alonso-Basanta, Michelle; Lustig, Robert; Lin, Haibo; Deville, Curtiland; Hill-Kayser, Christine; Tochner, Zelig; McDonough, James [Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2014-09-01

    Purpose: To report on a universal bolus (UB) designed to replace the range shifter (RS); the UB allows the treatment of shallow tumors while keeping the pencil beam scanning (PBS) spot size small. Methods and Materials: Ten patients with brain cancers treated from 2010 to 2011 were planned using the PBS technique with bolus and the RS. In-air spot sizes of the pencil beam were measured and compared for 4 conditions (open field, with RS, and with UB at 2- and 8-cm air gap) in isocentric geometry. The UB was applied in our clinic to treat brain tumors, and the plans with UB were compared with the plans with RS. Results: A UB of 5.5 cm water equivalent thickness was found to meet the needs of the majority of patients. By using the UB, the PBS spot sizes are similar with the open beam (P>.1). The heterogeneity index was found to be approximately 10% lower for the UB plans than for the RS plans. The coverage for plans with UB is more conformal than for plans with RS; the largest increase in sparing is usually for peripheral organs at risk. Conclusions: The integrity of the physical properties of the PBS beam can be maintained using a UB that allows for highly conformal PBS treatment design, even in a simple geometry of the fixed beam line when noncoplanar beams are used.

  17. Perbandingan Efek Pemberian Norepinefrin Bolus Intravena dengan Norepinefrin Infus Kontinu dalam Tatalaksana Hipotensi, Laju Nadi, dan Nilai APGAR pada Seksio Sesarea dengan Anestesi Spinal

    Directory of Open Access Journals (Sweden)

    Fitri Sepviyanti Sumardi

    2015-04-01

    Full Text Available Vasopresors are commonly used for the treatment of hypotension in spinal anesthesia for cesarean section. This research aimed to compare intravenous bolus of norepinephrine to continuous infusion of norepinephrine effectiveness in hypotension management in caesarean section patient under spinal anesthesia and their effect on heart rate and APGAR Score, The experimental study was conducted in a double-blind randomized manner to 44 American Society of Anesthesiologist (ASA physical status II pregnant women undergoing cesarean section with spinal anesthesia in Dr. Hasan Sadikin General Hospital Bandung within the period of September to -November 2013. The Study subjects were grouped into two groups, the first group received 4 µg intravenous bolus of norepinephrine group (NB and and the second received 8 µg/minute continuous infusion of norepinephrine group (NK. Data were analyzed by t-test, Mann-Whitney test, chi-square and analysis of variance (ANOVA t-test with p0.05. Conclusion from this study is the administration of norepinephrine in both ways can be used for the treatment of hypotension of spinal anesthesia without affecting the heart rate and APGAR score

  18. MEMORIA VISUAL COMO PARTE DEL PROCESO LECTOR

    OpenAIRE

    Gamero-Muñiz, Antonia

    2013-01-01

    Este trabajo tiene como objetivo indagar la relación entre los movimientos sacádicos, velocidad y comprensión lectora y la memoria visual en alumnos de 2ºESO, con el propósito de contribuir a la labor docente en los apoyos del aprendizaje de una correcta lectura y tomando como fundamentación teórica la importancia de la memoria visual en el proceso lector. Se ha seleccionado una muestra de 24 niños y 21 niñas con edades comprendidas entre 13 y 15 años. Se evaluaron los movimientos sacádico...

  19. La fenomenología como atavismo

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    Galán, Iván

    2009-04-01

    Full Text Available This paper deals with phenomenology as a result of phenomenological freedom in its possibility of understanding a phenomenon as wild phenomenon. From this perspective, we are enabled to transcend established symbolic systems and to pose the question on the existence of a sense which is immature, not-saturated and imperfect without exception.El artículo pretende mostrar la vigencia de la fenomenología como expresión de la libertad fenomenológica, como posibilidad siempre abierta de acceder al fenómeno en cuanto fenómeno puro, registro arquitectónico en el que, saltando por sobre los sistemas simbólicos instituidos, nos es permitido plantear en toda su radicalidad la pregunta por la existencia de un sentido siempre prematuro, no saturado y jamás clausurable.

  20. O historiador como intelectual mediador da cultura

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    Alex Fernandes Borges

    2017-07-01

    Full Text Available O presente artigo visa analisar teoricamente a possibilidade de se qualificar o historiador, tomando por base uma tipologia ideal extraída da teoria da história de Jörn Rüsen, como um intelectual mediador, notadamente com base no conceito proposto a partir dos estudos de mediação cultural desenvolvido por Jesús Martín-Barbero e recentemente sistematizado no país por Ângela de Castro Gomes e Patrícia Hansen. Diante disso, articulou-se as hipóteses em três eixos: caracterização do intelectual mediador da cultura como uma categoria de análise compreensiva; instituição de um tipo ideal de historiador nos moldes weberianos e; a subsunção deste àquela.

  1. La Realidad Aumentada como complemento motivacional

    Directory of Open Access Journals (Sweden)

    Gazcón, Nicolás Fernando

    2016-06-01

    Full Text Available El acelerado avance de la tecnología permite que las tecnologías emergentes sean accesibles por todos los usuarios. Ejemplos de estas tecnologías son la Realidad Aumentada y la Reconstrucción 3D, que gracias a dispositivos como tabletas o teléfonos inteligentes, pueden utilizarse de manera ubicua. Éstas tienen un enorme potencial en el campo de la educación, ya sea como recurso para entender conceptos complejos, como para motivar el aprendizaje de nuevos contenidos. El desafío de estas tecnologías es integrarlas para que sean accesibles y fáciles de utilizar por los docentes y los alumnos. En este trabajo presentamos una metodología para motivar el aprendizaje tanto en tareas de campo, mediante el uso de la Reconstrucción 3D, como en el ámbito escolar mediante libros aumentados. Por medio de un caso de estudio introducimos la Reconstrucción 3D de elementos fósiles de un sitio paleontológico bonaerense, para luego incorporar estos contenidos generados en un libro aumentado. A partir de la digitalización de huellas y fósiles de sitios paleontológicos, se obtuvieron modelos 3D que se integraron en un ambiente de aprendizaje inmersivo en el aula mediante los libros aumentados. Presentamos las opiniones de docentes de distintas disciplinas, que resaltan las posibilidades de esta metodología para su inclusión en el ámbito educacional regional.

  2. EL CONFLICTO COMO CONSTRUCTOR DE CIUDAD

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    Twiggy Ortegón

    2012-04-01

    Full Text Available El planteamiento central de este articulo, es el de sugerir una análisis en torno a algunas de las condiciones o mecanismo necesarios para que el conflicto opere como un potenciador de la diferencia y creador de alternativas para la convivencia Se realiza una distinción del concepto, un análisis de contenidos interaccionales en dinámicas de conflicto y su relación con el contexto urbano de Bogotá, enfocándose en ámbitos escolares. En ciudades como Bogotá, las discusiones y acciones que diferentes estamentos han emprendido frente a la manera de concebir y gestionar el conflicto, desembocan en la creación de diferentes organismos como los centros de conciliación, la aplicación de fórmulas y técnicas para la solución de conflictos, el desarrollo de propuestas desde entes administrativos a nivel distrital y las nuevas disposiciones que plantea la Ley 115 sobre Gobierno Escolar y manuales de convivencia.

  3. Effects of orally applied butyrate bolus on histone acetylation and cytochrome P450 enzyme activity in the liver of chicken – a randomized controlled trial

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    Mátis Gábor

    2013-01-01

    Full Text Available Abstract Background Butyrate is known as histone deacetylase inhibitor, inducing histone hyperacetylation in vitro and playing a predominant role in the epigenetic regulation of gene expression and cell function. We hypothesized that butyrate, endogenously produced by intestinal microbial fermentation or applied as a nutritional supplement, might cause similar in vivo modifications in the chromatin structure of the hepatocytes, influencing the expression of certain genes and therefore modifying the activity of hepatic microsomal drug-metabolizing cytochrome P450 (CYP enzymes. Methods An animal study was carried out in chicken as a model to investigate the molecular mechanisms of butyrate’s epigenetic actions in the liver. Broiler chicks in the early post-hatch period were treated once daily with orally administered bolus of butyrate following overnight starvation with two different doses (0.25 or 1.25 g/kg body weight per day for five days. After slaughtering, cell nucleus and microsomal fractions were separated by differential centrifugation from the livers. Histones were isolated from cell nuclei and acetylation of hepatic core histones was screened by western blotting. The activity of CYP2H and CYP3A37, enzymes involved in biotransformation in chicken, was detected by aminopyrine N-demethylation and aniline-hydroxylation assays from the microsomal suspensions. Results Orally added butyrate, applied in bolus, had a remarkable impact on nucleosome structure of hepatocytes: independently of the dose, butyrate caused hyperacetylation of histone H2A, but no changes were monitored in the acetylation state of H2B. Intensive hyperacetylation of H3 was induced by the higher administered dose, while the lower dose tended to increase acetylation ratio of H4. In spite of the observed modification in histone acetylation, no significant changes were observed in the hepatic microsomal CYP2H and CYP3A37 activity. Conclusion Orally added butyrate in bolus

  4. Multi-detector row CT of the kidney: Optimizing scan delays for bolus tracking techniques of arterial, corticomedullary, and nephrographic phases

    Energy Technology Data Exchange (ETDEWEB)

    Goshima, Satoshi [Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1193 (Japan); Kanematsu, Masayuki [Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1193 (Japan); Department of Radiology Services, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1193 (Japan); Nishibori, Hironori; Kondo, Hiroshi; Tsuge, Yusuke [Department of Radiology, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1193 (Japan); Yokoyama, Ryujiro; Miyoshi, Toshiharu [Department of Radiology Services, Gifu University School of Medicine, 1-1 Yanagido, Gifu 501-1193 (Japan); Onozuka, Minoru [Department of Physiology and Neuroscience, Kanagawa Dental College, Yokosuka, Kanagawa (Japan); Shiratori, Yoshimune [Department of Medical Informatics, Gifu University School of Medicine, Gifu (Japan); Moriyama, Noriyuki [Department of Diagnostic Radiology, National Cancer Center Hospital, Tsukiji, Chuo-Ku, Tokyo (Japan); Bae, Kyongtae T. [Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO (United States)

    2007-09-15

    Purpose: To determine optimal scan delays for renal arterial-, corticomedullary-, and nephrographic-phase imaging with multi-detector row computed tomography (MDCT) of the kidney using a bolus-tracking technique. Methods and materials: One hundred and twenty-eight patients underwent three-phase CT scan of the kidney with eight-row MDCT after receiving 2 mL/kg of 300 mg I/mL contrast medium at 4 mL/s. Patients were prospectively randomized into three groups with different scan delays for the three scan phases (arterial, corticomedullary, and nephrographic) after bolus-tracking triggered at 50 HU of aortic contrast enhancement: group 1 (5, 20, 45 s); group 2 (10, 25, 50 s); and group 3 (15, 30, 55 s). Mean CT values (HU) of the abdominal aorta, renal artery, renal vein, renal cortex, and renal medulla were measured; increases in CT values pre- to post-contrast were assessed as contrast enhancement. Renal artery-to-vein and renal cortex-to-medulla contrast differences were also assessed. Qualitative analysis was also performed. Results: Mean renal artery enhancement was 240-288 HU at 5-15 s after the trigger and peaked at 10 s (P < .001). Mean renal cortical enhancement was 195-217 HU at 10-30 s and peaked at 25 s (P < .01). Contrast enhancement in the renal medulla increased gradually and reached mean 145 HU at 55 s. Cortex-to-medulla contrast difference was high (110-140 HU) at 5-30 s and decreased below 30 HU at 45 s after the trigger. Renal artery-to-vein contrast difference was high (121-125 HU) at 5-10 s. Qualitative results correlated well with quantitative results. Conclusion: For the injection protocol used in this study, optimal scan delays after the bolus-tracking trigger were 5-10 s for renal arterial, 15-25 s for corticomedullary, and 50-55 s for nephrographic phases.

  5. Radio universitaria: trabajo en red como imperativo

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    Tiziana Cavallo

    2014-01-01

    Full Text Available Trabajo en red es un concepto clave en la radio universitaria, tanto desde el punto de vista individual como del colectivo. A través de dos estudios de caso, enfocados en la radio universitaria de Italia y de Colombia, este artículo muestra cómo el trabajo en red ha sido decisivo para el fortalecimiento de su función, la ampliación de su impacto, la conformación de su identidad y el crecimiento de su visibilidad en las sociedades en las cuales desarrollan su labor.

  6. La fatiga como estado motivacional subjetivo

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    D. Cárdenas

    2017-03-01

    No obstante, la tendencia actual es entender la fatiga como un estado motivacional complejo cuyo origen tiene lugar en numerosos procesos fisiológicos y psicológicos que sirven para regular el esfuerzo y proteger al organismo de daños graves. Los objetivos de la presente revisión narrativa son analizar los diferentes enfoques existentes para el estudio y la explicación de la fatiga, establecer el vínculo con el concepto de carga de entrenamiento y justificar la importancia de evaluar las repercusiones de la carga mental para conseguir una adecuada planificación y control del proceso de entrenamiento.

  7. El cáncer como oportunidad

    OpenAIRE

    Mallo Caamaño, Rocío

    2013-01-01

    El objetivo de este proyecto es el de tratar el tema de la actitud ante el cáncer. El diagnóstico del cáncer es algo devastador para la persona diagnosticada principalmente, además de para sus allegados más cercanos. Apoyo en este trabajo la propuesta del cáncer como una oportunidad; una oportunidad para aprender de la experiencia traumática que éste supone y salir reforzados de la situación.

  8. La idea del Geocoaching como herramienta interdisciplinar

    OpenAIRE

    Grau Martínez, Sergio

    2017-01-01

    Treball Final de Grau en Mestre o Mestra d'Educació Primària. Codi: MP1040. Curs acadèmic: 2016/2017 Con este trabajo se pretende demostrar que existen alternativas activas y dinámicas que favorecen notablemente el aprendizaje significativo y la interdisciplinariedad de algunas asignaturas, en este caso, la educación física y las ciencias sociales y naturales. Para ello, en dicho trabajo se propone utilizar la idea del “geocaching” como base y herramienta para realizar una serie de sesi...

  9. La Beta 2 Microglobulina como Marcador Tumoral.

    OpenAIRE

    Saúco Márquez, Juan José

    2016-01-01

    En el presente trabajo hemos efectuado un estudio acerca del valor que tiene la Beta 2 Microglobulina para ser empleada como marcador tumoral. Esta sustancia es una microproteína que es producida por casi todas las células del organismos excepto los eritrocitos y las células trofoblásticas, es liberada a la circulación y es filtrada a nivel glomerular siendo reabsorbida por los túbulos renales en cuyas células es catabolizada y degradada ha...

  10. La indiferencia como instrumento de poder

    Directory of Open Access Journals (Sweden)

    Sergio Carlos Staude

    2014-10-01

    Full Text Available La indiferencia como respuestaante las situaciones de horror queprovoca la guerra llega a adquirirdiferentes funciones. Puede ser unindicador del resguardo necesariopara tramitar lo traumático de losacontecimientos, también un modode desmentir la responsabilidad deestos o bien ser un instrumentosiniestro de poder destinado agarantizar la eficacia de quienesejercen la violencia, neutralizar lasrespuestas del medio social y marginarlas reacciones posibles de lasvíctimas. Se destacan los recursosque aportan el psicoanálisis, lacreación ficcional del arte y, en particular,los esfuerzos de legitimaciónde la justicia para paliar los efectosiatrogénicos de la indiferencia.

  11. La entrevista como encuentro de subjetividades

    Directory of Open Access Journals (Sweden)

    Emma Ruiz Martín del Campo

    2003-01-01

    Full Text Available Se parte de la comprensión de la subjetividad como la expresión preñada de cultura de cada ser humano que se gesta en las relaciones interpersonales, primero entre el infante y las personas que le prodigan los cuidados tempranos, y después en la adolescencia y la edad adulta, con cada vez más representantes de la cultura de la socialización. En dicha interacción, la persona aprende a convivir con otros y a modelar sus impulsos, lo que le permite encontrar las formas más satisfactorias posibles de experimentarse a sí misma y tomar parte en las actividades de su entorno social. El equilibrio entre el individuo que busca satisfacer sus impulsos y necesidades y la cultura a la que pertenece es dinámico, por lo que la subjetividad se transforma a lo largo de toda la vida. Tras abundar sobre la subjetividad, se describen dos formas de orientar la entrevista a profundidad: la psicoanalítica y la etnopsicoanalítica. La entrevista psicoanalítica explora la subjetividad como tal y en ella el entrevistador actúa como un acompañante del sujeto en la progresiva comprensión de sí mismo y de su historia individual, desentrañando significados del comportamiento hasta entonces inconscientes para sí mismo, que se clarifican en la interacción. La entrevista etnopiscoanalítica busca explorar la experiencia cultural de las personas. Expertos en ciencias sociales entrenados a la vez en el descubrimiento del inconsciente se involucran en un medio cultural nuevo para ellos y a través de entrevistas y conversaciones con los integrantes de la comunidad que visitan van descubriendo formas de participación de estos en los espacios de vida social, así como las maneras que dan cuenta de símbolos y modos de reacción propios de su cultura. Cada una de estas dos formas de entrevista es ilustrada con un ejemplo que da muestra plásticamente del encuentro de las subjetividades

  12. No tomar lo real como real

    Directory of Open Access Journals (Sweden)

    Jean Baudrillard

    2015-01-01

    Full Text Available El problema de la comunicación es hoy el de los medios de comunicación. La comunicación en sí ya no tiene tanto sentido. El aparato tecnológico que debería jugar un rol de intermediario en realidad no es un intermediario sino una especie de obstáculo en la relación comunicativa. Vale decir que los medios se autonomizan como una especie de aparato autorreferencial, que se desarrolla por sí mismo y pierde de vista su finalidad y se vuelve proliferante.

  13. Guatemala como alternativa de desarrollo local

    Directory of Open Access Journals (Sweden)

    Rosa Elba Hernandez Cruz

    2015-01-01

    Full Text Available El área aledaña a la Reserva de la biósfera del Volcán Tacaná, en Chiapas México destaca por la producción de café, además de una alta diversidad de flora y fauna; sin embargo las comunidades rurales que habitan estos espacios están en constante búsqueda de alternativas productivas para mejorar sus medios de vida y cuidar el ambiente el cual está sufriendo deterioro. Ante esta situación se planteó como objetivo la integración de una red de fincas agroecoturísticas en los municipios de Cacahoatán, Tuxtla Chico, Unión Juárez en Chiapas, México y una comunidad en Guatemala. Para construir la propuesta se utilizó la metodología de modos de vida, se realizaron talleres participativos, recorridos en campo y se identificaron los productos turísticos. Se concluye, a partir del análisis de los modos de vida, que la región presenta características y oportunidades para desarrollar la red de agroecoturismo como una alternativa económica.

  14. Marañón como modelo

    Directory of Open Access Journals (Sweden)

    Gracia, Diego

    2013-02-01

    Full Text Available As a result of his consistent attitude as citizen and doctor and his “liberal spirit”, Marañón has gone down in the history of the twentieth century as an archetype. Marañón was, above all, a moralist in the Kantian sense, an autonomous person not governed by external criteria but by duty; a thinker convinced of the transforming role of the positive sciences, towards a happier and more just society through a deep intellectual reform. Marañón, like Fernando de los Rios, integrated Kraussism, neo-Kantianism and socialism and from this ideological platform sought the necessary moral change in the Spanish people.Marañón ha pasado a la historia del siglo XX como arquetipo, debido a su actitud coherente y a su “talante liberal”. Marañón fue, sobre todo, un moralista en el sentido kantiano. Una persona autónoma que no se rigió por criterios externos, sino por deber; un convencido del papel transformador de las ciencias positivas en pos de una sociedad más feliz y más justa gracias a una profunda reforma intelectual. Marañón, como Fernando de los Ríos, integró krausismo, neokantismo y socialismo y desde esa plataforma ideológica, propugnó el necesario cambio moral del pueblo español.

  15. Las comunidades locales como estructuras meso.

    Directory of Open Access Journals (Sweden)

    Ferrand, Alexis

    2002-09-01

    Full Text Available Entre el nivel micro y el nivel macro: meso. Si el nivel macro está definido por la regulación nacional, estatal o del mercado y el nivel micro por la regulación interpersonal, una agencia de regulación intermediaria de mayor importancia ha sido definida como “comunidad local” (Wellman, Fischer. Aparte de las dimensiones organizacionales (organizaciones locales, clubes, tiendas... e institucionales (poder local, partidos... locales, es posible definir algunas propiedades estructurales pertinentes de los sistemas de relaciones interpersonales privadas: uno es el grado de “cerrado” (closure local (Barnes: redes locales vs. transversales, o la “dualidad” de estos sistemas. Apoyándose en la idea de que la eficiencia de los “puentes” reside en el tipo de cliques que conectan (Lin, es posible definir tipos variados de micro-estructuras, cuyas distribuciones en diferentes localidades son indicadores sucedáneos o aproximaciones de las diferentes meso estructuras de sistemas relacionales como combinaciones de redes “locales” y “no locales”.

  16. Tecnologia como fundamento do cuidar em Neonatologia

    Directory of Open Access Journals (Sweden)

    José Antonio de Sá Neto

    2010-01-01

    Full Text Available Se trata de un artículo sobre la evolución histórica de la tecnología en neonatología, resaltando aspectos conceptuales y reflexivos sobre el impacto tecnológico en el proceso de cuidar. A pesar de que en los últimos años, la tecnología ha contribuido para mejorar la supervivencia de prematuros extremos nacidos con muy bajo peso, algunas veces da lugar a una modalidad de atención mecánica e impersonal, que se contrapone a cuestiones de índole ética y humana. Se propone una discusión crítica y reflexiva acerca del uso de la tecnología en el cuidado neonatal, destacando sus implicaciones y adecuaciones a las necesidades del recién nacido. Se concluyó que lo que determina si una tecnología es buena o mala, si deshumaniza, despersonaliza o interpreta como objeto al sujeto a cuidar, es la manera como es utilizada, convirtiéndose en imprescindible el perfeccionamiento y la actualización de los profesionales de la salud. En este ejercicio análitico es necesario reflexionar acerca de nuevas maneras de brindar cuidados, utilizando el arte, la sensibilidad y la creatividad en la adaptación y humanización de las tecnologías.

  17. Quitina y carboximetilquitosana como agentes desintegrantes

    Directory of Open Access Journals (Sweden)

    Sol A Fernández Monagas

    1998-08-01

    Full Text Available Se realizó un estudio comparativo de la quitina y la carboximetilquitosana como agentes desintegrantes, y se evaluó la influencia ejercida por el método empleado en la elaboración de las tabletas sobre la actividad desintegrante de ambos polímeros. La quitina presentó buenas características como agente desintegrante independientemente del método utilizado en la elaboración de las tabletas, mientras que la actividad desintegrante de la carboximetilquitosana fue afectada por el proceso de granulación.A comparative study of chitin and carboxymethylchitosan as disintegrating agents was wade made. The influence exerted bu tje method used in the preparation of the tablets on the disintegrating activity of both polymers was evaluated. Chitin proved to have good characteristics as a disintegrating agent independently of the method used to make tablets. The disintegrating activity of carboxymethylchitosan was affected by the granulation process.

  18. El lenguaje como instrumento de poder

    Directory of Open Access Journals (Sweden)

    MARÍA TERESA SUÁREZ GONZÁLEZ

    2009-01-01

    Full Text Available La investigación denominada 'El lenguaje como instrumento de poder' planteó dos interrogantes que permitieron, por un lado, evidenciar ¿cuáles estrategias discursivas permiten analizar la relación entre lenguaje y poder en el discurso de la segunda posesión del presidente Álvaro Uribe Vélez y, por otro, analizar las implicaciones que tienen las mencionadas estrategias en la construcción de sentido. Lo anterior con el fin de mirar cómo se ejerce poder mediante las prácticas discursivas, dado que quien emite un discurso busca, ante todo, convencer y cambiar la mentalidad de los receptores, a través de la comunicación de creencias, actitudes, valores y un sinnúmero de saberes tomados de su entorno y de la cultura, por medio de estrategias discusivas que son empleadas de manera consciente, de acuerdo con el fin que se persiga. Teniendo en cuenta lo anterior, esta ponencia presenta los resultados obtenidos en la investigación, desarrollada en la Maestría en Lingüística de la UPTC, los cuales muestran el discurso como una interacción a través de la cual se evidencian marcas de poder y se construyen los acontecimientos y las identidades de los sujetos, mediante la comunicación.

  19. Bloque de tierra comprimida como material constructivo

    Directory of Open Access Journals (Sweden)

    Óscar Javier Gutiérrez Junco

    2011-07-01

    Full Text Available La construcción con tierra es poco usada en la actualidad debido a la falta de difusión e investigación, y a que es relacionada con la pobreza; por ende, se desaprovechan muchas de sus ventajas, como la abundancia demateria prima, la localización, la disponibilidad, el reciclaje, la producción sin consumo de energía (calorífica, el bajo costo y la resistencia –con un adecuado estudio del material tierra, de la estructuración y del suelo de fundación–; otras de sus ventajas son el aislamiento térmico y acústico. Con el paso del tiempo se han mejorado las técnicas constructivas con tierra, realizando estabilizaciones e implementando el uso de maquinaria y herramienta mecánica para elaborar bloques de tierra comprimida, y así facilitar el trabajo y obtener mayor rendimiento. Este artículo presenta la tierra como material constructivo, las técnicas o sistemas constructivos, los bloques de tierra comprimida (BTC y algunos ensayos realizados a estos bloques.

  20. El manual como texto Schoolbook as text

    Directory of Open Access Journals (Sweden)

    Agustín Escolano Benito

    2012-12-01

    Full Text Available Este trabajo aborda la cuestión de la identidad del libro escolar como un género textual específico en el contexto de la manualística clásica y moderna, contextualizando los análisis en el marco de la cultura de la escuela tradicional y en la era de la revolución digital y bajo una perspectiva historiográfica y teórica. También plantea el nacimiento y primeros desarrollos de la manualística como campo intelectual y académico y sus contribuciones a la definición de la identidad del libro escolar.This paper discusses the question of identifying a coursebook as a specific text genre in the context of the classical and modern manualistics, situating the analysis within the traditional school culture and the digital revolution era, under a historical and theoretical perspective. It also covers the birth and initial development of manualistics as an intelectual and academic field and its contributions to the definition of the schoolbook identity.

  1. Reproducibility of 5-HT2A receptor measurements and sample size estimations with [18F]altanserin PET using a bolus/infusion approach

    DEFF Research Database (Denmark)

    Haugbøl, Steven; Pinborg, Lars H; Arfan, Haroon M

    2006-01-01

    PURPOSE: To determine the reproducibility of measurements of brain 5-HT2A receptors with an [18F]altanserin PET bolus/infusion approach. Further, to estimate the sample size needed to detect regional differences between two groups and, finally, to evaluate how partial volume correction affects...... reproducibility and the required sample size. METHODS: For assessment of the variability, six subjects were investigated with [18F]altanserin PET twice, at an interval of less than 2 weeks. The sample size required to detect a 20% difference was estimated from [18F]altanserin PET studies in 84 healthy subjects....... Regions of interest were automatically delineated on co-registered MR and PET images. RESULTS: In cortical brain regions with a high density of 5-HT2A receptors, the outcome parameter (binding potential, BP1) showed high reproducibility, with a median difference between the two group measurements of 6...

  2. Metastasizing, Luciferase Transduced MAT-Lu Rat Prostate Cancer Models: Follow up of Bolus and Metronomic Therapy with Doxorubicin as Model Drug

    International Nuclear Information System (INIS)

    Jantscheff, Peter; Esser, Norbert; Geipel, Andreas; Woias, Peter; Ziroli, Vittorio; Goldschmidtboing, Frank; Massing, Ulrich

    2011-01-01

    The most fatal outcomes of prostate carcinoma (PCa) result from hormone-refractory variants of the tumor, especially from metastatic spread rather than from primary tumor burden. The goal of the study was to establish and apply rat MAT-Lu prostate cancer tumor models for improved non-invasive live follow up of tumor growth and metastasis by in vivo bioluminescence. We established luciferase transduced MAT-Lu rat PCa cells and studied tumor growth and metastatic processes in an ectopic as well as orthotopic setting. An intravenous bolus treatment with doxorubicin was used to demonstrate the basic applicability of in vivo imaging to follow up therapeutic intervention in these models. In vitro analysis of tissue homogenates confirmed major metastatic spread of subcutaneous tumors into the lung. Our sensitive method, however, for the first time detects metastasis also in lymph node (11/24), spleen (3/24), kidney (4/24), liver (5/24), and bone tissue (femur or spinal cord - 5/20 and 12/20, respectively). Preliminary data of orthotopic implantation (three animals) showed metastatic invasion to investigated organs in all animals but with varying preference (e.g., to lymph nodes). Intravenous bolus treatment of MAT-Lu PCa with doxorubicin reduced subcutaneous tumor growth by about 50% and the number of animals affected by metastatic lesions in lymph nodes (0/4), lung (3/6) or lumbar spine (0/2), as determined by in vivo imaging and in vitro analysis. Additionally, the possible applicability of the luciferase transduced MAT-Lu model(s) to study basic principles of metronomic therapies via jugular vein catheter, using newly established active microport pumping systems, is presented

  3. Dietary fat acutely increases glucose concentrations and insulin requirements in patients with type 1 diabetes: implications for carbohydrate-based bolus dose calculation and intensive diabetes management.

    Science.gov (United States)

    Wolpert, Howard A; Atakov-Castillo, Astrid; Smith, Stephanie A; Steil, Garry M

    2013-04-01

    Current guidelines for intensive treatment of type 1 diabetes base the mealtime insulin bolus calculation exclusively on carbohydrate counting. There is strong evidence that free fatty acids impair insulin sensitivity. We hypothesized that patients with type 1 diabetes would require more insulin coverage for higher-fat meals than lower-fat meals with identical carbohydrate content. We used a crossover design comparing two 18-h periods of closed-loop glucose control after high-fat (HF) dinner compared with low-fat (LF) dinner. Each dinner had identical carbohydrate and protein content, but different fat content (60 vs. 10 g). Seven patients with type 1 diabetes (age, 55 ± 12 years; A1C 7.2 ± 0.8%) successfully completed the protocol. HF dinner required more insulin than LF dinner (12.6 ± 1.9 units vs. 9.0 ± 1.3 units; P = 0.01) and, despite the additional insulin, caused more hyperglycemia (area under the curve >120 mg/dL = 16,967 ± 2,778 vs. 8,350 ± 1,907 mg/dL⋅min; P Carbohydrate-to-insulin ratio for HF dinner was significantly lower (9 ± 2 vs. 13 ± 3 g/unit; P = 0.01). There were marked interindividual differences in the effect of dietary fat on insulin requirements (percent increase significantly correlated with daily insulin requirement; R(2) = 0.64; P = 0.03). This evidence that dietary fat increases glucose levels and insulin requirements highlights the limitations of the current carbohydrate-based approach to bolus dose calculation. These findings point to the need for alternative insulin dosing algorithms for higher-fat meals and suggest that dietary fat intake is an important nutritional consideration for glycemic control in individuals with type 1 diabetes.

  4. Reproducibility of 5-HT2A receptor measurements and sample size estimations with [18F]altanserin PET using a bolus/infusion approach

    International Nuclear Information System (INIS)

    Haugboel, Steven; Pinborg, Lars H.; Arfan, Haroon M.; Froekjaer, Vibe M.; Svarer, Claus; Knudsen, Gitte M.; Madsen, Jacob; Dyrby, Tim B.

    2007-01-01

    To determine the reproducibility of measurements of brain 5-HT 2A receptors with an [ 18 F]altanserin PET bolus/infusion approach. Further, to estimate the sample size needed to detect regional differences between two groups and, finally, to evaluate how partial volume correction affects reproducibility and the required sample size. For assessment of the variability, six subjects were investigated with [ 18 F]altanserin PET twice, at an interval of less than 2 weeks. The sample size required to detect a 20% difference was estimated from [ 18 F]altanserin PET studies in 84 healthy subjects. Regions of interest were automatically delineated on co-registered MR and PET images. In cortical brain regions with a high density of 5-HT 2A receptors, the outcome parameter (binding potential, BP 1 ) showed high reproducibility, with a median difference between the two group measurements of 6% (range 5-12%), whereas in regions with a low receptor density, BP 1 reproducibility was lower, with a median difference of 17% (range 11-39%). Partial volume correction reduced the variability in the sample considerably. The sample size required to detect a 20% difference in brain regions with high receptor density is approximately 27, whereas for low receptor binding regions the required sample size is substantially higher. This study demonstrates that [ 18 F]altanserin PET with a bolus/infusion design has very low variability, particularly in larger brain regions with high 5-HT 2A receptor density. Moreover, partial volume correction considerably reduces the sample size required to detect regional changes between groups. (orig.)

  5. Metastasizing, Luciferase Transduced MAT-Lu Rat Prostate Cancer Models: Follow up of Bolus and Metronomic Therapy with Doxorubicin as Model Drug

    Energy Technology Data Exchange (ETDEWEB)

    Jantscheff, Peter, E-mail: jantscheff@tumorbio.uni-freiburg.de [Tumour Biology Center, Clinical Research, Department Lipids & Liposomes, Breisacher Str.117, D-79106 Freiburg (Germany); Esser, Norbert [ProQinase GmbH, Breisacher Str. 117, D-79106 Freiburg (Germany); Geipel, Andreas; Woias, Peter [Laboratory for Design of Microsystems, Department of Microsystems Engineering (IMTEK), Georges-Köhler-Allee 106, D-79110 Freiburg (Germany); Ziroli, Vittorio [Tumour Biology Center, Clinical Research, Department Lipids & Liposomes, Breisacher Str.117, D-79106 Freiburg (Germany); Goldschmidtboing, Frank [Laboratory for Design of Microsystems, Department of Microsystems Engineering (IMTEK), Georges-Köhler-Allee 106, D-79110 Freiburg (Germany); Massing, Ulrich [Tumour Biology Center, Clinical Research, Department Lipids & Liposomes, Breisacher Str.117, D-79106 Freiburg (Germany)

    2011-06-17

    The most fatal outcomes of prostate carcinoma (PCa) result from hormone-refractory variants of the tumor, especially from metastatic spread rather than from primary tumor burden. The goal of the study was to establish and apply rat MAT-Lu prostate cancer tumor models for improved non-invasive live follow up of tumor growth and metastasis by in vivo bioluminescence. We established luciferase transduced MAT-Lu rat PCa cells and studied tumor growth and metastatic processes in an ectopic as well as orthotopic setting. An intravenous bolus treatment with doxorubicin was used to demonstrate the basic applicability of in vivo imaging to follow up therapeutic intervention in these models. In vitro analysis of tissue homogenates confirmed major metastatic spread of subcutaneous tumors into the lung. Our sensitive method, however, for the first time detects metastasis also in lymph node (11/24), spleen (3/24), kidney (4/24), liver (5/24), and bone tissue (femur or spinal cord - 5/20 and 12/20, respectively). Preliminary data of orthotopic implantation (three animals) showed metastatic invasion to investigated organs in all animals but with varying preference (e.g., to lymph nodes). Intravenous bolus treatment of MAT-Lu PCa with doxorubicin reduced subcutaneous tumor growth by about 50% and the number of animals affected by metastatic lesions in lymph nodes (0/4), lung (3/6) or lumbar spine (0/2), as determined by in vivo imaging and in vitro analysis. Additionally, the possible applicability of the luciferase transduced MAT-Lu model(s) to study basic principles of metronomic therapies via jugular vein catheter, using newly established active microport pumping systems, is presented.

  6. Metastasizing, Luciferase Transduced MAT‑Lu Rat Prostate Cancer Models: Follow up of Bolus and Metronomic Therapy with Doxorubicin as Model Drug

    Directory of Open Access Journals (Sweden)

    Peter Woias

    2011-06-01

    Full Text Available The most fatal outcomes of prostate carcinoma (PCa result from hormone-refractory variants of the tumor, especially from metastatic spread rather than from primary tumor burden. The goal of the study was to establish and apply rat MAT-Lu prostate cancer tumor models for improved non-invasive live follow up of tumor growth and metastasis by in vivo bioluminescence. We established luciferase transduced MAT-Lu rat PCa cells and studied tumor growth and metastatic processes in an ectopic as well as orthotopic setting. An intravenous bolus treatment with doxorubicin was used to demonstrate the basic applicability of in vivo imaging to follow up therapeutic intervention in these models. In vitro analysis of tissue homogenates confirmed major metastatic spread of subcutaneous tumors into the lung. Our sensitive method, however, for the first time detects metastasis also in lymph node (11/24, spleen (3/24, kidney (4/24, liver (5/24, and bone tissue (femur or spinal cord - 5/20 and 12/20, respectively. Preliminary data of orthotopic implantation (three animals showed metastatic invasion to investigated organs in all animals but with varying preference (e.g., to lymph nodes. Intravenous bolus treatment of MAT-Lu PCa with doxorubicin reduced subcutaneous tumor growth by about 50% and the number of animals affected by metastatic lesions in lymph nodes (0/4, lung (3/6 or lumbar spine (0/2, as determined by in vivo imaging and in vitro analysis. Additionally, the possible applicability of the luciferase transduced MAT-Lu model(s to study basic principles of metronomic therapies via jugular vein catheter, using newly established active microport pumping systems, is presented.

  7. Comparison the effect of two ways of tube feeding including bolus and continuous infusion on gastric residual volume and diarrhea in patients hospitalized in Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Shahriari M

    2015-05-01

    Full Text Available Background and Objective: Proper nutritional support is one of the important caring aspects in patients who were hospitalized in Intensive Care Unit. Although the several studies have been done concerning the selection of proper nutrition method for patients, but there is no agreement on this issue. The aim of current study was the compare the effect of two ways of tube feeding including bolus and continuous infusion on gastric residual volume and diarrhea in patients hospitalized in Intensive Care Unit.  Materials and Method: The current clinical trial was conducted on patients who were hospitalized in intensive care unit in Alzahra hospital in Isfahan, 2013. Fifty patients were selected through convenient sampling and were randomly assigned into two groups of 25 people of intervention and control. Nutrition was done through infusion pump in intervention group and by bolus in control group. Gastric residual volume and diarrhea was assessed each four hours for four days. Data were gathered through checklist and were analyzed by SPSS18 using descriptive and inferential statistics including independent T-test, Fisher's exact test and repeated measures ANOVA.  Results: The results showed that the mean of gastric residual volume in control group was more than the intervention group on the third day (p=0.04. Also, the mean of gastric residual volume did not show significant difference at different times in intervention group, but the mean of gastric residual volume was significantly increased in control group at different times (p=0.04. Fisher's exact test showed no significant difference between two groups concerning the diarrhea frequency.  Conclusion: In nutritional support with continuous infusion method, gastric residual volume was not increased and gastric emptying rate was not diminished. Therefore, this method can be used as an appropriate nutritional support in intensive care unit.

  8. Las javieradas como caso de estudio

    Directory of Open Access Journals (Sweden)

    Mª Cruz Porcal Gonzalo

    2006-01-01

    Full Text Available A pesar de su todavía modesta participación en la economía y en el empleo regional, el turismo en Navarra ha mostrado durante los últimos años un significativo dinamismo tal y como, por ejemplo, lo testimonia el incremento del número de visitantes y de las empresas turísticas. Favorecido por una serie de circunstancias de índole variada, este desarrollo turístico se sustenta en una gran diversidad geográfica y cultural patente en los paisajes, el arte, las fiestas, la gastronomía, etc. Pero Navarra es, a su vez, una región que secularmente ha otorgado un gran peso a la tradición y a las creencias religiosas. En este contexto, algunas de las numerosas acciones emprendidas por la administración regional para dinamizar el sector turístico se han encaminado a revalorizar dos importantes legados culturales: el castillo de Javier y el Camino de Santiago. Se aprecia que ambos se hallan estrechamente relacionados con el turismo cultural, el turismo religioso y las peregrinaciones, unos fenómenos que hunden sus raíces en tiempos pasados pero que continúan teniendo en la actualidad una indudable relevancia a escala mundial. La intención primordial del presente trabajo es analizar el turismo de peregrinaciones en Navarra, más concretamente, el que tiene como destino del viaje la cuna de San Francisco Javier. Con dicho afán, se realiza una reflexión conceptual previa y un breve repaso de las fiestas y tradiciones religiosas que forman parte del patrimonio cultural intangible de Navarra, haciendo particular hincapié en las romerías y en el Camino de Santiago. Al hilo de ello, se afronta, a continuación, el estudio de la peregrinación más singular y populosa de Navarra: la Javierada. Su origen, sus principales rasgos, el perfil y las motivaciones de los peregrinos, los caracteres e hitos más importantes del recorrido, las peculiaridades del destino —entendido como lugar sagrado y espacio turístico— constituyen las principales

  9. Arquitectura como percepción

    Directory of Open Access Journals (Sweden)

    Mañana Borrazás, Patricia

    2003-12-01

    Full Text Available This text sets out to illustrate types of basic analysis in researching a question as intrinsically human as perception. In the analysis of a construction, the aspects relative to perception allow us to access interesting information as to how a construction functions and what is implied by its different spaces, information which is in direct relation to more human, living aspects of architecture. These analyses complement formal analyses, as while these allow us to describe a construction in time and space, analyses of perception seek to stress the existing relationship between the human being and the construction, understanding architecture as a physical element to be experienced and which has been constructed to create a favourable atmosphere for certain perceptions. The study first shows the most basic elements in perception analysis and how these support a methodology that attempts to understand a construction in all its aspects (formal, social, symbolic, giving as an example a Neolithic Galician burial mound.Este texto trata de ilustrar los tipos de análisis básicos para investigar una cuestión tan intrínsecamente humana como la percepción. En el análisis de una construcción, los aspectos relativos a la percepción nos permiten acceder a una interesante información de cómo una construcción funciona y qué implican sus distintos espacios, información en directa relación con los aspectos más humanos y vivenciales de la arquitectura. Son unos análisis complementarios a los análisis formales, ya que mientras estos nos permiten describir en el espacio y en el tiempo una construcción, los análisis de percepción tratan de incidir en la relación existente entre el ser humano y la construcción, entendiendo a la arquitectura también como elemento físico a experimentar y que ha sido construido para propiciar ciertas percepciones. Se exponen en primer lugar las claves más básicas de los análisis de percepción y cómo estos se

  10. Como Perseu se defendeu de Medusa?

    Directory of Open Access Journals (Sweden)

    Rose Lumertz de Freitas

    2012-04-01

    Full Text Available Na psicanálise francesa, principalmente com Lacan, o conceito de falta passou a ser de grande importância. Ao que, então, perguntamos: o que é a falta? E quando esta falta? O que acontece? O que acontece quando o não especularizável não está excluído, se fazendo, assim, especular? Quando Perseu vai ao encontro de Medusa, guiando-se por sua imagem refletida em um espelho de bronze polido, segurado por Atena, como pôde este herói defender-se de Medusa? Qual foi a forma encontrada por ele para se defender da presença do objeto que introduz a dimensão do real nu?

  11. La cultura como verdad: pobreza latinoamericana

    Directory of Open Access Journals (Sweden)

    Ana María Rocchietti

    2000-04-01

    Full Text Available El artículo parte de un balance crítico de la obra Antropología de la Pobreza, del antropólogo Oscar Lewis para analizar el concepto de pobreza en América Latina. Se argumenta que la cultura de la pobreza ofrece la posibilidad de incluir a las formaciones simbólicas de las tradiciones vivientes y a las que emergen en la existencia comunitaria de los pobres como un factor de peso en la evolución de las relaciones de fuerza entre las clases subalternas y las clases dominantes; entre los sectores populares rurales y urbanos y los gobiernos; entre las formaciones sociales nacionales y el imperialismo.

  12. Hume: a teoria social como sistema

    Directory of Open Access Journals (Sweden)

    Rolf Kuntz

    2011-12-01

    Full Text Available Hume defende na Investigação sobre o Entendimento Humano a parcimônia no uso de princípios explicativos. Tenta-se mostrar, neste artigo, como ele procurou seguir essa diretriz em seus trabalhos sobre os sentimentos morais, a história, a política e a economia. Explora-se, ao mesmo tempo, o caráter sistemático do projeto enunciado no começo do Tratado da Natureza Humana.In his Enquiry on Human Understanding Hume proposes a rule of parcimony in the use of explanatory principles. This essay is an attempt to show how the philosopher managed to follow that rule in his writings on moral sentiments, history, politics and economics. At the same time, it explores the systematic character of the project described in the presentation of the Treatise on Human Nature.

  13. Characterization of Lanthanum Ferric Cobaltite doped with Strontium (LSCF) films deposited by spray-pyrolysis for application as cathode in PaCOS-TI; Caracterizacao de filmes de CFLE depositados por spray-pirolise para utilizacao como catodo em PaCOS-TI

    Energy Technology Data Exchange (ETDEWEB)

    Almeida, L.S.; Guimaraes, V.F.; Paes Junior, H.R. [Universidade Estadual do Norte Fluminense Darcy Ribeiro (UENF), Campos dos Goytacazes, RJ (Brazil). Lab. de Materiais Avancados], Emails: laryssadsa@yahoo.com.br, valtencyguimaraes@yahoo.com.br, herval@uenf.br

    2010-07-01

    The lanthanum ferric cobaltite doped with strontium (LSCF) is a ceramic material with the perovskite structure that stands out in the field of research for its use as cathode in solid oxide fuel cells at intermediate temperatures (IT-SOFC). The films were synthesized by spray-pyrolysis technique on 8% mol Yttria stabilized zirconia (YSZ) substrates. It was studied the influence of heat treatment temperatures (600-1000 deg C) on the properties of the films under the conditions of treatment during four hours. Samples were tested electrically by measuring the variation of electrical conductivity with temperature, structurally by X-ray diffraction (XRD) and morphologically by scanning electron microscopy (SEM). The films heat treated at 700 deg C for 4 hours showed better performance for application as cathode. (author)

  14. Use of phyllosilicates in electrochemical devices: possible use of sepiolite as a support of catalysts in direct alcohol fuel cells (DAFC); Utilizacao de filosilicatos em dispositivos eletroquimicos: possivel uso da sepiolita como suporte de catalisadores em celulas a combustivel com uso direto de etanol (DAFC)

    Energy Technology Data Exchange (ETDEWEB)

    Parra-Silva, J.; Silva, A.C.; Mello-Castanho, S.R.H. [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Cerpa, A. [Universidad Europea de Madrid, Madrid (Spain)

    2014-07-01

    Direct alcohol Fuel cells (DAFC) are interesting to use Brazil for reasons of fuel logistics and availability. The catalysts used in these devices to promote the oxidation of alcohol at the anode need to be fixed on a substrate which must provide high specific surface area, porosity, chemical and thermal resistance, this target can be achieved with the characteristics sepiolite. This paper proposes sepiolite as catalyst support for DAFC. Sepiolite is a phyllosilicate with double layered tetrahedral silicon cells and fibrillar structure. Catalysts (Pt / Sb / Sn) were prepared by cation substitution method and tested by cyclic voltammetry. Techniques as XRD and FT-IR were also used for characterizing materials. Was obtained up to 35 mA / g (Pt) peak current (redox ethanol) indicating the possibility of sepiolite technology development to use un proposed purpose. (author)

  15. Study of the rice husk ash utilization as filler polypropylene matrix and ionization radiation effect on this composite; Estudos da utilizacao da cinza de casca de arroz como carga em matriz de polipropileno e do efeito da radiacao ionizante sobre este composito

    Energy Technology Data Exchange (ETDEWEB)

    Alfaro, Eduardo de Faria

    2010-07-01

    In the first step of this work, it was evaluated the possibility of using rice husk ash as a filler in polypropylene (PP) making a comparison with talc which is the most used mineral filler in polymers. This comparison was made by using polypropylene with 20% rice husk ash as well as polypropylene with 20% talc measuring their properties. Despite the properties of the PP with 20% rice husk ash decreased compared with the composite of polypropylene with 20% talc it can be said that the rice husk ash can be used as filler for or other utilization less noble of PP . This way it is being given a destination for this residue that it is disposable in the environment contributing to its preservation, moreover reducing the product cost. This work had also as an aim to study the ionizing radiation effect in the properties of these composites. It was used the coupling agent, maleic anhydride , to verify a best sample homogenization. According to the results it can be said that PP is a semicrystalline polymer, and so it has its morphology modified when exposed to the irradiation process. This fact is due to the scission mechanisms of the polymeric chains which it is in compliance to the literature. (author)

  16. Titanium dioxide use (TiO{sub 2}) in cement matrix as a photocatalyst of nitrogen oxides (NO{sub x}); Utilizacao de dioxido de titanio (TiO{sub 2}) em matriz cimenticia como fotocatalisador de oxidos de nitrogenio (NO{sub x})

    Energy Technology Data Exchange (ETDEWEB)

    Casagrande, C.A.; Hotza, D.; Repette, W.L.; Jochem, L.F., E-mail: cezar.acasa@gmail.com [Universidade Federal de Santa Catarina (UFSC), Florianopolis, SC (Brazil)

    2012-07-01

    The use of titanium dioxide (TiO{sub 2}) in the photodegradation of nitrogen oxides (NO{sub x}) is a technology that can contribute against to environmental pollution. This work shows the feasibility of using TiO{sub 2} in mortars for photocatalysis. The Degussa P25 titania were characterized chemically and physically, revealing that the sample consists of nanoparticles, but has become crowded. Tests Samples (TS) were manufactured with added titania and the NO{sub x} tests at 28, 60 and 120 days of age of TSs, showing that it was 3% capable of degrading 100% of the NO{sub x} gas flow. Proved that conditions like relative humidity, flow and radiation intensity are relevant when it comes to efficiency in photocatalysis, altering the efficiency by varying these conditions. The photocatalysis with titania in cement matrix was efficient in NO{sub x} degradation, presenting itself as a promising technique to control environmental pollution.

  17. Supervisory utilization as a support information instrument of the data base acquisition and availability by Intranet and Internet natural gas micro-cogeneration; Utilizacao de um supervisorio como ferramenta de suporte de informacoes na aquisicao e disponibilizacao dos dados via Intranet e Internet de um sistema de micro-cogeracao de energia

    Energy Technology Data Exchange (ETDEWEB)

    Camara, Paulo; Sousa, Walter [Centro de Tecnologias do Gas (CTGAS), Natal, RN (Brazil); Petch, Moacir; Diogenes, Pedro; Carrasco, Benjamim [PETROBRAS S.A., Rio de Janeiro, RJ (Brazil)

    2008-07-01

    The globalization effects intensify the information of technology's usage, not only on the creation of new products and processes, as well, support to operation of new equipment. The Information Technology turns to being more penetrating in the companies' activities, making and changing paradigms and, consequently, in the way how information is conceived. In the partnership PETROBRAS, the Centro de Tecnologias do Gas - CTGAS and the group FOCKINK, was developed and has been launched in the brazilian market the first system of generation and micro-cogeneration by natural gas, activated by an engine diesel derivative by natural gas. The prototype is able to make 35 kW/55 kVA of electric energy, 7TR's (84.000 BTU's) of energy for refrigeration and has a capacity of warming 2200 l / h of water in the temperature of 25 deg C until 85 deg C. The equipment utilizes as a monitoring system a supervisor Elipse Scada, produced by Elipse, which is composed by acquisition and monitoring tools that turns possible the creation of screens with graphics to make easier the support, monitoring, activating and variable control, just like: pressure, temperature, electrical and mechanical. The supervisor keeps in touch with (02) two computers: the first, makes the communication with the supervisor system and the other is used to select the information to be able by web, through CTGAS home page. The access by home page of the information about the data on the co-generator will make easier the client's decision for the acquisition of the equipment. The main objective of this work is, through Information Technology is to present an application case of Elipse Scada Software in micro-cogeneration system installed at CTGAS to turn easier the obtainment of this information, change the relations into an integrate changing, expanding frontiers, creating by this way new challenges. (author)

  18. Electrolytic hydrogen production at off-peak consumption and his utilization as energy vector at peak consumption through use of fuel cells; Producao de hidrogenio eletrolitico nos horarios fora de ponta e sua utilizacao como vetor energetico nos horarios de ponta atraves do uso de celulas a combustivel

    Energy Technology Data Exchange (ETDEWEB)

    Gambetta, Francielle [Universidade Estadual de Campinas (UNICAMP), SP (Brazil). Faculdade de Engenharia Mecanica. Dept. de Energia]. E-mail: fgambetta@fem.unicamp.br; Silva, Ennio Peres da [Universidade Estadual de Campinas (UNICAMP), SP (Brazil). Inst. de Fisica. Lab. de Hidrogenio

    2008-07-01

    Due the fact that consumers have different demand, depending on the pace of economic activities and their daily habits of consumption, there is a different electrical demand throughout the day. Demand, in general, is minimal during the morning and it grows with the move for hours to reach peak consumption between 18:00 and 22:00, then turning to fall. It is old the idea of storing electricity produced in off-peak for its consumption in peak hours. To store large amounts of electrical power is required its conversion into some other form of energy, since it is impossible to store electrical energy as such in large quantities. One way of storing electricity is in the form of hydrogen produced by electrolysis of water which then can be stored, purified and converted into electricity through fuel cells. When there is an increase in demand for electricity, there is a need to expand the supply of energy, which means investments in generation, transmission and distribution. This work was performed a preliminary analysis of the production of electrolytic hydrogen in hours of low demand and its use in the generation of electricity in peak hours, making use of the fuel cells, so that to a certain limit value of increased electricity demand, there is no need for expansion of supply of Foz do Iguacu/PR. Moreover, at this work, the ability to harness the heat generated in fuel cells for heating water in homes was considered. (author)

  19. El atal como ambiente de aprendizaje inclusivo

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    Inmaculada González Falcón

    2017-04-01

    Full Text Available En las últimas décadas la creciente llegada de población inmigrantes en España ha generado la determinación de nuevas políticas educativas de escolarización para el alumnado de origen extranjero. En la comunidad andaluza, se destaca la creación del “Aula Temporal de Aceleración Lingüística” para la promoción de la enseñanza de la lengua vehicular y la integración socioeducativa del alumnado de origen extranjero. El trabajo que aquí se presenta forma parte de proyecto nacional I+D+I (Ref. CSO2013-43266-R sobre las trayectorias de estos dispositivos. Este artículo se formula bajo un doble objetivo: por un lado, analizar las variables didácticas que se desarrollan en las ATAL de dos centros públicos de educación secundaria de la provincia onubense; y por otro, valorar las semejanzas y disonancias entre dichas aulas a través de un estudio etnográfico, explicitando de igual modo los condicionantes en cuanto a tres ejes de análisis: física-funcional, temporal y relacional. Los resultados se dirigen hacia el reconocimiento del aula como espacio de apoyo emocional y de atención personal desde la configuración de ambientes de aprendizaje. Este hecho evidencia la reflexión hacia modelos educativos que conformen un marco de actuación intercultural como generadores de la inclusión para el alumnado extranjero en los centros educativos.

  20. Taxonomia como elemento estruturante em portais corporativos

    Directory of Open Access Journals (Sweden)

    Luciane Paula Vital

    2012-01-01

    Full Text Available Este trabalho busca discutir os objetivos e requisitos necessários a um portal corporativo e de que forma a construção de uma taxonomia possibilita atingi-los, configurando-se em um modelo de representação da informação e do conhecimento nesse contexto. Apresenta a evolução das intranets em direção aos portais, construindo um ponto de acesso comum as informações organizacionais. Apresenta uma revisão sobre as funcionalidades que um portal corporativo deve apresentar. Conceitua e caracteriza os diferentes tipos de taxonomia e a forma com que organiza e representa a informação. Por fim, apresenta a taxonomia como ferramenta para a determinação de categorias conceituais e de relacionamentos semânticos de uma área, assim como, da estrutura navegacional, permitindo qualificar o processo de recuperação da informação. Palavras-chave Taxonomia. Portais Corporativos. Representação da Informação. Organização da Informação. Abstract This article discusses the objectives and requirements necessary for a corporate portal and how to build a taxonomy allows for to reach them, becoming a model of representation information and knowledge in this context. Shows the evolution of intranets into the portal, building a common access point to information organizational. Presents an overview of the features that an enterprise portal should present. Conceptualizes and describes the different types of taxonomy and the way it organizes and represents information. Finally, the taxonomy as a tool for determining the conceptual categories and semantic relationships of an area, as well as the navigational structure, allowing the process to qualify for retrieval. Keywords Taxonomy. Enterprise Portal. Information Representation. Information Organization.

  1. El paisaje como archivo del territorio

    Directory of Open Access Journals (Sweden)

    Esther Isabel Prada Llorente

    2004-09-01

    (1 Este trabajo es una parte seleccionada sobre un aspecto muy concreto, como es la escala territorial, de la tesis doctoral “Sayago, evolución histórica y proyección futura de su estructura territorial” leída en la Escuela Técnica Superior de Arquitectura de Madrid en octubre de 2002. (2 Sayago: Posible relación con yacimientos mineros de época celta derivando de la palabra céltica Salliacum. Sus formas medievales serían: Saliago, Salago, Salagu y Sayago (cfr. MARTÍN VISO, 1996. De sayo, sayal, capa o “sagum” celtibérico y lusitano de color pardo, buriel o vellorí de las ovejas llamadas negras. Se pagaban como tributos por los vencidos celtíberos a las tribus romanas. Con el “paño sayal” se confeccionaron (hasta finales del s.XIX, principios del XX, todas las prendas externas de la indumentaria sayaguesa (cfr. Del Brío Mateos, 1998. (3 Escuadro: Topónimo de origen romanizador posiblemente referido a algún tipo de parcelación romana (Informante: Juan Vicent, prehistoriador del C.S.I.C. “Ex-cuadro” o “fuera del cuadro”, según la tradición popular este poblamiento hubiera surgido a raíz de los acompañamientos que las tropas romanas necesitaban para su abastecimiento en todos los aspectos, dejando fuera del recinto en otro lugar, al conjunto de herreros, artesanos, prostitutas, etc. que constituían dicho acompañamiento

  2. O PRODUTO COMO CAUSADOR DE ACIDENTES

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    Widomar Carpes Jr

    2004-06-01

    Full Text Available Neste artigo analisa-se a contribuição dos produtos para a geração de acidentes, apresentando-se estatísticas de acidentes de trabalho, de trânsito e aeronáuticos. Além disso, para melhor ilustrar a relação entre produtos e a ocorrência de acidentes, alguns casos de acidentes ocorridos e divulgados pela mídia são comentados. As estatísticas e os casos comentados demonstram a importância do estudo dos acidentes envolvendo produtos, evidenciando que praticamente todos os acidentes estão relacionados com o uso de produtos industrializados. Então, se analisa histórica e criticamente as principais teorias de acidentes de trabalho, porque são as únicas teorias existentes em relação aos acidentes. Além delas, são analisados os diversos conceitos sobre o erro humano e sua ocorrência, pois estes são apontados como grandes causadores de acidentes. Nesta análise, se observa que os acidentes estão mais relacionados aos perigos ou às características perigosas dos produtos do que às atitudes e ao comportamento do usuário. Faz-se uma revisão dos conceitos associados aos acidentes, tais como perigo, risco, acidente e dano, a partir dos quais apresenta-se um fluxograma contendo os elementos necessários para a manifestação dos acidentes. Ao final, conclui-se que a participação dos produtos na ocorrência de acidentes é evidente e que o comportamento do usuário é dependente das características do produto e da situação na qual ele é utilizado.

  3. El desarrollo organizacional como facilitador del cambio

    Directory of Open Access Journals (Sweden)

    Henry Molina

    2000-01-01

    Full Text Available El Desarrollo Organizacional (DO ha surgido de las exigencias de un ambiente cambiante y del conocimiento originado por la evolución de las ciencias sociales aplicadas. Los cambios rápidos dentro del entorno organizacional han exigido procesos y estructuras organizacionales que sean mucho más flexibles y que brinden mayor capacidad de respuesta que las estructuras tradicionales. Se requieren nuevas capacidades individuales y organizacionales que puedan impulsar las iniciativas individuales y la disposición para asumir riesgos. Igualmente, debemos considerar que existen marcadas diferencias entre las características individuales de los gerentes, las características individuales de los profesionales del desarrollo organizacional, sus habilidades y conocimientos y los estilos de las intervenciones del desarrollo organizacional. Tbdas estas diferencias hacen que sea virtualmente imposible predecir con precisión el curso y los resultados de las intervenciones en las organizaciones cliente. En este documento presento un resumen de lecturas acerca del desarrollo organizacional como facilitador del cambio; y expongo un marco de referencia para la comprensión de los factores determinantes de la relación entre las intervenciones del DO y los cambios organizacionales con el fin de mejorar la predictabilidad y la efectividad de los esfuerzos de cambio de sus intervenciones. El propósito central de este documento es dotar a los agentes de cambio de conocimiento y herramientas para que comprendan las características del cambio, los métodos de aprendizaje tanto de las organizaciones como de la gente y de cómo los agentes de cambio deben diseñar sus intervenciones y posteriormente mejorar los resultados de las mismas

  4. Cost-effectiveness of once daily GLP-1 receptor agonist lixisenatide compared to bolus insulin both in combination with basal insulin for the treatment of patients with type 2 diabetes in Norway.

    Science.gov (United States)

    Huetson, Pernilla; Palmer, James L; Levorsen, Andrée; Fournier, Marie; Germe, Maeva; McLeod, Euan

    2015-01-01

    Lixisenatide is a potent, selective and short-acting once daily prandial glucagon-like peptide-1 receptor agonist which lowers glycohemoglobin and body weight by clinically significant amounts in patients with type 2 diabetes treated with basal insulin, with limited risk of hypoglycemia. To assess the cost-effectiveness of lixisenatide versus bolus insulin, both in combination with basal insulin, in patients with type 2 diabetes in Norway. The IMS CORE Diabetes Model, a non-product-specific and validated simulation model, was used to make clinical and cost projections. Transition probabilities, risk adjustments and the progression of complication risk factors were derived from the UK Prospective Diabetes Study, supplemented with Norwegian data. Patients were assumed to receive combination treatment with basal insulin, lixisenatide or bolus insulin therapy for 3 years, followed by intensification of a basal-bolus insulin regimen for their remaining lifetime. Simulated healthcare costs, taken from the public payer perspective, were derived from microcosting and diagnosis related groups, discounted at 4% per annum and reported in Norwegian krone (NOK). Productivity costs were also captured based on extractions from the Norwegian Labor and Welfare Administration. Health state utilities were derived from a systematic literature review. Sensitivity and scenario analyses were performed. Lixisenatide in combination with basal insulin was associated with increased quality-adjusted life years (QALYs) and reduced lifetime healthcare costs compared to bolus insulin in combination with basal insulin in patients with Type 2 diabetes, and can be considered dominant. The net monetary benefit of lixisenatide versus bolus insulin was NOK 39,369 per patient. Results were sensitive to discounting, the application of excess body weight associated disutility and uncertainty surrounding the changes in HbA1c. Lixisenatide may be considered an economically efficient therapy in combination

  5. Como reescribir funciones aleatorias multivariadas como univariadas para hacer cokrigeage. La teoría

    Directory of Open Access Journals (Sweden)

    Adrian Martínez-Vargas

    2010-03-01

    Full Text Available En el año 2005 Martínez-Vargas formuló un sistema de cokrigeage puro heterotópico para estimar una función aleatoria regionalizada (RF Z*(x definida como la combinación lineal de n RF's univariadas Zi(x, cuyos coeficientes 1i(x son indicatrices de un set disyuntivo de categorías i. Aparentemente este modelo se contradice pues asume que las covarianzas cruzadas existen en un mismo punto, a pesar de su carácter puramente heterotópico. Para evadir dicha contradicción se redefinió el set de RF Zi(x como una única RF Z(x,i, siendo los puntos (x,i y (x,j no coincidentes si i y j no son iguales. La heterotopía fue simplemente considerada como una omisión de la RF Z(x,. en los datos y en los puntos a estimar, no impuesta por el modelo; entonces el resultado es simplemente un caso particular del cokrigeage clásico. Con esta notación se reescribió el sistema de cokrigeage clásico como el sistema de krigeage de la RF univariada Z(x,i, asumiendo que esta posee un drift definido como m(x,i,j, donde los miembros fl(x,i,j de m(x,i,j pueden ser linealmente dependientes o independientes. Bajo esta notación el sistema de krigeage se reduce a un sistema univariado, la existencia de más de una variable o la presencia de heterotropía no impone la necesidad de manipulaciones extras para definir el sistema de ecuaciones de krigeage, incrementándose la eficiencia computacional.

  6. A AUTOESTIMA COMO ALIADA DO PROCESSO ENSINOAPRENDIZAGEM

    Directory of Open Access Journals (Sweden)

    Gonçalina dos Santos

    2013-06-01

    Full Text Available O presente trabalho caracteriza-se como um desdobramento de um projeto de pesquisa da Universidade Estadual do Norte Fluminense (UENF, sobre o estudo de um olhar sobre objetos de aprendizagem como metodologia no ensino da matemática à luz da teoria dos registros de representação semiótica. Nosso trabalho visa verificar a influência da aplicação desta metodologia de ensino na autoestima dos educandos. Essa pesquisa foi desenvolvida dentro do método qualitativo e quantitativo descritivo exploratório, tendo a natureza do objeto e dos objetivos propostos neste estudo. A pesquisa foi realizada no Colégio Maria de Nazaré na Cidade do Rio de Janeiro, onde os alunos responderam o questionário de autoestima de Rosenberg (1989. A pesquisa foi composta por dois grupos um de análise experimental e outro de controle. No Brasil a temática da autoestima é pouco abordada cientificamente. Palavra fácil na psicologização das relações humanas. Por auto-estima entende-se a avaliação que o indivíduo faz de si mesmo. Expressa uma atitude de aprovação ou de repulsa de si e engloba o auto-julgamento em relação à competência e valor Em relação às pequenas diferenças apresentadas nos resultados encontrados nos grupo experimental, há dificuldade em se afirmar categoricamente a questão. Ao avaliar a média do grupo de controle no inicio da pesquisa, encontrava-se em 49,28% de autoestima, no final este mesmo grupo apresenta uma redução para 48,23%de autoestima. Já ao avaliar a média do grupo experimental no inicio da pesquisa este encontrava-se com 47,5% de autoestima, obtendo um aumento para 49,5% após a inserção do objeto de aprendizagem nas aulas.

  7. Quando um primitivo é como um orbe? Quando um primitivo é como um orbe?

    Directory of Open Access Journals (Sweden)

    J. Hillis Miller

    2008-04-01

    Full Text Available Minhas estratégias de analise textual se tornarão mais ou menos evidentes na leitura que se segue. Sua proveniência deveriam tornar-se & cia. 0 ensaio foi inicialmente pensado come parte do livro The Linguistic Moment (Princeton: Princeton University Press, 1985. Aqui, como no livro, minha preocupação maior e com aqueles momentos em poemas em que a poesia como meio de comunicação constitui problema. Interessa-me particularmente a forma pela qual as fronteiras entre a linguagem conceitual e a figurative se tornam pouco visiveis no poema "A Primitive like an Orb", da última fase da poesia de Wallace Stevens.

  8. ESPACIOS RENATURALIZADOS COMO AMBIENTES DE APRENDIZAJE

    Directory of Open Access Journals (Sweden)

    Yenny Rosas

    2015-12-01

    Los espacios renaturalizados, se consolidan como ambientes de aprendizaje para el ejercicio de la ciudadanía y la convivencia, a partir del desarrollo de metodologías participativas y haciendo uso de tecnologías apropiadas. Para ello se diseñaron e implementaron una serie de sesiones, con el fin de contribuir a la transformación del entorno y de permitir la conectividad ecológica presente en el ecosistema estratégico ubicado allí mismo, además de consolidar experiencias en el desarrollo de capacidades ciudadanas esenciales. Para la institución educativa se construyó, un jardín agroecológico y se sembraron árboles con fines productivos y ornamentales, permitiendo de esa manera la generación de identidad con respecto a los espacios renaturalizados, la estructura ecológica, además de reconocer las relaciones socio-ecológicas que alrededor de estos espacios se desarrollan. Entorno a la intervención, se construyeron conocimientos propios del currículo, además se identificaron las problemáticas ambientales propias de la zona, permitiendo de esa manera la armonización de la relación naturaleza-cultura y la adaptación ecosistémica al cambio climático, que requiere la ciudad de Bogotá.

  9. De como os alunos entendem os textos

    Directory of Open Access Journals (Sweden)

    Peronard Th, Marianne

    1991-01-01

    Full Text Available Nosso interesse na compreensão do texto escrito apresenta uma tendência pedagógica. Tal perspectiva guiou a seleção de nossa estrutura teórica, os limites de nosso trabalho experimental e a natureza dos instrumentos que usamos, tanto durante a avaliação das habilidades de compreensão dos alunos como durante as aplicações instrucionais. Nosso foco tem se localizado na compreensão inferencial, a qual medimos pedindo aos estudantes que verbalizassem as inferências necessárias para conbstruir uma interpretação coerente. Para garantir uma sanidade ecológica, temos nos mantido o mais próximo possível de uma situação escolar, um fato que, em resumo, parece ter sido autodestruidor. Nossos resultados mostram fracas habilidades de compreensão por parte dos sujeitos (aproximadamente 2600 alunos. Suas respostas manifestam pouco raciocínio inferencial e suas estratégias, baixa adaptação à estrutura ou conteúdo do texto. De fato a estratégia mais comum parece ser a que nós chamamos de "estratégia lexical restrita", que é mais uma "estratégia de resposta" do que uma estratégia de compreensão

  10. El budismo como una espiritualidad no religiosa

    Directory of Open Access Journals (Sweden)

    Marta Granés Bayona

    2014-09-01

    Full Text Available El budismo plantea acceder a una visión de la realidad desligada de creencias y supuestos de todo tipo. Para conseguirlo plantea una indagación libre en referencia al enclaustramiento de nuestro pensar y sentir al que nos somete el ego. El ego con sus necesidades y deseos genera un acceso a la realidad relativo a nosotros. Lo que se propone es una liberación de esta lectura para que la realidad pueda aparecer frente a nosotros de manera independiente de las imposiciones del ego, es decir, un acceso a ella ab-soluto (suelto de nosotros. El budismo es, pues, una propuesta de ‘espiritualidad no religiosa’, para la que el mismo término espiritualidad  resultaría inadecuado porque en él subyace la creencia en el ‘espíritu’. Vemos que por todo ello el mensaje budista resulta muy apropiado para las sociedades hoy presentes, bien para aquellas que están transitando de una sociedad agrícola a una industrial, que conlleva a debilitar las convicciones religiosas hasta disolverlas; bien para aquellas que están próximas o han entrado ya en las sociedades llamadas de conocimiento, innovación y cambio continuo cuya condición de movilidad impide  las creencias, porque son fijadoras, lo que arrastra como consecuencia la imposibilidad de tener religión ni espiritualidad. 

  11. Como obter vantagem competitiva utilizando business intelligence?

    Directory of Open Access Journals (Sweden)

    Avanilde Kemczinski

    2003-03-01

    Full Text Available Este artigo tem por objetivo definir Business Intelligence e identificar as tecnologias de informação e comunicação que dão suporte a este tipo de sistema de informação. Faz-se uma contextualização sobre o conceito e as tipologias de sistemas de informação (SI. Data Warehouse, Data Mart e Data Mining são os recursos tecnológicos denominados de Back-end system, utilizados para armazenar dados relevantes e extrair padrões de comportamento e tendências dos processos organizacionais. Os DSS (Decision Support Systems, EIS (Executive Information Systems e ferramentas de OLAP (On-Line Analytical Processing são caracterizados como Front-end systems para os sistemas de Business Intelligence, requerendo-se ampla funcionalidade, flexibilidade e usabilidade para que o usuário possa fazer a transformação das informações em conhecimento estratégico que apóie a tomada de decisão organizacional, objetivando a vantagem competitiva. Palavras-chave: Sistemas de Informação, Business Intelligence, Data Mining, Data Warehouse, OLAP.

  12. Daimien Hirst : el artista como preparador

    Directory of Open Access Journals (Sweden)

    Nike Verena Fakiner

    2006-01-01

    Full Text Available El cuerpo más allá de su razón biológica, es un espacio de proyección donde se escenifican las normas y los valores socioculturales y científicos. La ciencia médica constituye un régimen escópico, en cuyo marco se construye un imaginario acerca del cuerpo, que modela y normaliza la percepción que el sujeto moderno establece con él. Hirst trabaja desde el cuerpo muerto, como medio y material de trabajo, para cuestionar el posicionamiento del cuerpo en el discurso de la medicina. Para ello se sirve de imágenes corporales situadas en la frontera entre Medicina y Arte.The body, beyond its biological meaning, is a space of projection of cultural and scientific norms and values. The medicine constitutes a scopic regime, where an imaginary of body is built up which normalizes its perception by the modern subject. Hirst works with the dead body as medium and material of work, in order to question body` s position in medicine discourse. Therefore, he works with body images placed on the border line between Medicine and Art.

  13. La moneda como ofrenda en los manantiales

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    Manuel Abad Varela

    1992-01-01

    Full Text Available A la vista de como se han producido la mayoría de los hallazgos analizados y según se desprende de las fuentes escritas, diríamos que en la península ibérica y sobre todo en la parte Occidental se realizaron en la Antigüedad ofrendas monetales a divinidades de las aguas y fundamentalmente, por las referencias que tenemos, a las divinidades de las fuentes termales. Únicamente nos queda la duda de si la fuente de Peña Cutral en Retortillo (Reinosa, Santander es termal o no, pues si no lo fuese sería el único hallazgo dentro de una fuente no termal. Se podría entender, con ciertos reparos en algún caso, que también se hicieron arrojándolas al curso de los ríos, depositándolas en la orilla y lanzándolas a las charcas o pantanos. Por otro lado, las monedas que se han encontrado en las fuentes, en contraposición con las recogidas en los ríos, suelen estar en muy mala conservación, hasta el punto de que muchas se desintegran en las manos al estar muy atacadas por los ácidos. A juzgar por algunos de los hallazgos, se podría creer que las ofrendas más valiosas se procuró depositarlas en lugares seguros o resguardados, como es el caso de la Hermida, de la Fuente de El Sarso, del Balneario de Fortuna y podríamos recordar también el hallazgo del conocido depósito de Oñate. De acuerdo con la cronología de las monedas y según sus resultados estadísticos, la costumbre o rito de depositar o arrojar «stips» a las aguas, principalmente termales, se practicó en la península Ibérica más intensamente entre los siglos i a. C. al ii d. C. Este período coincide con el momento que más estuvo en boga el uso de las aguas termales, a juzgar por lo que se trató el tema en las fuentes escritas. Al mismo tiempo que se percibe esta moda en la vida diaria, pues Suetonio nos dice que Augusto, a pesar de que por su naturaleza enfermiza no abusaba de los baños, sin embargo, cuando necesitaba templar los nervios tomaba baños de mar o las

  14. Josep Beuys : el arte como creencia y como salvación

    Directory of Open Access Journals (Sweden)

    María López Ruido

    1995-01-01

    Full Text Available Joseph Beuys, nacido en Cléveris (Renania del Norte-Westfalia en 1921 y faliecido en Dusseldorf en 1986, posee una obra madura casi desde un primer momento. Superficialmente podríamos verla como el canto a sí mismo de un gran narcisista, donde sus experiencias y su persona son los grandes protagonistas. En una lectura más profunda, estos hechos personales no son más que el medio para ir más allá del yo y dar lugar a una creación plástica de trascendencia social. Tras la 2- Guerra Mundial, en la que lucha como piloto de la Luftwaffe, estudia en la Academia de Bellas Artes de Dusseldorf. Será a partir de los años 60 cuando encontremos al auténtico Beuys, escultor objetual e instalador, el creador de la plástica social, y desde sus contactos con Fluxus en 1962, el Beuys accionista. En los 70, se nos presenta el artista más claramente politizado. La educación, la incidencia social del arte, el arte como «tercera vía o vía alternativa» entre socialismo y capitalismo, la ecología serán sus materiales de trabajo.

  15. Continuous Transversus Abdominis Plane Nerve Blocks: Does Varying Local Anesthetic Delivery Method-Automatic Repeated Bolus Versus Continuous Basal Infusion-Influence the Extent of Sensation to Cold?: A Randomized, Triple-Masked, Crossover Study in Volunteers.

    Science.gov (United States)

    Khatibi, Bahareh; Said, Engy T; Sztain, Jacklynn F; Monahan, Amanda M; Gabriel, Rodney A; Furnish, Timothy J; Tran, Johnathan T; Donohue, Michael C; Ilfeld, Brian M

    2017-04-01

    It remains unknown whether continuous or scheduled intermittent bolus local anesthetic administration is preferable for transversus abdominis plane (TAP) catheters. We therefore tested the hypothesis that when using TAP catheters, providing local anesthetic in repeated bolus doses increases the cephalad-caudad cutaneous effects compared with a basal-only infusion. Bilateral TAP catheters (posterior approach) were inserted in 24 healthy volunteers followed by ropivacaine 2 mg/mL administration for a total of 6 hours. The right side was randomly assigned to either a basal infusion (8 mL/h) or bolus doses (24 mL administered every 3 hours for a total of 2 bolus doses) in a double-masked manner. The left side received the alternate treatment. The primary end point was the extent of sensory deficit as measured by cool roller along the axillary line at hour 6 (6 hours after the local anesthetic administration was initiated). Secondary end points included the extent of sensory deficit as measured by cool roller and Von Frey filaments along the axillary line and along a transverse line at the level of the anterior superior iliac spine at hours 0 to 6. Although there were statistically significant differences between treatments within the earlier part of the administration period, by hour 6 the difference in extent of sensory deficit to cold failed to reach statistical significance along the axillary line (mean = 0.9 cm; SD = 6.8; 95% confidence interval -2.0 to 3.8; P = .515) and transverse line (mean = 2.5 cm; SD = 10.1; 95% confidence interval -1.8 to 6.8; P = .244). Although the difference between treatments was statistically significant at various early time points for the horizontal, vertical, and estimated area measurements of both cold and mechanical pressure sensory deficits, no comparison remained statistically significant by hour 6. No evidence was found in this study involving healthy volunteers to support the hypothesis that changing the local anesthetic

  16. Como Lo Hago Yo: Mielomeningocele En Bolivia

    Science.gov (United States)

    Dabdoub, Carlos F.; Dabdoub, Carlos B.; Villavicencio, Ramiro; Quevedo, Germán

    2014-01-01

    Introducción: Las malformaciones del tubo neural (MTN) representan la segunda causa más frecuente de anomalías congénitas, luego de las cardiopatías. En este grupo se destaca el mielomeningocele (MMC) por su mayor incidencia, y por ser la más incapacitante y la más compleja entre todas las demás malformaciones del sistema nervioso c`entral (SNC). En Bolivia, como en muchos países de Sudamérica, los bajos niveles socio-culturales y la debilidad en el sistema sanitario, hacen que su incidencia y su morbilidad, sean mayores que en las naciones más desarrolladas. Material y Métodos: Se realizó un estudio retrospectivo y descriptivo de 70 casos de MMC, atendidos por un equipo multidisciplinario en el Hospital Universitario Japonés (HUJ) de Santa Cruz de la Sierra, entre 2008-2011. De ellos, 60 fueron intervenidos quirúrgicamente. Resultados: Se realizaron controles prenatales sólo en 27 mujeres (38.6%), diagnosticándose una disrafia espinal en apenas dos casos (7.4%). La edad de ingreso del MMC en su mayoría fue después de las 24 horas (65.6%), predominando su localización en la región lumbosacra (64.3%). De ellos, 67.2% eran abiertos, presentando un 32.9% un daño neurológico motor parcial mientras que 47.1% tenían paraplejia por debajo de la lesión. De los 70 casos, tres (4.3%) no fueron intervenidos, por presentar defectos congénitos severos o estado general grave. Las principales complicaciones posoperatorias inmediatas fueron: dehiscencia de sutura y/o infección de la herida (16.6%), fístula de líquido cefalorraquídeo (LCR) (10%) e infección del SNC (11.7%). La mortalidad general y postoperatoria fue de 7.1% y 3.3%, respectivamente. Al mes de vida presentaban hidrocefalia un 80% de los pacientes operados, colocándose una derivación ventriculoperitoneal (DVP) de presión media. De 9 pacientes que tuvieron un acompanamiento de dos o más años, seis presentaron una médula anclada, que fueron intervenidas quirúrgicamente. Conclusi

  17. La participacion ciudadana como fuente de democracia

    Directory of Open Access Journals (Sweden)

    Orlando José Cadrazco Salcedo

    2009-01-01

    Full Text Available Resumen:La Participación ciudadana es un órgano de deliberación donde confluyen todos los factores reales de poder paradecidir sobre aspectos como el plan de desarrollo, plan de ordenamiento territorial y presupuesto (atendiendo alente territorial donde se establezca , en sí este modelo es un verdadero desarrollo del concepto de democraciaparticipativa que consagra nuestra Carta Política, es un ejemplo de que la soberanía popular consagrada en elartículo tercero de la Carta va más allá del formalismo legalista y los intrincados vericuetos de la ley 134 de 1994que nunca han permitido que se ponga en marcha un verdadero desarrollo de la democracia participativa, y quepor fin salgamos de ese esquema retrogrado de la representatividad y por supuesto que a través de este modelolleguemos a un verdadero contrato social que provenga de las bases.Palabras claves:Democracia Participativa. Carta Politica, Sociedad, Participaciòn Ciudadana, Modelo Democrático, ConstituciónPolítica.Abstract:Citizen participation is a deliberative body where all the real power to decide on aspects such as the developmentplan, development plan and budget (according to the local authority where it is established, this model is itself atrue development the concept of participatory democracy enshrined in our Constitution, is an example of popularsovereignty enshrined in the third article of the Charter goes beyond the legal formalities and vericuetos the intricaciesof the law 134 of 1994 which have never been allowed to put ongoing development of a true participatorydemocracy, and they finally get out of this backward scheme of representation and of course that through this modelto create a real social contract comes from the grassroots.Keywords:Participatory Democracy. Charter Politics, Society, Politics, democratic, Constitution.

  18. Teresa Wilms Montt: la visceralidad como activismo

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    Cecilia Macon

    2017-07-01

    Full Text Available Es usual señalar que el debate sobre las emociones solo pasó a formar parte del feminismo en los últimos años. Sin embargo, es notoria la referencia en la literatura feminista de la primera ola al espacio de lo íntimo en términos de una colisión de emociones profundamente política que puede ser definida en términos de “visceralidad”. El presente trabajo se enmarca en un proyecto que tiene como objetivo final señalar el modo en que la transmisión de los afectos formó parte fundamental de la constitución del feminismo en América Latina. Este artículo se ocupa analizar la producción de la escritora chilena Teresa Wilms Montt, muy particularmente su primera obra, “Inquietudes sentimentales” (1917. No se trata meramente de argumentar la presencia de la dimensión emocional, sino de indagar en la especificidad de ese momento de su escritura donde la categoría de ‘intimidad” se torna central a la hora de establecer principios feministas. Son las características de su recorrido -donde entran en colisión las emociones más diversas - y el vínculo que establece con las luchas políticas del feminismo de corte anarquista las que abren la posibilidad de entender esta etapa, dando cuenta de la constitución de una geografía afectiva para el activismo latinoamericano. Una geografía marcada, centralmente por el desafío a “estructuras del sentir” patriarcales a través de intervenciones que sacan a la luz el papel politico de la visceralidad en tanto acción.

  19. Study Protocol. ECSSIT – Elective Caesarean Section Syntocinon® Infusion Trial. A multi-centre randomised controlled trial of oxytocin (Syntocinon® 5 IU bolus and placebo infusion versus oxytocin 5 IU bolus and 40 IU infusion for the control of blood loss at elective caesarean section

    Directory of Open Access Journals (Sweden)

    Montgomery Alan A

    2009-08-01

    Full Text Available Abstract Background Caesarean section is one of the most commonly performed major operations in women throughout the world. Rates are escalating, with studies from the United States of America, the United Kingdom, China and the Republic of Ireland reporting rates between 20% and 25%. Operative morbidity includes haemorrhage, anaemia, blood transfusion and in severe cases, maternal death. The value of routine oxytocics in the third stage of vaginal birth has been well established and it has been assumed that these benefits apply to caesarean delivery as well. A slow bolus dose of oxytocin is recommended following delivery of the baby at caesarean section. Some clinicians use an additional infusion of oxytocin for a further period following the procedure. Intravenous oxytocin has a very short half-life (4–10 minutes therefore the potential advantage of an oxytocin infusion is that it maintains uterine contractility throughout the surgical procedure and immediate postpartum period, when most primary haemorrhages occur. The few trials to date addressing the optimal approach to preventing haemorrhage at caesarean section have been under-powered to evaluate clinically important outcomes. There has been no trial to date comparing the use of an intravenous slow bolus of oxytocin versus an oxytocin bolus and infusion. Methods and design A multi-centre randomised controlled trial is proposed. The study will take place in five large maternity units in Ireland with collaboration between academics and clinicians in the disciplines of obstetrics and anaesthetics. It will involve 2000 women undergoing elective caesarean section after 36 weeks gestation. The main outcome measure will be major haemorrhage (blood loss >1000 ml. A study involving 2000 women will have 80% power to detect a 36% relative change in the risk of major haemorrhage with two-sided 5% alpha. Discussion It is both important and timely that we evaluate the optimal approach to the management

  20. Study Protocol. ECSSIT – Elective Caesarean Section Syntocinon® Infusion Trial. A multi-centre randomised controlled trial of oxytocin (Syntocinon®) 5 IU bolus and placebo infusion versus oxytocin 5 IU bolus and 40 IU infusion for the control of blood loss at elective caesarean section

    Science.gov (United States)

    Murphy, Deirdre J; Carey, Michael; Montgomery, Alan A; Sheehan, Sharon R

    2009-01-01

    Background Caesarean section is one of the most commonly performed major operations in women throughout the world. Rates are escalating, with studies from the United States of America, the United Kingdom, China and the Republic of Ireland reporting rates between 20% and 25%. Operative morbidity includes haemorrhage, anaemia, blood transfusion and in severe cases, maternal death. The value of routine oxytocics in the third stage of vaginal birth has been well established and it has been assumed that these benefits apply to caesarean delivery as well. A slow bolus dose of oxytocin is recommended following delivery of the baby at caesarean section. Some clinicians use an additional infusion of oxytocin for a further period following the procedure. Intravenous oxytocin has a very short half-life (4–10 minutes) therefore the potential advantage of an oxytocin infusion is that it maintains uterine contractility throughout the surgical procedure and immediate postpartum period, when most primary haemorrhages occur. The few trials to date addressing the optimal approach to preventing haemorrhage at caesarean section have been under-powered to evaluate clinically important outcomes. There has been no trial to date comparing the use of an intravenous slow bolus of oxytocin versus an oxytocin bolus and infusion. Methods and design A multi-centre randomised controlled trial is proposed. The study will take place in five large maternity units in Ireland with collaboration between academics and clinicians in the disciplines of obstetrics and anaesthetics. It will involve 2000 women undergoing elective caesarean section after 36 weeks gestation. The main outcome measure will be major haemorrhage (blood loss >1000 ml). A study involving 2000 women will have 80% power to detect a 36% relative change in the risk of major haemorrhage with two-sided 5% alpha. Discussion It is both important and timely that we evaluate the optimal approach to the management of the third stage at

  1. Study protocol. ECSSIT - Elective Caesarean Section Syntocinon Infusion Trial. A multi-centre randomised controlled trial of oxytocin (Syntocinon) 5 IU bolus and placebo infusion versus oxytocin 5 IU bolus and 40 IU infusion for the control of blood loss at elective caesarean section.

    LENUS (Irish Health Repository)

    Murphy, Deirdre J

    2012-02-01

    BACKGROUND: Caesarean section is one of the most commonly performed major operations in women throughout the world. Rates are escalating, with studies from the United States of America, the United Kingdom, China and the Republic of Ireland reporting rates between 20% and 25%. Operative morbidity includes haemorrhage, anaemia, blood transfusion and in severe cases, maternal death. The value of routine oxytocics in the third stage of vaginal birth has been well established and it has been assumed that these benefits apply to caesarean delivery as well. A slow bolus dose of oxytocin is recommended following delivery of the baby at caesarean section. Some clinicians use an additional infusion of oxytocin for a further period following the procedure. Intravenous oxytocin has a very short half-life (4-10 minutes) therefore the potential advantage of an oxytocin infusion is that it maintains uterine contractility throughout the surgical procedure and immediate postpartum period, when most primary haemorrhages occur. The few trials to date addressing the optimal approach to preventing haemorrhage at caesarean section have been under-powered to evaluate clinically important outcomes. There has been no trial to date comparing the use of an intravenous slow bolus of oxytocin versus an oxytocin bolus and infusion. METHODS AND DESIGN: A multi-centre randomised controlled trial is proposed. The study will take place in five large maternity units in Ireland with collaboration between academics and clinicians in the disciplines of obstetrics and anaesthetics. It will involve 2000 women undergoing elective caesarean section after 36 weeks gestation. The main outcome measure will be major haemorrhage (blood loss >1000 ml). A study involving 2000 women will have 80% power to detect a 36% relative change in the risk of major haemorrhage with two-sided 5% alpha. DISCUSSION: It is both important and timely that we evaluate the optimal approach to the management of the third stage at

  2. Study protocol. ECSSIT - Elective Caesarean Section Syntocinon Infusion Trial. A multi-centre randomised controlled trial of oxytocin (Syntocinon) 5 IU bolus and placebo infusion versus oxytocin 5 IU bolus and 40 IU infusion for the control of blood loss at elective caesarean section.

    LENUS (Irish Health Repository)

    Murphy, Deirdre J

    2009-01-01

    BACKGROUND: Caesarean section is one of the most commonly performed major operations in women throughout the world. Rates are escalating, with studies from the United States of America, the United Kingdom, China and the Republic of Ireland reporting rates between 20% and 25%. Operative morbidity includes haemorrhage, anaemia, blood transfusion and in severe cases, maternal death. The value of routine oxytocics in the third stage of vaginal birth has been well established and it has been assumed that these benefits apply to caesarean delivery as well. A slow bolus dose of oxytocin is recommended following delivery of the baby at caesarean section. Some clinicians use an additional infusion of oxytocin for a further period following the procedure. Intravenous oxytocin has a very short half-life (4-10 minutes) therefore the potential advantage of an oxytocin infusion is that it maintains uterine contractility throughout the surgical procedure and immediate postpartum period, when most primary haemorrhages occur. The few trials to date addressing the optimal approach to preventing haemorrhage at caesarean section have been under-powered to evaluate clinically important outcomes. There has been no trial to date comparing the use of an intravenous slow bolus of oxytocin versus an oxytocin bolus and infusion. METHODS AND DESIGN: A multi-centre randomised controlled trial is proposed. The study will take place in five large maternity units in Ireland with collaboration between academics and clinicians in the disciplines of obstetrics and anaesthetics. It will involve 2000 women undergoing elective caesarean section after 36 weeks gestation. The main outcome measure will be major haemorrhage (blood loss >1000 ml). A study involving 2000 women will have 80% power to detect a 36% relative change in the risk of major haemorrhage with two-sided 5% alpha. DISCUSSION: It is both important and timely that we evaluate the optimal approach to the management of the third stage at

  3. Tuberculosis como enfermedad ocupacional Tuberculosis as occupational disease

    OpenAIRE

    Alberto Mendoza-Ticona

    2012-01-01

    Existe evidencia suficiente para declarar a la tuberculosis como enfermedad ocupacional en diversos profesionales especialmente entre los trabajadores de salud. En el Perú están normados y reglamentados los derechos laborales inherentes a la tuberculosis como enfermedad ocupacional, como la cobertura por discapacidad temporal o permanente. Sin embargo, estos derechos aún no han sido suficientemente socializados. En este trabajo se presenta información sobre el riesgo de adquirir tuberculosis ...

  4. Contabilidade gerencial como apoio ao "just in time"

    OpenAIRE

    Costa, Sérgio De Carvalho

    2010-01-01

    Descreve as técnicas da filosofia "Just in Time" e apresenta as modificações necessárias aos Sistemas Gerencias para que se tornem coerentes com a filosofia JIT, bem como meçam adequadamente a melhoria contínua da Empresa. Critica tanto o Custeio' Direto como o Custeio por Absorção, apresentando como alternativa o Custeio "ABC". Mostra como o JIT facilita o Custeio dos Produtos e destaca os aspectos estratégicos da Avaliação de Desempenho. Finalmente discorre sobre um estudo de...

  5. Hepatic 123I-insulin binding kinetics in non-insulin-dependent (Type 2) diabetic patients after i.v. bolus administration

    International Nuclear Information System (INIS)

    Oolbekkink, M.; Veen, E.A. van der; Heine, R.J.; Hollander, W. den; Nauta, J.J.P.

    1989-01-01

    Insulin binding kinetics in the liver were studied in non insulin dependent (Type 2) diabetic patients, by i.v. bolus administration of 123 I-insulin. Eight Type 2 diabetic patients were compared with six male volunteers. Uptake of 123 I-insulin by liver and kidneys was measured by dynamic scintigraphy with a gamma camera during 30 min. Images of liver and kidneys appeared within 2-3 min after administration o