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Sample records for intra-abdominal pressure levels

  1. A user's guide to intra-abdominal pressure measurement.

    PubMed

    Sugrue, Michael; De Waele, Jan J; De Keulenaer, Bart L; Roberts, Derek J; Malbrain, Manu L N G

    2015-01-01

    The intra-abdominal pressure (IAP) measurement is a key to diagnosing and managing critically ill medical and surgical patients. There are an increasing number of techniques that allow us to measure the IAP at the bedside. This paper reviews these techniques. IAP should be measured at end-expiration, with the patient in the supine position and ensuring that there is no abdominal muscle activity. The intravesicular IAP measurement is convenient and considered the gold standard. The level where the mid-axillary line crosses the iliac crest is the recommended zero reference for the transvesicular IAP measurement; moreover, marking this level on the patient increases reproducibility. Protocols for IAP measurement should be developed for each ICU based on the locally available tools and equipment. IAP measurement techniques are safe, reproducible and accurate and do not increase the risk of urinary tract infection. Continuous IAP measurement may offer benefits in specific situations in the future. In conclusion, the IAP measurement is a reliable and essential adjunct to the management of patients at risk of intra-abdominal hypertension. PMID:25973661

  2. Intra-abdominal pressures during activity in women using an intra-vaginal pressure transducer.

    PubMed

    Shaw, Janet M; Hamad, Nadia M; Coleman, Tanner J; Egger, Marlene J; Hsu, Yvonne; Hitchcock, Robert; Nygaard, Ingrid E

    2014-01-01

    Strenuous physical activity has been linked to pelvic floor disorders in women. Using a novel wireless intra-vaginal pressure transducer, intra-abdominal pressure was measured during diverse activities in a laboratory. Fifty-seven women performed a prescribed protocol using the intra-vaginal pressure transducer. We calculated maximal, area under the curve and first moment of the area intra-abdominal pressure for each activity. Planned comparisons of pressure were made between levels of walking and cycling and between activities with reported high pressure in the literature. Findings indicate variability in intra-abdominal pressure amongst individuals doing the same activity, especially in activities that required regulation of effort. There were statistically significant differences in maximal pressure between levels of walking, cycling and high pressure activities. Results for area under the curve and first moment of the area were not always consistent with maximal pressure. Coughing had the highest maximal pressure, but had lower area under the curve and first moment of the area compared to most activities. Our data reflect novel findings of maximal, area under the curve and first moment of the area measures of intra-abdominal pressure, which may have clinical relevance for how physical activity relates to pelvic floor dysfunction. PMID:24575741

  3. Intra-Abdominal Pressure Correlates with Extracellular Water Content

    PubMed Central

    Dąbrowski, Wojciech; Kotlinska-Hasiec, Edyta; Jaroszynski, Andrzej; Zadora, Przemyslaw; Pilat, Jacek; Rzecki, Ziemowit; Zaluska, Wojciech; Schneditz, Daniel

    2015-01-01

    Background Secondary increase in intra-abdominal pressure (IAP) may result from extra-abdominal pathology, such as massive fluid resuscitation, capillary leak or sepsis. All these conditions increase the extravascular water content. The aim of this study was to analyze the relationship between IAP and body water volume. Material and Methods Adult patients treated for sepsis or septic shock with acute kidney injury (AKI) and patients undergoing elective pharyngolaryngeal or orthopedic surgery were enrolled. IAP was measured in the urinary bladder. Total body water (TBW), extracellular water content (ECW) and volume excess (VE) were measured by whole body bioimpedance. Among critically ill patients, all parameters were analyzed over three consecutive days, and parameters were evaluated perioperatively in surgical patients. Results One hundred twenty patients were studied. Taken together, the correlations between IAP and VE, TBW, and ECW were measured at 408 time points. In all participants, IAP strongly correlated with ECW and VE. In critically ill patients, IAP correlated with ECW and VE. In surgical patients, IAP correlated with ECW and TBW. IAP strongly correlated with ECW and VE in the mixed population. IAP also correlated with VE in critically ill patients. ROC curve analysis showed that ECW and VE might be discriminative parameters of risk for increased IAP. Conclusion IAP strongly correlates with ECW. PMID:25849102

  4. The Increase of Intra-Abdominal Pressure Can Affect Intraocular Pressure

    PubMed Central

    Ece, Ilhan; Vatansev, Celalettin; Kucukkartallar, Tevfik; Tekin, Ahmet; Kartal, Adil; Okka, Mehmet

    2015-01-01

    Objective. This study aims to explore the usage of intraocular pressure measurements as the early indicator of the increase in intra-abdominal pressure. Methods. In this prospective study, 40 patients undergoing elective surgery were included. Patients were divided into four groups of 10 patients. The control group (Group C) was not subjected to laparoscopic intervention. Laparoscopic surgery was, respectively, performed with an intra-abdominal pressure of 9, 12, and 15 mmHg in Groups L (low), M (medium), and H (high pressure). Intraocular pressure was measured binocularly in each patient at three different times (before, during, and end of surgery) using a contact tonometer. Results. Patients' gender, age, body mass index (BMI), American Society of Anesthesiology (ASA) class, and operative times were not different among the groups. No complications occurred with either the surgery or measurement of intraocular pressure. Intubation was associated with a severe rise in IOP (P < 0.05). An increase in intraocular pressure was seen in groups M and H (P < 0.05). Conclusion. Intraocular pressure was increased in the groups with an intra-abdominal pressure of 12 mmHg or more. Measuring the intraocular pressure might be a useful method to estimate the intra-abdominal pressure. This trial is registered with NCT02319213. PMID:25648230

  5. Correlation between intra-abdominal pressure and pulmonary volumes after superior and inferior abdominal surgery

    PubMed Central

    de Cleva, Roberto; de Assumpção, Marianna Siqueira; Sasaya, Flavia; Chaves, Natalia Zuniaga; Santo, Marco Aurelio; Fló, Claudia; Lunardi, Adriana C.; Filho, Wilson Jacob

    2014-01-01

    OBJECTIVE: Patients undergoing abdominal surgery are at risk for pulmonary complications. The principal cause of postoperative pulmonary complications is a significant reduction in pulmonary volumes (FEV1 and FVC) to approximately 65-70% of the predicted value. Another frequent occurrence after abdominal surgery is increased intra-abdominal pressure. The aim of this study was to correlate changes in pulmonary volumes with the values of intra-abdominal pressure after abdominal surgery, according to the surgical incision in the abdomen (superior or inferior). METHODS: We prospectively evaluated 60 patients who underwent elective open abdominal surgery with a surgical time greater than 240 minutes. Patients were evaluated before surgery and on the 3rd postoperative day. Spirometry was assessed by maximal respiratory maneuvers and flow-volume curves. Intra-abdominal pressure was measured in the postoperative period using the bladder technique. RESULTS: The mean age of the patients was 56±13 years, and 41.6% 25 were female; 50 patients (83.3%) had malignant disease. The patients were divided into two groups according to the surgical incision (superior or inferior). The lung volumes in the preoperative period showed no abnormalities. After surgery, there was a significant reduction in both FEV1 (1.6±0.6 L) and FVC (2.0±0.7 L) with maintenance of FEV1/FVC of 0.8±0.2 in both groups. The maximum intra-abdominal pressure values were similar (p = 0.59) for the two groups. There was no association between pulmonary volumes and intra-abdominal pressure measured in any of the groups analyzed. CONCLUSIONS: Our results show that superior and inferior abdominal surgery determines hypoventilation, unrelated to increased intra-abdominal pressure. Patients at high risk of pulmonary complications should receive respiratory care even if undergoing inferior abdominal surgery. PMID:25029580

  6. Does elevated intra-abdominal pressure during laparoscopic colorectal surgery cause acute gastrointestinal injury?

    PubMed Central

    Cai, Zhenghao; Malbrain, Manu L.N.G.; Sun, Jing; Pan, Ruijun; Ma, Junjun; Feng, Bo; Dong, Feng

    2015-01-01

    Introduction The incidence of acute gastrointestinal injury (AGI) after colorectal surgery is low when laparoscopic techniques are used. While elevated intra-abdominal pressure (IAP) and intra-abdominal hypertension (IAH) are associated with AGI grade II, little is known about the relation between increased IAP during laparoscopy and subsequent AGI. Aim To assess the impact of increased IAP during laparoscopic colorectal surgery on the incidence of postoperative AGI. Material and methods Sixty-six patients (41 men and 25 women) with colorectal cancer undergoing elective laparoscopic colorectal surgery were randomized into 3 groups, according to different IAP levels during CO2 pneumoperitoneum (10 mm Hg, 12 mm Hg and 15 mm Hg). We recorded the incidence of AGI after surgery by assessing the following parameters: time to first flatus/defecation, time to first bowel movement, time to tolerance of semi-liquid food and the occurrence of vomiting/diarrhea. Moreover, inflammatory mediators were measured before the induction of CO2 pneumoperitoneum and on postoperative day 1. Results Acute gastrointestinal injury occurred in 15 (27.3%) patients. In all 3 study groups, the elevation of IAP during CO2 pneumoperitoneum did not significantly increase the occurrence of symptoms of AGI, vomiting or diarrhea. Lower IAP levels did not significantly accelerate recovery of gastrointestinal function or shorten postoperative hospital stay. The changes in serum IL-6 after surgery did not correlate with the value of IAP. Conclusions The level of IAP elevation during laparoscopic colorectal surgery does not increase the occurrence of AGI after surgery. PMID:26240615

  7. Evaluation of hemodynamic changes using different intra-abdominal pressures for laparoscopic cholecystectomy.

    PubMed

    Umar, Asif; Mehta, Kuldeep Singh; Mehta, Nandita

    2013-08-01

    Biliary diseases known since ages constitute major portion of digestive tract disorders world over. Among these cholelithiasis being the fore runner causing general ill health, thereby requiring surgical intervention for total cure. The study was undertaken in an attempt to compare the hemodynamic changes in patient undergoing laparoscopic cholecystectomy using different intra-abdominal pressures created due to carbon dioxide insufflation. The patients were randomly allocated to one of the three groups in which different levels of intra-abdominal pressures (8-10 mmHg,11-13 mmHg and 14 mmHg and above) were maintained. The base line parameters monitored were heart rate, non invasive blood pressur(systolic and mean)and end tidal carbon dioxide. All the parameters were monitored at various intervals i.e. Immediately during insufflation, 5 min, 10 min, 20 min, 30 min after CO2 insufflation and after every 10 min if surgery exceeds 30 min, at exsufflation,10 min after CO2 exsufflation. Patients were ventilated with Pedius Drager Ventilator keeping tidal volume 8-10 ml/kg and respiratory rate 12-14 breaths/min. During surgery patients were placed in reverse Trendlenburg position (head up) at 15 °. The results obtained were evaluated statistically and analyzed. Baseline characteristics were found to be comparable. Hemodynamic variables were reported as mean and standard deviation. Statistical significance among groups was evaluated using Analysis of Variance and unpaired student t test (two tailed). Inter-group comparisons were made using Bonferroni test. A p-value of <0.05 was considered as statistically significant. In all the three groups the mean heart rate (baseline 84.08 ± 12.50, 87.96 ± 15.73 and 86.92 ± 17.00 respectively) increased during CO2 insufflation and the rise in heart rate continued till exsufflation after which it decreased and at 10 min after exsufflation the heart rates were comparable with the baseline. The inter

  8. Effects of ovariohysterectomy on intra-abdominal pressure and abdominal perfusion pressure in cats.

    PubMed

    Bosch, L; Rivera del Álamo, M M; Andaluz, A; Monreal, L; Torrente, C; García-Arnas, F; Fresno, L

    2012-12-15

    Intra-abdominal pressure (IAP) and abdominal perfusion pressure (APP) have shown clinical relevance in monitoring critically ill human beings submitted to abdominal surgery. Only a few studies have been performed in veterinary medicine. The aim of this study was to assess how pregnancy and abdominal surgery may affect IAP and APP in healthy cats. For this purpose, pregnant (n=10) and non-pregnant (n=11) queens undergoing elective spaying, and tomcats (n=20, used as controls) presented for neutering by scrotal orchidectomy were included in the study. IAP, mean arterial blood pressure (MAP), APP, heart rate and rectal temperature (RT) were determined before, immediately after, and four hours after surgery. IAP increased significantly immediately after abdominal surgery in both female groups when compared with baseline (P<0.05) and male (P<0.05) values, and returned to initial perioperative readings four hours after surgery. Tomcats and pregnant females (P<0.05) showed an increase in MAP and APP immediately after surgery decreasing back to initial perioperative values four hours later. A significant decrease in RT was appreciated immediately after laparotomy in both pregnant and non-pregnant queens. IAP was affected by abdominal surgery in this study, due likely to factors, such as postoperative pain and hypothermia. Pregnancy did not seem to affect IAP in this population of cats, possibly due to subjects being in early stages of pregnancy. PMID:23118052

  9. Intra-abdominal pressure: Time ripe to revise management guidelines of acute pancreatitis?

    PubMed Central

    Jaipuria, Jiten; Bhandari, Vimal; Chawla, Avneet Singh; Singh, Mohit

    2016-01-01

    AIM: To systematically review evidence on pathophysiology of intra-abdominal pressure (IAP) in acute pancreatitis (AP) with its clinical correlates. METHODS: Systematic review of available evidence in English literature with relevant medical subject heading terms on PubMed, Medline and Scopus with further search from open access sources on internet as suggested by articles retrieved. RESULTS: Intra-abdominal hypertension (IAH) is increasingly gaining recognition as a point of specific intervention with potential to alter disease outcome and improve mortality in AP. IAH can be expected in at least 17% of patients presenting with diagnosis of AP to a typical tertiary care hospital (prevalence increasing to 50% in those with severe disease). Abdominal compartment syndrome can be expected in at least 15% patients with severe disease. Recent guidelines on management of AP do not acknowledge utility of surveillance for IAP other than those by Japanese Society of Hepato-Biliary-Pancreatic Surgery. We further outline pathophysiologic mechanisms of IAH; understanding of which advances our knowledge and helps to coherently align common observed variations in management related conundrums (such as fluid therapy, nutrition and antibiotic prophylaxis) with potential to further individualize treatment in AP. CONCLUSION: We suggest that IAP be given its due place in future practice guidelines and that recommendations be formed with help of a broader panel with inclusion of clinicians experienced in management of IAH. PMID:26909242

  10. Is clinical examination an accurate indicator of raised intra-abdominal pressure in critically injured patients?

    PubMed Central

    Kirkpatrick, Andrew W.; Brenneman, Frederick D.; McLean, Richard F.; Rapanos, Theodore; Boulanger, Bernard R.

    2000-01-01

    Objectives To determine the rate of elevated intra-abdominal pressure (IAP) and to evaluate the accuracy of clinical abdominal examination in the assessment of IAP in the critically injured trauma patient. Design A prospective blinded study. Setting The medical-surgical critical care unit of a university-affiliated regional adult trauma centre. Patients Forty-two adult blunt trauma victims, who had a mean injury severity score of 36. Interventions Urinary bladder pressure was measured daily and classified as normal (10 mm Hg or less), elevated (more than 10 mm Hg) or significantly elevated (more than 15 mm Hg). A blinded clinical assessment of abdominal pressure was concurrently performed and recorded as elevated or normal. Main outcome measures The sensitivity, specificity and accuracy and the positive and negative predictive values of the 2 interventions in identifying elevated IAP. Results Twenty-one patients (50%) had an elevated IAP at some point during the study. Of the 147 bladder pressure measurements done in these 42 patients, 47 (32%) were more than 10 mm Hg and 16 (11%) were more than 15 mm Hg. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of clinical abdominal examination for identifying elevated IAP were 40%, 94%, 76%, 77% and 77%, respectively. Clinical abdominal examination had a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 56%, 87%, 35%, 94% and 84% respectively, for significantly elevated IAP. Conclusions Urinary bladder pressure was commonly elevated among our population of critically injured adults. Compared with bladder pressure measurements, clinical abdominal assessment showed poor sensitivity and accuracy for elevated IAP. These findings suggest that more routine measurements of bladder pressure in patients at risk for intra-abdominal hypertension should be performed. PMID:10851415

  11. [Measurement of intra-abdominal pressure with intravesical system Unometer Abdo-Pressure].

    PubMed

    Marín Vivó, G; Revuelta Escuté, M; Rodríguez Martínez, X

    2014-04-01

    The measurement of intra-abdominal pressure (IAP) has been incorporated routinely in Critical Units in order to monitor and control those clinical situations that make us suspicious of intraabdominal hypertension (IAH). There are several methods to measure IAP [1-3]: direct measurement, a catheter inserted through suprapubic aspiration, although it is a discouraged procedure by being very invasive; and indirect measurement. In this method there are mainly three different techniques: Through femoral vein puncture: a catheter into the inferior vena cava is channeled. It is a technique being deprecated invasive, associated with venous thrombosis, retroperitoneal hematoma and infection. Through a gastric tube: impractical, requires managing large amounts of water associated with leakage through the pylorus risk. Through intravesical measurement: is the most commonly used method. The bladder catheter allows monitoring the PIA and diuresis and electrolyte control. This method has potential for infection associated with catheterization risk. Although this risk, it is considered the gold standard for the measurement of IAP. Have now been introduced to the market each measuring intravesical kits guaranteeing sterility circuit without disconnections. It is necessary to know the material and the correct procedure for measuring the PIA and how to interpret the results. PMID:24864414

  12. Development of a wireless intra-vaginal transducer for monitoring intra-abdominal pressure in women

    PubMed Central

    Coleman, Tanner J.; Thomsen, Jens C.; Maass, Sean D.; Hsu, Yvonne; Nygaard, Ingrid E.

    2011-01-01

    Pelvic floor disorders (PFD) affect one of every four women in the United States. Elevated intra-abdominal pressure (IAP) during daily activity or strenuous physical activity has been identified as a risk factor in the prevalence of PFD. However, the relationship between IAP and physical activity is poorly understood and oftentimes activity restrictions are prescribed by physicians without clinical evidence linking various activities to elevated IAP. There are currently no pressure transducers capable of monitoring IAP non-invasively out of a clinical environment. To overcome this shortcoming, a novel intra-vaginal pressure transducer (IVT) was developed to continuously monitor IAP. Improvements were made to the first generation IVT by incorporating wireless capability to enhance the device’s mobility while creating a more robust IAP monitoring system. To ensure the changes maintained the functionality of the original device design, comparison testing with standard clinical pressure transducers in both bench top and clinical settings was conducted. The wireless device was found to have high linearity, robust signal transmission, and dynamic response that outperforms the clinical standard rectal transducer and is similar to the original first generation non-wireless design. The wireless IVT presented here is a mobile wireless device capable of measuring, storing and transmitting IAP data during various physical activities. PMID:22147020

  13. Possible harmful effects of high intra-abdominal pressure on the pelvic girdle.

    PubMed

    Mens, Jan; Hoek van Dijke, Gilbert; Pool-Goudzwaard, Annelies; van der Hulst, Victor; Stam, Henk

    2006-01-01

    The present study explores the hypothesis that a high intra-abdominal pressure (IAP) loads the ligaments of the pelvic girdle to such an extent that frequent periods of high IAP might cause pain and/or interfere with recovery of patients with pelvic girdle pain (PGP). In a theoretical model the size of the load of IAP on the pelvic girdle was computed. The diameters of abdomen and pelvis needed for the calculations were measured on MRI scans; the IAP values during activities were gained from literature. In slim, healthy subjects the calculated load on the pelvic ring during activities of daily living was 26.0-52.0 N with peaks to 135 N. During straining, vigorous work or heavy exercises the load could increase to values ranging from 104 to 520 N. The load is higher in subjects with pain or fatigue, or in case of a distended abdomen. When the load on the pelvic ring induced by IAP is larger than 100 N, the force exceeds the force at which a pelvic belt relieves complaints in PGP; at 90 N, the force is larger than the force at which isometric hip adduction provokes pain in PGP. We conclude that the size of the load induced by IAP on the pelvic girdle seems to be sufficient to cause pain in patients with PGP and might interfere with recovery. It seems worthwhile to give patients with PGP instructions to reduce IAP as much as possible during activities. PMID:16439232

  14. Effects of Altered Intra-abdominal Pressure on the Upper Airway Collapsibility in a Porcine Model

    PubMed Central

    Ren, Shu-Lin; Li, Yan-Ru; Wu, Ji-Xiang; Ye, Jing-Ying; Jen, Rachel

    2015-01-01

    Background: Obstructive sleep apnea is strongly associated with obesity, particularly abdominal obesity common in centrally obese males. Previous studies have demonstrated that intra-abdominal pressure (IAP) is increased in morbid obesity, and tracheal traction forces may influence pharyngeal airway collapsibility. This study aimed to investigate that whether IAP plays a role in the mechanism of upper airway (UA) collapsibility via IAP-related caudal tracheal traction. Methods: An abdominal wall lifting (AWL) system and graded CO2 pneumoperitoneum pressure was applied to four supine, anesthetized Guizhou miniature pigs and its effects on tracheal displacement (TD) and airflow dynamics of UA were studied. Individual run data in 3 min obtained before and after AWL and obtained before and after graded pneumoperitoneum pressure were analyzed. Differences between baseline and AWL/graded pneumoperitoneum pressure data of each pig were examined using a Student's t-test or analysis of variance. Results: Application of AWL resulted in decreased IAP and significant caudal TD. The average displacement amplitude was 0.44 mm (P < 0.001). There were three subjects showed increased tidal volume (TV) (P < 0.01) and peak inspiratory airflow (P < 0.01); however, the change of flow limitation inspiratory UA resistance (Rua) was not significant. Experimental increased IAP by pneumoperitoneum resulted in significant cranial TD. The average displacement amplitude was 1.07 mm (P < 0.001) when IAP was 25 cmH2O compared to baseline. There were three subjects showed reduced Rua while the TV increased (P < 0.01). There was one subject had decreased TV and elevated Rua (P < 0.001). Conclusions: Decreased IAP significantly increased caudal TD, and elevated IAP significantly increased cranial TD. However, the mechanism of UA collapsibility appears primarily mediated by changes in lung volume rather than tracheal traction effect. TV plays an independent role in the mechanism of UA collapsibility

  15. REPRODUCIBILITY OF INTRA-ABDOMINAL PRESSURE MEASURED DURING PHYSICAL ACTIVITIES VIA A WIRELESS VAGINAL TRANSDUCER

    PubMed Central

    Egger, Marlene J.; Hamad, Nadia M.; Hitchcock, Robert W.; Coleman, Tanner J.; Shaw, Janet M.; Hsu, Yvonne; Nygaard, Ingrid E.

    2014-01-01

    Aims In the urodynamics laboratory setting, a wireless pressure transducer, developed to facilitate research exploring intra-abdominal pressure (IAP) and pelvic floor disorders, was highly accurate. We aimed to study reproducibility of IAP measured using this transducer in women during activities performed in an exercise science laboratory. Methods Fifty seven women (mean ± SD: age 30.4 ±9.3 years; body mass index=22.4 ± 2.68 kg/m2) completed two standardized activity sessions using the same transducer at least three days apart. Pressure data for 31 activities were transmitted wirelessly to a base station and analyzed for mean net maximal IAP, area under the curve (AUC) and first moment of the area (FMA.) Activities included typical exercises, lifting 13.6 to 18.2 kg, and simulated household tasks. Analysis for test-retest reliability included Bland-Altman plots with absolute limits of agreement (ALOA), Wilcoxon signed rank tests to assess significant differences between sessions, intraclass correlations, and kappa statistics to assess inter-session agreement in highest vs. other quintiles of maximal IAP. Results Few activities exhibited significant differences between sessions in maximal IAP, or in AUC and FMA values. For 13 activities, the agreement between repeat measures of maximal IAP was better than ± 10 cm H20; for 20 activities, better than ± 15 cm H20. ALOA increased with mean IAP. The highest quintile of IAP demonstrated fair/substantial agreement between sessions in 25 of 30 activities. Conclusion Reproducibility of IAP depends on the activity undertaken. Interventions geared towards lowering IAP should account for this, and maximize efforts to improve IAP reproducibility. PMID:25730430

  16. Measurement of intra-abdominal pressure in large incisional hernia repair to prevent abdominal compartmental syndrome

    PubMed Central

    ANGELICI, A.M.; PEROTTI, B.; DEZZI, C.; AMATUCCI, C.; MANCUSO, G.; CARONNA, R.; PALUMBO, P.

    2016-01-01

    Introduction The repair of large incisional hernias may occasionally lead to a substantial increase in intra-abdominal pressure (IAP), and rarely to abdominal compartmental syndrome (ACS) with subsequent respiratory, vascular, and visceral complications. Measurement of the IAP has recently become a common practice in monitoring critical patients, even though such measurements were obtained in the early 1900s. Patients and Methods A prospective study involving 54 patients undergoing elective abdominal wall gap repair (mean length, 17.4 cm) with a tension-free technique after incisional hernia was conducted. The purpose of the study was to determine whether or not urinary pressure for indirect IAP measurement is a reliable method for the early identification of patients with a higher risk of developing ACS. IAP measurements were performed using a Foley catheter connected to a HOLTECH® medical manometer. IAP values were determined pre-operatively, after anesthetic induction, upon patient awakening, upon patient arrival in the ward after surgery, and 24 h after surgery before removing the catheter. All patients were treated by the same surgical team using a prosthetic composite mesh (PARIETEX®). Results Incisional hernia repair caused an increase in the mean IAP score of 2.68 mmHg in 47 of 54 patients (87.04%); the IAP was decreased in two patients (3.7%) and remained equal in five patients before and 24 h after surgery (9.26%). FEV-1, measured 24 h after surgery, increased in 50 patients (92.6%), remained stable in two patients (3.7%), and decreased in two patients (3.7%). The mean increase in FEV-1 was 0.0676 L (maximum increase = 0.42 L and minimum increase = 0.01 L) in any patient who developed ACS. Conclusions Measurement of urinary bladder pressure has been shown to be easy to perform and free of complications. Measurement of urinary bladder pressure can also be a useful tool to identify patients with a higher risk of developing ACS. PMID:27142823

  17. Can Selection of Mechanical Ventilation Mode Prevent Increased Intra-Abdominal Pressure in Patients Admitted to the Intensive Care Unit?

    PubMed Central

    Rafiei, Mohammad Reza; Aghadavoudi, Omid; Shekarchi, Babak; Sajjadi, Seyed Sajed; Masoudifar, Mehrdad

    2013-01-01

    Background: Increased intra-abdominal pressure (IAP) results in dysfunction of vital organs. The aim of the present study was to evaluate the effect of mechanical ventilation mode on IAP. Methods: In a cohort study, a total of 60 patients aged 20-70 years who were admitted to the ICU and underwent mechanical ventilation were recruited. Mechanical ventilation included one of the three modes: Biphasic positive airway pressure (BIPAP) group, synchronize intermittent mandatory ventilation (SIMV) group, or continuous positive airway pressure (CPAP) group. For each patient, mechanical ventilation mode and its parameters, blood pressure, SpO2, and status of tube feeding and IAP were recorded. Results: Our findings indicate that the study groups were not significantly different in terms of anthropometric characteristics including age (64.5 ± 4, P = 0.1), gender (male/female 31/29, P = 0.63), and body mass index (24 ± 1.2, P = 0.11). Increase IAP was related to the type of respiratory mode with the more increased IAP observed in SIMV mode, followed by BIPAP and CPAP modes (P = 0.01). There were significant correlations between increased IAP and respiratory variables including respiratory rate, pressure support ventilation, and inspiratory pressure (P < 0.05). Tube feeding tolerance through NG-tube was lower in SIMV group, followed by BIPAP and CPAP groups (P < 0.05). Conclusions: There is a significant relationship between respiratory modes and IAP; therefore, it is better to utilize those types of mechanical ventilation like CPAP and BIPAP mode in patients who are prone to Intra-abdominal hypertension. PMID:23930166

  18. Influence of lumbar spine rhythms and intra-abdominal pressure on spinal loads and trunk muscle forces during upper body inclination.

    PubMed

    Arshad, Rizwan; Zander, Thomas; Dreischarf, Marcel; Schmidt, Hendrik

    2016-04-01

    Improved knowledge on spinal loads and trunk muscle forces may clarify the mechanical causes of various spinal diseases and has the potential to improve the current treatment options. Using an inverse dynamic musculoskeletal model, this sensitivity analysis was aimed to investigate the influence of lumbar spine rhythms and intra-abdominal pressure on the compressive and shear forces in L4-L5 disc and the trunk muscle forces during upper body inclination. Based on in vivo data, three different spine rhythms (SRs) were used along with alternative settings (with/without) of intra-abdominal pressure (IAP). Compressive and shear forces in L4-L5 disc as well as trunk muscle forces were predicted by inverse static simulations from standing upright to 55° of intermediate trunk inclination. Alternate model settings of intra-abdominal pressure and different spine rhythms resulted in significant variation of compression (763 N) and shear forces (195 N) in the L4-L5 disc and in global (454 N) and local (156 N) trunk muscle forces at maximum flexed position. During upper body inclination, the compression forces at L4-L5 disc were mostly released by IAP and increased for larger intervertebral rotation in a lumbar spine rhythm. This study demonstrated that with various possible assumptions of lumbar spine rhythm and intra-abdominal pressure, variation in predicted loads and muscles forces increase with larger flexion. It is therefore, essential to adapt these model parameters for accurate prediction of spinal loads and trunk muscle forces. PMID:26922676

  19. Validity and Reliability of an Instrumented Speculum Designed to Minimize the Effect of Intra-abdominal Pressure on the Measurement of Pelvic Floor Muscle Strength

    PubMed Central

    Ashton-Miller, James A.; Zielinski, Ruth; Miller, Janis M.; DeLancey, John O.L.

    2015-01-01

    Background Existing clinical measurements of pelvic floor muscle strength are contaminated by crosstalk from intra-abdominal pressure. We tested an improved instrumented speculum designed to minimize this crosstalk. The hypotheses were that the speculum yields: 1) maximum vaginal closure forces unrelated to intra-abdominal pressure, 2) discriminatory validity between women who have strong vs. weak pelvic floor muscles, and 3) acceptable test-retest reliability. Methods Maximum voluntary vaginal closure force was measured in 40 incontinent women (20–77 years) using the improved instrumented speculum on two visits spaced one month apart. At the baseline visit, intra-abdominal pressure was also estimated via intra-vesical catheterization during the vaginal closure force measurement. Subjective estimate of pelvic floor muscle strength was also assessed using digital palpation by a skilled examiner to determine group placement as “strong” (n=31) or “weak” (n=9). Findings Vaginal closure force was not significantly correlated with intra-abdominal pressure (r = −.26, p = .109). The groups with subjectively scored strong and weak pelvic floor muscles differed significantly by mean [SD] maximum vaginal closure force (3.8 [1.7] vs. 1.9 [0.8] N respectively, p < .01.) Across both time points the mean vaginal closure force was 3.42 [1.67] N with a range of .68 to 9.05 N. Mean Visit 1 and Visit 2 vaginal closure force scores did not differ (3.41 [1.8] and 3.42 [1.6] N, respectively). The vaginal closure force repeatability coefficient was 3.1 N. Interpretation The improved speculum measured maximum vaginal closure force without evidence of crosstalk from intra-abdominal pressure, while retaining acceptable discriminant validity and repeatability. PMID:25307868

  20. Evidence for Negative Effects of Elevated Intra-Abdominal Pressure on Pulmonary Mechanics and Oxidative Stress

    PubMed Central

    Davarcı, I.; Karcıoğlu, M.; Tuzcu, K.; İnanoğlu, K.; Yetim, T. D.; Motor, S.; Ulutaş, K. T.; Yüksel, R.

    2015-01-01

    Objective. To compare the effects of pneumoperitoneum on lung mechanics, end-tidal CO2 (ETCO2), arterial blood gases (ABG), and oxidative stress markers in blood and bronchoalveolar lavage fluid (BALF) during laparoscopic cholecystectomy (LC) by using lung-protective ventilation strategy. Materials and Methods. Forty-six patients undergoing LC and abdominal wall hernia (AWH) surgery were assigned into 2 groups. Measurements and blood samples were obtained before, during pneumoperitoneum, and at the end of surgery. BALF samples were obtained after anesthesia induction and at the end of surgery. Results. Peak inspiratory pressure, ETCO2, and pCO2 values at the 30th minute were significantly increased, while there was a significant decrease in dynamic lung compliance, pH, and pO2 values in LC group. In BALF samples, total oxidant status (TOS), arylesterase, paraoxonase, and malondialdehyde levels were significantly increased; the glutathione peroxidase levels were significantly decreased in LC group. The serum levels of TOS and paraoxonase were significantly higher at the end of surgery in LC group. In addition, arylesterase level in the 30th minute was increased compared to baseline. Serum paraoxonase level at the end of surgery was significantly increased when compared to AWH group. Conclusions. Our study showed negative effects of pneumoperitoneum in both lung and systemic levels despite lung-protective ventilation strategy. PMID:25685845

  1. Disruption of the gastroesophageal junction by central obesity and waist belt: role of raised intra-abdominal pressure.

    PubMed

    Lee, Y Y; McColl, K E L

    2015-01-01

    Obesity is a major reason for the recent increase in incidence of reflux disease and cancers at the distal esophagus and gastroesophageal junction (GOJ) and is mediated through a rise in the intra-abdominal pressure (IAP) but the exact mechanisms are unclear. Raised IAP from obesity and with application of waist belt produces mechanical distortion of the GOJ through formation of partial hiatus hernia. Even though there is no trans-sphincteric acid reflux, there is increased ingress of acid into the lower sphincter (intra-sphincteric reflux) as a consequence of raised IAP. In addition, short segment acid reflux is more evident in obese subjects with a belt on. Acid pocket is also enlarged in hiatus hernia, and acts as a reservoir of acid available to reflux whenever the sphincter fails. Above mechanisms may explain the common occurrence of cardiac lengthening and inflammation found in asymptomatic obese subjects. The inflamed cardia is also immunohistochemically similar to non-intestinal Barrett's mucosa, which is of etiological importance for cancers at the GOJ. Interventions that can reduce the mechanical distortion and acid exposure at the GOJ, including diet, exercise, drugs, sphincter augmentation therapy, and surgery, are clinically relevant in the treatment of gastroesophageal reflux disease but more data are needed whether if these strategies are also effective in preventing cancer. As a conclusion, raised IAP produces silent mechanical disruption of the GOJ, which may explain the high occurrence of cancers in this region and it is potentially reversible with early interventions. PMID:24575877

  2. The effect of different types of abdominal binders on intra-abdominal pressure

    PubMed Central

    Zhang, Hua-Yu; Liu, Dong; Tang, Hao; Sun, Shi-Jin; Ai, Shan-Mu; Yang, Wen-Qun; Jiang, Dong-Po; Zhang, Lian-Yang

    2016-01-01

    Objectives: To investigate the effect of non-elastic/elastic abdominal binders on intra-vesical pressure (IVP), physiological functions, and clinical outcomes in laparotomy patients at the perioperative stage. Methods: This prospective study was conducted from May to October 2014 at the Trauma Surgery Department, Daping Hospital, Chongqing, China. Laparotomy patients were randomly divided into non-elastic abdominal binder group (28 patients), and elastic abdominal binder group (29 patients). Binders were applied for 14 days following the operation, or until discharge. Demographic information, Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE-II) scores (prior to the operation, on the first day after operation, the day IVP measurement was stopped, and one day before discharge), and outcomes were recorded. The IVP was measured before the operation to postoperative day 7. Results: There were no significant differences in the demographic information, outcomes, SOFA or APACHE-II scores between the 2 groups. Initial out-of-bed mobilization occurred earlier in the elastic binder group (3.2 ± 2.0 versus 5.0 ± 3.7 days, p=0.028). A greater increase in IVP was observed in the non-elastic binder group than in the elastic binder group (2.9 ± 1.1 versus 1.1 ± 0.7 mm Hg, p=0.000). Conclusion: Elastic binders have relatively little effect on IVP and are more helpful at promoting postoperative recovery than non-elastic binders. Therefore, elastic binders are more suitable for clinical use. PMID:26739977

  3. High Intra-abdominal Pressure Enhances the Penetration and Antitumor Effect of Intraperitoneal Cisplatin on Experimental Peritoneal Carcinomatosis

    PubMed Central

    Esquis, Philippe; Consolo, David; Magnin, Guy; Pointaire, Philippe; Moretto, Philippe; Ynsa, Maria Dolores; Beltramo, Jean-Luc; Drogoul, Carole; Simonet, Michel; Benoit, Laurent; Rat, Patrick; Chauffert, Bruno

    2006-01-01

    Objective: To investigate the role of increased intra-abdominal pressure (IAP) on the intratumoral accumulation and the antitumor effect of intraperitoneal cisplatin in rats with advanced peritoneal carcinomatosis. To evaluate the tolerance of IAP in pigs, as it is a large animal with a body size equivalent to humans. Summary Background Data: To investigate if an active convection, driven by a positive IAP, increases cisplatin penetration and antitumor effectiveness in a model of advanced peritoneal carcinomatosis in rats. Experimental Design: BDIX rats with macroscopic peritoneal tumors received cisplatin administered as intravenous injection (IV), conventional intraperitoneal injection (IP), or sustained intraperitoneal injection of cisplatin given in a large volume of solvent for maintaining IAP for 1 hour. Platinum tissue concentration was measured by atomic absorption spectroscopy (AAS), and platinum distribution into the tumor nodules was assessed by the particular-induced x-ray emission (PIXE) method. The antitumor effect was assessed in a survival experiment. The hemodynamic, local, and systemic tolerance of IAP, with or without cisplatin, was evaluated in Large White pigs. Results: The maximum tolerated IAP was 22 mm Hg for 1 hour in nonventilated rats. IAP, in comparison with IV or conventional IP injections, resulted in the increased concentration and depth of diffusion of platinum into diaphragm and peritoneal tumor nodules. Consequently, IAP treatment induced an extended survival of rats treated at an advanced stage of carcinomatosis. In 7 50- to 70-kg ventilated pigs, a 40-mm Hg IAP was well tolerated when maintained stable for 2 hours. Renal failure occurred in pigs receiving a total dose of 200 and 400 mg of cisplatin with IAP, but a dose of 100 mg was well tolerated. Conclusions: Intraperitoneal chemotherapy with increased IAP, in comparison with conventional IP or IV chemotherapy, improved the tumor accumulation and the antitumor effect of

  4. Mechanical ventilation and intra-abdominal hypertension: 'Beyond Good and Evil'.

    PubMed

    Pelosi, Paolo; Vargas, Maria

    2012-01-01

    Intra-abdominal hypertension is frequent in surgical and medical critically ill patients. Intra-abdominal hypertension has a serious impact on the function of respiratory as well as peripheral organs. In the presence of alveolar capillary damage, which occurs in acute respiratory distress syndrome (ARDS), intra-abdominal hypertension promotes lung injury as well as edema, impedes the pulmonary lymphatic drainage, and increases intra-thoracic pressures, leading to atelectasis, airway closure, and deterioration of respiratory mechanics and gas exchange. The optimal setting of mechanical ventilation and its impact on respiratory function and hemodynamics in ARDS associated with intra-abdominal hypertension are far from being assessed. We suggest that the optimal ventilator management of patients with ARDS and intra-abdominal hypertension would include the following: (a) intra-abdominal, esophageal pressure, and hemodynamic monitoring; (b) ventilation setting with protective tidal volume, recruitment maneuver, and level of positive end-expiratory pressure set according to the 'best' compliance of the respiratory system or the lung; (c) deep sedation with or without neuromuscular paralysis in severe ARDS; and (d) open abdomen in selected patients with severe abdominal compartment syndrome. PMID:23256904

  5. Do obese but metabolically normal women differ in intra-abdominal fat and physical activity levels from those with the expected metabolic abnormalities? A cross-sectional study

    PubMed Central

    2010-01-01

    Background Obesity remains a major public health problem, associated with a cluster of metabolic abnormalities. However, individuals exist who are very obese but have normal metabolic parameters. The aim of this study was to determine to what extent differences in metabolic health in very obese women are explained by differences in body fat distribution, insulin resistance and level of physical activity. Methods This was a cross-sectional pilot study of 39 obese women (age: 28-64 yrs, BMI: 31-67 kg/m2) recruited from community settings. Women were defined as 'metabolically normal' on the basis of blood glucose, lipids and blood pressure. Magnetic Resonance Imaging was used to determine body fat distribution. Detailed lifestyle and metabolic profiles of participants were obtained. Results Women with a healthy metabolic profile had lower intra-abdominal fat volume (geometric mean 4.78 l [95% CIs 3.99-5.73] vs 6.96 l [5.82-8.32]) and less insulin resistance (HOMA 3.41 [2.62-4.44] vs 6.67 [5.02-8.86]) than those with an abnormality. The groups did not differ in abdominal subcutaneous fat volume (19.6 l [16.9-22.7] vs 20.6 [17.6-23.9]). A higher proportion of those with a healthy compared to a less healthy metabolic profile met current physical activity guidelines (70% [95% CIs 55.8-84.2] vs 25% [11.6-38.4]). Intra-abdominal fat, insulin resistance and physical activity make independent contributions to metabolic status in very obese women, but explain only around a third of the variance. Conclusion A sub-group of women exists who are metabolically normal despite being very obese. Differences in fat distribution, insulin resistance, and physical activity level are associated with metabolic differences in these women, but account only partially for these differences. Future work should focus on strategies to identify those obese individuals most at risk of the negative metabolic consequences of obesity and on identifying other factors that contribute to metabolic status

  6. Relationship between intra-abdominal pressure and vaginal wall movements during Valsalva in women with and without pelvic organ prolapse: technique development and early observations

    PubMed Central

    Spahlinger, D. M.; Newcomb, L.; Ashton-Miller, J. A.; DeLancey, J. O. L.; Chen, Luyun

    2014-01-01

    Objectives To develop and test a method for measuring the relationship between the rise in intra-abdominal pressure and sagittal plane movements of the anterior and posterior vaginal walls during Valsalva in a pilot sample of women with and without prolapse. Methods Mid-sagittal MRI images were obtained during Valsalva while changes in intra-abdominal pressure were measured via a bladder catheter in 5 women with cystocele, 5 women with rectocele, and 5 controls. The regional compliance of the anterior and posterior vagina wall support systems were estimated from the ratio of displacement (mm) of equidistant points along the anterior and posterior vaginal walls to intra-abdominal pressure rise (mmHg). Results The compliance of both anterior and posterior vaginal wall support systems varied along different regions of vaginal wall for all three groups, with the highest compliance found near the vaginal apex and the lowest near the introitus. Women with cystocele had more compliant anterior and posterior vaginal wall support systems than women with rectocele. The movement direction differs between cystocele and rectocele. In cystocele, the anterior vaginal wall moves mostly toward the vaginal orifice in the upper vagina, but in a ventral direction in the lower vagina. In rectocele, the direction of the posterior vaginal wall movement is generally toward the vaginal orifice. Conclusions Movement of the vaginal wall and compliance of its support is quantifiable and was found to vary along the length of the vagina. Compliance was greatest in the upper vagina of all groups. Women with cystocele demonstrated the most compliant vaginal wall support. PMID:24474605

  7. Successful laparoscopic repair of an incarcerated Bochdalek hernia associated with increased intra-abdominal pressure during use of blow gun: A case report

    PubMed Central

    Harada, Manabu; Tsujimoto, Hironori; Nagata, Ken; Ito, Nozomi; Yamazaki, Kenji; Kanematsu, Kyohei; Horiguchi, Hiroyuki; Kajiwara, Yoshiki; Hiraki, Shuichi; Aosasa, Suefumi; Yamamoto, Junji; Hase, Kazuo

    2016-01-01

    Background Bochdalek hernia is a congenital diaphragmatic hernia, and adult cases are rare, with a reported frequency of 0.17%–6% among all diaphragmatic hernias. Presentation of case A 78-year-old man was referred to our hospital with a sudden onset of whole abdominal pain after playing with a blow gun. Chest radiography and computed tomography revealed diaphragmatic hernia with the small intestine. We therefore diagnosed him with an incarcerated Bochdalek hernia associated with increased intra-abdominal pressure during use of blow gun. Laparoscopic repair was performed. The omentum, transverse colon, and small intestine were located in the left thoracic cavity, without ischemic change. After placing the herniated organs into the abdominal cavity, we performed a primary closure of the diaphragmatic defect with interrupted non-absorbable sutures. Discussion It is generally recommended that all adult Bochdalek hernia patients undergo surgical repair to prevent life-threatening complications due to incarceration. Recently, laparoscopic techniques for repair the hernia have gained popularity, especially in elective cases. In our case, we could successfully perform emergency laparoscopic repair, as it is associated with a shorter inpatient hospitalization period. Conclusion An incarcerated Bochdalek hernias associated with increased intra-abdominal pressure is an uncommon clinical finding in an adult, and laparoscopic repair of an incarcerated Bochdalek hernia is safe, feasible, and an excellent option as it is minimally invasive. PMID:27111876

  8. [The patient with intra-abdominal hypertension].

    PubMed

    Sakka, Samir G

    2016-01-01

    An intra-abdominal hypertension (IAH) defined as a pathological increase in intra-abdominal pressure (IAP) is commonly found on ICU admission or during the ICU stay. Several studies confirmed that an IAH is an independent predictor for mortality of critically ill patients. The abdominal compartment syndrome (ACS) which is defined as a sustained IAP>20 mmHg (with or without an abdominal perfusion pressure [APP]<60mmHg) that is associated with new organ dysfunction or failure has a mortality of up to 60%. In general, an IAH may be induced by several intra-abdominal as well as extra-abdominal conditions. Reduced abdominal wall compliance, intra-abdominal pathologies (either of the peritoneal space or parenchymateous organs) may lead to an IAH. Most commonly, intra-abdominal infections and/or sepsis and severe trauma or burns are predisposing for an IAH. An early sign may be a decrease in urinary output. The effects of an increased IAP on cardiovascular function are well recognized and include negative effects on preload, afterload and contractility. However, all other compartments of the body may be affected by an IAH. Thus, by an increase of the respective compartment pressure, e.g. intracranial pressure, a poly-compartment syndrome may result. Adequate prevention, a forward-looking strategy, and objective techniques for measurement of IAP are required to avoid or early detect an IAH or ACS. Finally, an immediate and consequent interdisciplinary management using conservative, interventional and operative options are necessary to solve an IAH or ACS. PMID:26863642

  9. The biological effects of higher and lower positive end-expiratory pressure in pulmonary and extrapulmonary acute lung injury with intra-abdominal hypertension

    PubMed Central

    2014-01-01

    Introduction Mechanical ventilation with high positive end-expiratory pressure (PEEP) has been used in patients with acute respiratory distress syndrome (ARDS) and intra-abdominal hypertension (IAH), but the role of PEEP in minimizing lung injury remains controversial. We hypothesized that in the presence of acute lung injury (ALI) with IAH: 1) higher PEEP levels improve pulmonary morphofunction and minimize lung injury; and 2) the biological effects of higher PEEP are more effective in extrapulmonary (exp) than pulmonary (p) ALI. Methods In 48 adult male Wistar rats, ALIp and ALIexp were induced by Escherichia coli lipopolysaccharide intratracheally and intraperitoneally, respectively. After 24 hours, animals were anesthetized and mechanically ventilated (tidal volume of 6 mL/kg). IAH (15 mmHg) was induced and rats randomly assigned to PEEP of 5 (PEEP5), 7 (PEEP7) or 10 (PEEP10) cmH2O for 1 hour. Results In both ALIp and ALIexp, higher PEEP levels improved oxygenation. PEEP10 increased alveolar hyperinflation and epithelial cell damage compared to PEEP5, independent of ALI etiology. In ALIp, PEEP7 and PEEP10 increased lung elastance compared to PEEP5 (4.3 ± 0.7 and 4.3 ± 0.9 versus 3.1 ± 0.3 cmH2O/mL, respectively, P <0.01), without changes in alveolar collapse, interleukin-6, caspase-3, type III procollagen, receptor for advanced glycation end-products, and vascular cell adhesion molecule-1 expressions. Moreover, PEEP10 increased diaphragmatic injury compared to PEEP5. In ALIexp, PEEP7 decreased lung elastance and alveolar collapse compared to PEEP5 (2.3 ± 0.5 versus 3.6 ± 0.7 cmH2O/mL, P <0.02, and 27.2 (24.7 to 36.8) versus 44.2 (39.7 to 56.9)%, P <0.05, respectively), while PEEP7 and PEEP10 increased interleukin-6 and type III procollagen expressions, as well as type II epithelial cell damage compared to PEEP5. Conclusions In the current models of ALI with IAH, in contrast to our primary hypothesis, higher PEEP is more effective in

  10. Quantifying the Amount of Bleeding and Associated Changes in Intra-Abdominal Pressure and Mean Airway Pressure in Patients Undergoing Lumbar Fixation Surgeries: A Comparison of Three Positioning Systems

    PubMed Central

    Gupta, Vikas; Abraham, Mary; Punetha, Pankaj; Bundela, Yashpal

    2016-01-01

    Study Design Prospective, randomised controlled, single centre study of 45 patients posted for two level lumbar fixation surgery in the prone position. Purpose To compare intra-abdominal pressure (IAP), mean airway pressure mean airway pressure and blood loss during the spine surgery in prone position using three different positioning systems. Overview of Literature Studies have correlated IAP with the amount of perioperative bleeding. However, IAP and airway pressures while assessing the bleeding comparing two or more prone positioning systems are unclear. Methods This prospective study was conducted on a cohort of 45 patients scheduled for two-level lumbar fixation. Patients were randomly allocated to a spine table, Wilson's frame, and thermomodulated pads. Bladder pressure as an indicator of IAP, mean and peak airway pressures, and blood loss were monitored. Results IAP increased whenever patient position was changed to prone .The increase in pressure was more in the Wilson's frame group but was statistically significant only on prolonged positioning. Adopting the prone position always increased the mean airway pressure, but the increased was significant only in the Wilson's frame group. Mean airway pressure decreased in the spine table group and was statistically significant. The blood loss in the spine table group was significantly less as compared to the other groups. Conclusions Positioning on a spine table results in less blood loss and low mean airway pressure. The Wilson's frame results in high IAP, increased mean airway pressure, and more blood loss. The thermomodulated frame increases mean airway pressure and produces a moderate increase in IAP and airway pressure. PMID:27114757

  11. Antibiotic penetration of experimental intra-abdominal abscesses.

    PubMed

    Galandiuk, S; Lamos, J; Montgomery, W; Young, S; Polk, H C

    1995-06-01

    Intra-abdominal abscess is seldom adequately treated by systemic antibiotics alone and often requires surgical or computed tomography-guided drainage for resolution. Abscess penetration of six currently used antibiotics was examined in a murine intra-abdominal abscess model. Ampicillin/sulbactam, cefmetazole, clindamycin, and trospectomycin penetrated intra-abdominal abscesses to a greater degree than cefoxitin and ceftriaxone. Abscess pus antibiotic levels were not significantly higher after multiple doses than after a single dose. Pus antibiotic levels below the MIC90 for Bacteroides and E. coli within intra-abdominal abscess were observed for most antibiotics with the doses used in this study. Selection of antibiotics with a greater ability to penetrate abscess may be important in optimally treating patients with abdominal infection. PMID:7762902

  12. Cardiopulmonary monitoring in intra-abdominal hypertension.

    PubMed

    Malbrain, Manu L N G; Ameloot, Koen; Gillebert, Carl; Cheatham, Michael L

    2011-07-01

    Cardiopulmonary dysfunction and failure are commonly encountered in the patient with intra-abdominal hypertension (IAH) or abdominal compartment syndrome. Accurate assessment and optimization of preload, contractility, and afterload in conjunction with appropriate goal-directed resuscitation and assessment of fluid responsiveness are essential to restore end-organ perfusion. In patients with IAH, the traditional "barometric" preload indicators such as pulmonary artery occlusion pressure and central venous pressure are erroneously increased. Volumetric monitoring techniques have been proven to be superior in directing the appropriate resuscitation together with targeted abdominal perfusion pressure. If such limitations are not recognized, misinterpretation of the patient's cardiac status is likely, resulting in inappropriate and potentially detrimental therapy. IAH also markedly affects the mechanical properties of the chest wall and consequently also the respiratory function. Altered mechanical properties of the chest wall may limit ventilation, influence the work of breathing, affect the interaction between the respiratory muscles, hasten the development of respiratory failure, and interfere with gas exchange. Pulmonary monitoring is important to understand the relationships between intra-abdominal pressure and chest wall mechanics and the impact of IAH on ventilator-induced lung injury, lung distention, recruitment, and lung edema. PMID:21944448

  13. Change in Intra-Abdominal Fat Predicts the Risk of Hypertension in Japanese Americans.

    PubMed

    Sullivan, Catherine A; Kahn, Steven E; Fujimoto, Wilfred Y; Hayashi, Tomoshige; Leonetti, Donna L; Boyko, Edward J

    2015-07-01

    In Japanese Americans, intra-abdominal fat area measured by computed tomography is positively associated with the prevalence and incidence of hypertension. Evidence in other populations suggests that other fat areas may be protective. We sought to determine whether a change in specific fat depots predicts the development of hypertension. We prospectively followed up 286 subjects (mean age, 49.5 years; 50.4% men) from the Japanese American Community Diabetes Study for 10 years. At baseline, subjects did not have hypertension (defined as blood pressure ≥140/90 mm Hg) and were not taking blood pressure or glucose-lowering medications. Mid-thigh subcutaneous fat area, abdominal subcutaneous fat area, and intra-abdominal fat area were directly measured by computed tomography at baseline and 5 years. Logistic regression was used to estimate odds of incident hypertension over 10 years in relation to a 5-year change in fat area. The relative odds of developing hypertension for a 5-year increase in intra-abdominal fat was 1.74 (95% confidence interval, 1.28-2.37), after adjusting for age, sex, body mass index, baseline intra-abdominal fat, alcohol use, smoking status, and weekly exercise energy expenditure. This relationship remained significant when adjusted for baseline fasting insulin and 2-hour glucose levels or for diabetes mellitus and pre-diabetes mellitus classification. There were no significant associations between baseline and change in thigh or abdominal subcutaneous fat areas and incident hypertension. In conclusion, in this cohort of Japanese Americans, the risk of developing hypertension is related to the accumulation of intra-abdominal fat rather than the accrual of subcutaneous fat in either the thigh or the abdominal areas. PMID:26063668

  14. Pre-eclampsia renamed and reframed: Intra-abdominal hypertension in pregnancy.

    PubMed

    Sawchuck, Diane J; Wittmann, Bernd K

    2014-11-01

    This hypothesis proposes pre-eclampsia is caused by intra-abdominal hypertension in pregnancy. Sustained or increasing intra-abdominal pressure ⩾12mmHg causes impaired venous return to the heart, systemic vascular resistance, ischemia reperfusion injury, intestinal permeability, translocation of lipopolysaccharide endotoxin to the liver, cytotoxic immune response, systemic inflammatory response, pressure transmission to thoracic and intra-cranial compartments, and multi-organ dysfunction. This hypothesis is predicated on Pascal's law, evidence founded in the intra-abdominal hypertension literature, and the adapted equation ΔIAP-P=ΔIAVF/Cab, where ΔIAP-P=change in intra-abdominal pressure in pregnancy, ΔIAVF=change in intra-abdominal vector force (volume and force direction) and Cab=abdominal compliance. Factors causing increased intra-abdominal pressure in pregnancy include: progressive uterine expansion, obstetrical factors that increase intra-uterine volume excessively or acutely, maternal anthropometric measurements that affect intra-abdominal pressure thresholds, maternal postures that increase abdominal force direction, abdominal compliance that is decreased, diminished with advancing gestation, or has reached maximum expansion, habitation at high altitude, and rapid drops in barometric pressure. We postulate that the threshold for lipopolysaccharide translocation depends on the magnitude of intra-abdominal pressure, the intestinal microbiome complex, and the degree of intestinal permeability. We advance that delivery cures pre-eclampsia through the mechanism of abdominal decompression. PMID:25189485

  15. A focus on intra-abdominal infections

    PubMed Central

    2010-01-01

    Complicated intra-abdominal infections are an important cause of morbidity and are frequently associated with poor prognosis, particularly in higher risk patients. Well defined evidence-based recommendations for intra-abdominal infections treatment are partially lacking because of the limited number of randomized-controlled trials. Factors consistently associated with poor outcomes in patients with intra-abdominal infections include increased illness severity, failed source control, inadequate empiric antimicrobial therapy and healthcare-acquired infection. Early prognostic evaluation of complicated intra-abdominal infections is important to select high-risk patients for more aggressive therapeutic procedures. The cornerstones in the management of complicated intra-abdominal infections are both source control and antibiotic therapy. The timing and the adequacy of source control are the most important issues in the management of intra-abdominal infections, because inadequate and late control of septic source may have a negative effect on the outcomes. Recent advances in interventional and more aggressive techniques could significantly decrease the morbidity and mortality of physiologically severe complicated intra-abdominal infections, even if these are still being debated and are yet not validated by limited prospective trials. Empiric antimicrobial therapy is nevertheless important in the overall management of intra-abdominal infections. Inappropriate antibiotic therapy may result in poor patient outcomes and in the appearance of bacterial resistance. Antimicrobial management is generally standardised and many regimens, either with monotherapy or combination therapy, have proven their efficacy. Routine coverage especially against Enterococci and candida spp is not always recommended, but can be useful in particular clinical conditions. A de escalation approach may be recommended in patients with specific risk factors for multidrug resistant infections such as

  16. Intra-abdominal hypertension and acute pancreatitis.

    PubMed

    Mifkovic, A; Skultety, J; Sykora, P; Prochotsky, A; Okolicany, R

    2013-01-01

    Intra-abdominal hypertension (IAH) contributes to organ dysfunction and leads to the development of the abdominal compartment syndrome (ACS). IAH and ACS are relatively frequent findings in patiens with severe acute pancreatitis (SAP) and are associated with deterioration in organ functions. The most affected are cardiovascular, respiratory and renal functions. The incidence of IAH in patients with SAP is approximately 60-80%. There is an accumulating evidence in human and animal studies that changes of perfusion, particularly to the microvasculature, are crucial events in the progression of acute pancreatitis (AP). The perfusion of the small and large intestine is impaired due to reduced arterial pressure, increased vascular resistence and diminished portal blood flow. Bacterial translocation has been described in patients with ACS, and this may apply to patients with SAP. Approximately 30-40% of SAP patients develop ACS because of pancreatic (retroperitoneal) inflammation, peripancreatic tissue edema, formation of fluid collections or abdominal distension. Surgical debridement was the preferred treatment to control necrotizing pancreatitis in the past. However, the management of necrotizing pancreatitis has changed over the last decade. The main objective of this article is to describe the association between IAH and AP and to emphasize this situation in clinical praxis as well (Fig. 1, Ref. 38). PMID:23406186

  17. Intra-abdominal sepsis after hepatic resection.

    PubMed Central

    Pace, R F; Blenkharn, J I; Edwards, W J; Orloff, M; Blumgart, L H; Benjamin, I S

    1989-01-01

    One hundred and thirty hepatic resections performed over an 8-year period were reviewed for evidence of postoperative intra-abdominal sepsis. Of 126 patients who survived for more than 24 hours after operation, 36 developed culture positive intra-abdominal collections (28.6%). Significant independent variables associated with the development of intra-abdominal sepsis were diagnoses of trauma or cholangiocarcinoma, and the need for reoperation to control hemorrhage during the postoperative period. Before 1984, infected fluid collections were treated predominantly by operative drainage, but this has largely been replaced by percutaneous methods, which have proven effective in most cases. Eighteen (50%) of the infections were caused by a mixed bacterial culture, with Streptococcus faecalis, Staphylococcus epidermidis, Staphylococcus aureus and Escherichia coli being the most common isolates. Six patients with clinical signs of sepsis had a sterile fluid collection drained with complete relief of symptoms. This review suggests that intra-abdominal sepsis is a frequent complication after hepatic resection, and can often be managed successfully by nonoperative percutaneous drainage. PMID:2493775

  18. Intra-abdominal sepsis: the role of surgery.

    PubMed

    Gallinaro, R N; Polk, H C

    1991-09-01

    The role of the surgeon in intra-abdominal sepsis is multifactorial. A comprehensive understanding of the incidence and pathophysiology of diseases which cause intra-abdominal sepsis is the key to the diagnosis and treatment of such ailments. In simplest terms, the aetiology has two basic mechanisms: (a) violation of the 'bug-body barrier' and (b) obstruction to the flow of a body fluid with subsequent bacterial overgrowth. Either of these mechanisms may affect any of the organs within the abdomen, leading to sepsis. The peritoneal cavity is a dynamic structure which responds to insults in certain predictable manners which notify the alert physician that danger is present. Recognition of these signs through history and physical examination are the most important aspects of diagnosis. Confirmation of suspicions can be obtained with radiological modalities, but they are not a substitute for clinical judgement. Treatment of intra-abdominal sepsis should always begin with resuscitation and systemic antibiotics. Alleviation of the septic source is mandatory, and this may be achieved either operatively or non-operatively (i.e. percutaneous or endoscopic procedures). When the patient does not improve after the initial procedure, then a missed focus of infection must be investigated. In some cases, a planned or staged second operation may be needed to further debride necrotic tissue. Antibiotics should be of adequate spectrum and bioavailability to kill the species of bacteria most likely to cause the infection. This regimen may be altered when culture and sensitivity reports are completed. Finally, patients whose immune system function has been altered by disease or treatment must be assumed very ill until proven otherwise. These are general guidelines in the management of patients with intra-abdominal sepsis. Individual cases may necessitate slight modifications, but all require a high level of vigilance and expertise in order to combat a very lethal disease. PMID

  19. 2013 WSES guidelines for management of intra-abdominal infections

    PubMed Central

    2013-01-01

    Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high. The 2013 update of the World Society of Emergency Surgery (WSES) guidelines for the management of intra-abdominal infections contains evidence-based recommendations for management of patients with intra-abdominal infections. PMID:23294512

  20. Effect of changes in intra-abdominal pressure on diameter, cross-sectional area, and distensibility of the lower esophageal sphincter of healthy dogs as determined by use of an endoscopic functional luminal imaging probe.

    PubMed

    Mayhew, Philipp D; Pitt, Kathryn A; Steffey, Michele A; Culp, William T N; Kass, Philip H; Marks, Stanley L

    2016-08-01

    OBJECTIVE To evaluate the effect of intra-abdominal pressure (IAP) on morphology and compliance of the lower esophageal sphincter (LES) by use of impedance planimetry in healthy dogs and to quantify the effect of changes in IAP. ANIMALS 7 healthy, purpose-bred sexually intact male hound-cross dogs. PROCEDURES Dogs were anesthetized, and cross-sectional area (CSA), minimal diameter (MD), LES length, LES volume, and distensibility index (DI) of the LES were evaluated by use of an endoscopic functional luminal imaging probe. For each dog, measurements were obtained before (baseline) and after creation of a pneumoperitoneum at an IAP of 4, 8, and 15 mm Hg. Order of the IAPs was determined by use of a randomization software program. RESULTS CSA and MD at 4 and 8 mm Hg were not significantly different from baseline measurements; however, CSA and MD at 15 mm Hg were both significantly greater than baseline measurements. The LES length and LES volume did not differ significantly from baseline measurements at any IAP. The DI differed inconsistently from the baseline measurement but was not substantially affected by IAP. CONCLUSIONS AND CLINICAL RELEVANCE Pneumoperitoneum created with an IAP of 4 or 8 mm Hg did not significantly alter LES morphology in healthy dogs. Pneumoperitoneum at an IAP of 15 mm Hg caused a significant increase in CSA and MD of the LES. Compliance of the LES as measured by the DI was not greatly altered by pneumoperitoneum at an IAP of up to 15 mm Hg. PMID:27463542

  1. Effects of low and standard intra-abdominal pressure on systemic inflammation and immune response in laparoscopic adrenalectomy: A prospective randomised study

    PubMed Central

    Schietroma, Mario; Pessia, Beatrice; Stifini, Derna; Lancione, Laura; Carlei, Francesco; Cecilia, Emanuela Marina; Amicucci, Gianfranco

    2016-01-01

    BACKGROUND: The advantages of laparoscopic adrenalectomy (LA) over open adrenalectomy are undeniable. Nevertheless, carbon dioxide (CO2) pneumoperitoneum may have an unfavourable effect on the local immune response. The aim of this study was to compare changes in the systemic inflammation and immune response in the early post-operative (p.o.) period after LA performed with standard and low-pressure CO2 pneumoperitoneum. MATERIALS AND METHODS: We studied, in a prospective randomised study, 51 patients consecutively with documented adrenal lesion who had undergone a LA: 26 using standard-pressure (12-14 mmHg) and 25 using low-pressure (6-8 mmHg) pneumoperitoneum. White blood cells (WBC), peripheral lymphocyte subpopulation, human leucocyte antigen-DR (HLA-DR), neutrophil elastase, interleukin (IL)-6 and IL-1, and C-reactive protein (CRP) were investigated. RESULTS: Significantly higher concentrations of neutrophil elastase, IL-6 and IL-1 and CRP were detected p.o. in the standard-pressure group of patients in comparison with the low-pressure group (P < 0.05). A statistically significant change in HLA-DR expression was recorded p.o. at 24 h, as a reduction of this antigen expressed on the monocyte surface in patients from the standard group; no changes were noted in low-pressure group patients (P < 0.05). CONCLUSIONS: This study demonstrated that reducing the pressure of the pneumoperitoneum to 6-8 mmHg during LA reduced p.o. inflammatory response and averted p.o. immunosuppression. PMID:27073301

  2. Mechanical Intestinal Obstruction in a Porcine Model: Effects of Intra-Abdominal Hypertension. A Preliminary Study

    PubMed Central

    Sánchez-Margallo, F. M.; Latorre, R.; López-Albors, O.; Wise, R.; Malbrain, M. L. N. G.; Castellanos, G.

    2016-01-01

    Introduction Mechanical intestinal obstruction is a disorder associated with intra-abdominal hypertension and abdominal compartment syndrome. As the large intestine intraluminal and intra-abdominal pressures are increased, so the patient’s risk for intestinal ischaemia. Previous studies have focused on hypoperfusion and bacterial translocation without considering the concomitant effect of intra-abdominal hypertension. The objective of this study was to design and evaluate a mechanical intestinal obstruction model in pigs similar to the human pathophysiology. Materials and Methods Fifteen pigs were divided into three groups: a control group (n = 5) and two groups of 5 pigs with intra-abdominal hypertension induced by mechanical intestinal obstruction. The intra-abdominal pressures of 20 mmHg were maintained for 2 and 5 hours respectively. Hemodynamic, respiratory and gastric intramucosal pH values, as well as blood tests were recorded every 30 min. Results Significant differences between the control and mechanical intestinal obstruction groups were noted. The mean arterial pressure, cardiac index, dynamic pulmonary compliance and abdominal perfusion pressure decreased. The systemic vascular resistance index, central venous pressure, pulse pressure variation, airway resistance and lactate increased within 2 hours from starting intra-abdominal hypertension (p<0.05). In addition, we observed increased values for the peak and plateau airway pressures, and low values of gastric intramucosal pH in the mechanical intestinal obstruction groups that were significant after 3 hours. Conclusion The mechanical intestinal obstruction model appears to adequately simulate the pathophysiology of intestinal obstruction that occurs in humans. Monitoring abdominal perfusion pressure, dynamic pulmonary compliance, gastric intramucosal pH and lactate values may provide insight in predicting the effects on endorgan function in patients with mechanical intestinal obstruction. PMID

  3. Intra-abdominal hypertension in the ICU – a prospective epidemiological study

    PubMed Central

    ARABADZHIEV, GEORGI M.; TZANEVA, VALENTINA G.; PEEVA, KATYA G.

    2015-01-01

    The aim of this prospective study is to examine the frequency and the severity of intra-abdominal hypertension in a mixed ICU of the University hospital. Methods A closed system for intravesical intermittent measurement of IAP was constructed. Results The frequency and the severity of IAH were examined in the period from June 2009 to December 2012 in 240 ICU patients divided into 3 groups (patients submitted to elective surgery, emergency surgery, and medical patients) in the University Hospital. In the elective surgery group there was 12.5% IAH, while in the emergency group IAH was 43.75%, and in the medical patients it was 42.5%. There was no statistical significant difference in the frequency of IAH among the mixed population of patients we examined and those studied by other authors with the same type of population. Conclusions The standardized measurement of intra-abdominal pressure is fundamental for defining intra-abdominal hypertension and abdominal compartment syndrome. The measurement of intra-abdominal pressure should be a part of the basic monitoring of patients at risk of intra-abdominal hypertension. Our point of view is that before there are indications for a surgical decompression, less invasive treatment options should be optimized. PMID:26528070

  4. [Intra-abdominal infection and new quinolones].

    PubMed

    Gnocchi, C A

    1999-01-01

    Intra-abdominal infection is defined as the presence of an infectious process within the peritoneal cavity. It may be local or have a systemic consequence generating multiple organic disfunction. Most of the studies report a mortality of 30% in severe intra-abdominal infection. Secondary peritonitis is caused by the loss of integrity of the gastrointestinal apparatus, which contaminates with pathogens the peritoneal cavity. Invariably they are polymicrobial infections, mostly due to facultative anaerobic and anaerobic Gram negative bacilli. Prognosis of peritonitis depends on the struggle between two forces: local and systemic immunity of the host and the volume, nature and length of the contamination. Microorganisms and their products estimulate cellular defenses in the host and activate numerous inflammatory mediators responsible for sepsis. Antibiotic treatment of secondary peritonitis must act mainly against Escherichia coli and Bacteroides fragilis. The adequate and early empirical administration of antibiotics against these bacteria is well established. It is necessary to consider if the infection is localized or generalized and if it is accompanied or not by organic disfunction. It also has to be taken into account if peritonitis is community or hospital-acquired when choosing the antibiotic scheme. In community-acquired peritonitis with low to moderate infections a combination of metronidazole-ceftriaxone, metronidazole-gentamycin or a monodrug like ampicillin-sulbactam may be used. In severe hospital-acquired peritonitis imipenem or the combination piperacillin-tazobactam are effective. New quinolones such as trovafloxacin or clinafloxacin, with excellent activity against aerobes and anaerobes producing intra-abdominal infections, may be effective. Future clinical trials are needed to determine their utility. Tertiary peritonitis represent a systemic inflammatory response with multiorganic failure due to the uncontrolled activation of the inflammatory

  5. Mild to moderate intra-abdominal hypertension: Does it matter?

    PubMed Central

    Maddison, Liivi; Starkopf, Joel; Reintam Blaser, Annika

    2016-01-01

    This review summarizes the epidemiology, pathophysiological consequences and impact on outcome of mild to moderate (Grade I to II) intra-abdominal hypertension (IAH), points out possible pitfalls in available treatment recommendations and focuses on tasks for future research in the field. IAH occurs in about 40% of ICU patients. Whereas the prevalence of abdominal compartment syndrome seems to be decreasing, the prevalence of IAH does not. More than half of IAH patients present with IAH grade I and approximately a quarter with IAH grade II. However, most of the studies have addressed IAH as a yes-or-no variable, with little or no attention to different severity grades. Even mild IAH can have a negative impact on tissue perfusion and microcirculation and be associated with an increased length of stay and duration of mechanical ventilation. However, the impact of IAH and its different grades on mortality is controversial. The influence of intra-abdominal pressure (IAP) on outcome most likely depends on patient and disease characteristics and the concomitant macro- and microcirculation. Therefore, management might differ significantly. Today, clear triggers for interventions in different patient groups with mild to moderate IAH are not defined. Further studies are needed to clarify the clinical importance of mild to moderate IAH identifying clear triggers for interventions to lower the IAP. PMID:26855899

  6. Intra-abdominal injury following blunt trauma becomes clinically apparent within 9 hours

    PubMed Central

    Jones, Edward L.; Stovall, Robert T.; Jones, Teresa S.; Bensard, Denis D.; Burlew, Clay Cothren; Johnson, Jeffrey L.; Jurkovich, Gregory Jerry; Barnett, Carlton C.; Pieracci, Frederic M.; Biffl, Walter L.; Moore, Ernest E.

    2014-01-01

    Background The diagnosis of blunt abdominal trauma can be challenging and resource intensive. Observation with serial clinical assessments plays a major role in the evaluation of these patients, but the time required for intra-abdominal injury to become clinically apparent is unknown. The purpose of this study was to determine the amount of time required for an intra-abdominal injury to become clinically apparent after blunt abdominal trauma via physical examination or commonly followed clinical values. Methods A retrospective review of patients who sustained blunt trauma resulting in intra-abdominal injury between June 2010 and June 2012 at a Level 1 academic trauma center was performed. Patient demographics, injuries, and the amount of time from emergency department admission to sign or symptom development and subsequent diagnosis were recorded. All diagnoses were made by computed tomography or at the time of surgery. Patient transfers from other hospitals were excluded. Results Of 3,574 blunt trauma patients admitted to the hospital, 285 (8%) experienced intra-abdominal injuries. The mean (SD) age was 36(17) years, the majority were male (194 patients, 68%) and the mean (SD) Injury Severity Score (ISS) was 21 (14). The mean (SD) time from admission to diagnosis via computed tomography or surgery was 74 (55) minutes. Eighty patients (28%) required either surgery (78 patients, 17%) or radiographic embolization (2 patients, 0.7%) for their injury. All patients who required intervention demonstrated a sign or symptom of their intra-abdominal injury within 60 minutes of arrival, although two patients were intervened upon in a delayed fashion. All patients with a blunt intra-abdominal injury manifested a clinical sign or symptom of their intra-abdominal injury, resulting in their diagnosis within 8 hours 25 minutes of arrival to the hospital. Conclusion All diagnosed intra-abdominal injuries from blunt trauma manifested clinical signs or symptoms that could prompt

  7. Expression of ceramide-metabolising enzymes in subcutaneous and intra-abdominal human adipose tissue

    PubMed Central

    2012-01-01

    Background Inflammation and increased ceramide concentrations characterise adipose tissue of obese women with high liver fat content compared to equally obese women with normal liver fat content. The present study characterises enzymes involved in ceramide metabolism in subcutaneous and intra-abdominal adipose tissue. Methods Pathways leading to increased ceramide concentrations in inflamed versus non-inflamed adipose tissue were investigated by quantifying expression levels of key enzymes involved in ceramide metabolism. Sphingomyelinases (sphingomyelin phosphodiesterases SMPD1-3) were investigated further using immunohistochemistry to establish their location within adipose tissue, and their mRNA expression levels were determined in subcutaneous and intra-abdominal adipose tissue from both non-obese and obese subject. Results Gene expression levels of sphingomyelinases, enzymes that hydrolyse sphingomyelin to ceramide, rather than enzymes involved in de novo ceramide synthesis, were higher in inflamed compared to non-inflamed adipose tissue of obese women (with high and normal liver fat contents respectively). Sphingomyelinases were localised to both macrophages and adipocytes, but also to blood vessels and to extracellular regions surrounding vessels within adipose tissue. Expression levels of SMPD3 mRNA correlated significantly with concentrations of different ceramides and sphingomyelins. In both non-obese and obese subjects SMPD3 mRNA levels were higher in the more inflamed intra-abdominal compared to the subcutaneous adipose tissue depot. Conclusions Generation of ceramides within adipose tissue as a result of sphingomyelinase action may contribute to inflammation in human adipose tissue. PMID:22974251

  8. Intra-abdominal esophageal duplication cyst in an adult.

    PubMed

    Kim, Young Wan; Sohn, Tai Il; Shim, Hyo Sup; Kim, Choong Bai

    2005-12-31

    Esophageal duplication cysts are congenital anomalies of the foregut that are rarely found in the abdomen. An accurate preoperative diagnosis is not always possible, so the definitive diagnosis can be made by histologic examination of the surgical specimen. We experienced a case of Intra-abdominal esophageal duplication cyst in a 52-year-old female, who initially presented with an esophageal submucosal tumor on upper gastrointestinal endoscopy. She did not have any gastrointestinal symptoms. Barium esophagography, chest computed tomography scan and endoscopic ultrasonography demonstrated the cystic lesion in the intra-abdominal esophagus. Transhiatal enucleation of the lesion was performed successfully via the abdominal approach with no postoperative complications. Histologic study showed that the cyst wall contained a two-layered muscle coat and the surface of the lumen was lined by pseudo-ciliated columnar epithelium. The patient has been doing well without any complaints for 3 months of follow-up period. PMID:16385665

  9. Morphology-Independent Virulence of Candida Species during Polymicrobial Intra-abdominal Infections with Staphylococcus aureus

    PubMed Central

    Nash, Evelyn E.; Peters, Brian M.; Fidel, Paul L.

    2015-01-01

    Intra-abdominal polymicrobial infections cause significant morbidity and mortality. An experimental mouse model of Candida albicans-Staphylococcus aureus intra-abdominal infection (IAI) results in 100% mortality by 48 to 72 h postinoculation, while monomicrobial infections are avirulent. Mortality is associated with robust local and systemic inflammation without a requirement for C. albicans morphogenesis. However, the contribution of virulence factors coregulated during the yeast-to-hypha transition is unknown. This also raised the question of whether other Candida species that are unable to form hyphae are as virulent as C. albicans during polymicrobial IAI. Therefore, the purpose of this study was to evaluate the ability of non-albicans Candida (NAC) species with various morphologies and C. albicans transcription factor mutants (efg1/efg1 and cph1/cph1) to induce synergistic mortality and the accompanying inflammation. Results showed that S. aureus coinoculated with C. krusei or C. tropicalis was highly lethal, similar to C. albicans, while S. aureus-C. dubliniensis, S. aureus-C. parapsilosis, and S. aureus-C. glabrata coinoculations resulted in little to no mortality. Local and systemic interleukin-6 (IL-6) and prostaglandin E2 (PGE2) levels were significantly elevated during symptomatic and/or lethal coinfections, and hypothermia strongly correlated with mortality. Coinoculation with C. albicans strains deficient in the transcription factor Efg1 but not Cph1 reversed the lethal outcome. These results support previous findings and demonstrate that select Candida species, without reference to any morphological requirement, induce synergistic mortality, with IL-6 and PGE2 acting as key inflammatory factors. Mechanistically, signaling pathways controlled by Efg1 are critical for the ability of C. albicans to induce mortality from an intra-abdominal polymicrobial infection. PMID:26483410

  10. Moxifloxacin-loaded nanoemulsions having tocopheryl succinate as the integral component improves pharmacokinetics and enhances survival in E. coli-induced complicated intra-abdominal infection.

    PubMed

    Shukla, Prashant; Verma, Ajeet Kumar; Dwivedi, Pankaj; Yadav, Arti; Gupta, Pramod Kumar; Rath, Srikanta Kumar; Mishra, Prabhat Ranjan

    2014-12-01

    In the present work, a novel nanoemulsion laden with moxifloxacin has been developed for effective management of complicated intra-abdominal infections. Moxifloxacin nanoemulsion fabricated using high pressure homogenization was evaluated for various pharmaceutical parameters, pharmacokinetics (PK) and pharmacodynamics (PD) in rats with E. coli-induced peritonitis and sepsis. The developed nanoemulsion MONe6 (size 168 ± 28 nm and zeta potential (ZP) 24.78 ± 0.45 mV, respectively) was effective for intracellular delivery and sustaining the release of MOX. MONe6 demonstrated improved plasma (AUC(MONe6/MOX) = 2.38-fold) and tissue pharmacokinetics of MOX (AUC(MONe6/MOX) = 2.63 and 1.47 times in lung and liver, respectively). Calculated PK/PD index correlated well with a reduction in bacterial burden in plasma as well as tissues. Enhanced survival on treatment with MONe6 (65.44%) and as compared to the control group (8.22%) was a result of reduction in lipid peroxidation, neutrophil migration, and cytokine levels (TNF-α and IL6) as compared to untreated groups in the rat model of E. coli-induced sepsis. Parenteral nanoemulsions of MOX hold a promising advantage in the therapy of E. coli-induced complicated intra-abdominal infections and is helpful in the prevention of further complications like septic shock and death. PMID:25317848

  11. Clinical characteristics of ceftriaxone plus metronidazole in complicated intra-abdominal infection

    PubMed Central

    2015-01-01

    Purpose Empirical antibiotics in complicated intra-abdominal infection (c-IAI), such as secondary peritonitis are a first step of treatment. Empirical antibiotic regimen is very diverse. Ceftriaxone plus metronidazole regimen (CMR) is one of the empirical antibiotic regimens used in treatment of c-IAI. However, although CMR is a widely used empirical antibiotic regimen, study regarding success, failure or efficacy of CMR has been poorly understood. This retrospective study is conducted to compare the clinical efficacy of this regimen in c-IAI according to clinical characteristics. Methods The subjects were patients in this hospital who were diagnosed as secondary peritonitis between 2009 and 2013. Retrospective analysis was performed based on the records made after surgery regarding clinical characteristics including albumin level, blood pressure, pulse rate, respiration rate, smoking, age, sex, body mass index, hemoglobin, coexisting disease, leukocytosis, and APACHE (acute physiology and chronic health evaluation) II score. Results A total of 114 patients were enrolled. In univariated analysis, the success and failure of CMR showed significant association with preoperative low albumin, old age, and preoperative tachycardia. In multivariated analysis, low albumin and preoperative tachycardia were significant. Conclusion It is thought that an additional antibiotic treatment plan is necessary in patients with low albumin and tachycardia when the empirical antibiotic regimen is CMR in c-IAI. Conduct of research through well-designed prospective randomized clinical study is also necessary in order to evaluate the appropriateness of CMR and decide on a proper empirical antibiotic regimen between many regimens in c-IAI based on our country. PMID:26131444

  12. Multiple giant intra abdominal lipomas: A rare presentation

    PubMed Central

    Kshirsagar, Ashok Y.; Nangare, Nitin R.; Gupta, Vaibhav; Vekariya, Mayank A.; Patankar, Ritvij; Mahna, Abhishek; Wader, J.V.

    2014-01-01

    INTRODUCTION Solitary or multiple lipomas, composed of mature fat, represents by far the most common benign mesenchymal neoplasm occurring throughout the whole body, but they rarely originate in the intestinal mesentery. PRESENTATION OF CASE A 60-year-old male presented with left sided abdominal distension and pain since 4 months, ultrasonography and computerized tomography abdomen was suggestive of multiple well-defined fat density lesions in the lower abdomen and pelvis. USG guided fine needle aspiration cytology was conclusive of a spindle cell lesion. Exploratory laparotomy was performed and multiple major fat tissue swellings were excised. Histopathology confirmed it to be spindle cell type of lipoma. DISCUSSION Because of the silent nature the exact prevalence of lipomas is unknown. It can arise in any location in which fat is normally present, reported intra abdominal lipomas have been very rare. Clinical manifestations depend on the size and location of the growth. In most patients, symptoms are few or absent. USG and CT scan abdomen are used for the diagnosis. Complete surgical excision being the only treatment. CONCLUSION Intra abdominal lipoma is a very rare entity, and many cases might be ignored due to their silent nature. They might or might not present with any symptoms. Complete surgical excision being the only treatment, with a very good prognosis. PMID:24862028

  13. Diagnostic imaging of intra-abdominal cyst in heifer using the computed tomography

    PubMed Central

    OTOMARU, Konosuke; FUJIKAWA, Takuro; SAITO, Yasuo; ANDO, Takaaki; OBI, Takeshi; MIURA, Naoki; KUBOTA, Chikara

    2015-01-01

    A 10-month-old Japanese black heifer was diagnosed as having an intra-abdominal cyst using computed tomography (CT). Through a posterior ventral midline incision, the cyst was removed, and the heifer completely recovered after the surgery. CT scans enabled detection of the intra-abdominal cyst and measurements of the diameter of the cyst before the surgery. PMID:25924971

  14. A Giant Intra Abdominal Mass Mimicking Renal Cell Carcinoma: A Rare Presentation of Renal Angiomyolipoma.

    PubMed

    Haque, M E; Rahman, M A; Kaisar, I; Islam, M F; Salam, M A

    2016-07-01

    Angiomyolipoma (AML) is a benign tumor commonly found in kidney than extra renal sites. Most of the small renal angiomyolipomas are diagnosed incidentally on ultrasound and other imaging studies. Some renal AMLs present clinically when become very big, giant renal angiomyolipoma. Although almost all cases are benign, a relatively rare variant of epitheloid angiomyolipoma has got malignant potential and can even metastasize. Ultrasonography, CT and MRI scan are usually used for diagnosis of angiomyolipoma with high level of accuracy; even though some lesions may be confused as renal cell carcinoma on imaging studies. Here, a 48 year old man presented with a large intra-abdominal mass preoperatively diagnosed as a case of right renal cell carcinoma and radical nephrectomy was performed. Histopathology revealed epitheloid angiomyolipoma (EAML). PMID:27612907

  15. Removal of intra-abdominal mislocated intrauterine devices by laparoscopy.

    PubMed

    Balci, O; Capar, M; Mahmoud, A S; Colakoglu, M C

    2011-10-01

    This retrospective study was carried out on 15 patients who underwent laparoscopy for the removal of a mislocated IUD from 2003 to 2009. The mean duration of usage of an IUD was 16.1 months. The IUD was found in the Pouch of Douglas in six patients; in the posterior wall of the uterus in three patients; in the adnexa in three patients; in the omentum in two patients and it was embedded in the rectal serosa in one patient. The types of the IUDs were TCu-380A (n = 13) and Mirena(®) (n = 2). The mean laparoscopic operation time was 25 min. No major complications occurred. A second ancillary port was required in three patients. All patients were discharged within 24 h. Laparoscopic removal of the intra-abdominal IUD must be the first choice of therapy. If possible, a single ancillary port should be preferred for the removal of mislocated IUDs. We advise that surgical removal and surgical risk should be discussed with the patients, even if asymptomatic. PMID:21973139

  16. Inhibition of cyclooxygenase-2 prevents intra-abdominal adhesions by decreasing activity of peritoneal fibroblasts

    PubMed Central

    Wei, Guangbing; Chen, Xin; Wang, Guanghui; Jia, Pengbo; Xu, Qinhong; Ping, Gaofeng; Wang, Kang; Li, Xuqi

    2015-01-01

    Background Postoperative intra-abdominal adhesions are common complications after abdominal surgery. The exact molecular mechanisms that are responsible for these complications remain unclear, and there are no effective methods for preventing adhesion formation or reformation. The aim of the study reported here was to investigate the preventive effects and underlying potential molecular mechanisms of selective cyclooxygenase-2 (COX-2) inhibitors in a rodent model of postoperative intra-abdominal adhesions. Materials and methods The expression of COX-2 in postoperative intra-abdominal adhe-sions and normal peritoneal tissue was examined by immunohistochemistry and Western blot analysis. Assays were performed to elucidate the effect of COX-2 inhibition on hypoxia-induced fibroblast activity in vitro and on intra-abdominal adhesion formation in vivo. Results Hypoxia-induced COX-2 expression in peritoneal fibroblasts was increased in postoperative intra-abdominal adhesions. Inhibition of COX-2 attenuated the activating effect of hypoxia on normal peritoneal fibroblasts in vitro. Data indicate that selective COX-2 inhibitor prevents in vivo intra-abdominal adhesion by inhibition of basic fibroblast growth factor and transforming growth factor-beta expression, but not through an antiangiogenic mechanism. Furthermore, using selective COX-2 inhibitors to prevent intra-abdominal adhesions did not adversely affect the weight, bowel motility, or healing of intestinal anastomoses in a rat model. Conclusion These results show that hypoxia-induced COX-2 expression in peritoneal fibroblasts is involved in the formation of intra-abdominal adhesions. Inhibition of COX-2 prevents postoperative intra-abdominal adhesions through suppression of inflammatory cytokines. PMID:26109851

  17. Intestinal strangulation caused by intra-abdominal lipomas in a dog.

    PubMed

    McLaughlin, R; Kuzma, A B

    1991-12-01

    Pedunculated, intra-abdominal lipomas caused intestinal strangulation in a Doberman Pinscher. The dog was treated surgically to remove the lipomas and the devitalized intestine but died soon after surgery. Histologic evaluation confirmed the diagnosis of lipoma. PMID:1778747

  18. The use of anti-gravity suits for the control of critical intra-abdominal hemmorhage

    NASA Technical Reports Server (NTRS)

    Kravik, S.; Landmark, K.

    1980-01-01

    The history and use as well as the physiology of the use of antigravity suits for the control of critical intra-abdominal hemorrhages is reviewed. The use of this suit is highly recommended, especially for first aid.

  19. Intra-abdominal fat is related to metabolic syndrome and non-alcoholic fat liver disease in obese youth

    PubMed Central

    2013-01-01

    Background Previous studies have shown an association between adiposity, especially intra-abdominal adipose tissue, and hemodynamic/metabolic comorbidities in adults, however it is not clear in pediatric population. The aim of the study was to analyze the relationship between non-alcoholic fatty liver disease (NAFLD) and components of metabolic syndrome (MS) with values of intra-abdominal (IAAT) and subcutaneous (SCAT) adipose tissue in obese children and adolescents. Methods Cross-sectional study. Subjects: 182 obese sedentary children and adolescents (aged 6 to 16 y), identified by the body mass index (BMI). Measurements: Body composition and trunk fat by dual-energy X-ray absorptiometry- DXA; lipid profile, blood pressure and pubertal stage were also assessed. NAFLD was classified as absent (0), mild (1), moderate (2) and severe (3), and intra-abdominal and subcutaneous abdominal fat thickness were identified by ultrasound. The MS was identified according to the cut offs proposed by World Health Organization adapted for children and adolescents. The chi-square test was used to compare categorical variables, and the binary logistic regression indicated the magnitude of the associations adjusted by potential cofounders (sex, age, maturation, NAFLD and HOMA-IR). Results Higher quartile of SCAT was associated with elevated blood pressure (p = 0.015), but not associated with NAFLD (p = 0.665). Higher IAAT was positively associated with increased dyslipidemia (p = 0.001), MS (p = 0.013) and NAFLD (p = 0.005). Intermediate (p = 0.007) and highest (p = 0.001) quartile of IAAT were also associated with dyslipidemia, independently of age, sex, maturation, NAFLD and HOMA-IR (homeostatic model assessment-insulin resistance). Conclusion Obese children and adolescents, with higher IAAT are more prone to develop MS and NAFLD than those with higher values of SCAT, independent of possible confounding variables. PMID:23919592

  20. Umbilical intra-abdominal vein varix: a case report and review of the literature.

    PubMed

    Virdis, G; Gulotta, A; Cherchi, C; Spanedda, G; Olzai, M G; Ambrosini, G; Dessole, S; Capobianco, G

    2016-01-01

    Fetal umbilical intra-abdominal vein varix (FIUV) is a rare congenital malformation characterized by focal dilatation of the umbilical vein. The authors report a case of pregnant woman at 32 weeks of gestation with a fetus affected by dilatation of an intra-abdominal portion of the umbilical vein. They performed continuous ultrasound and cardiotocographic monitoring, from admission to the delivery. They describe the case and perform a review of the literature. PMID:27132426

  1. Intra-abdominal hypertension and abdominal compartment syndrome in burns, obesity, pregnancy, and general medicine.

    PubMed

    Malbrain, Manu L N G; De Keulenaer, Bart L; Oda, Jun; De Laet, Inneke; De Waele, Jan J; Roberts, Derek J; Kirkpatrick, Andrew W; Kimball, Edward; Ivatury, Rao

    2015-01-01

    Intra-abdominal hypertension (IAH) is an important contributor to early organ dysfunction in trauma and sepsis. However, relatively little is known about the impact of intra-abdominal pressure (IAP) in general internal medicine, pregnant patients, and those with obesity or burns. The aim of this paper is to review the pathophysiologic implications and treatment options for IAH in these specific situations. A MEDLINE and PubMed search was performed and the resulting body-of-evidence included in the current review on the basis of relevance and scientific merit. There is increasing awareness of the role of IAH in different clinical situations. Specifically, IAH will develop in most (if not all) severely burned patients, and may contribute to early mortality. One should avoid over-resuscitation of these patients with large volumes of fluids, especially crystalloids. Acute elevations in IAP have similar effects in obese patients compared to non-obese patients, but the threshold IAP associated with organ dysfunction may be higher. Chronic elevations in IAP may, in part, be responsible for the pathogenesis of obesity-related co-morbid conditions such as hypertension, pseudotumor cerebri, pulmonary dysfunction, gastroesophageal reflux disease, and abdominal wall hernias. At the bedside, measuring IAP and considering IAH in all critical maternal conditions is essential, especially in preeclampsia/eclampsia where some have hypothesized that IAH may have an additional role. IAH in pregnancy must take into account the precautions for aorto-caval compression and has been associated with ovarian hyperstimulation syndrome. Recently, IAP has been associated with the cardiorenal dilemma and hepatorenal syndrome, and this has led to the recognition of the polycompartment syndrome. In conclusion, IAH and ACS have been associated with several patient populations beyond the classical ICU, surgical, and trauma patients. In all at risk conditions the focus should be on the early

  2. A necessary evil? Intra-abdominal hypertension complicating burn patient resuscitation

    PubMed Central

    2014-01-01

    Objective Severe burns are devastating injuries that result in considerable systemic inflammation and often require resuscitation with large volumes of fluid. The result of massive resuscitation is often raised intra-abdominal pressures leading to Intra-abdominal hypertension (IAH) and the secondary abdominal compartment syndrome. The objective of this study is to conduct (1) a 10 year retrospective study to investigate epidemiological factors contributing to burn injuries in Alberta, (2) to characterize fluid management and incidence of IAH and ACS and (3) to review fluid resuscitation with a goal to identify optimal strategies for fluid resuscitation. Design A comprehensive 10-year retrospective review of burn injuries from 1999. Outcome Measures Age, sex, date, mechanism of injury, location of incident, on scene vitals and GCS, type of transport to hospital and routing, ISS, presenting vitals and GCS, diagnoses, procedures, complications, hospital LOS, ICU LOS, and events surrounding the injury. Results One hundred and seventy five patients (79.4% M, 20.6% F) were identified as having traumatic burn injuries with a mean ISS score of 21.8 (±8.3). The mean age was 41.6 (±17.5) (range 14-94) years. Nearly half (49.7%) of patients suffered their injuries at home, 17.7% were related to industrial incidents and 14.3% were MVC related. One hundred and ten patients required ICU admission. ICU LOS 18.5 (±8.8) days. Hospital LOS 38.0 (±37.8) days. The mean extent of burn injury was 31.4 (±20.9) % TBSA. Nearly half of the patients suffered inhalational injuries (mild 12.5%, moderate 13.7%, severe 9.1%). Thirty-nine (22.2%) of patients died from their injuries. Routine IAP monitoring began in September, 2005 with 15 of 28 patients having at least two IAP measurements. The mean IAP was 16.5 (±5.7) cm H2O (range: 1-40) with an average of 58 (±97) IAP measurements per patient. Those patients with IAP monitoring had an average TBSA of 35.0 (±16.0)%, ISS of 47.5 (±7

  3. Effects of acute intra-abdominal hypertension on multiple intestinal barrier functions in rats

    PubMed Central

    Leng, Yuxin; Yi, Min; Fan, Jie; Bai, Yu; Ge, Qinggang; Yao, Gaiqi

    2016-01-01

    Intra-abdominal hypertension (IAH) is a common and serious complication in critically ill patients for which there is no well-defined treatment strategy. Here, we explored the effect of IAH on multiple intestinal barriers and discussed whether the alteration in microflora provides clues to guide the rational therapeutic treatment of intestinal barriers during IAH. Using a rat model, we analysed the expression of tight junction proteins (TJs), mucins, chemotactic factors, and Toll-like receptor 4 (TLR4) by immunohistochemistry. We also analysed the microflora populations using 16S rRNA sequencing. We found that, in addition to enhanced permeability, acute IAH (20 mmHg for 90 min) resulted in significant disturbances to mucosal barriers. Dysbiosis of the intestinal microbiota was also induced, as represented by decreased Firmicutes (relative abundance), increased Proteobacteria and migration of Bacteroidetes from the colon to the jejunum. At the genus level, Lactobacillus species and Peptostreptococcaceae incertae sedis were decreased, whereas levels of lactococci remained unchanged. Our findings outline the characteristics of IAH-induced barrier changes, indicating that intestinal barriers might be treated to alleviate IAH, and the microflora may be an especially relevant target. PMID:26980423

  4. WSES consensus conference: Guidelines for first-line management of intra-abdominal infections

    PubMed Central

    2011-01-01

    Intra-abdominal infections are still associated with high rate of morbidity and mortality. A multidisciplinary approach to the management of patients with intra-abdominal infections may be an important factor in the quality of care. The presence of a team of health professionals from various disciplines, working in concert, may improve efficiency, outcome, and the cost of care. A World Society of Emergency Surgery (WSES) Consensus Conference was held in Bologna on July 2010, during the 1st congress of the WSES, involving surgeons, infectious disease specialists, pharmacologists, radiologists and intensivists with the goal of defining recommendations for the early management of intra-abdominal infections. This document represents the executive summary of the final guidelines approved by the consensus conference. PMID:21232143

  5. Laparoscopic resection of an intra-abdominal cystic mass: a cystic mesothelioma

    PubMed Central

    Birch, Daniel W.; Park, Adrian; Chen, Vicki

    1998-01-01

    The clinical features of a patient with an intra-abdominal cystic mass do not lead to a specific diagnosis. Aspiration is usually ineffective because the mass recurs and cytologic investigation is often non-diagnostic. Conservative management is unsuccessful because symptoms often persist. Surgical management of cystic masses is required for definitive management and pathologic diagnosis. A laparoscopic approach to the diagnosis and treatment can provide essential anatomic information and a complete resection with minimal morbidity. A laparoscopic technique using 3 trocars and maintaining the integrity of the mass allows complete excision and removal of large intra-abdominal cystic masses as reported in a 43-year-old patient with a large intra-abdominal cystic mass identified as a benign cystic mesothelioma. PMID:9576001

  6. Robotic intra-abdominal vasectomy reversal: A new approach to a difficult problem

    PubMed Central

    Barazani, Yagil; Kaouk, Jihad; Sabanegh, Edmund S.

    2014-01-01

    The management of obstructive azoospermia resulting from intra-abdominal vasal obstruction poses a formidable surgical challenge. A number of surgical methods have been described to address this problem, including both open and laparoscopic approaches to mobilize and sometimes even re-route the abdominal vas deferens prior to performing a re-anastamosis. We present the first report, to our knowledge, of robotic intra-abdominal vasectomy reversal used to repair obstructive azoospermia resulting from prior laparoscopic vasectomy. In doing so, we summarize the techniques described previously in the literature and build upon this body of surgical experience by combining robotic-assisted laparoscopic mobilization of the vas with robotic vasovasostomy. We believe this novel approach for repairing intra-abdominal vasal defects minimizes morbidity, while at the same time obviating the need for the operating microscope, and thus represents a practical alternative to existing techniques. PMID:25024801

  7. [Treatment of pain in advanced-stage intra-abdominal neoplasms].

    PubMed

    Polati, E; Finco, G; Rigo, V; Gottin, L; Pinaroli, A M; Iacono, C; Mangiante, G; Serio, G; Ischia, S

    1993-01-01

    Different types of pain are present in far advanced intra-abdominal cancer, sometimes in the same site too. An accurate semeiological analysis of pain is important because different types of pain often differently respond to the available therapeutical tools. In this paper the results and the complications of the most important methods of pain management in far advanced intra-abdominal cancer are examined. Analysis of the data reveals that the association of more methods, pharmacological and non, should be a rule rather than the exception. PMID:7923502

  8. Laparoscopic Excision of Large Intra-Abdominal Cysts in Children: Needle Hitch Technique

    PubMed Central

    Antao, Brice; Tan, Jeffrey; Quinn, Feargal

    2015-01-01

    Laparoscopic surgery has both diagnostic and therapeutic advantages in the management of intra-abdominal cysts in children. Large cysts in small children pose technical challenges during laparoscopic surgery, requiring multiple incisions and advanced laparoscopic skills. This paper describes a novel laparoscopic technique using minimal manipulation for both aspiration and excision of the cyst. This simple, safe, and effective approach was used to achieve traction and facilitate excision of a large intra-abdominal cyst in a neonate and a young child. PMID:26798349

  9. Streptococcus milleri and Recurrent Intra-Abdominal Abscesses: A Case Report and Literature Review

    PubMed Central

    Gana, Tabitha M.; Awolaran, Olugbenga; Akhtar, Sobia

    2016-01-01

    We report a case of recurrent intra-abdominal abscesses as a postoperative complication following diverticular perforation in which Streptococcus milleri (SM) was isolated. SM is evaluated here as a potent pyogenic organism commonly associated with intra-abdominal abscess especially in the postoperative setting. With the commonly adopted conservative management, the challenges of recurrence and prolonged hospital stay experienced in the indexed case as well as many other previous reports are highlighted. We also present a recommendation of the need for a more intensive approach of SM-related abscess drainage along with areas that would benefit further research. PMID:27313942

  10. Antifungal activity of the piroctone olamine in experimental intra-abdominal candidiasis.

    PubMed

    do Couto, Fabíola Maria Marques; do Nascimento, Silene Carneiro; Júnior, Silvio Francisco Pereira; da Silva, Vanessa Karina Alves; Leal, André Ferraz Goiana; Neves, Rejane Pereira

    2016-01-01

    This work aimed to evaluate the antifungal activity of piroctone olamine in the treatment of intra-abdominal candidiasis in an experimental model using Swiss mice. The mice (n = 6) were infected by intraperitoneal injection of 0.2 ml of C. albicans (10(7)cells/ml in saline). The animals were observed daily for clinical signs and mortality for 14 days. The treatment with piroctone olamine (0.5 mg/kg) was performed 72 h after infection by intraperitoneal administration. For comparison, a group of animals (n = 6) was treated with amphotericin B (0.5 mg/kg). The mycological diagnosis was made by collecting the liver, spleen and kidneys. Data regarding the fungal growth and mortality were analyzed statistically by Student's t test and analysis of variance (ANOVA), with level of significance set at P < 0.05. The difference in fungal growth scoring between the control group and the treatment groups (piroctone olamine and amphotericin B) was statistically significant (P < 0.05). The difference in fungal growth scoring between the treatment groups (piroctone olamine and amphotericin B) was not statistically significant (P < 0.05). PMID:27119072

  11. Intra-abdominal fat. Part III. Neoplasms lesions of the adipose tissue.

    PubMed

    Smereczyński, Andrzej; Kołaczyk, Katarzyna; Bernatowicz, Elżbieta

    2016-06-01

    This article focuses on various cancerous lesions that are found beyond organs in the intra-abdominal fat and can be visualized with ultrasonography. These lesions are divided into five groups. The first group includes primary benign tumors containing adipocytes, such as lipoma, lipoblastoma, hibernoma and other lesions with an adipose tissue component, such as myolipoma, angiomyolipoma, myelolipoma and teratoma. The second group comprises primary malignant adipocytecontaining tumors, including liposarcoma and immature teratoma. The third group contains primary benign tumors without an adipocyte component that are located in intra-abdominal fat. This is a numerous group of lesions represented by cystic and solid tumors. The fourth group encompasses primary malignant tumors without an adipocyte component that are located in intra-abdominal fat. These are rare lesions associated mainly with sarcomas: fibrosarcoma, malignant fibrous histiocytoma, hemangiopericytoma and leiomyosarcoma. An epithelioid tumor at this site is mesothelioma. The last but not least group includes secondary malignant tumors without an adipocyte component located in intra-abdominal fat. This is the most numerous group with prevailing carcinoma foci. For each of these groups, the authors present ultrasound features of individual lesions and discuss their differential diagnosis. In the vast majority of cases, the material for cytological and histological analysis can be obtained during ultrasound-guided procedures. This is the advantage of this imaging modality. PMID:27446599

  12. Intra-abdominal fat. Part III. Neoplasms lesions of the adipose tissue

    PubMed Central

    Kołaczyk, Katarzyna; Bernatowicz, Elżbieta

    2016-01-01

    This article focuses on various cancerous lesions that are found beyond organs in the intra-abdominal fat and can be visualized with ultrasonography. These lesions are divided into five groups. The first group includes primary benign tumors containing adipocytes, such as lipoma, lipoblastoma, hibernoma and other lesions with an adipose tissue component, such as myolipoma, angiomyolipoma, myelolipoma and teratoma. The second group comprises primary malignant adipocytecontaining tumors, including liposarcoma and immature teratoma. The third group contains primary benign tumors without an adipocyte component that are located in intra-abdominal fat. This is a numerous group of lesions represented by cystic and solid tumors. The fourth group encompasses primary malignant tumors without an adipocyte component that are located in intra-abdominal fat. These are rare lesions associated mainly with sarcomas: fibrosarcoma, malignant fibrous histiocytoma, hemangiopericytoma and leiomyosarcoma. An epithelioid tumor at this site is mesothelioma. The last but not least group includes secondary malignant tumors without an adipocyte component located in intra-abdominal fat. This is the most numerous group with prevailing carcinoma foci. For each of these groups, the authors present ultrasound features of individual lesions and discuss their differential diagnosis. In the vast majority of cases, the material for cytological and histological analysis can be obtained during ultrasound-guided procedures. This is the advantage of this imaging modality. PMID:27446599

  13. Intra-abdominal pulmonary secuestration as an exceptional cause of abdominal mass in the adult☆

    PubMed Central

    Moreno-Sanz, C.; Herrero Bogajo, M.L.; Picazo-Yeste, J.; Morandeira Rivas, A.; Manzanera-Diaz, M.; Sedano-Vizcaino, C.

    2013-01-01

    INTRODUCTION Pulmonary sequestration (PS) is an extremely rare malformation defined as a portion of lung tissue isolated from the pulmonary system. PSs are classified into intralobar type and intra-abdominal PS that represents only 2.5% of cases. There are 20 cases of PS reported in adults and only two were managed by laparoscopic approach. We report a case of intra-abdominal PS mimicking a gastroesophageal duplication cyst in an adult. Besides its rarity, this is the first intra-abdominal PS in an adult managed by an anterior laparoscopic approach. PRESENTATION OF CASE A 60-year-old female patient had had epigastric and left upper quadrant pain for several days. Physical examination was normal. Image test were consistent with a gastroesophageal duplication. The patient was taken to the operating room for laparoscopic exploration and resection. The pathological diagnosis was extralobar pulmonary sequestration. DISCUSSION Less than 20 cases of PS have been reported in adults and only two cases were managed by a lateral laparoscopic approach. In contrast to these reports, we used an anterior approach due to the GEJ suspected origin of the mass. CONCLUSION Extralobar intra-abdominal PS is an extremely rare condition during adulthood but this diagnosis should be included in the differential diagnosis of a left-sided suprarenal mass. Due to the difficulty in achieving a definitive preoperative diagnosis, surgery is recommended. Laparoscopic resection is safe and effective but careful preoperative imaging studies are recommended in order to plan the most suitable approach. PMID:24091075

  14. Physical Activity and Reduced Intra-abdominal Fat in Midlife African-American and White Women

    PubMed Central

    Dugan, Sheila A.; Everson-Rose, Susan A.; Karavolos, Kelly; Avery, Elizabeth F.; Wesley, Deidre E.; Powell, Lynda H.

    2011-01-01

    The purpose of our study was to determine whether self-reported physical activity (PA), including recreational, household, and exercise activities, is associated with intra-abdominal fat (IAF) in community-dwelling white and black midlife women. We performed a cross-sectional study of 369 women from the Chicago site of the Study of Women’s Health Across the Nation (SWAN) ancillary study, the SWAN Fat Patterning Study. PA level was the independent variable, and IAF, assessed by computerized tomography (CT) scan, was the dependent variable. Measures were obtained at SWAN Fat Patterning Baseline visit between August 2002 and December 2005. Linear regression models explored the association between PA and IAF. The first model included IAF as the outcome and total score PA as the main predictor, adjusting for total percent fat mass, age, and ethnicity. The second model included education, parity, sex hormone–binding globulin (SHBG) level, and depressive symptoms, measured by Center for Epidemiological Studies-Depression (CES-D) scale. Each 1-point higher total PA score was associated with a 4.0 cm2 lower amount of IAF (P = 0.004), independent of total percent fat mass, age, ethnicity, SHBG level, educational level, CES-D, and parity. Associations did not differ between white and black women. This study demonstrates a significant negative association between PA and IAF independent of multiple covariates in midlife women. Our findings suggest that motivating white and black women to increase PA during midlife may lessen IAF, which may have a positive impact on subsequent development of diabetes and cardiovascular disease. PMID:19876007

  15. Intra-abdominal fat. Part I. The images of the adipose tissue localized beyond organs

    PubMed Central

    Kołaczyk, Katarzyna; Bernatowicz, Elżbieta

    2015-01-01

    Unaltered fat is a permanent component of the abdominal cavity, even in slim individuals. Visceral adiposity is one of the important factors contributing to diabetes, cardiovascular diseases and certain neoplasms. Moreover, the adipose tissue is an important endocrine and immune organ of complex function both when normal and pathological. Its role in plastic surgery, reconstruction and transplantology is a separate issue. The adipose tissue has recently drawn the attention of research institutes owing to being a rich source of stem cells. This review, however, does not include these issues. The identification of fat is relatively easy using computed tomography and magnetic resonance imaging. It can be more difficult in an ultrasound examination for several reasons. The aim of this paper is to present various problems associated with US imaging of unaltered intra-abdominal fat located beyond organs. Based on the literature and experience, it has been demonstrated that the adipose tissue in the abdominal cavity has variable echogenicity, which primarily depends on the amount of extracellular fluid and the number of connective tissue septa, i.e. elements that potentiate the number of areas that reflect and scatter ultrasonic waves. The normal adipose tissue presents itself on a broad gray scale: from a hyperechoic area, through numerous structures of lower reflection intensity, to nearly anechoic regions mimicking the presence of pathological fluid collections. The features that facilitate proper identification of this tissue are: sharp margins, homogeneous structure, high compressibility under transducer pressure, no signs of infiltration of the surrounding structures and no signs of vascularization when examined with the color and power Doppler. The accumulation of fat tissue in the abdominal cavity can be generalized, regional or focal. The identification of the adipose tissue in the abdominal cavity using ultrasonography is not always easy. When in doubt, the

  16. Intra-abdominal fat. Part I. The images of the adipose tissue localized beyond organs.

    PubMed

    Smereczyński, Andrzej; Kołaczyk, Katarzyna; Bernatowicz, Elżbieta

    2015-09-01

    Unaltered fat is a permanent component of the abdominal cavity, even in slim individuals. Visceral adiposity is one of the important factors contributing to diabetes, cardiovascular diseases and certain neoplasms. Moreover, the adipose tissue is an important endocrine and immune organ of complex function both when normal and pathological. Its role in plastic surgery, reconstruction and transplantology is a separate issue. The adipose tissue has recently drawn the attention of research institutes owing to being a rich source of stem cells. This review, however, does not include these issues. The identification of fat is relatively easy using computed tomography and magnetic resonance imaging. It can be more difficult in an ultrasound examination for several reasons. The aim of this paper is to present various problems associated with US imaging of unaltered intra-abdominal fat located beyond organs. Based on the literature and experience, it has been demonstrated that the adipose tissue in the abdominal cavity has variable echogenicity, which primarily depends on the amount of extracellular fluid and the number of connective tissue septa, i.e. elements that potentiate the number of areas that reflect and scatter ultrasonic waves. The normal adipose tissue presents itself on a broad gray scale: from a hyperechoic area, through numerous structures of lower reflection intensity, to nearly anechoic regions mimicking the presence of pathological fluid collections. The features that facilitate proper identification of this tissue are: sharp margins, homogeneous structure, high compressibility under transducer pressure, no signs of infiltration of the surrounding structures and no signs of vascularization when examined with the color and power Doppler. The accumulation of fat tissue in the abdominal cavity can be generalized, regional or focal. The identification of the adipose tissue in the abdominal cavity using ultrasonography is not always easy. When in doubt, the

  17. Optimal times above MICs of ceftibuten and cefaclor in experimental intra-abdominal infections.

    PubMed

    Onyeji, C O; Nicolau, D P; Nightingale, C H; Quintiliani, R

    1994-05-01

    The duration of time that serum drug levels remain above the MIC (time above the MIC) for the pathogen has been shown to be the most significant parameter determining the efficacies of beta-lactam antibiotics. In the described study, we investigated the optimal time above the MIC of ceftibuten and cefaclor using a nonneutropenic mouse model of intra-abdominal infections caused by Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, and Streptococcus pneumoniae. The abilities of the drugs to protect mice against the organisms were determined in mouse protection tests, and the doses were fractionated to produce various dosing regimens with different times above the MIC. All drug-organism combinations showed a significant correlation (r > 0.9) between drug efficacy and the time above the MIC. Also, with ceftibuten treatment, the different dosing regimens that produced equal times above the MIC resulted in the same efficacy, whereas with cefaclor, an apparent dose-dependent effect was observed. These results showed that for a 100% recovery from K. pneumoniae and E. coli infections, the optimal times above the MIC with ceftibuten treatment were 2.2 and 1.6 h, respectively. Relatively high doses of both antibiotics were required to ensure recovery from S. pneumoniae infections. In vitro time-kill studies demonstrated that cefaclor exhibits a marked inoculum effect against the pathogens, and there was a concentration-dependent killing at a large inoculum size. On the other hand, ceftibuten showed no inoculum effect. It is suggested that optimization of both dose and time above the MIC appears to be necessary for the treatment of S. aureus infections with cefaclor, and this may apply to other beta-lactams tht exhibit marked inoculum effects. PMID:8067747

  18. Poor oncologic outcomes of hepatocellular carcinoma patients with intra-abdominal infection after hepatectomy

    PubMed Central

    Ruan, Dan-Yun; Lin, Ze-Xiao; Li, Yang; Jiang, Nan; Li, Xing; Wu, Dong-Hao; Wang, Tian-Tian; Chen, Jie; Lin, Qu; Wu, Xiang-Yuan

    2015-01-01

    AIM: To evaluate the impact of postoperative infectious complications on hepatocellular carcinoma following curative hepatectomy. METHODS: We performed a retrospective analysis of 200 hepatocellular carcinoma patients who underwent hepatectomy at our institution between September 2003 and June 2011. The patients’ demographics, clinicopathological characteristics and postoperative infectious complications were analyzed. The Clavien-Dindo classification was adopted to assess the severity of complications. The dynamic change in the neutrophil-to-lymphocyte ratio, defined as the absolute neutrophil count divided by the absolute lymphocyte count, after surgery was also investigated. The observation endpoints for this study were recurrence-free survival and overall survival of the patients. Statistical analysis of the survival curves was performed using the Kaplan-Meier method and the log-rank test. The prognostic value of each variable for predicting prognosis was assessed via multivariate Cox proportional hazards regression analysis. The cutoff score for each variable was selected based on receiver operating characteristic curve analysis. All statistical tests were two-sided, and significance was set at P < 0.05. RESULTS: The median age of the patients was 49 years, and the majority of patients were male (86%) and had been infected with hepatitis B virus (86%). The 30-d postoperative infectious complication rate was 34.0% (n = 68). Kaplan-Meier survival analysis revealed that postoperative infection was significantly correlated with tumor recurrence (P < 0.001). The postoperative intra-abdominal infection group exhibited a worse prognosis than the non-intra-abdominal infection group (P < 0.001). A significantly increased incidence of postoperative intra-abdominal infection was observed in the patients with hepatic cirrhosis (P = 0.028), concomitant splenectomy (P = 0.007) or vascular invasion (P = 0.026). The patients who had an elevated postoperative neutrophil

  19. Postoperative Adhesion Development Following Cesarean and Open Intra-Abdominal Gynecological Operations

    PubMed Central

    Awonuga, Awoniyi O.; Fletcher, Nicole M.; Saed, Ghassan M.; Diamond, Michael P.

    2011-01-01

    In this review, we discuss the pathophysiology of adhesion development, the impact of physiological changes associated with pregnancy on markers of adhesion development, and the clinical implications of adhesion development following cesarean delivery (CD). Although peritoneal adhesions develop after the overwhelming majority of intra-abdominal and pelvic surgery, there is evidence in the literature that suggests that patients having CD may develop adhesions less frequently. However, adhesions continue to be a concern after CD, and are likely significant, albeit on average less than after gynecological operations, but with potential to cause significant delay in the delivery of the baby with serious, lifelong consequences. Appreciation of the pathophysiology of adhesion development described herein should allow a more informed approach to the rapidly evolving field of intra-abdominal adhesions and should serve as a reference for an evidence-based approach to consideration for the prevention and treatment of adhesions. PMID:21775773

  20. Unrecognized clozapine-related constipation leading to fatal intra-abdominal sepsis – a case report

    PubMed Central

    Oke, Vikram; Schmidt, Frances; Bhattarai, Bikash; Basunia, Md; Agu, Chidozie; Kaur, Amrit; Enriquez, Danilo; Quist, Joseph; Salhan, Divya; Gayam, Vijay; Mungikar, Prajakta

    2015-01-01

    Clozapine is the preferred antipsychotic used for the treatment of resistant schizophrenia with suicidal ideation. The drug is started at a low dose and gradually increased to a target dose of 300–450 mg/day. It is well known to cause agranulocytosis and neutropenia. Several cases of fatal sepsis have been reported in neutropenic patients and emphasis is placed on monitoring for agranulocytosis; however, clozapine also causes intestinal hypomotility and constipation, which if unrecognized can lead to intestinal obstruction, bowel necrosis, and intra-abdominal sepsis. Reduced behavioral pain reactivity in schizophrenics may alter the ability to express pain, potentially leading to a delay in the presentation for medical attention. We report a case of fatal intra-abdominal sepsis secondary to an unrecognized case of clozapine-related constipation. PMID:26392790

  1. Characterization of anisotropy in viscoelastic properties of intra-abdominal soft tissues.

    PubMed

    Deo, Dhanannjay; Singh, Tejinder Paul; Dunnican, Ward; De, Suvranu

    2009-01-01

    A portable instrumentation rig is presented for characterizing nonlinear viscoelastic anisotropic response of intra-abdominal organ-tissues. Two linearly independent in-situ experiments are performed at each indentation site on the intra-abdominal organ, by subjecting the organ to 1) normal and 2) tangential displacement stimuli using the above robotic device. For normal indentation experiments, the indenter is ramped into the tissue and held for 10 seconds before sinusoidal indentation stimuli are applied. For tangential (shear) loading, the indenter tip is rigidly glued to the soft tissue surface. Sinusoidal displacement stimuli are then applied laterally in the tangential plane and the force response is recorded. Tangential loading is repeated along orthogonal directions to measure in-plane mechanical properties. Combined analysis of both experiments leads to assessment of anisotropy. In situ experiments on fresh human cadavers are currently under way at the Albany Medical College. PMID:19377118

  2. Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA).

    PubMed

    Sartelli, Massimo; Weber, Dieter G; Ruppé, Etienne; Bassetti, Matteo; Wright, Brian J; Ansaloni, Luca; Catena, Fausto; Coccolini, Federico; Abu-Zidan, Fikri M; Coimbra, Raul; Moore, Ernest E; Moore, Frederick A; Maier, Ronald V; De Waele, Jan J; Kirkpatrick, Andrew W; Griffiths, Ewen A; Eckmann, Christian; Brink, Adrian J; Mazuski, John E; May, Addison K; Sawyer, Rob G; Mertz, Dominik; Montravers, Philippe; Kumar, Anand; Roberts, Jason A; Vincent, Jean-Louis; Watkins, Richard R; Lowman, Warren; Spellberg, Brad; Abbott, Iain J; Adesunkanmi, Abdulrashid Kayode; Al-Dahir, Sara; Al-Hasan, Majdi N; Agresta, Ferdinando; Althani, Asma A; Ansari, Shamshul; Ansumana, Rashid; Augustin, Goran; Bala, Miklosh; Balogh, Zsolt J; Baraket, Oussama; Bhangu, Aneel; Beltrán, Marcelo A; Bernhard, Michael; Biffl, Walter L; Boermeester, Marja A; Brecher, Stephen M; Cherry-Bukowiec, Jill R; Buyne, Otmar R; Cainzos, Miguel A; Cairns, Kelly A; Camacho-Ortiz, Adrian; Chandy, Sujith J; Che Jusoh, Asri; Chichom-Mefire, Alain; Colijn, Caroline; Corcione, Francesco; Cui, Yunfeng; Curcio, Daniel; Delibegovic, Samir; Demetrashvili, Zaza; De Simone, Belinda; Dhingra, Sameer; Diaz, José J; Di Carlo, Isidoro; Dillip, Angel; Di Saverio, Salomone; Doyle, Michael P; Dorj, Gereltuya; Dogjani, Agron; Dupont, Hervé; Eachempati, Soumitra R; Enani, Mushira Abdulaziz; Egiev, Valery N; Elmangory, Mutasim M; Ferrada, Paula; Fitchett, Joseph R; Fraga, Gustavo P; Guessennd, Nathalie; Giamarellou, Helen; Ghnnam, Wagih; Gkiokas, George; Goldberg, Staphanie R; Gomes, Carlos Augusto; Gomi, Harumi; Guzmán-Blanco, Manuel; Haque, Mainul; Hansen, Sonja; Hecker, Andreas; Heizmann, Wolfgang R; Herzog, Torsten; Hodonou, Adrien Montcho; Hong, Suk-Kyung; Kafka-Ritsch, Reinhold; Kaplan, Lewis J; Kapoor, Garima; Karamarkovic, Aleksandar; Kees, Martin G; Kenig, Jakub; Kiguba, Ronald; Kim, Peter K; Kluger, Yoram; Khokha, Vladimir; Koike, Kaoru; Kok, Kenneth Y Y; Kong, Victory; Knox, Matthew C; Inaba, Kenji; Isik, Arda; Iskandar, Katia; Ivatury, Rao R; Labbate, Maurizio; Labricciosa, Francesco M; Laterre, Pierre-François; Latifi, Rifat; Lee, Jae Gil; Lee, Young Ran; Leone, Marc; Leppaniemi, Ari; Li, Yousheng; Liang, Stephen Y; Loho, Tonny; Maegele, Marc; Malama, Sydney; Marei, Hany E; Martin-Loeches, Ignacio; Marwah, Sanjay; Massele, Amos; McFarlane, Michael; Melo, Renato Bessa; Negoi, Ionut; Nicolau, David P; Nord, Carl Erik; Ofori-Asenso, Richard; Omari, AbdelKarim H; Ordonez, Carlos A; Ouadii, Mouaqit; Pereira Júnior, Gerson Alves; Piazza, Diego; Pupelis, Guntars; Rawson, Timothy Miles; Rems, Miran; Rizoli, Sandro; Rocha, Claudio; Sakakhushev, Boris; Sanchez-Garcia, Miguel; Sato, Norio; Segovia Lohse, Helmut A; Sganga, Gabriele; Siribumrungwong, Boonying; Shelat, Vishal G; Soreide, Kjetil; Soto, Rodolfo; Talving, Peep; Tilsed, Jonathan V; Timsit, Jean-Francois; Trueba, Gabriel; Trung, Ngo Tat; Ulrych, Jan; van Goor, Harry; Vereczkei, Andras; Vohra, Ravinder S; Wani, Imtiaz; Uhl, Waldemar; Xiao, Yonghong; Yuan, Kuo-Ching; Zachariah, Sanoop K; Zahar, Jean-Ralph; Zakrison, Tanya L; Corcione, Antonio; Melotti, Rita M; Viscoli, Claudio; Viale, Perluigi

    2016-01-01

    Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients. The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance. The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria. An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs. PMID:27429642

  3. Laparoscopic management of intra-abdominal infections: Systematic review of the literature

    PubMed Central

    Coccolini, Federico; Tranà, Cristian; Sartelli, Massimo; Catena, Fausto; Saverio, Salomone Di; Manfredi, Roberto; Montori, Giulia; Ceresoli, Marco; Falcone, Chiara; Ansaloni, Luca

    2015-01-01

    AIM: To investigate the role of laparoscopy in diagnosis and treatment of intra abdominal infections. METHODS: A systematic review of the literature was performed including studies where intra abdominal infections were treated laparoscopically. RESULTS: Early laparoscopic approaches have become the standard surgical technique for treating acute cholecystitis. The laparoscopic appendectomy has been demonstrated to be superior to open surgery in acute appendicitis. In the event of diverticulitis, laparoscopic resections have proven to be safe and effective procedures for experienced laparoscopic surgeons and may be performed without adversely affecting morbidity and mortality rates. However laparoscopic resection has not been accepted by the medical community as the primary treatment of choice. In high-risk patients, laparoscopic approach may be used for exploration or peritoneal lavage and drainage. The successful laparoscopic repair of perforated peptic ulcers for experienced surgeons, is demonstrated to be safe and effective. Regarding small bowel perforations, comparative studies contrasting open and laparoscopic surgeries have not yet been conducted. Successful laparoscopic resections addressing iatrogenic colonic perforation have been reported despite a lack of literature-based evidence supporting such procedures. In post-operative infections, laparoscopic approaches may be useful in preventing diagnostic delay and controlling the source. CONCLUSION: Laparoscopy has a good diagnostic accuracy and enables to better identify the causative pathology; laparoscopy may be recommended for the treatment of many intra-abdominal infections. PMID:26328036

  4. Complicated intra-abdominal infections in Europe: a comprehensive review of the CIAO study

    PubMed Central

    2012-01-01

    The CIAO Study (“Complicated Intra-Abdominal infection Observational” Study) is a multicenter investigation performed in 68 medical institutions throughout Europe over the course of a 6-month observational period (January-June 2012). Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study. 2,152 patients with a mean age of 53.8 years (range: 4–98 years) were enrolled in the study. 46.3% of the patients were women and 53.7% were men. Intraperitoneal specimens were collected from 62.2% of the enrolled patients, and from these samples, a variety of microorganisms were collectively identified. The overall mortality rate was 7.5% (163/2.152). According to multivariate analysis of the compiled data, several criteria were found to be independent variables predictive of patient mortality, including patient age, the presence of an intestinal non-appendicular source of infection (colonic non-diverticular perforation, complicated diverticulitis, small bowel perforation), a delayed initial intervention (a delay exceeding 24 hours), sepsis and septic shock in the immediate post-operative period, and ICU admission. Given the sweeping geographical distribution of the participating medical centers, the CIAO Study gives an accurate description of the epidemiological, clinical, microbiological, and treatment profiles of complicated intra-abdominal infections (IAIs) throughout Europe. PMID:23190741

  5. Metabolic effects of intra-abdominal fat in GHRKO mice

    PubMed Central

    Masternak, Michal M.; Bartke, Andrzej; Wang, Feiya; Spong, Adam; Gesing, Adam; Fang, Yimin; Salmon, Adam B.; Hughes, Larry F.; Liberati, Teresa; Boparai, Ravneet; Kopchick, John J.; Westbrook, Reyhan

    2011-01-01

    SUMMARY Mice with targeted deletion of the growth hormone receptor (GHRKO mice) are GH resistant, small, obese, hypoinsulinemic, highly insulin sensitive and remarkably long-lived. To elucidate the unexpected coexistence of adiposity with improved insulin sensitivity and extended longevity, we examined effects of surgical removal of visceral (epididymal and perinephric) fat on metabolic traits related to insulin signaling and longevity. Comparison of results obtained in GHRKO mice and in normal animals from the same strain revealed disparate effects of visceral fat removal (VFR) on insulin and glucose tolerance, adiponectin levels, accumulation of ectopic fat, phosphorylation of insulin signaling intermediates, body temperature and respiratory quotient (RQ). Overall, VFR produced the expected improvements in insulin sensitivity and reduced body temperature and RQ in normal mice and had opposite effects in GHRKO mice. Some of the examined parameters were altered by VFR in opposite directions in GHRKO and normal mice, others were affected in only one genotype or exhibited significant genotype × treatment interactions. Functional differences between visceral fat of GHRKO and normal mice were confirmed by measurements of adipokine secretion, lipolysis and expression of genes related to fat metabolism. We conclude that in the absence of GH signaling the secretory activity of visceral fat is profoundly altered and unexpectedly promotes enhanced insulin sensitivity. The apparent beneficial effects of visceral fat in GHRKO mice may also explain why reducing adiposity by calorie restriction fails to improve insulin signaling or further extend longevity in these animals. PMID:22040032

  6. Metabolic effects of intra-abdominal fat in GHRKO mice.

    PubMed

    Masternak, Michal M; Bartke, Andrzej; Wang, Feiya; Spong, Adam; Gesing, Adam; Fang, Yimin; Salmon, Adam B; Hughes, Larry F; Liberati, Teresa; Boparai, Ravneet; Kopchick, John J; Westbrook, Reyhan

    2012-02-01

    Mice with targeted deletion of the growth hormone receptor (GHRKO mice) are growth hormone (GH) resistant, small, obese, hypoinsulinemic, highly insulin sensitive and remarkably long-lived. To elucidate the unexpected coexistence of adiposity with improved insulin sensitivity and extended longevity, we examined effects of surgical removal of visceral (epididymal and perinephric) fat on metabolic traits related to insulin signaling and longevity. Comparison of results obtained in GHRKO mice and in normal animals from the same strain revealed disparate effects of visceral fat removal (VFR) on insulin and glucose tolerance, adiponectin levels, accumulation of ectopic fat, phosphorylation of insulin signaling intermediates, body temperature, and respiratory quotient (RQ). Overall, VFR produced the expected improvements in insulin sensitivity and reduced body temperature and RQ in normal mice and had opposite effects in GHRKO mice. Some of the examined parameters were altered by VFR in opposite directions in GHRKO and normal mice, and others were affected in only one genotype or exhibited significant genotype × treatment interactions. Functional differences between visceral fat of GHRKO and normal mice were confirmed by measurements of adipokine secretion, lipolysis, and expression of genes related to fat metabolism. We conclude that in the absence of GH signaling, the secretory activity of visceral fat is profoundly altered and unexpectedly promotes enhanced insulin sensitivity. The apparent beneficial effects of visceral fat in GHRKO mice may also explain why reducing adiposity by calorie restriction fails to improve insulin signaling or further extend longevity in these animals. PMID:22040032

  7. Intra-abdominal metastasis of an intracranial germinoma via ventriculo-peritoneal shunt in a 13-year-old female.

    PubMed

    Murray, Matthew J; Metayer, Lucy E; Mallucci, Conor L; Hale, Juliet P; Nicholson, James C; Kirollos, Ramez W; Burke, G A Amos

    2011-12-01

    A 13-year-old patient presented with massive intra-abdominal metastasis and spontaneous acute tumour lysis syndrome, 17-months after VP shunt placement for metastatic pineal germinoma treated with cranio-spinal-irradiation. Hyperhydration/rasburicase improved renal function, allowing chemotherapy with subsequent surgery. The patient remains event-free 34-months later. Risk of intra-abdominal metastasis from VP shunts is discussed. PMID:21501064

  8. The Incidence, Clinical Outcomes, and Risk Factors of Thrombocytopenia in Intra-Abdominal Infection Patients: A Retrospective Cohort Study

    PubMed Central

    Wu, Qin; Ren, Jianan; Wang, Gefei; Li, Guanwei; Gu, Guosheng; Wu, Xiuwen; Li, Yuan; Chen, Jun; Zhao, Yunzhao; Li, Jieshou

    2016-01-01

    Background Studies on the incidence and risk factors of thrombocytopenia among intra-abdominal infection patients remain absent, hindering efficacy assessments regarding thrombocytopenia prevention strategies. Methods We retrospectively studied 267 consecutively enrolled patients with intra-abdominal infections. Occurrence of thrombocytopenia was scanned for all patients. All-cause 28-day mortality was recorded. Variables from univariate analyses that were associated with occurrence of hospital-acquired thrombocytopenia were included in a multivariable logistic regression analysis to determine thrombocytopenia predictors. Results Median APACHE II score and SOFA score of the whole cohort was 12 and 3 respectively. The overall ICU mortality was 7.87% and the 28-day mortality was 8.98%. The incidence of thrombocytopenia among intra-abdominal infection patients was 21.73%. Regardless of preexisting or hospital-acquired one, thrombocytopenia is associated with an increased ICU mortality and 28-day mortality as well as length of ICU or hospital stay. A higher SOFA and ISTH score at admission were significant hospital-acquired thrombocytopenia risk factors. Conclusions This is the first study to identify a high incidence of thrombocytopenia in patients with intra-abdominal infections. Our findings suggest that the inflammatory milieu of intra-abdominal infections may uniquely predispose those patients to thrombocytopenia. More effective thrombocytopenia prevention strategies are necessary in intra-abdominal infection patients. PMID:26808492

  9. [Hospital management of patients with complicated intra-abdominal infections: pharmacoeconomic evaluations].

    PubMed

    Eandi, Mario

    2008-02-01

    Due to their high incidence and large resource consumption, complicated intra-abdominal infections (cIAIs) represent a heavy burden for the Italian National Health System (NHS) and the Italian society, with estimated annual costs of 1,5 and 3 billions Euro, respectively. The different strategies, monotherapy or antibiotic combinations, indicated for treating cIAIs induce significantly different acquisition and administration costs but substantially equivalent therapeutic results, with average clinical effectiveness rates of 70-80%. This apparent equivalence among different antibiotic protocols presumably depends on the widespread trend to individualize the therapeutic strategy according to the clinical severity and the community or nosocomial origin of cIAIs, as well as on some degree of non-appropriateness when empirically choosing a first-line antibiotic. The average cost for the nosocomial management of cIAI patients depends on several factors: posology and antibiotic drug acquisition and administration costs, days of antibiotic therapy, mix of antibiotic schedules, rates of the therapeutic failures that induce further drug consumption, prolong hospitalization and often require re-intervention and ICU utilization. The introduction in the therapeutic arsenal of a new antibiotic like tigecycline leads to a mild increase of the average antibiotic acquisition and treatment costs per patient: this increase is proportional to the percentage of patients treated with the new antibiotic. According to a decisional model, implemented on international outcome data and Italian costs, the mean cost for first-line antibiotic acquisition and the mean cost for first- and second-line antibiotic treatment represent respectively only 2% and 8% of the mean overall hospitalization cost. The mean hospitalization cost estimated by the model is noticeably higher than the mean value of DRG tariffs presumably reimbursed by the Italian NHS to hospitals for cIAI-related hospitalizations

  10. The Accuracy of Urinalysis in Predicting Intra-Abdominal Injury Following Blunt Traumas

    PubMed Central

    Sabzghabaei, Anita; Shojaee, Majid; Safari, Saeed; Hatamabadi, Hamid Reza; Shirvani, Reza

    2016-01-01

    Introduction: In cases of blunt abdominal traumas, predicting the possible intra-abdominal injuries is still a challenge for the physicians involved with these patients. Therefore, this study was designed, to evaluate the accuracy of urinalysis in predicting intra-abdominal injuries. Methods: Patients aged 15 to 65 years with blunt abdominal trauma who were admitted to emergency departments were enrolled. Abdominopelvic computed tomography (CT) scan with intravenous contrast and urinalysis were requested for all the included patients. Demographic data, trauma mechanism, the results of urinalysis, and the results of abdominopelvic CT scan were gathered. Finally, the correlation between the results of abdominopelvic CT scan, and urinalysis was determined. Urinalysis was considered positive in case of at least one positive value in gross appearance, blood in dipstick, or red blood cell count. Results: 325 patients with blunt abdominal trauma were admitted to the emergency departments (83% male with the mean age of 32.63±17.48 years). Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios of urinalysis, were 77.9% (95% CI: 69.6-84.4), 58.5% (95% CI: 51.2-65.5), 56% (95% CI: 48.5-63.3), 79.6% (95% CI: 71.8-85.7), 1.27% (95% CI: 1.30-1.57), and 0.25% (95% CI: 0.18-0.36), respectively. Conclusion: The diagnostic value of urinalysis in prediction of blunt traumatic intra-abdominal injuries is low and it seems that it should be considered as an adjuvant diagnostic tool, in conjunction with other sources such as clinical findings and imaging. PMID:26862543

  11. Massive intra-abdominal undifferentiated carcinoma derived from an endometrioid adenocarcinoma in a "normal-sized" ovary.

    PubMed

    Miyai, Kosuke; Yamamoto, Sohei; Aida, Shinsuke; Shimazaki, Hideyuki; Takano, Masashi; Kudoh, Kazuya; Furuya, Kenichi; Tamai, Seiichi; Matsubara, Osamu

    2010-07-01

    We report a case of massive intra-abdominal undifferentiated carcinoma derived from a tiny well-differentiated endometrioid adenocarcinoma of the ovary. The patient, a 56-year-old woman, who presented with a large intra-abdominal mass, underwent cytoreductive surgery with hysterectomy and bilateral salpingo-oophorectomy. Macroscopically, the intra-abdominal mass was composed of fragile and solid tumor components with extensive necro-hemorrhagic areas, mimicking a primary peritoneal tumor. Both ovaries were apparently normal in size, but a cut section of the right ovary revealed a 2-cm solid and cystic tumor showing focal rupture to the peritoneal surface. The intra-abdominal tumor consisted of pleomorphic cells without specific differentiation, showing diffuse sheet-like proliferation. The right ovarian tumor was a histologically well-differentiated endometrioid adenocarcinoma. Both the intra-abdominal undifferentiated tumor and the ovarian adenocarcinoma cells were immunohistochemically positive for keratin AE1/3, Ber-EP4, and CD10. Epithelial membrane antigen was positive only in the ovarian adenocarcinoma component, and vimentin was diffusely positive only in the intra-abdominal undifferentiated tumor component. Calretinin was negative in both tumor components. Allelotype analysis using 24 polymorphic markers located on 12 chromosomal arms showed that the intra-abdominal undifferentiated carcinoma and ovarian adenocarcinoma components had a high concordance rate (88%) of allelic patterns including identical allelic loss patterns at 7 chromosomal loci, suggesting a common genetic lineage. These data suggest that ovarian endometrioid adenocarcinoma, even when small in size, can give rise to a massive undifferentiated carcinoma filling the peritoneal cavity. PMID:20567143

  12. Treatment Modalities and Antimicrobial Stewardship Initiatives in the Management of Intra-Abdominal Infections

    PubMed Central

    Hoffmann, Charles; Zak, Matthew; Avery, Lisa; Brown, Jack

    2016-01-01

    Antimicrobial stewardship programs (ASPs) focus on improving the utilization of broad spectrum antibiotics to decrease the incidence of multidrug-resistant Gram positive and Gram negative pathogens. Hospital admission for both medical and surgical intra-abdominal infections (IAIs) commonly results in the empiric use of broad spectrum antibiotics such as fluoroquinolones, beta-lactam beta-lactamase inhibitors, and carbapenems that can select for resistant organisms. This review will discuss the management of uncomplicated and complicated IAIs as well as highlight stewardship initiatives focusing on the proper use of broad spectrum antibiotics. PMID:27025526

  13. Intra-abdominal inverted umblical cord in gastroschisis: a unique ultrasound finding.

    PubMed

    Koc, Gonca; Courtier, Jesse L; Kim, Jane S; Miniati, Douglas N; MacKenzie, John D

    2014-01-01

    A relatively new surgical technique allows for sutureless closure of a gastroschisis defect. Immediately after birth, a long umbilical cord stump is temporarily inverted into the abdominal cavity and later retracted and used to close the abdominal wall defect. Knowledge of this entity is important since the inverted umbilical cord simulates an intra-abdominal mass on cross-sectional imaging. While this procedure is well described in the surgical literature, the imaging features of inverted umbilical cord have yet to be reported. The case presented here highlights the sonographic imaging findings of the umbilical cord during the intestinal decompression phase of sutureless repair of gastroschisis. PMID:23907187

  14. Primary aortoenteric fistula to the sigmoid colon in association with intra-abdominal abscess.

    PubMed

    Lee, Wonho; Jung, Chul Min; Cho, Eun-Hee; Ryu, Dong Ryeol; Choi, Daehee; Kim, Jaihwan

    2014-04-01

    Primary aortoenteric fistula (PAEF) is a rare but catastrophic cause of massive gastrointestinal bleeding. Diagnosis of PAEF is difficult to make and is frequently delayed without strong clinical suspicion. Timely surgical intervention is essential for patient's survival. We report on a case of an 86-year-old woman with no history of abdominal surgery, who presented with abdominal pain. Initially, computed tomography scan showed an intra-abdominal abscess, located anterior to the aortic bifurcation. However, she was discharged without treatment because of spontaneous improvement on a follow-up computed tomography scan, which showed a newly developed right common iliac artery aneurysm. One week later, she was readmitted due to recurrent abdominal pain. On the second day of admission, sudden onset of gastrointestinal bleeding occurred for the first time. After several endoscopic examinations, an aortoenteric fistula bleeding site was found in the sigmoid colon, and aortography showed progression of a right common iliac artery aneurysm. We finally concluded that intra-abdominal abscess induced an infected aortic aneurysm and enteric fistula to the sigmoid colon. This case demonstrated an extremely rare type of PAEF to the sigmoid colon caused by an infected abdominal aortic aneurysm, which has rarely been reported. PMID:24755749

  15. Successful treatment of intra-abdominal eumycotic mycetoma caused by Penicillium duponti in a dog.

    PubMed

    Janovec, J; Brockman, D J; Priestnall, S L; Kulendra, N J

    2016-03-01

    A 2-year-old female neutered golden retriever was presented for investigation of an intra-abdominal mass. Computed tomography revealed a mass associated with the caudal pole of the right kidney. Incisional biopsy findings were consistent with eumycotic mycetoma. The mass was subsequently removed in conjunction with right ureteronephrectomy. Two years later, the dog re-presented with a splenic mass and fungal plaques located throughout the peritoneum. Splenectomy was performed and the mass was diagnosed as eumycotic mycetoma caused by Penicillium duponti. Indefinite systemic treatment with 10 mg/kg itraconazole orally once a day was initiated. Thirty-two months after the last surgery, there were no clinical signs apart from mild polydipsia. Haematology and biochemistry results were unremarkable. To the authors' knowledge, this is the first report of successful treatment of intra-abdominal eumycotic mycetoma with a combination of surgery and systemic antifungal therapy in the dog. Penicillium duponti has not apparently been reported to cause disease in animals or humans. PMID:26017318

  16. Primary ovarian teratoma and GCT with intra-abdominal metastasis in a dog.

    PubMed

    Coggeshall, Jason D; Franks, Joanne N; Wilson, Diane U; Wiley, Jennifer L

    2012-01-01

    This report describes the simultaneous occurrence of an ovarian teratoma and a granulosa cell tumor (GCT) with intra-abdominal metastasis in a 1.5 yr old female Doberman pinscher. At surgery, a 20 cm, smooth, intact mass associated with the left ovary and multiple 1-2 cm irregular masses in the broad ligament were found. The masses were surgically removed and submitted for histopathology. A histologic diagnosis of a teratoma and a GCT with broad ligament metastasis was made. Further treatment was elected by the owner and included two cycles of carboplatin therapy. The dog was euthanized 6 wk postoperatively for signs related to metastasis and dyspnea. Teratoma of the ovary, although it contains derivatives of all three embryonic germ cell layers, rarely presents together with either ovarian epithelial or sex cord-stromal tumors. To the authors' knowledge, this is the first reported case of an ovarian teratoma coexisting with a primary GCT with intra-abdominal metastasis in the same ovary in a dog. PMID:23033467

  17. Unexpected multiple intra-abdominal injuries after projectile fragmentation: report of three cases.

    PubMed

    Unlü, Aytekin; Petrone, Patrizio; Karşıdağ, Tamer; Asensio, Juan A

    2012-11-01

    Explosives create and energize particles that act as projectiles prone to further fragmentation or create other secondary missiles in the body. These fragments may result in secondary injuries. This has been repeatedly described in the orthopedic and neurosurgical literature. We report the same process for abdominal injuries after fascial penetration in the military setting. This is an observational case series study. Local wound exploration as a standard approach was performed in conscious patients who sustained abdominal wall injuries. Patients with negative physical examination were excluded from the study. An intraperitoneal injury was assumed in those with a full-thickness fascial defect, and laparotomy was performed. Twenty patients met the study eligibility criteria. Of those 20 patients, 12 had negative wound exploration and were excluded from the study, while abdominal organ injuries were found in eight (40%) patients. During laparotomy, projectile-induced injuries in a sprayed distribution were found in three (38%) of these patients. These injuries were far from the predictable trajectory and in the absence of bone fragmentation. The overall mean number of peritoneal defects was 1.7, and a mean 6.8 intra-abdominal injuries for each peritoneal defect were found when through-and-through injuries were excluded.Despite a single peritoneal defect, there may be multiple intraperitoneal injuries due to further fragmentation of the projectile. Under mass casualties, wound exploration with a full-thickness fascial defect could serve as an indicator of possible intra-abdominal injuries, and consequently indicate exploratory laparotomy. PMID:23588915

  18. Antibiotic management of complicated intra-abdominal infections in adults: The Asian perspective

    PubMed Central

    Kurup, Asok; Liau, Kui-Hin; Ren, Jianan; Lu, Min-Chi; Navarro, Narciso S.; Farooka, Muhammad Waris; Usman, Nurhayat; Destura, Raul V.; Sirichindakul, Boonchoo; Tantawichien, Terapong; Lee, Christopher K.C.; Solomkin, Joseph S.

    2014-01-01

    Regional epidemiological data and resistance profiles are essential for selecting appropriate antibiotic therapy for intra-abdominal infections (IAIs). However, such information may not be readily available in many areas of Asia and current international guidelines on antibiotic therapy for IAIs are for Western countries, with the most recent guidance for the Asian region dating from 2007. Therefore, the Asian Consensus Taskforce on Complicated Intra-Abdominal Infections (ACT-cIAI) was convened to develop updated recommendations for antibiotic management of complicated IAIs (cIAIs) in Asia. This review article is based on a thorough literature review of Asian and international publications related to clinical management, epidemiology, microbiology, and bacterial resistance patterns in cIAIs, combined with the expert consensus of the Taskforce members. The microbiological profiles of IAIs in the Asian region are outlined and compared with Western data, and the latest available data on antimicrobial resistance in key pathogens causing IAIs in Asia is presented. From this information, antimicrobial therapies suitable for treating cIAIs in patients in Asian settings are proposed in the hope that guidance relevant to Asian practices will prove beneficial to local physicians managing IAIs. PMID:25568794

  19. Risk Factors for the Development of Intra-Abdominal Fungal Infections in Acute Pancreatitis

    PubMed Central

    Schwender, Brian J.; Gordon, Stuart R.; Gardner, Timothy B.

    2015-01-01

    Objectives Intra-abdominal fungal infections (AFI) complicating acute pancreatitis arise in the context of pancreatic necrosis. Our goal was to determine which risk factors contribute to AFI in patients with acute pancreatitis. Methods Records were reviewed from 479 non-transfer patients admitted to our medical center with acute pancreatitis from 1985–2009. Using multivariable regression models, risk factors for AFI were identified. Results Out of 479 patients admitted with acute pancreatitis, 17 patients were subsequently found to have an AFI and 3 of these patients expired. The mean length of stay for patients with an AFI was 24 days and 76% were admitted to the intensive care unit. Patients with AFI were more likely to have received prophylactic antibiotics on admission (OR 1.7, 95% C.I. 1.2–2.3), TPN within 7 days of admission (OR 1.4, 95% C.I. 1.1–1.7) or to have necrosis on CT scan within 7 days of admission (OR 1.4, 95% C.I. 1.1–1.7). Multivariable regression models identified admission antibiotic use (OR 1.6, 95% C.I. 1.4–1.8) as the strongest predictor of AFI. Conclusion Admission antibiotics are the biggest risk factor for the development of intra-abdominal fungal infections in acute pancreatitis. Prophylactic antibiotics to prevent infected necrosis should therefore be discouraged. PMID:25872170

  20. Intra-abdominal hypertension and abdominal compartment syndrome in association with ruptured abdominal aortic aneurysm in the endovascular era: vigilance remains critical.

    PubMed

    Bozeman, Matthew C; Ross, Charles B

    2012-01-01

    Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are common complications of ruptured abdominal aortoiliac aneurysms (rAAAs) and other abdominal vascular catastrophes even in the age of endovascular therapy. Morbidity and mortality due to systemic inflammatory response syndrome (SIRS) and multiple organ failure (MOF) are significant. Recognition and management of IAH are key critical care measures which may decrease morbidity and improve survival in these vascular patients. Two strategies have been utilized: expectant management with prompt decompressive laparotomy upon diagnosis of threshold levels of IAH versus prophylactic, delayed abdominal closure based upon clinical parameters at the time of initial repair. Competent management of the abdominal wound with preservation of abdominal domain is also an important component of the care of these patients. In this review, we describe published experience with IAH and ACS complicating abdominal vascular catastrophes, experience with ACS complicating endovascular repair of rAAAs, and techniques for management of the abdominal wound. Vigilance and appropriate management of IAH and ACS remains critically important in decreasing morbidity and optimizing survival following catastrophic intra-abdominal vascular events. PMID:22454763

  1. Uncontrollable intra-abdominal bleeding necessitating low anterior resection of the rectum after stapled hemorrhoidopexy: report of a case.

    PubMed

    Blouhos, Konstantinos; Vasiliadis, Konstantinos; Tsalis, Konstantinos; Botsios, Dimitrios; Vrakas, Xenos

    2007-01-01

    Stapled hemorrhoidopexy (SH) has become a widely accepted surgical procedure for hemorrhoids; however, one of the most serious complications of this technique is severe bleeding. We report a case of extensive hemoperitoneum after SH for third-degree hemorrhoids. On postoperative day (POD) 1, the patient complained of severe abdominal pain and clinical signs of peritonitis soon became evident. Computed tomography (CT) showed blood in the abdomen. We performed an emergency exploratory laparotomy, which revealed extensive hemoperitoneum, and a devitalized, edematous rectum with a tense hematoma, approximately 1 cm above the staple line and extending up to the level of the peritoneal reflection. We also found a small seromuscular laceration in the anterior aspect of the rectum just above the peritoneal reflection. This small laceration was bleeding actively. Thus, we performed a low anterior resection and the patient was discharged from hospital 10 days later. We report this case to raise awareness of the possibility of life-threatening intra-abdominal complications without evidence of typical rectal bleeding. PMID:17342370

  2. Selected overview of nongynecologic surgical intra-abdominal infections. Prophylaxis and therapy.

    PubMed

    Levin, S; Goodman, L J

    1985-11-29

    True prophylaxis of intra-abdominal nongynecologic infections is limited to elective, nonemergency surgery and is best shown in three clean-contaminated surgical procedures. All of these have an infection rate of approximately 10 to 20 percent and include all colon resection surgery, most gastric surgery, and about one third of the cholecystectomies for chronic calculous cholecystitis. Each of these three surgical procedures has a somewhat different pattern of bacterial pathogens. The most useful comparative studies of early preoperative therapy have been performed in cases of suspected appendicitis (50 percent of which usually show perforation or gangrene at the time of surgery) and penetrating abdominal wounds (80 percent of which usually enter some part of the bowel and theoretically soil the peritoneum). These procedures are usually classified as contaminated, with a 20 to 30 percent infection rate, or dirty, with a more than 30 percent infection rate, depending upon several factors. Comparative investigations of intraoperative and postoperative antibiotic therapy of established intra-abdominal infections are more difficult to obtain because of the heterogeneity of the sites, organisms, and medical and surgical therapy. The initial pathogens causing secondary peritonitis and hepatic, perirectal, diverticular, and most other types of intraperitoneal abscesses are mixed coliforms and anaerobes, with emphasis on the anaerobes. Retroperitoneal abscesses, pancreatic abscesses, and biliary tract infections are predominantly caused by coliforms. The organisms responsible for these early infections are usually community-acquired rather than more antibiotic-resistant hospital-acquired bacteria. Considering the availability of a large number of effective broad-spectrum antibacterial agents and therapeutic combinations, it has become increasingly difficult to assess the rightful place of any new prospective antimicrobial regimen unless it has quite unique characteristics

  3. Natural orifice transluminal endoscopic surgery (NOTES) for clinical management of intra-abdominal diseases.

    PubMed

    Liu, Liu; Chiu, Philip W Y; Reddy, Nagewasher; Ho, Khek-Yu; Kitano, Seigo; Seo, Dong Wan; Tajiri, Hisao

    2013-11-01

    Clinical research on natural orifice transluminal endoscopic surgery (NOTES) has been increasingly reported over the past 5 years and more than 1200 patients have received various NOTES procedures. The present article reviews the clinical practice of NOTES for the treatment of intra-abdominal diseases, and was carried out through systematic search with specific keywords in major databases for NOTES-related clinical literature. The last date of the search was 15 August, 2012. Transvaginal cholecystectomy is the commonest NOTES procedure reported, and its clinical feasibility and safety was established through prospective case series and randomized trials. There is a regional difference in NOTES development with the majority of NOTES fromCaucasian countries being transvaginal cholecystectomy and most reports from Asian countries being NOTES-related procedures. Safe closure of gastrointestinal access remains challenging, and novel endoscopic instruments are essential to enhance future development of NOTES. PMID:23967798

  4. Intra-abdominal bleeding during treprostinil infusion in a patient with pulmonary arterial hypertension

    PubMed Central

    Mindus, Stephanie; Pawlowski, Jacek; Nisell, Magnus; Ferrara, Giovanni

    2013-01-01

    Medical treatment of pulmonary arterial hypertension (PAH) is increasingly common. Prostacyclins were introduced in the early 90s, and treprostinil is one of the most frequently used drugs of this class today, owing to its long half-life and to the possibility to administer the molecule through several routes. Treprostinil is considered a safe drug and is associated with a significant improvement of exercise capacity, especially in patients with idiopathic PAH (iPAH). Systemic sclerosis-associated PAH (sc-PAH) correlates to a worse prognosis compared with that of iPAH. Despite these considerations, safety data on treprostinil are still limited and mainly derived from randomised controlled trials and retrospective studies with relatively small and heterogeneous cohorts of patients with PAH. We report the occurrence of a severe intra-abdominal bleeding during treprostinil infusion in a patient with sc-PAH. PMID:23446048

  5. Intra-Abdominal Desmoid Tumour (DT) with Pelvic Extension-A Case Report

    PubMed Central

    Kumar, Sathish Selva; Ramachandran, Padmini; G, Veena; Madhusudhan, Napa; Kumbhar, Uday

    2014-01-01

    Desmoid Tumour (DT) is a rare benign, myofibroblastic tumour originating from muscle fascia with tendency to recur but, it rarely metastasizes. We are reporting here a case of DT that presented as an intra-abdominal mass with pelvic extension in a patient who underwent hysterectomy for fibroid uterus seventeen years ago. A clinical diagnosis of ovarian malignancy was made. Ovarian tumour markers for surface epithelial and germ cell tumours were negative. Imaging studies suggested DT and the same was excised surgically. A histopathological diagnosis of DT was made and confirmed with immunohistochemistry (IHC) markers. DT should always be considered especially in female patients with previous history of surgery. A complete surgical excision is the treatment of choice with recurrent cases requiring radiotherapy. A differential diagnosis like sarcoma and further toxic chemotherapy can be avoided with careful histopathological evaluation and IHC confirmation of DTs. PMID:24596759

  6. Percutaneous fine-needle aspiration biopsy of intra-abdominal masses.

    PubMed Central

    Ho, C. S.; Tao, L. C.; McLoughlin, M. J.

    1978-01-01

    Percutaneous fine-needle aspiration biopsies were performed in 51 patients with various intra-abdominal masses localized by palpation, radiologic studies, ultrasonography or radioisotope scanning. Biopsy specimens were considered positive for malignant disease in 35 (85%) of the 41 patients with such disease, including 26 (96%) of the 27 with metastases. There was one false-positive diagnosis of malignant disease from the biopsy specimens. Surgery became unnecessary as a result of aspiration biopsy in at least 12 patients. One patient showed evidence of intrahepatic bleeding during liver biopsy but recovered spontaneously, and the liver appeared normal at laparotomy 3 weeks later. Aspiration biopsy is an accurate, relatively painless, inexpensive and safe method of establishing a diagnosis of intraabdominal malignant disease. Considerable experience of the cytologist is necessary for good results. PMID:737606

  7. Implanting intra-abdominal radiotransmitters with external whip antennas in ducks

    USGS Publications Warehouse

    Korschgen, C.E.; Kenow, K.P.; Gendron-Fitzpatrick, A.; Green, W.L.; Dein, F.J.

    1996-01-01

    We developed and evaluated a surgical procedure for implanting intra-abdominal radiotransmitters with external whip antennas in captive mallards (Anas platyrhynchos). Transmitters were implanted in the abdominal cavity and the antennas exited through the caudal abdominal wall and skin. Birds with implanted transmitters developed mild to moderate localized air sac reactions. These reactions involved adhesions of the right anterior abdominal air sac to the liver with contractions around the transmitters and antenna catheters. The adhesions were reinforced by a proliferation of connective tissue and lined by multinucleated giant cells (foreign body reaction). Casual observation indicated that neither behavior nor activity of the birds was altered by the histological reaction to the transmitter implant. No increase in systemic lesions (particularly liver or kidney) could be correlated with the histological reactions. Our evaluations indicate that the procedure is a reliable method for radiomarking ducks and the technique has been successfully used in 2 field studies.

  8. Intra-abdominal seminoma found incidentally during trauma workup in a man with bilateral cryptorchidism

    PubMed Central

    Velez, Danielle; Zhao, Philip; Mayer, Tina; Singer, Eric

    2015-01-01

    Bilateral cryptorchidism is a rare occurrence and seminoma is the most common germ cell tumor found in undescended testes when they occur. We present the case of a patient with bilateral cryptorchidism who presented to our trauma center after a motor vehicle collision and was found incidentally to have a 17-cm intra-abdominal mass. The mass was subsequently biopsied and proven to be seminoma. The patient completed three cycles of bleomycin/etoposide/cisplatin chemotherapy and successfully underwent a postchemo retroperitoneal lymph node dissection with no viable residual tumor or positive lymph nodes found in the surgical specimen. He also had an orchiopexy of the contralateral testicle. The patient recovered fully and has been found to be recurrence-free four months postoperatively. We highlight the importance of cisplatin-based chemotherapy and extensive tumor resection as the mainstay of initial cancer control. PMID:26692683

  9. Intra-Abdominal Candidiasis: The Importance of Early Source Control and Antifungal Treatment

    PubMed Central

    Vergidis, Pascalis; Clancy, Cornelius J.; Shields, Ryan K.; Park, Seo Young; Wildfeuer, Brett N.; Simmons, Richard L.; Nguyen, M. Hong

    2016-01-01

    Intra-abdominal candidiasis (IAC) is poorly understood compared to candidemia. We described the clinical characteristics, microbiology, treatment and outcomes of IAC, and identified risk factors for mortality. We performed a retrospective study of adults diagnosed with IAC at our center in 2012–2013. Risk factors for mortality were evaluated using multivariable logistic regression. We identified 163 patients with IAC, compared to 161 with candidemia. Types of IAC were intra-abdominal abscesses (55%), secondary peritonitis (33%), primary peritonitis (5%), infected pancreatic necrosis (5%), and cholecystitis/cholangitis (3%). Eighty-three percent and 66% of secondary peritonitis and abscesses, respectively, stemmed from gastrointestinal (GI) tract sources. C. albicans (56%) and C. glabrata (24%) were the most common species. Bacterial co-infections and candidemia occurred in 67% and 6% of patients, respectively. Seventy-two percent of patients underwent an early source control intervention (within 5 days) and 72% received early antifungal treatment. 100-day mortality was 28%, and highest with primary (88%) or secondary (40%) peritonitis. Younger age, abscesses and early source control were independent predictors of survival. Younger age, abscesses and early antifungal treatment were independently associated with survival for IAC stemming from GI tract sources. Infectious diseases (ID) consultations were obtained in only 48% of patients. Consulted patients were significantly more likely to receive antifungal treatment. IAC is a common disease associated with heterogeneous manifestations, which result in poor outcomes. All patients should undergo source control interventions and receive antifungal treatment promptly. It is important for the ID community to become more engaged in treating IAC. PMID:27123857

  10. Therapeutic Role of Interleukin 22 in Experimental Intra-abdominal Klebsiella pneumoniae Infection in Mice

    PubMed Central

    Zheng, Mingquan; Horne, William; McAleer, Jeremy P.; Pociask, Derek; Eddens, Taylor; Good, Misty; Gao, Bin

    2016-01-01

    Interleukin 22 (IL-22) is an IL-10-related cytokine produced by T helper 17 (Th17) cells and other immune cells that signals via IL-22 receptor alpha 1 (IL-22Ra1), which is expressed on epithelial tissues, as well as hepatocytes. IL-22 has been shown to have hepatoprotective effects that are mediated by signal transducer and activator of transcription 3 (STAT3) signaling. However, it is unclear whether IL-22 can directly regulate antimicrobial programs in the liver. To test this hypothesis, hepatocyte-specific IL-22Ra1 knockout (Il22Ra1Hep−/−) and Stat3 knockout (Stat3Hep−/−) mice were generated and subjected to intra-abdominal infection with Klebsiella pneumoniae, which results in liver injury and necrosis. We found that overexpression of IL-22 or therapeutic administration of recombinant IL-22 (rIL-22), given 2 h postinfection, significantly reduced the bacterial burden in both the liver and spleen. The antimicrobial activity of rIL-22 required hepatic Il22Ra1 and Stat3. Serum from rIL-22-treated mice showed potent bacteriostatic activity against K. pneumoniae, which was dependent on lipocalin 2 (LCN2). However, in vivo, rIL-22-induced antimicrobial activity was only partially reduced in LCN2-deficient mice. We found that rIL-22 also induced serum amyloid A2 (SAA2) and that SAA2 had anti-K. pneumoniae bactericidal activity in vitro. These results demonstrate that IL-22, through IL-22Ra1 and STAT3 singling, can induce intrinsic antimicrobial activity in the liver, which is due in part to LCN2 and SAA2. Therefore, IL-22 may be a useful adjunct in treating hepatic and intra-abdominal infections. PMID:26729763

  11. The Preventive Effect of Dexmedetomidine Against Postoperative Intra-abdominal Adhesions in Rats

    PubMed Central

    Kuru, Serdar; Bozkirli, Osman Bahadir; Barlas, Aziz Mutlu; Duymus, Mehmet Esat; Senes, Mehmet; Yumusak, Nihat; Yilmaz, Cevdet; Kismet, Kemal

    2015-01-01

    This study aimed to determine the possible preventive effects of dexmedetomidine on postoperative intra-abdominal adhesions. Dexmedetomidine is a highly selective and potent α2 adrenergic agonist with sedative, analgesic, anxiolytic, sympatholytic, hemodynamic, and diuretic properties. In recent years, investigations have shown that dexmedetomidine possesses secondary antioxidant and also anti-inflammatory effects. Thirty Wistar albino male rats were randomized and divided into 3 groups of 10 animals each: group 1, sham-operated; group 2, cecal abrasion + peritoneal dissection; group 3, cecal abrasion + peritoneal dissection followed by daily intravenous injection of 10 μg/kg dexmedetomidine for 10 days. The animals were killed on postoperative day 21. Blood and cecal samples were taken for biochemical and histopathologic evaluation. In this study, biochemical and pathologic parameters were significantly better in the cecal abrasion + peritoneal dissection + dexmedetomidine group when compared with the cecal abrasion + peritoneal dissection group. Tissue malondialdehyde, myeloperoxidase, total sulfhydryl, and catalase were found to be significantly different between the cecal abrasion/peritoneal dissection + dexmedetomidine and the cecal abrasion/peritoneal dissection groups. Plasma malondialdehyde and total sulfhydryl values were also statistically different between these groups (P < 0.05). Statistical analyses of mean pathologic scores showed that the histopathologic damage in the cecal abrasion/peritoneal dissection + dexmedetomidine group was significantly less than the damage in the control group (P < 0.05 for all pathologic parameters). The results of this study show that dexmedetomidine had a significant preventive effect on postoperative intra-abdominal adhesions. We concluded that these effects might be due to antioxidant and anti-inflammatory activities. PMID:25594644

  12. Therapeutic Role of Interleukin 22 in Experimental Intra-abdominal Klebsiella pneumoniae Infection in Mice.

    PubMed

    Zheng, Mingquan; Horne, William; McAleer, Jeremy P; Pociask, Derek; Eddens, Taylor; Good, Misty; Gao, Bin; Kolls, Jay K

    2016-01-01

    Interleukin 22 (IL-22) is an IL-10-related cytokine produced by T helper 17 (Th17) cells and other immune cells that signals via IL-22 receptor alpha 1 (IL-22Ra1), which is expressed on epithelial tissues, as well as hepatocytes. IL-22 has been shown to have hepatoprotective effects that are mediated by signal transducer and activator of transcription 3 (STAT3) signaling. However, it is unclear whether IL-22 can directly regulate antimicrobial programs in the liver. To test this hypothesis, hepatocyte-specific IL-22Ra1 knockout (Il22Ra1(Hep-/-)) and Stat3 knockout (Stat3(Hep-/-)) mice were generated and subjected to intra-abdominal infection with Klebsiella pneumoniae, which results in liver injury and necrosis. We found that overexpression of IL-22 or therapeutic administration of recombinant IL-22 (rIL-22), given 2 h postinfection, significantly reduced the bacterial burden in both the liver and spleen. The antimicrobial activity of rIL-22 required hepatic Il22Ra1 and Stat3. Serum from rIL-22-treated mice showed potent bacteriostatic activity against K. pneumoniae, which was dependent on lipocalin 2 (LCN2). However, in vivo, rIL-22-induced antimicrobial activity was only partially reduced in LCN2-deficient mice. We found that rIL-22 also induced serum amyloid A2 (SAA2) and that SAA2 had anti-K. pneumoniae bactericidal activity in vitro. These results demonstrate that IL-22, through IL-22Ra1 and STAT3 singling, can induce intrinsic antimicrobial activity in the liver, which is due in part to LCN2 and SAA2. Therefore, IL-22 may be a useful adjunct in treating hepatic and intra-abdominal infections. PMID:26729763

  13. Complicated intra-abdominal infections worldwide: the definitive data of the CIAOW Study

    PubMed Central

    2014-01-01

    The CIAOW study (Complicated intra-abdominal infections worldwide observational study) is a multicenter observational study underwent in 68 medical institutions worldwide during a six-month study period (October 2012-March 2013). The study included patients older than 18 years undergoing surgery or interventional drainage to address complicated intra-abdominal infections (IAIs). 1898 patients with a mean age of 51.6 years (range 18-99) were enrolled in the study. 777 patients (41%) were women and 1,121 (59%) were men. Among these patients, 1,645 (86.7%) were affected by community-acquired IAIs while the remaining 253 (13.3%) suffered from healthcare-associated infections. Intraperitoneal specimens were collected from 1,190 (62.7%) of the enrolled patients. 827 patients (43.6%) were affected by generalized peritonitis while 1071 (56.4%) suffered from localized peritonitis or abscesses. The overall mortality rate was 10.5% (199/1898). According to stepwise multivariate analysis (PR = 0.005 and PE = 0.001), several criteria were found to be independent variables predictive of mortality, including patient age (OR = 1.1; 95%CI = 1.0-1.1; p < 0.0001), the presence of small bowel perforation (OR = 2.8; 95%CI = 1.5-5.3; p < 0.0001), a delayed initial intervention (a delay exceeding 24 hours) (OR = 1.8; 95%CI = 1.5-3.7; p < 0.0001), ICU admission (OR = 5.9; 95%CI = 3.6-9.5; p < 0.0001) and patient immunosuppression (OR = 3.8; 95%CI = 2.1-6.7; p < 0.0001). PMID:24883079

  14. An atypical presentation of small bowel obstruction and perforation secondary to sporadic synchronous intra-abdominal desmoid tumours

    PubMed Central

    Abdalla, Sala; Wilkinson, Michelle; Wilsher, Mark; Uzkalnis, Aleksandras

    2016-01-01

    Introduction Desmoid tumours (DTs) are rare, soft tissue tumours which account for 0.03% of all neoplasms. They are characteristically locally invasive but do not metastasize. There is frequent association with females of reproductive age, a history of abdominal surgery or trauma and a family history of fibromatoses. Intra-abdominal DTs are infrequently sporadic and more commonly associated with inherited disorders such as familial adenomatous polyposis (FAP), attenuated FAP and Gardener’s syndrome. Presentation of case The authors report a rare case of small bowel obstruction and perforation secondary to sporadic, synchronous intra-abdominal DTs in a 54-year old man with atypical symptoms and no risk factors or family history. Discussion Intra-abdominal DTs have a worse prognosis as they can cause intestinal bleeding, obstruction and perforation. Due to the rarity of these tumours there are no clear guidelines on their management and this is instead based on small case series from specialist centres. In the non-acute setting patients with sporadic intra-abdominal DTs should be managed in a specialist sarcoma unit by a multidisciplinary team. In the presence of FAP or other polyposis syndromes patients with DTs should be managed at a specialist colorectal unit. Emergent presentations require emergency surgery in suitable candidates. Conclusion In non-emergency presentations of DTs, it is essential to exclude FAP, AFAP and other hereditary polyposis syndromes since this affects treatment and subsequent follow-up. PMID:26866881

  15. Role of radiological-assisted cytology in intra-abdominal lesions: A 3 years’ experience in a tertiary care center

    PubMed Central

    Dosi, Shilpi; Gupta, Garima; Kawatra, Mallika; Chakrabarti, Preeti Rihal; Agrawal, Purti; Jain, Mukul Raj

    2016-01-01

    Background: Fine needle aspiration (FNA) with assistance of radiological tools such as ultrasonography (USG) and computed tomography (CT) is an effective and safe technique for diagnosing intra-abdominal neoplastic and nonneoplastic lesions. Aims and Objectives: (1) To assess the utility of image-guided cytology in the diagnosis of intra-abdominal lesions. (2) To categorize various intra-abdominal lesions according to their site of occurrence and study their cytomorphological features. Materials and Methods: A cross-sectional study was conducted in the Department of Pathology between January 2012 and January 2015. A total of 174 cases with intra-abdominal lesions were included in the study. Results: In our study, diagnostic yield was 84.5%. The mean age was found to be 52 years with M: F ratio 1.1:1. We found that 92 (52.87%) cases were in hepatobiliary region, 33 (18.96%) in adnexa, 13 (7.47%) in pancreatic-ampullary region, 14 (8.04%) in unknown abdominal lumps, 8 (4.6%) in lymph nodes, 6 (3.4%) in renal, 5 (2.87%) in retroperitoneum, 2 (1.1%) in omental nodules, and 1 (0.5%) in splenic mass. Of total 174 cases, 106 (61%) cases were malignant, 10 (5.7%) benign, 16 (9.1%) inflammatory, 27 (15.5%) inadequate, and 15 (8.7%) suspicious for malignancy. Conclusion: Ultrasound and CT-guided FNA cytology had a significant role in diagnosis of palpable and nonpalpable intra-abdominal lesions. Being a relatively quick and safe method, it also avoids invasive diagnostic procedures. PMID:27127738

  16. Prediction of Pharmacokinetics and Penetration of Moxifloxacin in Human with Intra-Abdominal Infection Based on Extrapolated PBPK Model

    PubMed Central

    Yang, JianWei; Zhang, Yuan; Wang, YongMing; Zhang, JianLei; Zhao, YuanYuan; Dong, WeiLin

    2015-01-01

    The aim of this study is to develop a physiologically based pharmacokinetic (PBPK) model in intra-abdominal infected rats, and extrapolate it to human to predict moxifloxacin pharmacokinetics profiles in various tissues in intra-abdominal infected human. 12 male rats with intra-abdominal infections, induced by Escherichia coli, received a single dose of 40 mg/kg body weight of moxifloxacin. Blood plasma was collected at 5, 10, 20, 30, 60, 120, 240, 480, 1440 min after drug injection. A PBPK model was developed in rats and extrapolated to human using GastroPlus software. The predictions were assessed by comparing predictions and observations. In the plasma concentration versus time profile of moxifloxcinin rats, Cmax was 11.151 µg/mL at 5 min after the intravenous injection and t1/2 was 2.936 h. Plasma concentration and kinetics in human were predicted and compared with observed datas. Moxifloxacin penetrated and accumulated with high concentrations in redmarrow, lung, skin, heart, liver, kidney, spleen, muscle tissues in human with intra-abdominal infection. The predicted tissue to plasma concentration ratios in abdominal viscera were between 1.1 and 2.2. When rat plasma concentrations were known, extrapolation of a PBPK model was a method to predict drug pharmacokinetics and penetration in human. Moxifloxacin has a good penetration into liver, kidney, spleen, as well as other tissues in intra-abdominal infected human. Close monitoring are necessary when using moxifloxacin due to its high concentration distribution. This pathological model extrapolation may provide reference to the PK/PD study of antibacterial agents. PMID:25729270

  17. Bacteriology and drug susceptibility analysis of pus from patients with severe intra-abdominal infection induced by abdominal trauma

    PubMed Central

    ZHANG, SHAOYI; REN, LELE; LI, YOUSHENG; WANG, JIAN; YU, WENKUI; LI, NING; LI, JIESHOU

    2014-01-01

    The aim of the present study was to retrospectively analyze the bacteriology and drug susceptibility of pus flora from abdominal trauma patients with severe intra-abdominal infection (SIAI). A total of 41 patients with SIAI induced by abdominal trauma were enrolled in the study, from which 123 abdominal pus samples were obtained. The results from laboratory microbiology and drug sensitivity were subjected to susceptibility analysis using WHONET software. A total of 297 strains were isolated in which Gram-negative bacteria, Gram-positive bacteria and fungi accounted for 53.5 (159/297), 44.1 (131/297) and 0.7% (2/297), respectively. Anaerobic bacteria accounted for 1.7%. The five predominant bacteria were Escherichia coli (E. coli), Staphylococcus aureus (S. aureus), Klebsiella pneumoniae (K. pneumoniae), Enterococcus faecalis and Pseudomonas aeruginosa (P. aeruginosa). E. coli was highly susceptible to cefoperazone (91%) and imipenem (98%), while Gram-positive cocci were highly susceptible to teicoplanin (100%) and linezolid (100%). S. aureus was 100% susceptible to vancomycin and K. pneumoniae was highly susceptible to imipenem (100%) and amikacin (79%). P. aeruginosa was the most susceptible to ciprofloxacin (90%). Gram-negative bacterial infection was present in the majority of cases of SIAI. However, a large number of patients were infected by Gram-positive bacteria, particularly S. aureus that exhibited significant resistance to penicillin (100%), oxacillin (100%) and a third-generation cephalosporin antibiotic cefotaxime (95%). Amongst the pathogenic bacteria that cause SIAI, both Gram-negative and Gram-positive bacteria account for a high proportion, so high-level and broad-spectrum antibiotics should be initially used. PMID:24940451

  18. Comparison of Melatonin, Hypertonic Saline, and Hydroxyethyl Starch for Resuscitation of Secondary Intra-Abdominal Hypertension in an Animal Model.

    PubMed

    Chang, Mingtao; Tang, Hao; Liu, Dong; Li, Yang; Zhang, Lianyang

    2016-01-01

    A variety of agents may have a beneficial effect in reducing injury-induced intestinal edema of fluid, but studies confirming the efficacy and mechanisms of these agents in secondary intra-abdominal hypertension (IAH) are lacking. This study was to compare the effectiveness of melatonin, 7.5% hypertonic saline (HS), and hydroxyethyl starch 130/0.4 (HES) on the resuscitation of secondary IAH in a rat model. Female SD rats were divided into: sham group, shock group, lactated Ringer solution (LR) group, melatonin group, HS group, and HES group. Except for the sham group, all rats underwent a combination of inducing portal hypertension, hemorrhaging to a MAP of 40 mmHg for 2 hr, and using an abdominal restraint device. The collected blood was reinfused and the rats were treated with LR (30ml/h), melatonin (50 mg/kg) + LR, HS (6 ml/kg) + LR, and HES (30 ml/kg) + LR, respectively. The shock group received no fluids. LR was continuously infused for 6hr. The intestinal permeability, immunofluorescence of tight junction proteins, transmission electron microscopy, level of inflammatory mediators (TNF-a, IL-1β, IL-6) and of biochemical markers of oxidative stress (malondialdehyde, myeloperoxidase activity, and glutathione peroxidase) were assessed. Expressions of the protein kinase B (Akt) and of tight junction proteins were detected by Western blot. Compared with LR, HS, and HES, melatonin was associated with less inflammatory and oxidative injury, less intestinal permeability and injury, and lower incidence of secondary IAH in this model. The salutary effect of melatonin in this model was associated with the upregulation of intestinal Akt phosphorylation. PMID:27560478

  19. Comparison of Melatonin, Hypertonic Saline, and Hydroxyethyl Starch for Resuscitation of Secondary Intra-Abdominal Hypertension in an Animal Model

    PubMed Central

    Liu, Dong; Li, Yang; Zhang, Lianyang

    2016-01-01

    A variety of agents may have a beneficial effect in reducing injury-induced intestinal edema of fluid, but studies confirming the efficacy and mechanisms of these agents in secondary intra-abdominal hypertension (IAH) are lacking. This study was to compare the effectiveness of melatonin, 7.5% hypertonic saline (HS), and hydroxyethyl starch 130/0.4 (HES) on the resuscitation of secondary IAH in a rat model. Female SD rats were divided into: sham group, shock group, lactated Ringer solution (LR) group, melatonin group, HS group, and HES group. Except for the sham group, all rats underwent a combination of inducing portal hypertension, hemorrhaging to a MAP of 40 mmHg for 2 hr, and using an abdominal restraint device. The collected blood was reinfused and the rats were treated with LR (30ml/h), melatonin (50 mg/kg) + LR, HS (6 ml/kg) + LR, and HES (30 ml/kg) + LR, respectively. The shock group received no fluids. LR was continuously infused for 6hr. The intestinal permeability, immunofluorescence of tight junction proteins, transmission electron microscopy, level of inflammatory mediators (TNF-a, IL-1β, IL-6) and of biochemical markers of oxidative stress (malondialdehyde, myeloperoxidase activity, and glutathione peroxidase) were assessed. Expressions of the protein kinase B (Akt) and of tight junction proteins were detected by Western blot. Compared with LR, HS, and HES, melatonin was associated with less inflammatory and oxidative injury, less intestinal permeability and injury, and lower incidence of secondary IAH in this model. The salutary effect of melatonin in this model was associated with the upregulation of intestinal Akt phosphorylation. PMID:27560478

  20. Role of permissive hypotension, hypertonic resuscitation and the global increased permeability syndrome in patients with severe hemorrhage: adjuncts to damage control resuscitation to prevent intra-abdominal hypertension.

    PubMed

    Duchesne, Juan C; Kaplan, Lewis J; Balogh, Zsolt J; Malbrain, Manu L N G

    2015-01-01

    Secondary intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are closely related to fluid resuscitation. IAH causes major deterioration of the cardiac function by affecting preload, contractility and afterload. The aim of this review is to discuss the different interactions between IAH, ACS and resuscitation, and to explore a new hypothesis with regard to damage control resuscitation, permissive hypotension and global increased permeability syndrome. Review of the relevant literature via PubMed search. The recognition of the association between the development of ACS and resuscitation urged the need for new approach in traumatic shock management. Over a decade after wide spread application of damage control surgery damage control resuscitation was developed. DCR differs from previous resuscitation approaches by attempting an earlier and more aggressive correction of coagulopathy, as well as metabolic derangements like acidosis and hypothermia, often referred to as the 'deadly triad' or the 'bloody vicious cycle'. Permissive hypotension involves keeping the blood pressure low enough to avoid exacerbating uncontrolled haemorrhage while maintaining perfusion to vital end organs. The potential detrimental mechanisms of early, aggressive crystalloid resuscitation have been described. Limitation of fluid intake by using colloids, hypertonic saline (HTS) or hyperoncotic albumin solutions have been associated with favourable effects. HTS allows not only for rapid restoration of circulating intravascular volume with less administered fluid, but also attenuates post-injury oedema at the microcirculatory level and may improve microvascular perfusion. Capillary leak represents the maladaptive, often excessive, and undesirable loss of fluid and electrolytes with or without protein into the interstitium that generates oedema. The global increased permeability syndrome (GIPS) has been articulated in patients with persistent systemic inflammation failing

  1. Early administration of methylprednisolone promotes survival in rats with intra-abdominal sepsis.

    PubMed

    Hollenbach, S J; DeGuzman, L R; Bellamy, R F

    1986-01-01

    We determined how the following drugs affected survival of 350-gm Sprague-Dawley rats subjected to intra-abdominal sepsis according to the method of Wichterman et al (J Surg Res 29:189-201, 1980): gentamicin (4.5 mg/kg/day), clindamycin (30 mg/kg/day), naloxone (2 mg/kg/hr), or methylprednisolone given either as a continuous infusion (2 mg/kg/hr) or as a bolus (30 mg/kg). A control group received only saline in a volume equal to the drug vehicle volume. Treatment was started immediately after cecal ligation and puncture. Drugs not given by bolus were infused by Alzet mini-pump (Model 2001) for 7 days. Percent of original population surviving at 10 days was (size of original population): saline--48% (92), antibiotics--86% (43), naloxone--30% (43), continuous methylprednisolone--14% (43), bolus methylprednisolone--93% (45). Survival of animals receiving either antibiotics or bolus methylprednisolone was significantly increased over the control population. PMID:3779905

  2. Impact of Intra-Abdominal Adhesion on Living Donor Right Hepatectomy.

    PubMed

    Kim, S H; Lee, S D; Kim, Y K; Park, S-J

    2016-06-01

    The impact of intra-abdominal adhesion (IAA) on living donor right hepatectomy (LDRH) remains to be clarified. The purpose of this study was to compare both the donor and recipient outcomes of right lobe living donor liver transplantation according to IAA detected intraoperatively. LDRH donors were identified through a prospectively maintained database at the authors' institution between March 2008 and February 2014. IAA was graded according to Beck et al (Dis Colon Rectum 2000; 43: 1749-1753). LDRH donors with IAA (group A) were matched 1:3 to those without IAA (group B) based on age, gender, and BMI. Perioperative data, complications by the Clavien classification, and the outcomes with at least 12 months follow-up were compared. Thirty-two (7.6%) of a total of 420 LDRH donors had IAA around the liver. Nineteen donors had previous abdominal surgery. LDRH was successfully completed under upper midline laparotomy in all donors. Compared with group B, group A had a longer operative time (270 vs. 172 min; p < 0.001), a higher wound complication rate (28.1% vs. 4.2%; p = 0.009), and a longer postoperative stay (10 vs. 7 days; p = 0.009). All donors recovered completely to their previous activities. The 1-year graft and recipient survivals of recipients were comparable between two groups. These findings support the feasibility and safety of LDRH in patients with IAA. PMID:26613370

  3. Intra-Abdominal Abscess and Primary Peritonitis Caused by Streptococcus anginosus

    PubMed Central

    Terzi, Huseyin Agah; Demiray, Tayfur; Koroglu, Mehmet; Cakmak, Guner; Hakki Ciftci, Ihsan; Ozbek, Ahmet; Altindis, Mustafa

    2016-01-01

    Introduction The Streptococcus anginosus group of bacteria are low-virulence bacteria existing as commensals in the oral flora and gastrointestinal tracts of humans. S. anginosus may spread to the blood in individuals with poor oral hygiene in cases of oral infections, such as gingivitis and tooth abscesses, that develop following the loss of mucosal unity. This may lead to infections in the whole body, primarily as brain and liver abscesses. Case Presentation A 32-year-old male patient presented with complaints of nausea, vomiting, and diffuse abdominal pain. Diffuse abdominal tenderness and rebound tenderness were detected particularly in the epigastrium and right upper quadrant. Laboratory assessment revealed a leukocyte count of 20,500/mm3. Free fluid around the liver and heterogeneous areas of abscess formation in the right lateral gallbladder were revealed on abdominal computed tomography. Diffuse adhesions between the bowel and seropurulent free liquid in the abdomen were detected on surgical exploration, and a sample was taken for cultures. The patient was discharged without complications on the sixth postoperative day and his antibiotic course was completed with 4 weeks of oral treatment. We reviewed the literature for similar cases of disseminated pyogenic infections caused by the S. anginosus group. Conclusions It should be kept in mind that the oral flora bacterium S. anginosus may cause transient bacteremia and deep-seated organ abscesses in immunodeficient patients with poor oral hygiene. Such patients with intra-abdominal abscesses should be treated with antibiotics and surgery.

  4. [A Case of Intra-Abdominal Desmoid Tumor with Abacterial Peritonitis].

    PubMed

    Sumiyama, Fusao; Inada, Ryo; Nakamura, Fumiko; Ryota, Hironori; Miki, Hirokazu; Oishi, Masaharu; Matsumoto, Tomoko; Iwamoto, Shigeyoshi; Mukaide, Yumi; Ozaki, Takeshi; Michiura, Taku; Inoue, Kentaro; Kon, Masanori; Miyasaka, Chika; Uemura, Yoshiko; Hamada, Madoka

    2016-03-01

    A woman in her 50s visited our hospital in February 2015 with a complaint of dull abdominal pain in the right lower quadrant. She had a medical history of appendectomy for appendicitis in her 20s. Computed tomography(CT)revealed a tumor 90 mm in diameter near the ileocecum. Elective surgery was planned under the suspicion of gastrointestinal tumor, malignant lymphoma, or ileal cancer. She was emergently hospitalized 1 day earlier than scheduled because of high fever and severe abdominal pain. CT revealed that the tumor had increased to 120 mm in diameter without free air. Her white blood cell count was not elevated, and her symptoms improved readily with medical treatment. Thus, we performed the operation as scheduled. A tumor with a dark red recess on the surface had invaded the transverse colon intraoperatively, and a small amount of purulent ascites was present at the pouch of Douglas. We performed ileocecal resection with partial transverse colectomy. Histopathological examination led to the diagnosis of desmoid tumor in the mesentery of the terminal ileum. The surgical margins were negative for tumor cells. The tumor surface around the recess showed peritonitis, and the ascites showed no bacteria or tumor cells. The patient had been doing well without recurrence after discharge. Some cases of desmoid tumor with peritonitis have been reported, but most were caused by tumor penetration into the intestinal tract. We report herein a rare case of intra-abdominal desmoid tumor with abacterial peritonitis. PMID:27067862

  5. High Prevalence of Abdominal, Intra-Abdominal and Subcutaneous Adiposity and Clustering of Risk Factors among Urban Asian Indians in North India

    PubMed Central

    Bhardwaj, Swati; Misra, Anoop; Misra, Ranjita; Goel, Kashish; Bhatt, Surya Prakash; Rastogi, Kavita; Vikram, Naval K.; Gulati, Seema

    2011-01-01

    Objective To assess the prevalence of abdominal obesity including intra-abdominal and subcutaneous adiposity along with other cardiometabolic risk factors in urban Asian Indians living in New Delhi. Methods We conducted a cross-sectional epidemiological descriptive study with 459 subjects (217 males and 242 females), representing all socio-economic strata in New Delhi. The anthropometric profile [body mass index (BMI), waist circumference (WC) and skinfold thickness], fasting blood glucose (FBG) and lipid profile were recorded. Percent body fat (%BF), total abdominal fat (TAF), intra-abdominal adipose tissue (IAAT) and subcutaneous abdominal adipose tissue (SCAT) were quantified using predictive equations for Asian Indians. Results The overall prevalence of obesity was high [by BMI (>25 kg/m2), 50.1%]. The prevalence of abdominal obesity (as assessed by WC) was 68.9%, while that assessed by TAF was 70.8%. Increased IAAT was significantly higher in females (80.6%) as compared to males (56.7%) (p = 0.00) with overall prevalence being 69.3%. The overall prevalence of high SCAT was 67.8%, more in males (69.1%) vs. females (66.5%, p = 0.5). The prevalence of type 2 diabetes, the metabolic syndrome and hypertension was 8.5%, 45.3% and 29.2%, respectively. Hypertriglyceridemia, hypercholesterolemia and low levels of HDL-c were prevalent in 42.7%, 26.6% and 37% of the subjects, respectively. The prevalence of hypertriglyceridemia was significantly higher in males (p = 0.007); however, low levels of HDL-c were more prevalent in females as compared to males (p = 0.00). Conclusion High prevalence of generalized obesity, abdominal obesity (by measurement of WC, TAF, IAAT and SCAT) and dysmetabolic state in urban Asian Indians in north India need immediate public health intervention. PMID:21949711

  6. Ceftazidime-avibactam (CTZ-AVI) as a treatment for hospitalized adult patients with complicated intra-abdominal infections.

    PubMed

    Gardiner, Bradley J; Golan, Yoav

    2016-05-01

    Avibactam, a novel β-lactamase inhibitor, has recently been co-formulated with ceftazidime and approved for use in patients with complicated intra-abdominal and urinary tract infections, where no better treatment alternative exists. The basis for its FDA approval has been the extensive clinical experience with ceftazidime and the demonstration in vitro and in animal models that the addition of avibactam reverses resistance to ceftazidime in extended-spectrum β-lactamase and some carbapenemase-producing Enterobacteriaceae. Early clinical data are promising, with efficacy demonstrated in patients with complicated intra-abdominal and urinary tract infections. This review will summarize the in vitro, animal and clinical data available on this agent to date. PMID:27042762

  7. Mead Johnson Critical Care Symposium for the Practising Surgeon. 3. Monitoring and investigation of intra-abdominal sepsis.

    PubMed

    Hamilton, S M

    1988-09-01

    Diagnosis and management of intra-abdominal sepsis continue to be major problems in critically ill patients. Multiple system organ failure secondary to intra-abdominal sepsis continues to cause serious morbidity and death. The first step in management is to recognize the infection, while providing careful supportive therapy. A number of radiologic investigations, including ultrasonography and computed tomography, will help to diagnose a potential source of infection, which can be positively identified by fine-needle aspiration and culture. The septic focus must be drained either percutaneously or, if this fails, surgically. Use of specific antibiotics is imperative. Delay in diagnosis and surgery increases the death rate, so all available diagnostic modalities should be utilized, but these should not replace careful ongoing clinical assessment. PMID:3046729

  8. Evaluation of the effects of laparotomy and laparoscopy on the immune system in intra-abdominal sepsis--a review.

    PubMed

    Karantonis, Fotios-Filippos; Nikiteas, Nikolaos; Perrea, Despina; Vlachou, Antonia; Giamarellos-Bourboulis, Evangelos J; Tsigris, Christos; Kostakis, Alkiviadis

    2008-01-01

    This review portrays the most common experimental models of intra-abdominal sepsis. Additionally, it outlines the facts that distinguish laparotomy from laparoscopy, in respect to the immune response, when comparing these two techniques in experimental models of intra-abdominal sepsis. It describes the consequences of pneumoperitoneum and trauma produced by laparoscopy or laparotomy, respectively, on bacterial translocation and immunity. Furthermore, we report the few efforts that have been made in clinical settings, where surgeons have attempted to utilize laparoscopy as a therapeutic module when treating peritonitis or sepsis of abdominal origin. Certainly there is a need for more research in order to fortify the role of pneumoperitoneum in sepsis of abdominal origin. It seems that minimally invasive surgery will inevitably gain acceptance by surgeons, as evidence points that by inflicting less trauma the healing response is expected to be more efficient, especially in septic patients. PMID:19160143

  9. A Mimic of Intra-abdominal Malignancy: Physiological Urinary Excretion of FDG in the Rare Adult Vesicourachal Diverticulum.

    PubMed

    Hsieh, Te-Chun; Sun, Shung-Shung; Lin, Chen-Yuan; Wu, Yu-Chin; Kao, Chia-Hung

    2016-06-01

    Urachal remnant anomalies are rare, and vesicourachal diverticulum is the most uncommon subtype of these anomalies. We present such a rare case of vesicourachal diverticulum that is incidentally discovered during the staging surveillance of a known esophageal cancer with F-FDG PET/CT. The physiological urinary excretion of radiopharmaceutical in the vesicourachal diverticulum mimics intra-abdominal malignancy, which resolves spontaneously in the follow-up FDG PET/CT. PMID:26825197

  10. Guideline-Concordant Versus Discordant Antimicrobial Therapy in Patients With Community-Onset Complicated Intra-abdominal Infections.

    PubMed

    Huang, Lori L; Van Schooneveld, Trevor C; Huang, Robert D; Olsen, Keith M; Rupp, Mark E; Gross, Alan E

    2016-07-01

    Overall IDSA/SIS intra-abdominal infection guideline compliance was not associated with improved outcomes; however, there was a longer time to active therapy (P=.024) and higher mortality (P=.077) if empiric therapy was too narrow per guidelines. These findings support the need for the implementation of customized institutional guidelines adapted from the IDSA/SIS guidelines. Infect Control Hosp Epidemiol 2016;37:855-858. PMID:27020310

  11. Efficacy of L-627, a new carbapenem, in the treatment of experimentally induced intra-abdominal infections in rats.

    PubMed

    Nord, C E; Lahnborg, G

    1992-01-01

    A reproducible experimental model of intra-abdominal infections in rats has been devised in order to simulate intra-abdominal sepsis in patients. Pre-operatively, the rats were fed lean ground beef for two weeks in order to change the intestinal flora to one similar to that of humans. A 1-cm segment of ileum was isolated on its vascular pedicle. The intestine was then divided at each end of the segment and intestinal continuity was re-established by an end-to-end anastomosis. The segment of ileum was then returned to the abdominal cavity. This experimental model was used to compare the efficacy of L-627 with the combination of gentamicin plus metronidazole. Eighty per cent of the untreated animals died within three days. Animals treated with L-627 or gentamicin plus metronidazole had significantly decreased mortality and increased cure rates during the experimental period. Only two animals in the two treatment groups died. L-627 seems to be as useful as gentamicin plus metronidazole in the treatment of intra-abdominal infections. PMID:1306152

  12. Resistance training suppresses intra-abdominal fatty acid synthesis in ovariectomized rats.

    PubMed

    Stotzer, U S; Rodrigues, M F C; Domingos, M M; Silva, G H G; Duarte, F O; Gatto, C V G; Duarte, A C G O; Shiguemoto, G E; Perez, S E A; Selistre-de-Araujo, H S

    2015-03-01

    Ovarian hormone loss is associated with a shift in fat distribution to intra-abdomin al adipose tissue (intra-AAT) depots and with lipid metabolism disorders, which predisposes individuals to developing insulin resistance. Resistance training (RT) prevents increases in intra-AAT after ovarian hormone loss. However, the molecular mechanisms underlying these changes remain unclear. We investigated the effects of ovariectomy and RT on gene expression related to lipogenesis and fat oxidation in the intra-AAT of ovariectomized rats. Sprague-Dawley rats (n=6/group) were divided into the groups: sham-sedentary, ovariectomized-sedentary, sham-RT and ovariectomized-RT. RT groups performed a 10-week climbing program on a ladder with progressive overload. Intra-AAT was subjected to morphometric and mRNA analysis. Ovariectomized-sedentary group had larger adipocytes and higher expression of peroxisome proliferator-activated receptor-γ (PPAR-γ), sterol regulatory element-binding protein-1c (SREBP-1c), stearoyl-CoA desaturase-1 (SCD-1), acetyl-CoA carboxylase (ACC), hormone-sensitive lipase (HSL) and lower expression of the oxidative carnitinepalmitoyltransferase-I (CPT-1). RT counteracted OVX-induced increases in PPAR-γ and SCD-1 and decreased SREBP-1c. ACC and HSL were downregulated in ovariectomized-RT compared with the ovariectomized-sedentary group. Ovariectomized-RT group had the highest CPT-1 gene expression. Adipocyte size decreased in ovariectomized-RT group. Results suggest that RT reduces intra-AAT adipocyte size in ovariectomized rats by suppressing intra-AAT fatty acid synthesis and enhancing fatty acid β-oxidation. PMID:25415388

  13. Inhibition of skeletal muscle protein synthesis in septic intra-abdominal abscess

    SciTech Connect

    Vary, T.C.; Siegel, J.H.; Tall, B.D.; Morris, J.G.; Smith, J.A.

    1988-07-01

    Chronic sepsis is always associated with profound wasting leading to increased release of amino acids from skeletal muscle. Net protein catabolism may be due to decreased rate of synthesis, increased rate of degradation, or both. To determine whether protein synthesis is altered in chronic sepsis, the rate of protein synthesis in vivo was estimated by measuring the incorporation of (/sup 3/H)-phenylalanine in skeletal muscle protein in a chronic (5-day) septic rat model induced by creation of a stable intra-abdominal abscess using an E. coli + B. fragilis-infected sterile fecal-agar pellet as foreign body nidus. Septic rats failed to gain weight at rates similar to control animals, therefore control animals were weight matched to the septic animals. The skeletal muscle protein content in septic animals was significantly reduced relative to control animals (0.18 +/- 0.01 vs. 0.21 +/- 0.01 mg protein/gm wet wt; p less than 0.02). The rate of incorporation of (/sup 3/H)-phenylalanine into skeletal muscle protein from control animals was 39 +/- 4 nmole/gm wet wt/hr or a fractional synthetic rate of 5.2 +/- 0.5%/day. In contrast to control animals, the fractional synthetic rate in septic animals (2.6 +/- 0.2%/day) was reduced by 50% compared to control animals (p less than 0.005). The decreased rate of protein synthesis in sepsis was not due to an energy deficit, as high-energy phosphates and ATP/ADP ratio were not altered. This decrease in protein synthesis occurred even though septic animals consumed as much food as control animals.

  14. Critical evaluation of ceftolozane–tazobactam for complicated urinary tract and intra-abdominal infections

    PubMed Central

    Giancola, Stephanie E; Mahoney, Monica V; Bias, Tiffany E; Hirsch, Elizabeth B

    2016-01-01

    The rise in resistant Gram-negative pathogens continues to challenge clinicians treating infections. These resistant infections have inspired the development of new antimicrobial agents, including ceftolozane–tazobactam, a novel β-lactam/β-lactamase inhibitor combination approved by the US Food and Drug Administration for the treatment of complicated urinary tract infections (cUTIs) and complicated intra-abdominal infections (cIAIs) in combination with metronidazole. Ceftolozane exhibits bactericidal activity by inhibiting penicillin-binding proteins (PBPs), with high affinity for PBP1b, PBP1c, and PBP3. The addition of tazobactam protects ceftolozane from hydrolysis by irreversibly binding to some β-lactamase enzymes. Ceftolozane–tazobactam is active against a wide range of Gram-negative pathogens, including extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae and multidrug-resistant (MDR) Pseudomonas aeruginosa, several streptococcal species, and Bacteroides fragilis. When anaerobic coverage is needed, it should be used in combination with metronidazole. Ceftolozane demonstrates linear pharmacokinetics, low protein binding, and minimal accumulation with repeated dosing. The major pharmacokinetic/pharmacodynamic index for ceftolozane is the percentage of the dosing interval in which the plasma free drug concentration remains higher than the minimum inhibitory concentration (%T.MIC). Phase III clinical trials for the treatment of cUTIs and cIAIs have been completed, showing that it is an effective and safe alternative for the treatment of these infections. The approved dose for cUTIs and cIAIs is 1.5 g (1 g ceftolozane and 500 mg tazobactam) infused over 1 hour every 8 hours. A higher 3 g dose is currently in Phase III trials for the treatment of ventilated nosocomial pneumonia. Dosage adjustments are necessary for patients with moderate-to-severe renal impairment. Current data suggest that ceftolozane–tazobactam is a promising carbapenem

  15. Effects of Intraperitoneal Administration of Simvastatin in Prevention of Postoperative Intra-abdominal Adhesion Formation in Animal Model of Rat

    PubMed Central

    Javaherzadeh, Mojtaba; Shekarchizadeh, Ali; Kafaei, Marjan; Mirafshrieh, Abass; Mosaffa, Nariman; Sabet, Babak

    2016-01-01

    Objective: To determine the preventive effects of local administration of simvastatin for postoperative intra-abdominal adhesion formation in animal model of rat.  Methods: In this experimental study, 32 Wistar albino rats as the animal model of intra-abdominal adhesion formation were included. Adhesions were induced in all the animals via abrasion of the peritoneal and intestinal surface during laparotomy. Afterwards, the rats were randomly assigned to receive simvastatin (30 mg/kg body weight) as a single intraperitoneal dose at the time of laparotomy (n=16) or normal saline in same volume at the same time (n=16). At the day 21, animals were euthanized and the adhesions were quantified clinically (via repeated laparotomy) and pathologically and compared between the two groups. Results: The baseline characteristics of the animals were comparable between two study groups. Clinically, in simvastatin group, 10 rats (62.5%) did not develop any adhesion and 6 (37.5%) had first-grade adhesion; whereas in the control group, 11 (68.8%) rats had first- and 5 (31.2%) had second-grade adhesions (p<0.001). Pathologically, in simvastatin group, 6 rats (37.5%) had first-grade adhesion, while in control group, 11 rats (68.8%) had first- and 5 (31.2%) had second-grade adhesions (p<0.001). Conclusion: Our findings suggest that intraperitoneal administration of simvastatin is an effective method for prevention of postoperative intra-abdominal adhesion formation in animal model of rat.   PMID:27540550

  16. EUS-guided drainage and stent placement for postoperative intra-abdominal and pelvic fluid collections in oncological surgery

    PubMed Central

    Vilar-Cao, Zenaida; Sardina-Ferreiro, Raquel

    2012-01-01

    Objectives: The objective of this study was to evaluate the role and benefits of endoscopic ultrasonography (EUS) in the management of postoperative intra-abdominal fluid collections after attempted curative surgery for abdominal cancer. Methods: The authors retrospectively analysed the Endobase from 1 July 2007 to 30 January 2011 for patients with a postoperative intra-abdominal fluid collection who had undergone EUS-guided drainage and the placement of a stent. The data analysed included the demographics, type of surgery and clinical indications of each patient as well as their clinical and radiological findings. Results: Six patients (three men and three women; mean age, 61.8 years [range, 38–78 years]) with intra-abdominal and pelvic fluid collections after abdominal surgery for cancer had undergone EUS-guided internal drainage. All procedures had been performed using linear EUS guidance and 8-Fr stent drainage catheters (‘one step device’, Giovannini, NWOA system Needle-Wire, Cook). The collection types included perigastric abscess (n = 3), perigastric hematoma and rectal hematoma (n = 1), perirectal biloma (n = 1), and perirectal abscess (n = 1). Patients had undergone the following types of surgery: lower-anterior rectal resection (n = 2), Whipple’s duodenopancreatectomy type (n = 1), total gastrectomy (n = 1), splenectomy (n = 1), and distal pancreatectomy (n = 1). The number of stents inserted for each collection was one (five patients) and two (one patient). Conclusions: EUS-guided drainage and stenting provide another option for the management of postoperative collections. It allows access to areas that are difficult to reach with the CT-guided approach and it can be performed accurately, efficiently and safely. In addition to this, the internal nature of the drainage offers patients more comfort. PMID:22423258

  17. High-intensity focused ultrasound treatment for intra-abdominal desmoid tumors: a report of four cases.

    PubMed

    Shi, Yulan; Huang, Yanqin; Zhou, Meiqi; Ying, Xiao; Hu, Xiaoye

    2016-04-01

    Desmoid tumors are rare clonal fibroblastic proliferations that can arise at abdominal or extra-abdominal sites. Complete surgical resection is the primary treatment for resectable desmoid tumors, but a high rate of local recurrence has been reported even after complete resection. For patients with a recurrent tumor, the goals of treatment are to control the recurrence, maintain quality of life, and prolong survival. Radiofrequency ablation, radiotherapy, chemotherapy, and other medical therapies can be used as alternative methods, but there are considerable controversies over the roles of these methods in the management of desmoid tumors. High-intensity focused ultrasound (HIFU) is a minimally invasive and effective method for treatment of solid tumors. We used HIFU to treat four patients with intra-abdominal desmoid tumors from June 2011 to September 2013. Post-procedural pain was seen in all patients. One patient had an intra-abdominal abscess and another suffered a slight injury to the femoral nerve. The patients were followed up for 19-46 months (mean 34 months) until April 2015. The tumor in one patient disappeared, and no tumor progression was observed in the other patients. PMID:27033872

  18. Intra-abdominal desmoplastic small round cell tumors: CT and FDG-PET/CT findings with histopathological association

    PubMed Central

    CHEN, JINGJING; WU, ZENGJIE; SUN, BINBIN; LI, DACHENG; WANG, ZHENGUANG; LIU, FANGJUN; HUA, HUI

    2016-01-01

    Desmoplastic small round cell tumors (DSRCTs) are rare and aggressive malignant tumors. The aim of the present study was to analyze computed tomography (CT) and fluorodeoxyglucose positron emission tomography (FDG-PET)/CT imaging features of intra-abdominal desmoplastic DSRCT, and investigate the association of these features with histopathological results. The present study was a retrospective investigation of 4 patients with DSRCT. All patients underwent CT and dynamic CT, and 1 additionally underwent FDG-PET/CT scanning. Following a tumor resection, routine hematoxylin and eosin staining, and immunostaining, were performed and evaluated. Multiple large abdominopelvic masses were identified in all 4 patients; however, no indications of their site of origin were demonstrated. CT revealed soft-tissue masses with patchy foci of hypodense lesions. Contrast-enhanced CT revealed slightly or moderately heterogeneous enhancement of the lesions. Other observations from these patients included calcification (n=2), peritoneal seeding (n=3), hepatic metastasis (n=3), retroperitoneal lymphadenopathy (n=3) and ascites (n=2). FDG-PET/CT revealed multiple nodular increased FDG uptake in the abdominopelvic masses, and in the liver and peritoneum in 1 case. Intra-abdominal DSRCT demonstrated significant diagnostic characteristics on plain and contrast-enhanced CT. Multiple, bulky soft-tissue masses inside the peritoneal cavity, particularly in male adolescents and young adults, should be considered as potential cases of DSRCT. FDG-PET/CT techniques may be utilized to aid the staging of tumors. PMID:27123106

  19. Profile of ceftolozane/tazobactam and its potential in the treatment of complicated intra-abdominal infections

    PubMed Central

    Skalweit, Marion J

    2015-01-01

    Drug-resistant pathogens have gained a foothold especially in the most vulnerable patient populations, hospitalized and immunocompromised individuals. Furthermore, extended-spectrum β-lactamase and carbapenemase-producing organisms are finding their way even into the community, with patients presenting to the hospital with established colonization and infection with resistant Enterobacteriaceae in particular. Recently, a novel antipseudomonal cephalosporin in combination with an established Class A β-lactamase inhibitor, ceftolozane/tazobactam has been approved by the FDA for use in the treatment of complicated urinary tract infections and complicated intra-abdominal infections. Ceftolozane is a uniquely potent antipseudomonal cephalosporin because of its high affinity for the penicillin-binding proteins of Pseudomonas aeruginosa, its low affinity for the intrinsic Class C β-lactamases of P. aeruginosa, its ability to enter P. aeruginosa through the outer membrane without the utilization of OprD protein, and the fact that it is not a substrate of the often upregulated MexAB/OprM efflux system of P. aeruginosa. The biological chemistry, pharmacokinetics/pharmacodynamics, microbiologic spectrum, and clinical trials that led to the approval of ceftolozane is reviewed. A discussion regarding its potential role in the treatment of complicated intra-abdominal infections and other infectious disease syndromes associated with drug-resistant pathogens follows. PMID:26082619

  20. Intra-abdominal textiloma. A retained surgical sponge mimicking a gastric gastrointestinal stromal tumor: report of a case.

    PubMed

    Yamamura, Noriyuki; Nakajima, Kiyokazu; Takahashi, Tsuyoshi; Uemura, Mamoru; Nishitani, Akiko; Souma, Yoshihito; Nishida, Toshirou

    2008-01-01

    We describe a unique case of intra-abdominal textiloma (granuloma due to a retained foreign body), which mimicked a gastric tumor on preoperative imaging studies. A 78-year-old asymptomatic patient with a past history of a gastrectomy was referred for evaluation of an intra-abdominal mass lesion, which was incidentally observed on a computed tomography (CT) scan. Repeated CT with a higher resolution demonstrated a 5-cm heterogeneously enhanced mass with a distinct feeding artery. These findings were all compatible with a tumorous lesion originating in the gastric remnant, most likely gastric gastrointestinal stromal tumor. A diagnosis of textiloma was immediately made during surgery, and it was confirmed pathologically postoperatively. The feeding artery that appeared on CT images, which was a major reason for the false diagnosis, was considered to have resulted from a slow but continuous inflammation reaction around the retained surgical sponge. Surgeons should therefore always take the possibility of textilomas into consideration even with typical tumorous characteristics on preoperative imaging studies, especially in patients with a history of prior abdominal surgery. PMID:18516538

  1. Intra-abdominal fat. Part II: Non-cancerous lesions of the adipose tissue localized beyond organs.

    PubMed

    Smereczyński, Andrzej; Kołaczyk, Katarzyna; Bernatowicz, Elżbieta

    2016-03-01

    Adipose tissue does not belong to the most favorite structures to be visualized by ultrasound. It is not, however, free from various pathologies. The aim of this paper is to make abdominal cavity examiners more familiar with non-cancerous lesions found in intra-abdominal fat. The main focus is lesions that are rarely discussed in the literature. Visceral adiposity is one of important pathogenetic factors contributing to cardiovascular events, metabolic syndrome and even certain neoplasms. That is why this article exposes sonographic features that are the most characteristic of these lesions. The value of ultrasonography in the diagnosis of this pathology is underestimated, and a number of US scan reports do not reflect its presence in any way. Moreover, the article discusses more and more common mesenteritis, the lack of knowledge of which could pose difficulties in explaining the nature of symptoms reported by patients. Furthermore, this review presents lesions referred to in the literature as focal infarction of intra-abdominal fat. This section focuses on infarction of the greater and lesser omentum, epiploic appendagitis, mesenteric volvulus and focal fat necrosis resulting from pancreatitis. These lesions should be assessed with respect to the clinical context, and appropriate techniques of ultrasonography should be employed to allow careful determination of the size, shape, acoustic nature and location of lesions in relation to the integuments and large bowel, as well as their reaction to compression with an ultrasound transducer and behavior during deep inspiration. Moreover, each lesion must be obligatorily assessed in terms of blood flow. Doppler evaluation enables the differentiation between primary and secondary inflammation of intra-abdominal fat. The paper also draws attention to a frequent indirect sign of a pathological process, i.e. thickening and hyperechogenicity of fat, which sometimes indicates an ongoing pathology at a deeper site. This

  2. Intra-abdominal fat. Part II: Non-cancerous lesions of the adipose tissue localized beyond organs

    PubMed Central

    Kołaczyk, Katarzyna; Bernatowicz, Elżbieta

    2016-01-01

    Adipose tissue does not belong to the most favorite structures to be visualized by ultrasound. It is not, however, free from various pathologies. The aim of this paper is to make abdominal cavity examiners more familiar with non-cancerous lesions found in intra-abdominal fat. The main focus is lesions that are rarely discussed in the literature. Visceral adiposity is one of important pathogenetic factors contributing to cardiovascular events, metabolic syndrome and even certain neoplasms. That is why this article exposes sonographic features that are the most characteristic of these lesions. The value of ultrasonography in the diagnosis of this pathology is underestimated, and a number of US scan reports do not reflect its presence in any way. Moreover, the article discusses more and more common mesenteritis, the lack of knowledge of which could pose difficulties in explaining the nature of symptoms reported by patients. Furthermore, this review presents lesions referred to in the literature as focal infarction of intra-abdominal fat. This section focuses on infarction of the greater and lesser omentum, epiploic appendagitis, mesenteric volvulus and focal fat necrosis resulting from pancreatitis. These lesions should be assessed with respect to the clinical context, and appropriate techniques of ultrasonography should be employed to allow careful determination of the size, shape, acoustic nature and location of lesions in relation to the integuments and large bowel, as well as their reaction to compression with an ultrasound transducer and behavior during deep inspiration. Moreover, each lesion must be obligatorily assessed in terms of blood flow. Doppler evaluation enables the differentiation between primary and secondary inflammation of intra-abdominal fat. The paper also draws attention to a frequent indirect sign of a pathological process, i.e. thickening and hyperechogenicity of fat, which sometimes indicates an ongoing pathology at a deeper site. This

  3. Ultrasonography Guided Fine Needle Aspiration Cytology with Preparation of Cell Blocks in the Diagnosis of Intra- Abdominal Masses

    PubMed Central

    Muniyappa, Bharathi

    2015-01-01

    Background Ultrasonography guided Fine Needle Aspiration Cytology (FNAC) is currently the most favoured and increasingly used pre-operative diagnostic procedure in various deep seated neoplastic and non-neoplastic mass lesions. Cell blocks prepared from residual fine needle aspiration (FNA) material can aid in better morphologic assessment and contribute to establish a more definitive cytopathologic diagnosis. Aim To assess the value of ultrasonography guided FNAC in the diagnosis of intra-abdominal (non-pelvic) masses. Objectives To determine the reliability of ultrasonography guided FNAC in distinguishing neoplastic from non-neoplastic intra-abdominal mass lesions. To assess the usefulness of cell block as a complimentary diagnostic material in the morphologic evaluation of the lesions. Materials and Methods Aspirate material was collected from 62 patients with clinically and/or radiologically detected abdominal mass under ultrasonographic (USG) guidance. Pelvic masses were excluded from the study. In every case an attempt was made to prepare cell block (CB) from any residual material after preparation of routine smears. The final cytomorphologic diagnosis was correlated with clinical and radiologic findings, histopathologic diagnosis, follow up and response to therapy information. Results The diagnostic yield of USG guided FNAC was 96.77%. The cases included 42 malignant (67.74%), two (3.23%) benign, and 16 (25.8%) non-neoplastic lesions. Two (3.23%) smears were unsatisfactory for evaluation. In 45 out of 62 cases (72.58%) CB preparations were available. There was a good agreement between smear diagnosis and that observed on CB section. Additionally CB yielded better diagnostic material in 15.55% of cases and aided in establishing a more precise final cytopathologic diagnosis. Confirmation of diagnosis in the form of biopsy and/or surgically resected specimen and follow up was available in 56 cases. The overall diagnostic accuracy of USG guided FNAC was 96

  4. Successful Endosonography-Guided Drainage of an Intra-Abdominal Abscess in a 1-Year-Old Infant

    PubMed Central

    Ito, Yukiko; Isayama, Hiroyuki; Nakai, Yousuke; Umefune, Gyoutane; Sato, Tatsuya; Nakahara, Saori; Suwa, Junko; Kato, Keiichi; Nakata, Ryo

    2016-01-01

    Endoscopic ultrasound (EUS)-guided intervention has been established as a safe, effective and minimally invasive procedure for various diseases in adults, but there have been limited reports in pediatric patients. Herein, we report our experience with successful EUS-guided drainage of an intra-abdominal abscess in a 1-year-old infant concomitant with disseminated intravascular coagulation. The abscess was punctured via the stomach using a standard, convex-type echoendoscope, and the patient’s condition improved after naso-cystic catheter placement. Although the clinical course was complicated by delayed hemorrhage from the puncture site, the bleeding was successfully managed by endoscopic hemostasis using a standard forward-viewing endoscope. PMID:27114437

  5. Müllerian intra-abdominal carcinomatosis in hereditary breast ovarian cancer syndrome: implications for risk-reducing surgery.

    PubMed

    Casey, Murray Joseph; Colanta, Agnes B

    2016-07-01

    More than 40 years ago Lynch et al. described several multigenerational breast cancer family pedigrees which demonstrated autosomal dominant inheritance of a trait(s) that increased risks for both breast and ovarian cancers. Mutation carriers in at least 90 % of these hereditary breast ovarian cancer (HBOC) syndrome families have been linked to cancer-associated mutations in the genes BRCA1 and BRCA2. This review focuses on the contributions of Lynch, colleagues and collaborators and pertinent literature, toward defining the HBOC syndrome, the cancer risks that the inherited adverse mutations convey, the gynecologic tissues and organs from which the malignancy may arise to disseminate throughout the pelvic and abdominal organs and peritoneum and how this information can be used to reduce the risk and morbidities of intra-abdominal carcinomatosis in effected individuals. PMID:26875157

  6. Population Pharmacokinetics of Meropenem in Plasma and Cerebrospinal Fluid of Infants with Suspected or Complicated Intra-Abdominal Infections

    PubMed Central

    SMITH, P. BRIAN; COHEN-WOLKOWIEZ, MICHAEL; CASTRO, LISA M.; POINDEXTER, BRENDA; BIDEGAIN, MARGARITA; WEITKAMP, JOERN-HENDRIK; SCHELONKA, ROBERT L.; WARD, ROBERT M.; WADE, KELLY; VALENCIA, GLORIA; BURCHFIELD, DAVID; ARRIETA, ANTONIO; BHATT-MEHTA, VARSHA; WALSH, MICHELE; KANTAK, ANAND; RASMUSSEN, MAYNARD; SULLIVAN, JANICE E.; FINER, NEIL; BROZANSKI, BEVERLY S.; SANCHEZ, PABLO; ANKER, JOHN VAN DEN; BLUMER, JEFFREY; KEARNS, GREGORY L.; CAPPARELLI, EDMUND V.; ANAND, RAVINDER; BENJAMIN, DANIEL K.

    2011-01-01

    Background Suspected or complicated intra-abdominal infections are common in young infants and lead to significant morbidity and mortality. Meropenem is a broad-spectrum antimicrobial agent with excellent activity against pathogens associated with intra-abdominal infections in this population. The purpose of this study was to determine the pharmacokinetics (PK) of meropenem in young infants as a basis for optimizing dosing and minimizing adverse events. Methods Premature and term infants <91 days of age hospitalized in 24 neonatal intensive care units were studied. Limited PK sampling was performed following single and multiple doses of meropenem 20–30 mg/kg of body weight every 8–12 hours based on postnatal and gestational age at birth. Population and individual patient (Bayesian) PK parameters were estimated using NONMEM®. Results Two hundred infants were enrolled and received study drug. One hundred eighty-eight infants with 780 plasma meropenem concentrations were analyzed. Their median (range) gestational age at birth and postnatal age at PK evaluation were 28 (23–40) weeks and 21 (1–92) days, respectively. In the final PK model, meropenem clearance (CL) was strongly associated with serum creatinine (SCR) and postmenstrual age (PMA) (CL [L/h/kg] = 0.12*[(0.5/SCR)**0.27]*[(PMA/32.7)**1.46]). Meropenem concentrations remained >4 μg/mL for 50% of the dose interval and >2 μg/mL for 75% of the dose interval in 96% and 92% of patients, respectively. The estimated penetration of meropenem into the cerebrospinal fluid was 70% (5–148). Conclusions Meropenem dosing strategies based on postnatal and gestational age achieved therapeutic drug exposure in almost all infants. PMID:21829139

  7. Effect of Body Mass Index and Intra-Abdominal Fat Measured by Computed Tomography on the Risk of Bowel Symptoms

    PubMed Central

    Nagata, Naoyoshi; Sakamoto, Kayo; Arai, Tomohiro; Niikura, Ryota; Shimbo, Takuro; Shinozaki, Masafumi; Ihana, Noriko; Sekine, Katsunori; Okubo, Hidetaka; Watanabe, Kazuhiro; Sakurai, Toshiyuki; Yokoi, Chizu; Yanase, Mikio; Akiyama, Junichi; Uemura, Naomi; Noda, Mitsuhiko

    2015-01-01

    Background This study aims to investigate the association between body mass index (BMI) or intra-abdominal fat measured by computed tomography (CT) and bowel symptoms. Method A cohort of 958 Japanese adults who underwent colonoscopy and CT and completed questionnaires after excluding colorectal diseases was analyzed. Six symptoms (constipation, diarrhea, loose stools, hard stools, fecal urgency, and incomplete evacuation) using a 7-point Likert scale were evaluated between baseline and second questionnaire for test-retest reliability. Associations between BMI, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and symptom score were analyzed by a rank-ordered logistic model, adjusting for age, sex, smoking, and alcohol consumption, hypertension, diabetes mellitus, and dyslipidemia. Results Some bowel symptom scores were significantly (p<0.05) different between the age groups, sexes, smoking, and alcohol consumption. In multivariate analysis, constipation was associated with low BMI (p<0.01), low VAT area (p = 0.01), and low SAT area (p<0.01). Moreover, hard stools was associated with low BMI (p<0.01) and low SAT area (p<0.01). The remaining symptoms were not significantly associated with BMI or intra-abdominal fat. Test-retest reliability of bowel symptom scores with a mean duration of 7.5 months was good (mean kappa, 0.672). Conclusions Both low BMI and low abdominal fat accumulation appears to be useful indicators of increased risk for constipation and hard stools. The long-term test-retest reliability of symptom score suggests that bowel symptoms relevant to BMI or visceral fat remain consistent over several months. PMID:25906052

  8. Removal of intra-abdominal visceral adipose tissue improves glucose tolerance in rats: role of hepatic triglyceride storage.

    PubMed

    Foster, Michelle T; Shi, Haifei; Seeley, Randy J; Woods, Stephen C

    2011-10-24

    Epidemiological studies have demonstrated a strong link between increased visceral fat and metabolic syndrome. In rodents, removal of intra-abdominal but non-visceral fat improves insulin sensitivity and glucose homeostasis, though previous studies make an imprecise comparison to human physiology because actual visceral fat was not removed. We hypothesize that nutrient release from visceral adipose tissue may have greater consequences on metabolic regulation than nutrient release from non-visceral adipose depots since the latter drains into systemic but not portal circulation. To assess this we surgically decreased visceral white adipose tissue (~0.5 g VWATx) and compared the effects to removal of non-visceral epididymal fat (~4 g; EWATx), combination removal of visceral and non-visceral fat (~4.5 g; EWATx/VWATx) and sham-operated controls, in chow-fed rats. At 8 weeks after surgery, only the groups with visceral fat removed had a significantly improved glucose tolerance, although 8 times more fat was removed in EWATx compared with VWATx. This suggests that mechanisms controlling glucose metabolism are relatively more sensitive to reductions in visceral adipose tissue mass. Groups with visceral fat removed also had significantly decreased hepatic lipoprotein lipase (LPL) and triglyceride content compared with controls, while carnitine palmitoyltransferase (CPT-1A) was decreased in all fat-removal groups. In a preliminary experiment, we assessed the opposite hypothesis; i.e., we transplanted excess visceral fat from a donor rat to the visceral cavity (omentum and mesentery), which drains into the hepatic portal vein, of a recipient rat but observed no major metabolic effect. Overall, our results indicate surgical removal of intra-abdominal fat improves glucose tolerance through mechanism that may be mediated by reductions in liver triglyceride. PMID:21683727

  9. Results of a randomized trial comparing sequential intravenous/oral treatment with ciprofloxacin plus metronidazole to imipenem/cilastatin for intra-abdominal infections. The Intra-Abdominal Infection Study Group.

    PubMed Central

    Solomkin, J S; Reinhart, H H; Dellinger, E P; Bohnen, J M; Rotstein, O D; Vogel, S B; Simms, H H; Hill, C S; Bjornson, H S; Haverstock, D C; Coulter, H O; Echols, R M

    1996-01-01

    OBJECTIVE: In a randomized, double-blind, multicenter trial, ciprofloxacin/metronidazole was compared with imipenem/cilastatin for treatment of complicated intra-abdominal infections. A secondary objective was to demonstrate the ability to switch responding patients from intravenous (IV) to oral (PO) therapy. SUMMARY BACKGROUND DATA: Intra-abdominal infections result in substantial morbidity, mortality, and cost. Antimicrobial therapy often includes a 7- to 10-day intravenous course. The use of oral antimicrobials is a recent advance due to the availability of agents with good tissue pharmacokinetics and potent aerobic gram-negative activity. METHODS: Patients were randomized to either ciprofloxacin plus metronidazole intravenously (CIP/MTZ IV) or imipenem intravenously (IMI IV) throughout their treatment course, or ciprofloxacin plus metronidazole intravenously and treatment with oral ciprofloxacin plus metronidazole when oral feeding was resumed (CIP/MTZ IV/PO). RESULTS: Among 671 patients who constituted the intent-to-treat population, overall success rates were as follows: 82% for the group treated with CIP/MTZ IV; 84% for the CIP/MTZ IV/PO group; and 82% for the IMI IV group. For 330 valid patients, treatment success occurred in 84% of patients treated with CIP/MTZ IV, 86% of those treated with CIP/MTZ IV/PO, and 81% of the patients treated with IMI IV. Analysis of microbiology in the 30 patients undergoing intervention after treatment failure suggested that persistence of gram-negative organisms was more common in the IMI IV-treated patients who subsequently failed. Of 46 CIP/MTZ IV/PO patients (active oral arm), treatment success occurred in 96%, compared with 89% for those treated with CIP/MTZ IV and 89% for those receiving IMI IV. Patients who received intravenous/oral therapy were treated, overall, for an average of 8.6 +/- 3.6 days, with an average of 4.0 +/- 3.0 days of oral treatment. CONCLUSIONS: These results demonstrate statistical equivalence

  10. Body Mass Index Is a Marker of Nutrition Preparation Sufficiency Before Surgery for Crohn's Disease From the Perspective of Intra-Abdominal Septic Complications

    PubMed Central

    Zhang, Min; Gao, Xiang; Chen, Yuanhan; Zhi, Min; Chen, Huangwei; Tang, Jian; Su, Minli; Yao, Jiayin; Yang, Qingfan; Chen, Junrong; Hu, Pinjin; Liu, Huanliang

    2015-01-01

    Abstract Poor preoperative nutritional status for individuals with Crohn's disease (CD) is associated with intra-abdominal septic complications (IASCs). The present study aimed to investigate the association of the common nutrition indices serum albumin and body mass index (BMI) with IASCs. Sixty-four CD patients who had received elective intestinal operations were retrospectively investigated. Among these patients, 32 had received individualized fortified nutrition support. IASCs occurred in 7 patients (10.9%). Compared with non-IASC patients, IASC patients had a lower BMI (17.6 ± 2.7 vs 15.6 ± 1.3 kg/m2, P = 0.048). The area under the receiver operating characteristic curve according to the BMI-based IASC prediction was 0.772 (95% confidence interval [CI], 0.601–0.944; P = 0.020) with an optimum diagnostic cutoff value of 16.2 kg/m2. A BMI < 16.2 kg/m2 significantly increased the risk of developing an IASC (odds ratio [OR], 10.286; 95% CI, 1.158–91.386). Even after correction with the simplified CD activity index (CDAI), a low BMI level remained associated with IASCs (OR, 7.650; 95% CI, 0.808–72.427; P = 0.076). Serum albumin was not associated with IASCs. Although the fortified nutrition support group had an albumin level comparable to the control group, this group had a higher simplified CDAI score, a lower BMI level, and a comparable incidence rate of IASCs. Thus, BMI more accurately reflects the basic preoperative nutritional status of CD patients than serum albumin. BMI can aid in guiding preoperative nutrition support and judging the appropriate operation time for CD. PMID:26334908

  11. Clinical response and mortality in tigecycline complicated intra-abdominal infection and complicated skin and soft-tissue infection trials.

    PubMed

    Bassetti, Matteo; McGovern, Paul C; Wenisch, Christoph; Meyer, R Daniel; Yan, Jean Li; Wible, Michele; Rottinghaus, Scott T; Quintana, Alvaro

    2015-09-01

    An imbalance in all-cause mortality was noted in tigecycline phase 3 and 4 comparative clinical trials across all studied indications. We investigated clinical failure and mortality in phase 3 and 4 complicated skin and soft-tissue infection (cSSTI) and complicated intra-abdominal infection (cIAI) tigecycline trials using descriptive analyses of a blinded adjudication of mortality and multivariate regression analyses. Attributable mortality analyses of cSSTI revealed death due to infection in 0.1% of each treatment group (P=1.000). In cIAI, there were no significant differences between tigecycline (1.2%) and comparator (0.7%) subjects who died due to infection (P=0.243). For cIAI clinical failure, treatment interaction with organ dysfunction was observed with no difference observed between clinical cure for tigecycline (85.4%) and comparator (76.7%) treatment groups (odds ratio=0.58, 95% confidence interval 0.28-1.19). Tigecycline-treated subjects had more adverse events of secondary pneumonias (2.1% vs. 1.2%) and more adverse events of secondary pneumonias with an outcome of death (0.5% vs. 0.1%). These analyses do not suggest that tigecycline is a factor either for failure (cSSTI and cIAI studies) or for death (cIAI studies). PMID:26155003

  12. Primary sarcomatoid carcinoma of the jejunum with massive intra-abdominal hemorrhage: A case report and review of the literature

    PubMed Central

    ZHANG, BIN; CHENG, BO; WANG, LINXIONG; ZHAO, KE; ZHUO, GUANG-ZUAN; DING, JIAN-HUA

    2016-01-01

    Primary sarcomatoid carcinoma of the jejunum is an extremely rare condition, with only 16 cases reported in the literature to date. We herein report an additional case of a giant sarcomatoid carcinoma of the jejunum in a 62-year-old male patient, presenting as massive intra-abdominal hemorrhage. During emergency laparotomy, ~5 litres of bloody ascites was found in the peritoneal cavity and the tumor was located in the proximal jejunum. The tumor involved the entire wall of the jejunum and had directly invaded the neighboring parietal peritoneum, omentum, transverse colon and mesentery, with metastatic lymph nodes. The patient underwent palliative resection of the tumor; however, the course was rapidly progressive and he succumbed to progression of abdominal and liver metastases 4 weeks after surgery. The tumor was found to be positive for epithelial and mesenchymal markers on immunohistochemical analysis. This case emphasizes the aggressive clinical course and metastatic nature of this malignant tumor, with a supplementary review of the previously published literature. PMID:27123285

  13. [A Case in Which a Patient Was Operated for Intra-Abdominal Desmoid Tumors after Total Colectomy in FAP].

    PubMed

    Hoshi, Minako; Ikeda, Kimimasa; Higashiguchi, Kimiya; Kobayashi, Teruyuki; Sakai, Kenji; Koyama, Taichi; Doi, Takasi; Taniguchi, Hirokazu; Murakami, Masakazu; Kurokawa, Eiji; Nakamichi, Itsuko

    2015-11-01

    The patient was a 22-year-old woman with FAP, who had undergone laparoscopic total colectomy 3 years previously. She presented to our hospital with a high fever and abdominal pain. Large hard tumors were palpated in the right lower abdomen and pelvis. Blood examination showed an inflammatory response. CT scan revealed 17 cm diameter solid tumors. At surgery, 2 tumors arising from the mesentery of the small intestine were found, neither of which invaded any organs. We performed tumor extirpation with partial resection of the duodenum, ileum, right fallopian tube and rectum. A jejunal stoma was formed, leaving a length of remnant intestine of about 120 cm. The histopathological diagnosis was given as desmoid tumor with infection. The patient was discharged from the hospital on the 9th postoperative day. Desmoid tumor is the second most common cause of death in FAP patients. Although desmoids can also occur in the extremities, most FAP patients develop intra-abdominal tumors. Despite being histologically benign, they are locally infiltrative and can cause death through invasion and destruction of adjacent vital structures and organs. Here, we report a case of desmoid tumors with FAP with reference to the literature. PMID:26805225

  14. Clinical characteristics and antimicrobial patterns in complicated intra-abdominal infections: a 6-year epidemiological study in southern China.

    PubMed

    Ouyang, Wenwei; Xue, Huiling; Chen, Yunqin; Gao, Weiguo; Li, Xiaoyan; Wei, Jia; Wen, Zehuai

    2016-03-01

    Complicated intra-abdominal infection (cIAIs) are a common and important cause of morbidity worldwide. In this study, the clinical features, microbiological profiles, antimicrobial patterns and treatments of 3233 cIAI patients (mean age, 47.6 years; 54.7% male) with 3531 hospitalisations from 2008-2013 were retrospectively investigated. The most commonly isolated bacteria were Escherichia coli (47.6%), Klebsiella pneumoniae (16.9%), Enterococcus faecalis (10.4%) and Pseudomonas aeruginosa (8.8%). Ciprofloxacin, aminoglycoside (gentamicin), piperacillin/tazobactam and carbapenems exhibited activity against 53%, 76%, 88% and 100% of extended-spectrum β-lactamase (ESBL)-positive Enterobacteriaceae isolates, respectively. Pseudomonas aeruginosa isolates exhibited 100%, 95%, 88%, 71% and 76% susceptibility to aminoglycoside (gentamicin), ciprofloxacin, meropenem, imipenem and ceftazidime, respectively, and Enterococcus remained 100% susceptible to vancomycin and linezolid. β-Lactam antibacterials other than penicillin (specifically third-generation cephalosporins) and imidazole derivatives (ornidazole and metronidazole) were the most common first-line treatments. Patients subjected to regimen change after initial antibiotic treatment had predisposing conditions (e.g. older age, more severe co-morbidities) and a higher incidence of P. aeruginosa infection; in addition, these patients encountered a higher average cost of care and worse clinical outcomes compared with those without medication modification. Taken together, these findings indicate the importance of appropriate initial empirical therapy and suggest the use of combination therapy comprising cephalosporins and metronidazole. PMID:26899413

  15. Does Severity of Pelvic Fractures Correlate with the Incidence of Associated Intra-Abdominal Injuries in Children?

    PubMed

    Swaid, Forat; Peleg, Kobi; Alfici, Ricardo; Olsha, Oded; Givon, Adi; Kessel, Boris

    2016-06-01

    Background Pelvic fractures are considered a marker of injury severity, especially in the pediatric population. However, the correlation between the severity of pelvic fractures and incidence of associated abdominal injuries is not clear. Methods A retrospective cohort study involving blunt trauma patients up to the age of 14 years, who suffered from pelvic fractures, with or without associated intra-abdominal injuries. Results A total of 812 trauma patients were included in this study. Overall, 671 of them suffered from pelvic fractures with abbreviated injury scale (AIS) of 2, 103 with AIS of 3, and 38 with AIS of 4 to 5. Overall mortality was found to be 5.2%, strongly correlating with the severity of the pelvic fractures (p value < 0.0001). There was no correlation between the incidence of most extrapelvic abdominal organ injuries (liver, spleen, small bowel, and pancreas) and the severity of pelvic fractures. A significant correlation was found with intrapelvic organ injuries (p value < 0.0001) and kidney injuries (p = 0.03). Conclusions Mortality of pediatric trauma patients with pelvic fractures is correlated with the severity of the fractures. An increase in the severity of pelvic fractures in this population is associated with an increased incidence of pelvic organ injury, but is not associated with the presence of extrapelvic abdominal injuries, except for kidney injuries. PMID:25988750

  16. Doripenem in hospital infections: a focus on nosocomial pneumonia, complicated intra-abdominal infections, and complicated urinary tract infections.

    PubMed

    Lo, Tze Shien; Borchardt, Stephanie M; Welch, Justin M; Rohrich, Melissa A; Alonto, Augusto M; Alonto, Anne V

    2009-01-01

    Doripenem is the latest carbapenem on the market to date. Although not an antibiotic in a new class, it offers a glimmer of hope in combating serious infections secondary to multidrug-resistant Gram-negative bacteria when we have not seen a new class of antibacterial, particularly for Gram-negative bacteria, for more than 10 years. In vitro, doripenem exhibits a broad spectrum of activity against Gram-positive and Gram-negative bacteria, including extended-spectrum β-lactamase (ESBL) and Amp-C β-lactamase producing Enterobacteriaceae and anaerobes. Doripenem also exhibits better in vitro activity against Pseudomonas aeruginosa compared to other anti-pseudomonal carbapenems. It combines the desirable activities of both imipenem and meropenem. It has similar activity to imipenem against Gram-positive pathogens and has the antimicrobial spectrum of meropenem against Gram-negative organisms. Several randomized clinical trials have demonstrated that doripenem is non-inferior to meropenem, imipenem, piperacillin/tazobactam, or levofloxacin in its efficacy and safety profile in treating a wide range of serious bacterial infections including intra-abdominal infection, complicated urinary tract infection, and nosocomial pneumonia. Due to its wide spectrum of activity and good safety profile it is susceptible to misuse leading to increasing rates of resistance. Judicious use should be considered when using doripenem as a first-line agent or drug of choice for serious infections. Doripenem is a well-tolerated drug with common adverse effects including headache, nausea and diarrhea. Caution should be used in patients with hypersensitivity to carbapenems and adverse reactions to β-lactam agents. Dosage adjustment is needed for patients with renal impairment. Doripenem has demonstrated economic and clinical benefits. It has been shown to reduce hospital length of stay and duration of mechanical ventilation for intensive care unit (ICU) patients. Therefore, doripenem is a

  17. Not All Abdomens Are the Same: A Comparison of Damage Control Surgery for Intra-abdominal Sepsis versus Trauma.

    PubMed

    Smith, Jason W; Nash, Nick; Procter, Levi; Benns, Matthew; Franklin, Glen A; Miller, Keith; Harbrecht, Brian G; Bernard, Andrew C

    2016-05-01

    Damage control surgery (DCS) was developed to manage exsanguinating trauma patients, but is increasingly applied to the management of peritoneal sepsis and abdominal catastrophes. Few manuscripts compare the outcomes of these surgeries on disparate patient populations. A multi-institutional three group propensity score matched case cohort study comparing penetrating trauma (PT-DCS), blunt trauma (BT-DCS), and intraperitoneal sepsis (IPS-DCS) was performed comparing patients treated with DSC between 2008 and 2013. Propensity scoring was performed using demographic and presenting physiologic data. Four hundred and twelve patients were treated with DCS across two institutions. Propensity matching for age, gender, and initial Acute Physiology and Chronic Health Evaluation II score 80 identified 80 patients per group for comparison. Rate of primary fascial closure was lowest in the IPS-DCS group, and highest in the penetrating trauma DCS group. Intra-abdominal complication rates were highest in the IPS-DCS group. IPS-DCS had increased time to definitive closure compared with the other two groups (RR 1.8; 1.3-2.2; P < 0.03). Mortality at 90 days was highest in the IPS-DCS group and patients whose definitive closure was delayed >eight days were more than twice the risk of death at 90 days across all groups. (RR 2.15; 1.2-3.5; P < 0.002). Expected outcomes after the use of DCS for trauma and emergency general surgery are quite different. Despite this difference, prompt abdominal closure at the earliest possible opportunity afforded the best outcome in patients managed via DCS. PMID:27215724

  18. Complicated intra-abdominal infections in Europe: preliminary data from the first three months of the CIAO Study

    PubMed Central

    2012-01-01

    The CIAO Study is a multicenter observational study currently underway in 66 European medical institutions over the course of a six-month study period (January-June 2012). This preliminary report overviews the findings of the first half of the study, which includes all data from the first three months of the six-month study period. Patients with either community-acquired or healthcare-associated complicated intra-abdominal infections (IAIs) were included in the study. 912 patients with a mean age of 54.4 years (range 4–98) were enrolled in the study during the first three-month period. 47.7% of the patients were women and 52.3% were men. Among these patients, 83.3% were affected by community-acquired IAIs while the remaining 16.7% presented with healthcare-associated infections. Intraperitoneal specimens were collected from 64.2% of the enrolled patients, and from these samples, 825 microorganisms were collectively identified. The overall mortality rate was 6.4% (58/912). According to univariate statistical analysis of the data, critical clinical condition of the patient upon hospital admission (defined by severe sepsis and septic shock) as well as healthcare-associated infections, non-appendicular origin, generalized peritonitis, and serious comorbidities such as malignancy and severe cardiovascular disease were all significant risk factors for patient mortality. White Blood Cell counts (WBCs) greater than 12,000 or less than 4,000 and core body temperatures exceeding 38°C or less than 36°C by the third post-operative day were statistically significant indicators of patient mortality. PMID:22613202

  19. High pressure liquid level monitor

    DOEpatents

    Bean, Vern E.; Long, Frederick G.

    1984-01-01

    A liquid level monitor for tracking the level of a coal slurry in a high-pressure vessel including a toroidal-shaped float with magnetically permeable bands thereon disposed within the vessel, two pairs of magnetic field generators and detectors disposed outside the vessel adjacent the top and bottom thereof and magnetically coupled to the magnetically permeable bands on the float, and signal processing circuitry for combining signals from the top and bottom detectors for generating a monotonically increasing analog control signal which is a function of liquid level. The control signal may be utilized to operate high-pressure control valves associated with processes in which the high-pressure vessel is used.

  20. Level indicator for pressure vessels

    DOEpatents

    Not Available

    1982-04-28

    A liquid-level monitor for tracking the level of a coal slurry in a high-pressure vessel including a toroidal-shaped float with magnetically permeable bands thereon disposed within the vessel, two pairs of magnetic-field generators and detectors disposed outside the vessel adjacent the top and bottom thereof and magnetically coupled to the magnetically permeable bands on the float, and signal-processing circuitry for combining signals from the top and bottom detectors for generating a monotonically increasing analog control signal which is a function of liquid level. The control signal may be utilized to operate high-pressure control valves associated with processes in which the high-pressure vessel is used.

  1. Differential effects of aging and exercise on intra-abdominal adipose arteriolar function and blood flow regulation

    PubMed Central

    Davis, Robert T.; Stabley, John N.; Dominguez, James M.; Ramsey, Michael W.; McCullough, Danielle J.; Lesniewski, Lisa A.; Delp, Michael D.

    2013-01-01

    Adipose tissue (AT), which typically comprises an increased percentage of body mass with advancing age, receives a large proportion of resting cardiac output. During exercise, an old age-associated inability to increase vascular resistance within the intra-abdominal AT may compromise the ability of the cardiovascular system to redistribute blood flow to the active musculature, contributing to the decline in exercise capacity observed in this population. We tested the hypotheses that 1) there would be an elevated perfusion of AT during exercise with old age that was associated with diminished vasoconstrictor responses of adipose-resistance arteries, and 2) chronic exercise training would mitigate the age-associated alterations in AT blood flow and vascular function. Young (6 mo; n = 40) and old (24 mo; n = 28) male Fischer 344 rats were divided into young sedentary (YSed), old sedentary (OSed), young exercise trained (YET), or old exercise trained (OET) groups, where training consisted of 10-12 wk of treadmill exercise. In vivo blood flow at rest and during exercise and in vitro α-adrenergic and myogenic vasoconstrictor responses in resistance arteries from AT were measured in all groups. In response to exercise, there was a directionally opposite change in AT blood flow in the OSed group (∼150% increase) and YSed (∼55% decrease) vs. resting values. Both α-adrenergic and myogenic vasoconstriction were diminished in OSed vs. YSed AT-resistance arteries. Exercise training resulted in a similar AT hyperemic response between age groups during exercise (YET, 9.9 ± 0.5 ml·min−1·100−1 g; OET, 8.1 ± 0.9 ml·min−1·100−1 g) and was associated with enhanced myogenic and α-adrenergic vasoconstriction of AT-resistance arteries from the OET group relative to OSed. These results indicate that there is an inability to increase vascular resistance in AT during exercise with old age, due, in part, to a diminished vasoconstriction of AT arteries. Furthermore, the

  2. Bedside ultrasonography in the pediatric emergency department: the focused assessment with sonography in trauma examination uncovers an occult intra-abdominal tumor.

    PubMed

    Gallagher, Rachel; Vieira, Rebecca; Levy, Jason

    2012-10-01

    We present a case of a 3-year-old male with history of minor trauma, who was brought in by ambulance from the playground where he had an acute mental status change and was noted to be hypotensive on initial evaluation. History and examination did not indicate a clear etiology of his symptoms. Point-of-care emergency ultrasonography revealed free fluid in the abdomen and expedited the care of the child's unexpected intra-abdominal hemorrhage from an occult abdominal tumor. This case demonstrates the ability of practitioners to expedite and focus care with the use of rapid assessment with ultrasonography in the pediatric emergency department. PMID:23034502

  3. Effect of carbodiimide-derivatized hyaluronic acid gelatin on preventing postsurgical intra-abdominal adhesion formation and promoting healing in a rat model.

    PubMed

    Yuan, Fang; Lin, Long-Xiang; Zhang, Hui-Hui; Huang, Dan; Sun, Yu-Long

    2016-05-01

    Adhesions often occur after abdominal surgery. It could cause chronic pelvic pain, intestinal obstruction, and infertility. A hydrogel biomaterial, carbodiimide-derivatized hyaluronic acid gelatin (cd-HA gelatin), has been successfully used to reduce adhesion formation after flexor tendon grafting. This study investigated the efficacy of cd-HA gelatin in preventing postsurgical peritoneal adhesions in a rat model. The surgical traumas were created on the underlying muscle of the abdominal wall and the serosal layer of the cecum. The wounds were covered with or without cd-HA gelatin. Animals were euthanized at day 14 after surgery. Adhesion formation was assessed with adhesion degree and adhesion breaking strength. The healing of abdominal wall was evaluated with biomechanical testing and histological analysis. The adhesions occurred in all rats (n = 12) without cd-HA gelatin treatment. The application of cd-HA gelatin significantly reduced the adhesion rate from 100% to 58%. The decrease of adhesion breaking strength also manifested that cd-HA gelatin could reduce postsurgical intra-abdominal adhesion formation. Moreover, it was found that cd-HA gelatin was a safe material and could promote tissue healing. The cd-HA gelatin hydrogel could reduce the formation of intra-abdominal adhesions without adversely effects on wound healing. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 1175-1181, 2016. PMID:26749008

  4. Giant intra-abdominal mature cystic teratoma (dermoid cyst) in an adult man, with male genitourinary tissue including prostatic and penile elements.

    PubMed

    Thway, Khin; Berney, Dan; Hayes, Andrew J; Fisher, Cyril

    2016-08-01

    We describe a case of a giant intra-abdominal mature cystic teratoma in a 36-year-old man, which comprised typical features of differentiated teratoma/dermoid cyst but which contained a macroscopic rudimentary penis, with vasoformative erectile tissue-like structures consistent with corpora cavernosa, as well as scrotal-type skin and prostatic tissue. The genitourinary structures were well formed both grossly and microscopically and sharply demarcated from the rest of the neoplasm, which comprised typical differentiated teratoma, without any other macroscopic foci of organoid differentiation or of other histologic differentiation. The plasticity of the cells of differentiated teratoma, which enables it to undergo multidirectional differentiation, is well recognized, but the factors determining this distinct path of differentiation remain to be established. PMID:27038684

  5. Assessment of the attenuation of an intra-abdominal vein by use of a silicone-polyacrylic acid gradual venous occlusion device in dogs and cats.

    PubMed

    Wallace, Mandy L; Ellison, Gary W; Giglio, Robson F; Batich, Christopher D; Berry, Clifford R; Case, J Brad; Kim, Stanley E

    2016-06-01

    OBJECTIVE To evaluate the closure rate and completeness of closure for a silicone-polyacrylic acid gradual venous occlusion device placed around an intra-abdominal vein to simulate gradual occlusion of an extrahepatic portosystemic shunt. ANIMALS 3 purpose-bred cats and 2 purpose-bred dogs. PROCEDURES The device was surgically placed around an external (cats) or internal (dogs) iliac vein. Computed tomographic angiography was performed at the time of surgery and 2, 4, and 6 weeks after surgery. Ultrasonographic examinations of blood flow through the vein within the device were performed at the time of surgery and at weekly intervals thereafter. Dogs were euthanized 6 weeks after surgery, and the external iliac veins were harvested for histologic examination. RESULTS The prototype gradual venous occlusion device was successfully placed in all animals, and all animals recovered without complications following the placement procedure. The vessel was completely occluded in 2 cats by 6 weeks after surgery, as determined on the basis of results of CT and ultrasonography; there was incomplete occlusion with a luminal diameter of 1.5 mm in the other cat by 6 weeks after surgery. The vessel was completely occluded in both dogs by 6 weeks after surgery. Histologic examination of the external iliac veins obtained from the dogs revealed minimal inflammation of the vessel wall and no thrombus formation. CONCLUSIONS AND CLINICAL RELEVANCE The prototype device induced gradual attenuation of an intra-abdominal vessel over a 6-week period. This device may provide another option for gradual occlusion of extrahepatic portosystemic shunts. PMID:27227505

  6. Ceftazidime/avibactam: a novel cephalosporin/nonbeta-lactam beta-lactamase inhibitor for the treatment of complicated urinary tract infections and complicated intra-abdominal infections.

    PubMed

    Hidalgo, Jose A; Vinluan, Celeste M; Antony, Nishaal

    2016-01-01

    There has been greater interest in developing additional antimicrobial agents due to the increasing health care costs and resistance resulting from bacterial pathogens to currently available treatment options. Gram-negative organisms including Enterobacteriaceae and Pseudomonas aeruginosa are some of the most concerning threats due to their resistance mechanisms: extended-spectrum beta-lactamase production and Klebsiella pneumoniae carbapenemase enzymes. Ceftazidime is a third-generation broad-spectrum cephalosporin with activity against P. aeruginosa and avibactam is a novel nonbeta-lactam beta-lactamase inhibitor. Avycaz(®), the trade name for this new combination antibiotic, restores the activity of ceftazidime against some of the previously resistant pathogens. Avycaz was approved in 2015 for the treatment of complicated urinary tract infections, including pyelonephritis, and complicated intra-abdominal infections with the addition of metronidazole in patients with little to no other treatment options. This review article assesses the clinical trials and data that led to the approval of this antibiotic, in addition to its spectrum of activity and limitations. PMID:27528799

  7. Anaphylaxis, Intra-Abdominal Infections, Skin Lacerations, and Behavioral Emergencies: A Literature Review of Austere Analogs for a near Earth Asteroid Mission

    NASA Technical Reports Server (NTRS)

    Chough, Natacha G.; Watkins, Sharmi; Menon, Anil S.

    2012-01-01

    As space exploration is directed towards destinations beyond low-Earth orbit, the consequent new set of medical risks will drive requirements for new capabilities and more resources to ensure crew health. The Space Medicine Exploration Medical Conditions List (SMEMCL), developed by the Exploration Medical Capability element of the Human Research Program, addresses the risk of "unacceptable health and mission outcomes due to limitations of in-flight medical capabilities". It itemizes 85 evidence-based clinical requirements for eight different mission profiles and identifies conditions warranting further research and technology development. Each condition is given a clinical priority for each mission profile. Four conditions -- intra-abdominal infections, skin lacerations, anaphylaxis, and behavioral emergencies -- were selected as a starting point for analysis. A systematic literature review was performed to understand how these conditions are treated in austere, limited-resource, space-analog environments (i.e., high-altitude and mountain environments, submarines, military deployments, Antarctica, isolated wilderness environments, in-flight environments, and remote, resource-poor, rural environments). These environments serve as analogs to spaceflight because of their shared characteristics (limited medical resources, delay in communication, confined living quarters, difficulty with resupply, variable time to evacuation). Treatment of these four medical conditions in austere environments provides insight into medical equipment and training requirements for exploration-class missions.

  8. Removal of an intra-abdominal desmoplastic small round cell tumor by repetitive debulking surgery: A case report and literature review

    PubMed Central

    SHIMAZAKI, JIRO; MOTOHASHI, GYO; NISHIDA, KIYOTAKA; TABUCHI, TAKANOBU; UBUKATA, HIDEYUKI; TABUCHI, TAKAFUMI

    2014-01-01

    In the current study, a case of recurrent desmoplastic small round cell tumor (DSRCT) is presented, which was successfully treated by repetitive debulking surgery. In May 2010, a 39-year-old male, with a history of surgical resection of intra-abdominal DSRCT, visited the Ibaraki Medical Center, Tokyo Medical University Hospital (Ami, Japan) with severe lower abdominal discomfort. Abdominal computed tomography revealed a large tumor in the pouch of Douglas with a small number of nodules in the abdominal cavity. The recurrent DSRCT was diagnosed and removed via lower anterior resection; however, complete resection was impossible due to multiple peritoneal metastases. One year later, the patient developed pain in the right groin due to the growth of metastasized tumor cells in the groin lymph nodes. The affected lymph nodes were removed utilizing an extra-peritoneal approach. At the time of writing, the patient continues to survive without any symptoms 60 months since the initial surgery. In conclusion, surgical debulking is a significant procedure for relieving patient symptoms as well as improving the survival time of patients with metastatic and recurrent DSRCT. PMID:24765157

  9. Ceftazidime/avibactam: a novel cephalosporin/nonbeta-lactam beta-lactamase inhibitor for the treatment of complicated urinary tract infections and complicated intra-abdominal infections

    PubMed Central

    Hidalgo, Jose A; Vinluan, Celeste M; Antony, Nishaal

    2016-01-01

    There has been greater interest in developing additional antimicrobial agents due to the increasing health care costs and resistance resulting from bacterial pathogens to currently available treatment options. Gram-negative organisms including Enterobacteriaceae and Pseudomonas aeruginosa are some of the most concerning threats due to their resistance mechanisms: extended-spectrum beta-lactamase production and Klebsiella pneumoniae carbapenemase enzymes. Ceftazidime is a third-generation broad-spectrum cephalosporin with activity against P. aeruginosa and avibactam is a novel nonbeta-lactam beta-lactamase inhibitor. Avycaz®, the trade name for this new combination antibiotic, restores the activity of ceftazidime against some of the previously resistant pathogens. Avycaz was approved in 2015 for the treatment of complicated urinary tract infections, including pyelonephritis, and complicated intra-abdominal infections with the addition of metronidazole in patients with little to no other treatment options. This review article assesses the clinical trials and data that led to the approval of this antibiotic, in addition to its spectrum of activity and limitations. PMID:27528799

  10. Significant partial response of metastatic intra-abdominal and pelvic round cell liposarcoma to a small-molecule VEGFR-2 tyrosine kinase inhibitor apatinib

    PubMed Central

    Dong, Min; Bi, Jingwang; Liu, Xiaohong; Wang, Baocheng; Wang, Jun

    2016-01-01

    Abstract Introduction: Myxoid/round cell liposarcoma is the second most common subtype of liposarcoma. Chemotherapy and radiotherapy have a limited efficacy for treating advanced myxoid/round cell liposarcoma, with relatively serious side effects. Case presentation: We herein present a 68-year-old Chinese woman initially diagnosed with advanced multiple intra-abdominal and pelvic round cell liposarcoma. She refused to receive cytotoxic chemotherapy and received apatinib as the first-line therapy, a novel tyrosine kinase inhibitor of vascular endothelial growth factor receptor-2 that has been used in the treatment of patients with metastatic gastric cancer who progressed with 2 or more chemotherapy regimens. This patient was partially responsive to apatinib with a dose of 500 mg daily. No serious drug-related side effects were observed. Conclusion: Our findings indicate that some cases of liposarcoma may be responsive to antiangiogenic agent apatinib. Randomized clinical studies are needed to further confirm the efficacy and safety of apatinib in the clinical treatment of liposarcoma. PMID:27495042

  11. Evaluation of the effects of ozone therapy in the treatment of intra-abdominal infection in rats

    PubMed Central

    de Souza, Yglesio Moyses; Fontes, Belchor; Martins, Joilson O; Sannomiya, Paulina; Brito, Glacus S.; Younes, Riad N.; Rasslan, Samir

    2010-01-01

    INTRODUCTION The antibacterial effect of ozone (O3) has been described in the extant literature, but the role of O3 therapy in the treatment of certain types of infection remains controversial. OBJECTIVES To evaluate the effect of intraperitoneal (i.p.) O3 application in a cecal ligation/puncture rat model on interleukins (IL-6, IL-10) and cytokine-induced neutrophil chemoattractant (CINC)-1 serum levels, acute lung injury and survival rates. METHODS Four animal groups were used for the study: a) the SHAM group underwent laparotomy; b) the cecal ligation/puncture group underwent cecal ligation/puncture procedures; and c) the CLP+O2 and CLP+O3 groups underwent CLP+ corresponding gas mixture infusions (i.p.) throughout the observation period. IL-6, CINC-1 and IL-10 concentrations were determined by enzyme-linked immunosorbent assay (ELISA). Acute lung injury was evaluated with the Evans blue dye lung leakage method and by lung histology. P<0.05 was considered significant. RESULTS CINC-1 was at the lowest level in the SHAM group and was lower for the CLP+O3 group vs. the CLP+O2 group and the cecal ligation/puncture group. IL-10 was lower for the SHAM group vs. the other three groups, which were similar compared to each other. IL-6 was lower for the SHAM group vs. all other groups, was lower for the CLP+O3 or CLP+O2 group vs. the cecal ligation/puncture group, and was similar for the CLP+O3 group vs. the CLP+O2 group. The lung histology score was lower for the SHAM group vs. the other groups. The Evans blue dye result was lower for the CLP+O3 group vs. the CLP+O2 group and the cecal ligation/puncture group but similar to that of the SHAM group. The survival rate for the CLP+O3 group was lower than for the SHAM group and similar to that for the other 2 groups (CLP and CLP+O2). CONCLUSION Ozone therapy modulated the inflammatory response and acute lung injury in the cecal ligation/puncture infection model in rats, although there was no improvement on survival rates. PMID

  12. Antimicrobial Susceptibilities of Aerobic and Facultative Gram-Negative Bacilli from Intra-abdominal Infections in Patients from Seven Regions in China in 2012 and 2013

    PubMed Central

    Zhang, Hui; Yang, Qiwen; Liao, Kang; Ni, Yuxing; Yu, Yunsong; Hu, Bijie; Sun, Ziyong; Huang, Wenxiang; Wang, Yong; Wu, Anhua; Feng, Xianju; Luo, Yanping; Hu, Zhidong; Chu, Yunzhuo; Chen, Shulan; Cao, Bin; Su, Jianrong; Gui, Bingdong; Duan, Qiong; Zhang, Shufang; Shao, Haifeng; Kong, Haishen; Badal, Robert E.

    2015-01-01

    To evaluate the antimicrobial susceptibility of Gram-negative bacilli that caused hospital-acquired and community-acquired intra-abdominal infections (IAIs) in China between 2012 and 2013, we determined the susceptibilities to 12 antimicrobials and the extended-spectrum β-lactamase (ESBL) statuses of 3,540 IAI isolates from seven geographic areas in China in a central laboratory using CLSI broth microdilution and interpretive standards. Most infections were caused by Escherichia coli (46.3%) and Klebsiella pneumoniae (19.7%). Rates of ESBL-producing E. coli (P = 0.031), K. pneumoniae (P = 0.017), and Proteus mirabilis (P = 0.004) were higher in hospital-acquired IAIs than in community-acquired IAIs. Susceptibilities of enterobacteriaceae to ertapenem, amikacin, piperacillin-tazobactam, and imipenem were 71.3% to 100%, 81.3% to 100%, 64.7% to 100%, and 83.1% to 100%, respectively, but imipenem was ineffective against P. mirabilis (<20%). Although most ESBL-positive hospital-acquired isolates were resistant to third- and fourth-generation cephalosporins, the majority were susceptible to cefoxitin (47.9% to 83.9%). Susceptibilities of ESBL-positive isolates to ampicillin-sulbactam (<10%) were low, whereas susceptibilities to ciprofloxacin (0% to 54.6%) and levofloxacin (0% to 63.6%) varied substantially. The prevalences of cephalosporin-susceptible E. coli and K. pneumoniae were higher in the northeastern and southern regions than in the central and eastern regions, reflecting the ESBL-positive rates in these areas, and were lowest in the Jiangsu-Zhejiang (Jiang-Zhe) area where the rates of carbapenem resistance were also highest. Ertapenem, amikacin, piperacillin-tazobactam, and imipenem are the most efficacious antibiotics for treating IAIs in China, especially those caused by E. coli or K. pneumoniae. Resistance to cephalosporins and carbapenems is more common in the Jiang-Zhe area than in other regions in China. PMID:26482308

  13. Management of Intra-abdominal Abscesses in Children With Crohn’s Disease: A 12-year, Retrospective Single-center Review

    PubMed Central

    Dotson, Jennifer L.; Bashaw, Hillary; Nwomeh, Benedict; Crandall, Wallace V.

    2015-01-01

    Background Intra-abdominal abscesses (IAA) are complications of Crohn’s disease, which often result in hospitalization, surgery, and increased cost. Initial management may include medical therapy, percutaneous drainage (PD), or surgery, although the optimal management of IAA in children is unclear. Methods Retrospective review of all pediatric patients with Crohn’s disease who developed an IAA from January 1, 2000 to April 30, 2012. Three groups, based on initial IAA treatment modality (medical, PD, and surgery), were compared. Results Thirty cases of IAA were identified (mean age at IAA diagnosis, 15.4 ± 2.6 yr, 67% female, median Crohn’s disease duration, 2.6 mo). Computed tomography was the most common initial (93%) and follow-up (47%) imaging. The average time to follow-up imaging was 8.5 days. For initial management, 18 received medical therapy, 10 PD, and 2 had surgery. The medical therapy group received more computed tomography scans for follow-up imaging than the PD group (12 [67%] versus 2 [20%], P = 0.046). There were no significant differences in abscess characteristics or management of posttreatment course between these 2 groups. Surgical resection occurred in 3 patients (17%) in the medical group and 2 (20%) in the PD group during index hospitalization. No significant differences were identified among treatment groups for readmissions, complications, or abscess recurrence. By 1 year, 12 of the 18 medically managed patients (67%) had surgery, and 6 of the 10 patients (60%) treated with initial PD ultimately had surgery. Conclusions The majority of patients with IAA require definitive surgical treatment, and there were no clear predictors of those who did not. PMID:25803503

  14. The Great Roundleaf Bat (Hipposideros armiger) as a Good Model for Cold-Induced Browning of Intra-Abdominal White Adipose Tissue

    PubMed Central

    Ke, Shanshan; Fang, Na; Irwin, David M.; Lei, Ming; Zhang, Junpeng; Shi, Huizhen; Zhang, Shuyi; Wang, Zhe

    2014-01-01

    Background Inducing beige fat from white adipose tissue (WAT) is considered to be a shortcut to weight loss and increasingly becoming a key area in research into treatments for obesity and related diseases. However, currently, animal models of beige fat are restricted to rodents, where subcutaneous adipose tissue (sWAT, benign WAT) is more liable to develop into the beige fat under specific activators than the intra-abdominal adipose tissue (aWAT, malignant WAT) that is the major source of obesity related diseases in humans. Methods Here we induced beige fat by cold exposure in two species of bats, the great roundleaf bat (Hipposideros armiger) and the rickett's big-footed bat (Myotis ricketti), and compared the molecular and morphological changes with those seen in the mouse. Expression of thermogenic genes (Ucp1 and Pgc1a) was measured by RT-qPCR and adipocyte morphology examined by HE staining at three adipose locations, sWAT, aWAT and iBAT (interscapular brown adipose tissue). Results Expression of Ucp1 and Pgc1a was significantly upregulated, by 729 and 23 fold, respectively, in aWAT of the great roundleaf bat after exposure to 10°C for 7 days. Adipocyte diameters of WATs became significantly reduced and the white adipocytes became brown-like in morphology. In mice, similar changes were found in the sWAT, but much lower amounts of changes in aWAT were seen. Interestingly, the rickett's big-footed bat did not show such a tendency in beige fat. Conclusions The great roundleaf bat is potentially a good animal model for human aWAT browning research. Combined with rodent models, this model should be helpful for finding therapies for reducing harmful aWAT in humans. PMID:25393240

  15. Effect of Gender on the Total Abdominal Fat, Intra-Abdominal Adipose Tissue and Abdominal Sub-Cutaneous Adipose Tissue among Indian Hypertensive Patients

    PubMed Central

    Kumari, Savita; Jain, Sanjay

    2016-01-01

    Introduction Abdominal obesity is a better marker of adverse metabolic profile than generalized obesity in hypertensive subjects. Further, gender has effect on adiposity and its distribution. Aim Effect of gender on obesity and the distribution of fat in different sub-compartments of abdomen among Indian hypertensive subjects. Materials and Methods This observational study included 278 adult subjects (Males-149 & Females-129) with essential hypertension from a tertiary care centre in north India over one year. A detailed history taking and physical examination including anthropometry were performed in all patients. Total Abdominal Fat (TAF) and abdominal adipose tissue sub-compartments like Intra-Abdominal Adipose Tissue (IAAT) and Sub-Cutaneous Adipose Tissue (SCAT) were measured using the predictive equations developed for Asian Indians. Results Female hypertensive subjects had higher Body Mass Index (BMI) with more overweight (BMI ≥ 23kg/m2), and obesity (BMI≥ 25 kg/m2). Additionally, they had higher prevalence of central obesity based on both Waist Circumference (WC) criteria (WC≥ 90 cm in males and WC≥ 80 cm in females) and TAF criteria {≥245.6 cm2 (males) and ≥203.46 cm2 (females)} than male patients. But there was no difference in the prevalence of central obesity based on Waist Hip Ratio (WHR) criteria (WHR ≥0.90 in males and WHR ≥ 0.85 in females) between two genders. High TAF & IAAT were present in more females although there was no difference in the distribution of high SCAT between two genders. Conclusion Female hypertensive subjects were more obese with higher abnormal TAF & IAAT compared to male patients. However, there was no difference in the distribution of high SCAT among them. PMID:27190876

  16. Clinical and Economic Consequences of Failure of Initial Antibiotic Therapy for Patients with Community-Onset Complicated Intra-Abdominal Infections

    PubMed Central

    Chong, Yong Pil; Bae, In-Gyu; Lee, Sang-Rok; Chung, Jin-Won; Jun, Jae-Bum; Choo, Eun Ju; Moon, Soo-youn; Lee, Mi Suk; Jeon, Min Hyok; Song, Eun Hee; Lee, Eun Jung; Park, Seong Yeon; Kim, Yang Soo

    2015-01-01

    Objectives Complicated intra-abdominal infection (cIAI) is infection that extends beyond the hollow viscus of origin into the peritoneal space, and is associated with either abscess formation or peritonitis. There are few studies that have assessed the actual costs and outcomes associated with failure of initial antibiotic therapy for cIAI. The aims of this study were to evaluate risk factors and impact on costs and outcomes of failure of initial antibiotic therapy for community-onset cIAI. Methods A retrospective study was performed at eleven tertiary-care hospitals. Hospitalized adults with community-onset cIAI who underwent an appropriate source control procedure between August 2008 and September 2011 were included. Failure of initial antibiotic therapy was defined as a change of antibiotics due to a lack of improvement of the clinical symptoms and signs associated with cIAI in the first week. Results A total of 514 patients hospitalized for community-onset cIAI were included in the analysis. The mean age of the patients was 53.3 ± 17.6 years, 72 patients (14%) had health care-associated infection, and 48 (9%) experienced failure of initial antibiotic therapy. Failure of initial antibiotic therapy was associated with increased costs and morbidity. After adjustment for covariates, patients with unsuccessful initial therapy received an additional 2.9 days of parenteral antibiotic therapy, were hospitalized for an additional 5.3 days, and incurred $3,287 in additional inpatient charges. Independent risk factors for failure of initial antibiotic therapy were health care-associated infection, solid cancer, and APACHE II ≥13. Conclusions To improve outcomes and costs in patients with community-onset cIAI, rapid assessment of health care-associated risk factors and severity of disease, selection of an appropriate antibiotic regimen accordingly, and early infection source control should be performed. PMID:25910171

  17. Cardiovascular risk factors in middle age obese Indians: a cross-sectional study on association of per cent body fat and intra-abdominal fat mass

    PubMed Central

    Sandhu, Jaspal Singh; Esht, Vandana; Shenoy, Shweta

    2012-01-01

    Objectives To determine the association of per cent total body fat (TBF), intra-abdominal fat (IAF) mass and subcutaneous abdominal fat with cardiovascular risk factors in middle age obese Indians. Design Cross-sectional study. Setting Hydrostatic Laboratory, Department of Sports Medicine and Physiotherapy, Guru Nanak Dev University, India. Participants: 51 subjects aged 30–55 years with a body mass index value 23 and above. Methodology In all the participants, TBF was estimated by underwater weighing machine and IAF and subcutaneous fat were measured by ultrasonography. Lipid profile was determined by a semiautomated analyser. Main outcome measures were: IAF, per cent body fat to TBF ratio, lipid profile and risk of developing cardiovascular diseases. Results IAF was found to be significantly associated with lipid variables (95% CI, p<0.01) and risk of developing cardiovascular diseases (95% CI, p≤0.05) in both male and female subjects. TBF and subcutaneous fat thickness showed no significant results (95% CI, p>0.05) with either lipid variables or risk of developing cardiovascular diseases (tables 1 and 2). IAF mass showed significant association with age (95% CI, p<0.01) and significant negative association with physical activity (95% CI, p<0.05) in male subjects (tables 3 and 4). Conclusion An ultrasonic measurement of IAF is a better predictor of the risk of developing cardiovascular diseases in middle aged Indian population. In male subjects, physical activity of 5 or more days a week showed lesser amount of IAF as compared with those with physical activity <5 days a week. PMID:27326015

  18. Antimicrobial Susceptibilities of Aerobic and Facultative Gram-Negative Bacilli from Intra-abdominal Infections in Patients from Seven Regions in China in 2012 and 2013.

    PubMed

    Zhang, Hui; Yang, Qiwen; Liao, Kang; Ni, Yuxing; Yu, Yunsong; Hu, Bijie; Sun, Ziyong; Huang, Wenxiang; Wang, Yong; Wu, Anhua; Feng, Xianju; Luo, Yanping; Hu, Zhidong; Chu, Yunzhuo; Chen, Shulan; Cao, Bin; Su, Jianrong; Gui, Bingdong; Duan, Qiong; Zhang, Shufang; Shao, Haifeng; Kong, Haishen; Badal, Robert E; Xu, Yingchun

    2016-01-01

    To evaluate the antimicrobial susceptibility of Gram-negative bacilli that caused hospital-acquired and community-acquired intra-abdominal infections (IAIs) in China between 2012 and 2013, we determined the susceptibilities to 12 antimicrobials and the extended-spectrum β-lactamase (ESBL) statuses of 3,540 IAI isolates from seven geographic areas in China in a central laboratory using CLSI broth microdilution and interpretive standards. Most infections were caused by Escherichia coli (46.3%) and Klebsiella pneumoniae (19.7%). Rates of ESBL-producing E. coli (P = 0.031), K. pneumoniae (P = 0.017), and Proteus mirabilis (P = 0.004) were higher in hospital-acquired IAIs than in community-acquired IAIs. Susceptibilities of enterobacteriaceae to ertapenem, amikacin, piperacillin-tazobactam, and imipenem were 71.3% to 100%, 81.3% to 100%, 64.7% to 100%, and 83.1% to 100%, respectively, but imipenem was ineffective against P. mirabilis (<20%). Although most ESBL-positive hospital-acquired isolates were resistant to third- and fourth-generation cephalosporins, the majority were susceptible to cefoxitin (47.9% to 83.9%). Susceptibilities of ESBL-positive isolates to ampicillin-sulbactam (<10%) were low, whereas susceptibilities to ciprofloxacin (0% to 54.6%) and levofloxacin (0% to 63.6%) varied substantially. The prevalences of cephalosporin-susceptible E. coli and K. pneumoniae were higher in the northeastern and southern regions than in the central and eastern regions, reflecting the ESBL-positive rates in these areas, and were lowest in the Jiangsu-Zhejiang (Jiang-Zhe) area where the rates of carbapenem resistance were also highest. Ertapenem, amikacin, piperacillin-tazobactam, and imipenem are the most efficacious antibiotics for treating IAIs in China, especially those caused by E. coli or K. pneumoniae. Resistance to cephalosporins and carbapenems is more common in the Jiang-Zhe area than in other regions in China. PMID:26482308

  19. Evaluation of Tigecycline Efficacy and Post-Discharge Outcomes in a Clinical Practice Population with Complicated Intra-Abdominal Infection: A Propensity Score–Matched Analysis

    PubMed Central

    Mullins, C. Daniel; Quintana, Alvaro; Eckmann, Christian; Shelbaya, Ahmed; Ernst, Frank R.; Krukas, Michelle R.; Reisman, Arlene

    2016-01-01

    Abstract Background: The utility of tigecycline as compared with other antibiotic therapies in the treatment of patients with complicated intra-abdominal infection (cIAI) and the short- and long-term outcomes of a large cohort of severely ill patients were examined. We provide the first published data on post-discharge events for these patients. Methods: Retrospective data for the cIAI cohort were obtained from a large clinical database. Patients aged ≥18 y were selected for inclusion based on hospitalization with a relevant diagnosis code and procedure code, and guideline-compliant antimicrobial therapy. Propensity scoring was used to reduce treatment-selection bias introduced by the use of observational data. Tigecycline patients were placed into quintiles based on propensity score and were matched 1:3. Results: The final model based on propensity score matching included 2,424 patients: Tigecycline (n = 606) and other antibiotic therapy (n = 1,818). Treatment was successful in 426 (70.3%) tigecycline-treated patients and in 1,294 (71.2%) patients receiving other antibiotics. Similar treatment success occurred across all infection sites. Among survivors, treatment failure was associated with a greater need for all-cause re-hospitalization at 30 d and 180 d. No differences in cIAI-related re-hospitalization and discharge status were observed. Conclusions: Using propensity scores to match populations, similar outcomes were demonstrated between treatment with tigecycline and other antibiotics as expressed by treatment success, the need for re-admission, similar 30-d discharge status, and the need for re-admission at 180 d. PMID:26981640

  20. Comparison of Three-Dimensional (3D) Conformal Proton Radiotherapy (RT), 3D Conformal Photon RT, and Intensity-Modulated RT for Retroperitoneal and Intra-Abdominal Sarcomas

    SciTech Connect

    Swanson, Erika L.; Indelicato, Daniel J.; Louis, Debbie; Flampouri, Stella; Li, Zuofeng; Morris, Christopher G.; Paryani, Nitesh; Slopsema, Roelf

    2012-08-01

    Purpose: To compare three-dimensional conformal proton radiotherapy (3DCPT), intensity-modulated photon radiotherapy (IMRT), and 3D conformal photon radiotherapy (3DCRT) to predict the optimal RT technique for retroperitoneal sarcomas. Methods and Materials: 3DCRT, IMRT, and 3DCPT plans were created for treating eight patients with retroperitoneal or intra-abdominal sarcomas. The clinical target volume (CTV) included the gross tumor plus a 2-cm margin, limited by bone and intact fascial planes. For photon plans, the planning target volume (PTV) included a uniform expansion of 5 mm. For the proton plans, the PTV was nonuniform and beam-specific. The prescription dose was 50.4 Gy/Cobalt gray equivalent CGE. Plans were normalized so that >95% of the CTV received 100% of the dose. Results: The CTV was covered adequately by all techniques. The median conformity index was 0.69 for 3DCPT, 0.75 for IMRT, and 0.51 for 3DCRT. The median inhomogeneity coefficient was 0.062 for 3DCPT, 0.066 for IMRT, and 0.073 for 3DCRT. The bowel median volume receiving 15 Gy (V15) was 16.4% for 3DCPT, 52.2% for IMRT, and 66.1% for 3DCRT. The bowel median V45 was 6.3% for 3DCPT, 4.7% for IMRT, and 15.6% for 3DCRT. The median ipsilateral mean kidney dose was 22.5 CGE for 3DCPT, 34.1 Gy for IMRT, and 37.8 Gy for 3DCRT. The median contralateral mean kidney dose was 0 CGE for 3DCPT, 6.4 Gy for IMRT, and 11 Gy for 3DCRT. The median contralateral kidney V5 was 0% for 3DCPT, 49.9% for IMRT, and 99.7% for 3DCRT. Regardless of technique, the median mean liver dose was <30 Gy, and the median cord V50 was 0%. The median integral dose was 126 J for 3DCPT, 400 J for IMRT, and 432 J for 3DCRT. Conclusions: IMRT and 3DCPT result in plans that are more conformal and homogenous than 3DCRT. Based on Quantitative Analysis of Normal Tissue Effects in Clinic benchmarks, the dosimetric advantage of proton therapy may be less gastrointestinal and genitourinary toxicity.

  1. Risk factors for intra-abdominal hypertension and abdominal compartment syndrome among adult intensive care unit patients: a systematic review and meta-analysis

    PubMed Central

    2013-01-01

    Introduction Although intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are associated with substantial morbidity and mortality among critically ill adults, it remains unknown if prevention or treatment of these conditions improves patient outcomes. We sought to identify evidence-based risk factors for IAH and ACS in order to guide identification of the source population for future IAH/ACS treatment trials and to stratify patients into risk groups based on prognosis. Methods We searched electronic bibliographic databases (MEDLINE, EMBASE, PubMed, and the Cochrane Database from 1950 until January 21, 2013) and reference lists of included articles for observational studies reporting risk factors for IAH or ACS among adult ICU patients. Identified risk factors were summarized using formal narrative synthesis techniques alongside a random effects meta-analysis. Results Among 1,224 citations identified, 14 studies enrolling 2,500 patients were included. The 38 identified risk factors for IAH and 24 for ACS could be clustered into three themes and eight subthemes. Large volume crystalloid resuscitation, the respiratory status of the patient, and shock/hypotension were common risk factors for IAH and ACS that transcended across presenting patient populations. Risk factors with pooled evidence supporting an increased risk for IAH among mixed ICU patients included obesity (four studies; odds ratio (OR) 5.10; 95% confidence interval (CI), 1.92 to 13.58), sepsis (two studies; OR 2.38; 95% CI, 1.34 to 4.23), abdominal surgery (four studies; OR 1.93; 95% CI, 1.30 to 2.85), ileus (two studies; OR 2.05; 95% CI, 1.40 to 2.98), and large volume fluid resuscitation (two studies; OR 2.17; 95% CI, 1.30 to 3.63). Among trauma and surgical patients, large volume crystalloid resuscitation and markers of shock/hypotension and metabolic derangement/organ failure were risk factors for IAH and ACS while increased disease severity scores and elevated creatinine were

  2. A multicentre, open-label, randomized comparative study of tigecycline versus ceftriaxone sodium plus metronidazole for the treatment of hospitalized subjects with complicated intra-abdominal infections.

    PubMed

    Towfigh, S; Pasternak, J; Poirier, A; Leister, H; Babinchak, T

    2010-08-01

    Tigecycline (TGC) has demonstrated clinical efficacy and safety, in comparison with imipenem/cilastatin in phase 3 clinical trials, for complicated intra-abdominal infection (cIAI). The present study comprised a multicentre, open-label, randomized study of TGC vs. ceftriaxone plus metronidazole (CTX/MET) for the treatment of patients with cIAI. Eligible subjects were randomized (1:1) to receive either an initial dose of TGC (100 mg) followed by 50 mg every 12 h or CTX (2 g once daily) plus MET (1-2 g daily), for 4-14 days. The primary endpoint was the clinical response in the clinically evaluable (CE) population at the test of cure (TOC) assessment. Of 473 randomized subjects, 376 were CE. Among these, clinical cure rates were 70.4% (133/189) with TGC vs. 74.3% (139/187) with CTX/MET (95% CI -13.1 to 5.1; p 0.009 for non-inferiority). Clinical cure rates for subjects with Acute Physiological and Chronic Health Evaluation II scores > or =10 were 56.8% (21/37) with TGC vs. 58.3% (21/36) with CTX/MET. The microbiologic response was similar between the two treatment arms, with microbiological eradication at TOC achieved in 68.1% (94/138) of TGC-treated subjects and 71.5% (98/137) of CTX/MET-treated subjects. (The most frequently reported adverse events (AEs) for both treatment arms were nausea (TGC, 38.6% vs CTX/MET, 27.7%) and vomiting (TGC, 23.3% vs CTX/MET, 17.7%). Overall discontinuation rates as a result of an AE were 8.9% and 4.8% in TGC- and comparator-treated subjects, respectively. The results obtained in the present study demonstrate that TGC monotherapy is non-inferior to a combination regimen of CTX/MET with respect to treating subjects with cIAI. PMID:20670293

  3. Liquid-Level Monitor for Pressurized Vessels

    NASA Technical Reports Server (NTRS)

    Singh, J. J.; Davis, W. T.; Mall, G. H.

    1986-01-01

    Technique for monitoring water levels in pressurized stainless-steel cylinders, based on differences in gamma-ray attenuation coefficients in water and air, developed. Full-scale laboratory prototype system constructed to test technique. Technique usable with liquids other than water, since linear attenuation coefficients for intermediate-energy gamma rays in air considerably lower than in liquids. Also adaptable for continuous monitoring of liquid levels in resevoir systems and in underground storage tanks.

  4. Delayed intra-abdominal bleeding following trans-vaginal ultrasonography guided oocyte retrieval for in vitro fertilization in patients at risk for thrombo-embolic events under anticoagulant therapy

    PubMed Central

    Orvieto, Raoul

    2013-01-01

    We report herein, two cases of massive delayed (2 and 4 days) intra abdominal hemorrhage following ovum pick-up (OPU), in patients at risk for thrombo-embolic events, who concomitantly used therapeutic doses of low molecular weight heparin (LMWH). We discuss the possible mechanisms involved in causing the aforementioned delayed bleeding, and call for re-evaluation of the presently accepted anticoagulant co-treatment regimen. These case reports should direct physicians' attention and keep them alert, while conducting IVF treatment to this subgroup of high risk patients. PMID:24555090

  5. Ceftolozane/tazobactam activity tested against aerobic Gram-negative organisms isolated from intra-abdominal and urinary tract infections in European and United States hospitals (2012).

    PubMed

    Sader, Helio S; Farrell, David J; Flamm, Robert K; Jones, Ronald N

    2014-09-01

    Ceftolozane/tazobactam is under clinical development for treatment of complicated intra-abdominal infections (IAI), complicated urinary tract infections (UTI) and ventilator-associated pneumonia. We evaluated the in vitro activity of ceftolozane/tazobactam and comparator agents tested against Gram-negative aerobic bacteria causing IAI and healthcare-associated UTI (HCA-UTI). The organisms were consecutively collected from January to December 2012 from 59 medical centers located in the United States (USA) and 15 European countries by the Program to Assess Ceftolozane/Tazobactam Susceptibility (PACTS). The collection included 809 organisms from IAI and 2474 organisms from HCA-UTI, and susceptibility testing was performed by reference broth microdilution methods as described by the Clinical and Laboratory Standards Institute (CLSI) M07-A9 document. Overall, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa were the most frequently isolated pathogens from both infection types. Ceftolozane/tazobactam was very active against E. coli (MIC50/90, 0.25/0.5 mg/L; 98.5-99.9% inhibited at an MIC of ≤8 mg/L) and retained activity against many of the multidrug-resistant (MDR; MIC50/90, 0.5/2->32 mg/L) and ESBL-phenotype strains (MIC50/90, 0.5/2-32 mg/L). Ceftolozane/tazobactam was active against most K. pneumoniae strains (MIC50/90, 0.25/16 mg/L, 88.9-89.6% inhibited at an MIC of ≤8 mg/L), but some ESBL-phenotype (MIC50/90, 4-8/>32 mg/L) and MDR (MIC50/90, 16/>32 mg/L) isolates exhibited elevated MIC values. Ceftolozane/tazobactam was the most active agent tested against P. aeruginosa (MIC50/90, 0.5/4 mg/L; 93.4-95.7% inhibited at ≤8 mg/L) and retained potency against many MDR (MIC50/90, 2-4/>32 mg/L), ceftazidime-nonsusceptible (MIC50/90, 2-4/>32 mg/L) and meropenem-nonsusceptible (MIC50/90, 2/>32 mg/L) strains. Ceftolozane/tazobactam was also active against Klebsiella oxytoca (MIC50/90, ≤0.12-0.25/0.5-1 mg/L), Enterobacter spp. (MIC50/90, 0

  6. Sound pressure level in a municipal preschool

    PubMed Central

    Kemp, Adriana Aparecida Tahara; Delecrode, Camila Ribas; Guida, Heraldo Lorena; Ribeiro, André Knap; Cardoso, Ana Claúdia Vieira

    2013-01-01

    Summary Aim: To evaluate the sound pressure level to which preschool students are exposed. Method: This was a prospective, quantitative, nonexperimental, and descriptive study. To achieve the aim of the study we used an audio dosimeter. The sound pressure level (SPL) measurements were obtained for 2 age based classrooms. Preschool I and II. The measurements were obtained over 4 days in 8-hour sessions, totaling 1920 minutes. Results: Compared with established standards, the SPL measured ranged from 40.6 dB (A) to 105.8 dB (A). The frequency spectrum of the SPL was concentrated in the frequency range between 500 Hz and 4000 Hz. The older children produced higher SPLs than the younger ones, and the levels varied according to the activity performed. Painting and writing were the quietest activities, while free activities period and games were the noisiest. Conclusion: The SPLs measured at the preschool were higher and exceeded the maximum permitted level according to the reference standards. Therefore, the implementation of actions that aim to minimize the negative impact of noise in this environment is essential. PMID:25992013

  7. Comparison of the hemodynamic effects of gasless abdominal distention and CO2 pneumoperitoneum during incremental positive end-expiratory pressure.

    PubMed

    Woolley, D S; Puglisi, R N; Bilgrami, S; Quinn, J V; Slotman, G J

    1995-01-01

    Laparoscopy is used increasingly in managing critically ill patients. Carbon dioxide (CO2) pneumoperitoneum is used during these procedures. The increased intra-abdominal pressure of CO2 pneumoperitoneum, however, can affect cardiopulmonary performance adversely. Recently, gasless abdominal wall distention has been introduced as an alternative to CO2 pneumoperitoneum. The purpose of this study was to compare the hemodynamic effects of gasless abdominal distention (GAD) with those of CO2 pneumoperitoneum during mechanical ventilation with positive end-expiratory pressure (PEEP). Six anesthetized, paralyzed, mechanically ventilated adult swine were monitored with pulmonary artery and arterial catheters at incremental values of PEEP (0-20 cm H2O, by 5, Control) and then allowed to return to baseline hemodynamic status at 0 cm H2O PEEP. The animals were then randomly assigned to receive either CO2 pneumoperitoneum at 15 mm Hg intra-abdominal pressure (PNEUMO) or GAD (equal to anterior abdominal wall displacement of CO2) and PEEP was reapplied. The animals were allowed to return to hemodynamic baseline and PEEP was reapplied with the alternate method of abdominal wall distention. A complete hemodynamic profile and arterial/mixed venous blood gas measurements were monitored at each value of PEEP. With GAD, central venous pressure (CVP), pulmonary artery pressure (PAP), pulmonary capillary wedge pressure (PCWP), and PaCO2 were significantly reduced, compared to PNEUMO, and PaO2 was increased. Cardiac index was higher in GAD versus PNEUMO at baseline, but was lower for GAD at PEEP levels above 10 cm H2O. These results indicate that in its net effect, GAD does not exacerbate the adverse hemodynamic effects of PEEP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7830409

  8. Trends in Susceptibility of Escherichia coli from Intra-Abdominal Infections to Ertapenem and Comparators in the United States According to Data from the SMART Program, 2009 to 2013

    PubMed Central

    Kazmierczak, Krystyna M.; Badal, Robert E.; Hackel, Meredith A.; Bouchillon, Samuel K.; Biedenbach, Douglas J.; Sahm, Daniel F.

    2015-01-01

    Antimicrobial resistance in Enterobacteriaceae, including resistance to carbapenems, is increasing worldwide. However, using U.S. Study for Monitoring Antimicrobial Resistance Trends (SMART) data for 2009 to 2013, no statistically significant decreasing susceptibility trends were found overall for Escherichia coli isolates from patients with intra-abdominal infections. In the subset of isolates from community-associated infections, susceptibility to levofloxacin decreased significantly and the increasing rate of multidrug-resistant E. coli approached statistical significance. In 2013, ertapenem, imipenem, and amikacin showed the highest susceptibility rates (≥99%) and fluoroquinolones the lowest (<70%). The 10 non-ertapenem-susceptible isolates (0.3% of all E. coli isolates) encoded one or more carbapenemases, extended-spectrum β-lactamases (ESBLs), AmpC β-lactamases, or non-ESBL β-lactamases. PMID:25801558

  9. An alternative to reduction of surface pressure to sea level

    NASA Technical Reports Server (NTRS)

    Deardorff, J. W.

    1982-01-01

    The pitfalls of the present method of reducing surface pressure to sea level are reviewed, and an alternative, adjusted pressure, P, is proposed. P is obtained from solution of a Poisson equation over a continental region, using the simplest boundary condition along the perimeter or coastline where P equals the sea level pressure. The use of P would avoid the empiricisms and disadvantages of pressure reduction to sea level, and would produce surface pressure charts which depict the true geostrophic wind at the surface.

  10. Ceftolozane/Tazobactam Plus Metronidazole for Complicated Intra-abdominal Infections in an Era of Multidrug Resistance: Results From a Randomized, Double-Blind, Phase 3 Trial (ASPECT-cIAI)

    PubMed Central

    Solomkin, Joseph; Hershberger, Ellie; Miller, Benjamin; Popejoy, Myra; Friedland, Ian; Steenbergen, Judith; Yoon, Minjung; Collins, Sylva; Yuan, Guojun; Barie, Philip S.; Eckmann, Christian

    2015-01-01

    Background. Increasing antimicrobial resistance among pathogens causing complicated intra-abdominal infections (cIAIs) supports the development of new antimicrobials. Ceftolozane/tazobactam, a novel antimicrobial therapy, is active against multidrug-resistant Pseudomonas aeruginosa and most extended-spectrum β-lactamase (ESBL)–producing Enterobacteriaceae. Methods. ASPECT-cIAI (Assessment of the Safety Profile and Efficacy of Ceftolozane/Tazobactam in Complicated Intra-abdominal Infections) was a prospective, randomized, double-blind trial. Hospitalized patients with cIAI received either ceftolozane/tazobactam (1.5 g) plus metronidazole (500 mg) every 8 hours or meropenem (1 g) every 8 hours intravenously for 4–14 days. The prospectively defined objectives were to demonstrate statistical noninferiority in clinical cure rates at the test-of-cure visit (24–32 days from start of therapy) in the microbiological intent-to-treat (primary) and microbiologically evaluable (secondary) populations using a noninferiority margin of 10%. Microbiological outcomes and safety were also evaluated. Results. Ceftolozane/tazobactam plus metronidazole was noninferior to meropenem in the primary (83.0% [323/389] vs 87.3% [364/417]; weighted difference, −4.2%; 95% confidence interval [CI], −8.91 to .54) and secondary (94.2% [259/275] vs 94.7% [304/321]; weighted difference, −1.0%; 95% CI, −4.52 to 2.59) endpoints, meeting the prespecified noninferiority margin. In patients with ESBL-producing Enterobacteriaceae, clinical cure rates were 95.8% (23/24) and 88.5% (23/26) in the ceftolozane/tazobactam plus metronidazole and meropenem groups, respectively, and 100% (13/13) and 72.7% (8/11) in patients with CTX-M-14/15 ESBLs. The frequency of adverse events (AEs) was similar in both treatment groups (44.0% vs 42.7%); the most common AEs in either group were nausea and diarrhea. Conclusions. Treatment with ceftolozane/tazobactam plus metronidazole was noninferior to

  11. Efficacy and Safety of Ceftazidime-Avibactam Plus Metronidazole Versus Meropenem in the Treatment of Complicated Intra-abdominal Infection: Results From a Randomized, Controlled, Double-Blind, Phase 3 Program

    PubMed Central

    Mazuski, John E.; Gasink, Leanne B.; Armstrong, Jon; Broadhurst, Helen; Stone, Greg G.; Rank, Douglas; Llorens, Lily; Newell, Paul; Pachl, Jan

    2016-01-01

    Background. When combined with ceftazidime, the novel non–β-lactam β-lactamase inhibitor avibactam provides a carbapenem alternative against multidrug-resistant infections. Efficacy and safety of ceftazidime-avibactam plus metronidazole were compared with meropenem in 1066 men and women with complicated intra-abdominal infections from 2 identical, randomized, double-blind phase 3 studies (NCT01499290 and NCT01500239). Methods. The primary end point was clinical cure at test-of-cure visit 28–35 days after randomization, assessed by noninferiority of ceftazidime-avibactam plus metronidazole to meropenem in the microbiologically modified intention-to-treat (mMITT) population (in accordance with US Food and Drug Administration guidance), and the modified intention-to-treat and clinically evaluable populations (European Medicines Agency guidance). Noninferiority was considered met if the lower limit of the 95% confidence interval for between-group difference was greater than the prespecified noninferiority margin of −12.5%. Results. Ceftazidime-avibactam plus metronidazole was noninferior to meropenem across all primary analysis populations. Clinical cure rates with ceftazidime-avibactam plus metronidazole and meropenem, respectively, were as follows: mMITT population, 81.6% and 85.1% (between-group difference, −3.5%; 95% confidence interval −8.64 to 1.58); modified intention-to-treat, 82.5% and 84.9% (−2.4%; −6.90 to 2.10); and clinically evaluable, 91.7% and 92.5% (−0.8%; −4.61 to 2.89). The clinical cure rate with ceftazidime-avibactam plus metronidazole for ceftazidime-resistant infections was comparable to that with meropenem (mMITT population, 83.0% and 85.9%, respectively) and similar to the regimen's own efficacy against ceftazidime-susceptible infections (82.0%). Adverse events were similar between groups. Conclusions. Ceftazidime-avibactam plus metronidazole was noninferior to meropenem in the treatment of complicated intra-abdominal

  12. Characterization of extended-spectrum beta-lactamases and antimicrobial resistance of Klebsiella pneumoniae in intra-abdominal infection isolates in Latin America, 2008-2012. Results of the Study for Monitoring Antimicrobial Resistance Trends.

    PubMed

    Kazmierczak, Krystyna M; Lob, Sibylle H; Hoban, Daryl J; Hackel, Meredith A; Badal, Robert E; Bouchillon, Samuel K

    2015-07-01

    The Study for Monitoring Antimicrobial Resistance Trends has monitored the in vitro activity of several recommended antimicrobials used in the management of intra-abdominal infections (IAIs) globally since 2002. In this report, we document the changing susceptibility patterns to recommended antimicrobials in Klebsiella pneumoniae isolates from patients with IAIs in 11 Latin American countries between 2008 and 2012 and describe the beta-lactamases encoded by phenotypically extended-spectrum beta-lactamase (ESBL)-positive and ertapenem-nonsusceptible isolates. Overall, the incidence of phenotypically ESBL-positive K. pneumoniae did not change significantly from 2008 (40.4%) to 2012 (41.2%) (P > 0.05). However, trend analysis documented an increase in isolates encoding K. pneumoniae carbapenemase (KPC) or both KPC and an ESBL. Decreasing susceptibility (P < 0.05) was noted for cefepime, ceftazidime, ceftriaxone, ertapenem, and imipenem among all K. pneumoniae, as well as for cefepime, cefotaxime, cefoxitin, ceftriaxone, ertapenem, and imipenem among ESBL-positive isolates, while susceptibility of ESBL-negative isolates to ampicillin-sulbactam actually increased (P < 0.05). PMID:25956930

  13. Social Support, Assimilation and Biological Effective Blood Pressure Levels.

    ERIC Educational Resources Information Center

    Walsh, Anthony; Walsh, Patricia Ann

    1987-01-01

    The twin processes of migration and assimilation are highly stressful. This stress can be manifested in elevated blood pressure. According to this study, immigrants receiving high levels of social support had significantly lower blood pressure levels than those receiving less social support. (VM)

  14. Effects of Nd:YAG laser photoradiation on intra-abdominal tissues: a histological study of tissue damage versus power density applied

    SciTech Connect

    Brackett, K.A.; Sankar, M.Y.; Joffe, S.N.

    1986-01-01

    Liver, spleen, and pancreas were subjected to laser photoradiation of 50- to 100-Watt power levels. Samples were evaluated by light microscopy at 0 hours and 7, 14, and 21 days. Four zones of cellular damage were visible in liver and pancreas: coagulum, cavitation, acidophilia, and transition. Only the first three zones were clearly visible in the spleen. Mean lateral tissue penetration was 3.1 mm in liver, 3.3 mm in spleen, and 1.0 mm in pancreas. No significant increase in lateral penetration occurred with increasing power. Normal healing was observed in liver and spleen. Pancreatitis was found in all samples at 7 days postoperatively. At power levels of 80 W or less, recovery was observed. Above 80 W, pancreatic pseudocysts and necrosis led to death of the animals.

  15. The role of elevated liver transaminase levels in children with blunt abdominal trauma.

    PubMed

    Karaduman, Dolunay; Sarioglu-Buke, Akile; Kilic, Ilknur; Gurses, Ercan

    2003-05-01

    The role of serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) levels on intra-abdominal injury in children has not been adequately studied. In this report, the accuracy of these tests in predicting the degree and extend of intra-abdominal and hepatic injury in children with blunt abdominal trauma was investigated.Eighty-seven haemodynamically stable children with multiple trauma were prospectively evaluated. The SGOT and SGPT of patients with and without abdominal trauma (Groups I and II) were compared. Patients with and without radiologically verified intra-abdominal injury were further compared (Groups Ib and Ia). There was significant difference in SGOT and SGPT levels of Groups I and II. SGOT and SGPT levels were 333.6+/-283.8 and, 197.5+/-192.5 U/l, respectively in Group Ib; but 84.2+/-55.9, 43+/-29.8 U/l in Group Ia (P<0.001). In all patients with radiologically detected intra-abdominal pathology SGOT and SGPT levels were above 110.5 and 63.5 U/l, respectively. In patients with hepatic injury SGOT level was above 500 U/l and, SGPT level was above 300 U/l. Statistically significant positive correlation was found between radiologically detected intra-abdominal pathology and increased SGOT (above 110.5 U/l) and SGPT (above 63.5 U/l) levels (P<0.05). These data indicated that the SGOT and SGPT levels were significantly higher in patients with intra-abdominal injury even in the absence of hepatic injury. We suggest that liver function tests may be used as screening tests in children with blunt abdominal trauma in addition to physical abdominal examination. A sudden rise up to 110.5 U/l in SGOT and 63.5 U/l in SGPT indicate an intra-abdominal injury and severe hepatic injury should be suspected with higher levels of SGOT and SGPT. PMID:12667774

  16. The comparison of the effects of ellagic acid and diclofenac sodium on intra-abdominal adhesion: an in vivo study in the rat model.

    PubMed

    Allahverdi, Tulay Diken; Allahverdi, Ertuğrul; Yayla, Sadık; Deprem, Turgay; Merhan, Oğuz; Vural, Sevil

    2014-01-01

    Peritoneal adhesions are seen frequently after abdominal surgery and can cause serious complications. We aimed to evaluate the effects of the oral use of diclofenac sodium and ellagic acid on formation of postoperative adhesions in rats Studies have shown that agents with anti-inflammatory properties and antioxidant substances can prevent adhesion by decreasing oxidative stress. We compared and evaluated the effects of ellagic acid that has strong antioxidant and anti-inflammatory properties and the nonsteroidal anti-inflammatory diclofenac sodium on peritoneal adhesion development in our experimental study. Laparotomy was performed with a midline incision under general anesthesia and an adhesion model was created on the antimesenteric side of the cecum in Groups I, II, and III. Group I received 85 mg/kg ellagic acid and Group II, 50 mg/kg diclofenac sodium through the nasogastric catheter while Group III received no medication. Only laparotomy was performed in Group IV. The rats were sacrificed at the end of the 14th day. Following macroscopic scoring, tissue samples were removed and subjected to biochemical and histopathologic evaluation. The degree of adhesion and the malondialdehyde level were decreased (P < 0.05), and glutathione level increased (P < 0.05) in Group I compared to Group II and Group III. The effects of ellagic acid on the prevention of peritoneal adhesion were found to be stronger than diclofenac sodium. This can be explained by the fact that ellagic acid is a strong antioxidant and decreases oxidative stress with anti-inflammatory and anti-angiogenic effects. PMID:25216418

  17. Recovery of Neonatal Head Turning to Decreased Sound Pressure Level.

    ERIC Educational Resources Information Center

    Tarquinio, Nancy; And Others

    1990-01-01

    Investigated newborns' responses to decreased sound pressure level (SPL) by means of a localized head turning habituation procedure. Findings, which demonstrated recovery of neonatal head turning to decreased SPL, were inconsistent with the selective receptor adaptation model. (RH)

  18. 9. POWERHOUSE, LOWER LEVEL, LOOKING NORTHWEST, PRESSURE CASE WHICH CONTAINS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    9. POWERHOUSE, LOWER LEVEL, LOOKING NORTHWEST, PRESSURE CASE WHICH CONTAINS THE WATER TURBINE - Dayville Mills Hydroelectric Facility, Powerhouse, North side of Route 101, .5 mile west of Route 395, Killingly Center, Windham County, CT

  19. Distribution of extended-spectrum β-lactamases, AmpC β-lactamases, and carbapenemases among Enterobacteriaceae isolates causing intra-abdominal infections in the Asia-Pacific region: results of the study for Monitoring Antimicrobial Resistance Trends (SMART).

    PubMed

    Sheng, Wang-Huei; Badal, Robert E; Hsueh, Po-Ren

    2013-07-01

    The increasing trend of β-lactam resistance among Enterobacteriaceae is a worldwide threat. Enterobacteriaceae isolates causing intra-abdominal infections (IAI) from the Study for Monitoring Antimicrobial Resistance Trends (SMART) collected in 2008 and 2009 from the Asia-Pacific region were investigated. Detection of extended-spectrum β-lactamases (ESBLs), AmpC β-lactamases, and carbapenemases was performed by multiplex PCR. A total of 699 Enterobacteriaceae isolates with positive genotypic results, included Escherichia coli (n = 443), Klebsiella pneumoniae (n = 187), Enterobacter cloacae (n = 45), Klebsiella oxytoca (n = 9), Citrobacter freundii (n = 5), Proteus mirabilis (n = 3), Enterobacter aerogenes (n = 2), Morganella morganii (n = 2), and one each of Enterobacter asburiae, Proteus vulgaris, and Providencia rettgeri were analyzed. Nearly 20% of these β-lactamase-producing Enterobacteriaceae isolates were from community-associated IAI. CTX-M (588 isolates, including 428 [72.8%] with CTX-M-15) was the most common ESBL, followed by SHV (n = 59) and TEM (n = 4). CMY (n = 110, including 102 [92.7%] with CMY-2) was the most common AmpC β-lactamase, followed by DHA (n = 46) and ACT/MIR (n = 40). NDM (n = 65, including 62 [95.4%] with NDM-1) was the most common carbapenemase, followed by IMP (n = 7) and OXA (n = 7). Isolates from hospital-associated IAI had more complicated β-lactamase combinations than isolates from the community. Carbapenemases were all exclusively detected in Enterobacteriaceae isolates from India, except that IMP β-lactamases were also detected in Philippines and Australia. CTX-M β-lactamases were the predominant ESBLs produced by Enterobacteriaceae causing IAI in the Asia-Pacific region. Emergence of CTX-M-15-, CMY-2-, and NDM-1-producing Enterobacteriaceae isolates is of major concern and highlights the need for further surveillance in this area. PMID:23587958

  20. Surveillance of antimicrobial susceptibility of aerobic and facultative Gram-negative bacilli isolated from patients with intra-abdominal infections in China: the 2002-2009 Study for Monitoring Antimicrobial Resistance Trends (SMART).

    PubMed

    Yang, Qiwen; Wang, Hui; Chen, Minjun; Ni, Yuxing; Yu, Yunsong; Hu, Bijie; Sun, Ziyong; Huang, Wenxiang; Hu, Yunjian; Ye, Huifen; Badal, Robert E; Xu, Yingchun

    2010-12-01

    The objective of this study was to investigate the distribution and susceptibility of aerobic and facultative Gram-negative bacilli (GNB) isolated from patients with intra-abdominal infections (IAIs) in China. From 2002 to 2009, minimum inhibitory concentrations of 14 antibiotics for 3420 aerobic and facultative GNB from up to eight hospitals in six cities were determined by the broth microdilution method. Enterobacteriaceae comprised 82.9% (2834/3420) of the total isolates, with Escherichia coli (49.2%) being the most commonly isolated species followed by Klebsiella pneumoniae (17.0%), Enterobacter cloacae (5.8%) and Citrobacter freundii (2.3%). Amongst the antimicrobial agents tested, the three carbapenems (ertapenem, imipenem and meropenem) were the most active agents against Enterobacteriaceae, with susceptibility rates of 96.1-99.6% (2002-2009), 98.2-100% (2002-2009) and 99.6-100% (2002-2004), respectively, followed by amikacin (86.8-95.1%) and piperacillin/tazobactam (84.5-94.3%). Susceptibility rates of all tested third- and fourth-generation cephalosporins against Enterobacteriaceae declined by nearly 30%, with susceptibility rates of 40.2%, 39.1%, 56.3% and 51.8% in 2009 for ceftriaxone, cefotaxime, ceftazidime and cefepime, respectively. The occurrence of extended-spectrum β-lactamases increased rapidly, especially for E. coli (from 20.8% in 2002 to 64.9% in 2009). Susceptibility of E. coli to ciprofloxacin decreased from 57.6% in 2002 to 24.2% in 2009. The least active agent against Enterobacteriaceae was ampicillin/sulbactam (SAM) (25.3-44.3%). In conclusion, Enterobacteriaceae were the major pathogens causing IAIs, and carbapenems retained the highest susceptibility rates over the 8-year study period. Third- and fourth-generation cephalosporins, fluoroquinolones and SAM may not be ideal choices for empirical therapy of IAIs in China. PMID:21036547

  1. Giant horseshoe intra-abdominal abscess.

    PubMed Central

    Altemeier, W A; Culbertson, W R; Fidler, J P

    1975-01-01

    A study of 12 patients with giant horseshoe abscess of the abdominal and pelvic cavities seen at the Surgical Services of the University of Cincinnati Medical Center has emphasized the complexity and bizarre nature of these lesions. These infections represented a huge abscess or series of communicating abscesses extending from one subphrenic space along the corresponding paracolic gutter into the pelvis, up and along the opposite paracolic space, and into the other subphrenic space. Since these lesions occurred infrequently, they were often not recognized until they had become far advanced and had produced profound effects on the patients. The diagnosis was difficult and obscured by various factors including the postoperative state after laparotomy for complex diseases or serious injuries of the biliary tract, the genitourinary tract, or the alimentary tract. An important etiologic component of the formation of these giant abscesses was the continuing escape and collection of large volumes of fluid resulting from lesions of the biliary tract, postoperative hemorrhage, or an unrecognized large perforated peptic ulcer. Nine patients were treated successfully and 3 died. The many diagnostic and therapeutic problems presented by the patients with this interesting and complex lesion have emphasized the importance of earlier and more accurate diagnosis, early and adequate surgical drainage, intelligently applied antibiotic therapy and appropriate supportive treatment. Failure to recognize and drain effectively each of the component sections of this lesion led to continuing sepsis with prolonged morbidity, progressive debility, and death. Images Fig. 1. Fig. 2. PMID:1079447

  2. Intra-Abdominal Hematoma Following Enoxaparin Injection

    PubMed Central

    Chung, Kin Tong

    2016-01-01

    An elderly patient, who was being treated for therapeutic enoxaparin for a couple of days due to suspected deep vein thrombosis, was admitted to hospital following a collapse and severe abdominal pain. She was in hypovolemic shock and was fluid resuscitated. Ultrasound scan and computed tomography (CT) scan showed a large pelvic hematoma. Radiologists also suspected a possibility of bleeding from inferior epigastric artery following a CT angiogram. The patient was stabilized and transferred to intensive care unit (ICU) for further hemodynamic supports and close monitoring. The patient was then transferred back to the general ward when she was stable. She was managed conservatively as there were no more signs of active bleeding. Unfortunately, she died of recurrent bleeding three days after ICU discharge. PMID:27158226

  3. Intra-Abdominal Hematoma Following Enoxaparin Injection.

    PubMed

    Chung, Kin Tong

    2016-01-01

    An elderly patient, who was being treated for therapeutic enoxaparin for a couple of days due to suspected deep vein thrombosis, was admitted to hospital following a collapse and severe abdominal pain. She was in hypovolemic shock and was fluid resuscitated. Ultrasound scan and computed tomography (CT) scan showed a large pelvic hematoma. Radiologists also suspected a possibility of bleeding from inferior epigastric artery following a CT angiogram. The patient was stabilized and transferred to intensive care unit (ICU) for further hemodynamic supports and close monitoring. The patient was then transferred back to the general ward when she was stable. She was managed conservatively as there were no more signs of active bleeding. Unfortunately, she died of recurrent bleeding three days after ICU discharge. PMID:27158226

  4. Further assessment of forward pressure level for in situ calibration

    PubMed Central

    Scheperle, Rachel A.; Goodman, Shawn S.; Neely, Stephen T.

    2011-01-01

    Quantifying ear-canal sound level in forward pressure has been suggested as a more accurate and practical alternative to sound pressure level (SPL) calibrations used in clinical settings. The mathematical isolation of forward (and reverse) pressure requires defining the Thévenin-equivalent impedance and pressure of the sound source and characteristic impedance of the load; however, the extent to which inaccuracies in characterizing the source and/or load impact forward pressure level (FPL) calibrations has not been specifically evaluated. This study examined how commercially available probe tips and estimates of characteristic impedance impact the calculation of forward and reverse pressure in a number of test cavities with dimensions chosen to reflect human ear-canal dimensions. Results demonstrate that FPL calibration, which has already been shown to be more accurate than in situ SPL calibration, can be improved particularly around standing-wave null frequencies by refining estimates of characteristic impedance. Better estimates allow FPL to be accurately calculated at least through 10 kHz using a variety of probe tips in test cavities of different sizes, suggesting that FPL calibration can be performed in ear canals of all sizes. Additionally, FPL calibration appears a reasonable option when quantifying the levels of extended high-frequency (10–18 kHz) stimuli. PMID:22225044

  5. An aneroid pressure sensor for constant-level balloons

    NASA Technical Reports Server (NTRS)

    Levanon, N.; Afanasjevs, J.; Oehlkers, R. A.; Suomi, V. E.

    1975-01-01

    The pressure sensor for the Tropical Wind Energy conversion and Reference Level Experiment (TWERLE) is described. Key design features of the sensor are: capacitive coupling, reference at midrange, up-down counting, passive oven, storage at flight pressure and prelaunch calibration. Sensor specifications are given which are based on the production results of 440 units. Drift, as estimated from simulated life tests, is 1 mb per 6 months. The overall weight of the sensor, including thermal package, is 180 g.

  6. Charge transfer and atomic-level pressure in metallic glasses

    SciTech Connect

    Ding, Jun; Cheng, Yongqiang

    2014-02-03

    This paper presents a systematic study on the charge transfer and ionicity in various metallic-glass forming systems, as well as its relationship with other atomic-level structure indicators, using the Bader analysis method and molecular dynamics simulation. It is shown that in a binary or multicomponent system, the chemical effects (when more than one elements present) appear to play a more important role in setting the absolute level of the atomic-level pressure, compared to the topological fluctuation.

  7. Geosat observations of sea level response to barometric pressure forcing

    NASA Technical Reports Server (NTRS)

    Hoar, Timothy J.; Wilson, Clark R.

    1994-01-01

    Altimeter and sea level pressure data from the Geosat mission are analyzed for evidence of inverted barometer responses of sea level to atmospheric pressure forcing. Estimates of the inverted barometer coefficient are given for a variety of geographic regions and time scales using various orbit error removal strategies. There is some sensitivity to the orbit error removal method, but the estimated coefficients show a clear latitudinal dependence and are generally between -0.5 cm/mbar and -0.9 cm/mbar. The southern oceans respond slightly more like an inverted barometer than the northern oceans for similar latitudes. The regression exhibits significant geographic variability, particularly near major circulation features and in the northern hemisphere. The results suggest that the inverted barometer approximation is resonable over much of the oceans, but that some sea level variability may be correlated with barometric pressure by means other than the inverted barometer effect.

  8. Phase 2, Randomized, Double-Blind Study of the Efficacy and Safety of Two Dose Regimens of Eravacycline versus Ertapenem for Adult Community-Acquired Complicated Intra-Abdominal Infections

    PubMed Central

    Ramesh, Mayakonda Krishnamurthy; Cesnauskas, Gintaras; Novikovs, Nikolajs; Stefanova, Penka; Sutcliffe, Joyce A.; Walpole, Susannah M.

    2014-01-01

    Eravacycline is a novel fluorocycline, highly active against Gram-positive and Gram-negative pathogens in vitro, including those with tetracycline and multidrug resistance. This phase 2, randomized, double-blind study was conducted to evaluate the efficacy and safety of two dose regimens of eravacycline compared with ertapenem in adult hospitalized patients with complicated intra-abdominal infections (cIAIs). Patients with confirmed cIAI requiring surgical or percutaneous intervention and antibacterial therapy were randomized (2:2:1) to receive eravacycline at 1.5 mg/kg of body weight every 24 h (q24h), eravacycline at 1.0 mg/kg every 12 h (q12h), or ertapenem at 1 g (q24h) for a minimum of 4 days and a maximum of 14 days. The primary efficacy endpoint was the clinical response in microbiologically evaluable (ME) patients at the test-of-cure (TOC) visit 10 to 14 days after the last dose of study drug therapy. Overall, 53 patients received eravacycline at 1.5 mg/kg q24h, 56 received eravacycline at 1.0 mg/kg q12h, and 30 received ertapenem. For the ME population, the clinical success rate at the TOC visit was 92.9% (39/42) in the group receiving eravacycline at 1.5 mg/kg q24h, 100% (41/41) in the group receiving eravacycline at 1.0 mg/kg q12h, and 92.3% (24/26) in the ertapenem group. The incidences of treatment-emergent adverse events were 35.8%, 28.6%, and 26.7%, respectively. Incidence rates of nausea and vomiting were low in both eravacycline groups. Both dose regimens of eravacycline were as efficacious as the comparator, ertapenem, in patients with cIAI and were well tolerated. These results support the continued development of eravacycline for the treatment of serious infections, including those caused by drug-resistant Gram-negative pathogens. (This study has been registered at ClinicalTrials.gov under registration no. NCT01265784.) PMID:24342651

  9. A multicenter trial of the efficacy and safety of tigecycline versus imipenem/cilastatin in patients with complicated intra-abdominal infections [Study ID Numbers: 3074A1-301-WW; ClinicalTrials.gov Identifier: NCT00081744

    PubMed Central

    Oliva, María E; Rekha, Arcot; Yellin, Albert; Pasternak, Jacyr; Campos, Maria; Rose, Gilbert M; Babinchak, Timothy; Ellis-Grosse, Evelyn J; Loh, Evan

    2005-01-01

    Background Complicated intra-abdominal infections (cIAI) remain challenging to treat because of their polymicrobial etiology including multi-drug resistant bacteria. The efficacy and safety of tigecycline, an expanded broad-spectrum glycylcycline antibiotic, was compared with imipenem/cilastatin (IMI/CIS) in patients with cIAI. Methods A prospective, double-blind, multinational trial was conducted in which patients with cIAI randomly received intravenous (IV) tigecycline (100 mg initial dose, then 50 mg every 12 hours [q12h]) or IV IMI/CIS (500/500 mg q6h or adjusted for renal dysfunction) for 5 to14 days. Clinical response at the test-of-cure (TOC) visit (14–35 days after therapy) for microbiologically evaluable (ME) and microbiological modified intent-to-treat (m-mITT) populations were the co-primary efficacy endpoint populations. Results A total of 825 patients received ≥ 1 dose of study drug. The primary diagnoses for the ME group were complicated appendicitis (59%), and intestinal (8.8%) and gastric/duodenal perforations (4.6%). For the ME group, clinical cure rates at TOC were 80.6% (199/247) for tigecycline versus 82.4% (210/255) for IMI/CIS (95% CI -8.4, 5.1 for non-inferiority tigecycline versus IMI/CIS). Corresponding clinical cure rates within the m-mITT population were 73.5% (227/309) for tigecycline versus 78.2% (244/312) for IMI/CIS (95% CI -11.0, 2.5). Nausea (31.0% tigecycline, 24.8% IMI/CIS [P = 0.052]), vomiting (25.7% tigecycline, 19.4% IMI/CIS [P = 0.037]), and diarrhea (21.3% tigecycline, 18.9% IMI/CIS [P = 0.435]) were the most frequently reported adverse events. Conclusion This study demonstrates that tigecycline is as efficacious as imipenem/cilastatin in the treatment of patients with cIAI. PMID:16236177

  10. [Peak sound pressure levels of gunshots from starter's pistols].

    PubMed

    Rothschild, M A; Dieker, L; Prante, H; Maschke, C

    1998-12-01

    Starter's pistols are often bought for self-defense, but can also be used for criminal activities (e.g. assaults, etc.). When a starter's pistol is loaded with blank cartridges and is fired, a powerful shooting noise results. The level of the noise produced is high enough to cause acoustic trauma. For legal examinations and giving an expert opinion further information is needed about the power of such noise. We examined how high peak sound pressure levels were of the gunshots of blank cartridges and whether there existed any directional characteristics from the noise emissions. In all, 15 different models of starter's pistols of 8 different calibres were examined. In addition to blank cartridges, 8 mm tear gas cartridges were also examined. Four transducers were situated in the horizontal plane around the muzzle: 0 degree (shooting direction), 45 degrees, 90 degrees, and 180 degrees (towards the firer). The distances between the transducers and the muzzle were 25 cm, 50 cm, 100 cm, and 200 cm. At a distance of 1 m and in the 0 degree shooting direction the peak sound pressure levels of nearly all weapons tested exceeded 160 dB. At a shooting distance of 25 cm the peak sound pressure levels reached 181 dB. In addition, we observed a directional characteristic concerning the emission of noise: pistols produced higher peak sound pressure levels to the front than backwards towards the firer. PMID:10023593

  11. Ultrasonic level sensors for liquids under high pressure

    NASA Technical Reports Server (NTRS)

    Zuckerwar, A. J.; Mazel, D. S.; Hodges, D. Y.

    1986-01-01

    An ultrasonic level sensor of novel design continuously measures the level of a liquid subjected to a high pressure (up to about 40 MPa), as is sometimes required for the effective transfer of the liquid. The sensor operates as a composite resonator fabricated from a standard high-pressure plug. A flat-bottom hole is machined into the plug along its center line. An ultrasonic transducer is bonded rigidly to the interior surface of the bottom wall, while the exterior surface is in contact with the liquid. Although the bottom wall is designed to satisfy the pressure code, it is still sufficiently thin to permit ready excitation of the axisymmetric plate modes of vibration. The liquid level is measured by a conventional pulse-echo technique. A prototype sensor was tested successfully in a 2300-l water vessel at pressures up to about 37 MPa. A spectral analysis of the transmitted pulse reveals that the flexural, extensional, thickness-shear, and radial plate modes are excited into vibration, but none of these appears to be significantly affected by the pressurization of the liquid.

  12. Ultrasonic level sensors for liquids under high pressure

    NASA Astrophysics Data System (ADS)

    Zuckerwar, A. J.; Mazel, D. S.; Hodges, D. Y.

    1986-09-01

    An ultrasonic level sensor of novel design continuously measures the level of a liquid subjected to a high pressure (up to about 40 MPa), as is sometimes required for the effective transfer of the liquid. The sensor operates as a composite resonator fabricated from a standard high-pressure plug. A flat-bottom hole is machined into the plug along its center line. An ultrasonic transducer is bonded rigidly to the interior surface of the bottom wall, while the exterior surface is in contact with the liquid. Although the bottom wall is designed to satisfy the pressure code, it is still sufficiently thin to permit ready excitation of the axisymmetric plate modes of vibration. The liquid level is measured by a conventional pulse-echo technique. A prototype sensor was tested successfully in a 2300-l water vessel at pressures up to about 37 MPa. A spectral analysis of the transmitted pulse reveals that the flexural, extensional, thickness-shear, and radial plate modes are excited into vibration, but none of these appears to be significantly affected by the pressurization of the liquid.

  13. Health Promotion to Reduce Blood Pressure Level among Older Blacks.

    ERIC Educational Resources Information Center

    Haber, David

    1986-01-01

    Low-income Black elders completed a 10-week health promotion program for the purpose of lowering or stabilizing blood pressure levels. Comparisons were made between classes that met weekly versus three times a week, and between yoga and aerobics formats. A peer-led program was developed that continued for 10 months after the professionally-led…

  14. Application of Relationship Between Groundwater Level and Atmospheric Pressure Change

    NASA Astrophysics Data System (ADS)

    Kim, S. J.; Lee, K.

    2013-12-01

    Change in atmospheric pressure affects ground water levels. Barometric efficiency, which is an indicator for different exposure to the atmospheric pressure of observation well and adjacent ground cover, can be used as an effective tool for estimating some groundwater properties. If the top of an observation well is sealed and contact with the atmosphere is blocked, there would be no pressure difference between the well and adjacent ground cover. As a result, the difference between barometric efficiency values of sealed and unsealed well of identical condition can indicates the effect of atmospheric pressure changes on the groundwater level. One month observation data of hydraulic head and atmospheric pressure at Wonju-si in Gangwon-do, Korea are used. Two different methods, Clark's method and graphical method, are adopted to estimate the barometric efficiency. Because the efficiency has implication on the properties of aquifer covering condition, mapping of this efficiency might be used for estimating groundwater vulnerability of contamination from surface-loaded sources.

  15. Environmental correction factors for predicting room sound pressure levels

    SciTech Connect

    Warnock, A.C.C.

    1998-10-01

    ARI Standard 885 provides a method for calculating sound pressure levels in room below plenums containing air-handling devices. An important step in the calculation is the correction of the sound power for the device from values provided by the manufacturer to values appropriate for use in occupied spaces. This correction is called the environmental adjustment factor. It compensates for the fact that sound power measured for a source placed outdoors or in a hemi-free field has been found to be greater at low frequencies than the sound power measured for the same source in a reverberation room. When making predictions of sound pressure level in a room using such sound power levels, one has to estimate the reduction in sound power caused by the room. Estimated reductions provided in ARI 885 were examined during ASHRAE research project RP-755 and found to be too large. Lower values are suggested in this paper.

  16. Plumbing noise: Pressure levels and perception in a luxury condominium

    NASA Astrophysics Data System (ADS)

    Watry, Derek

    2005-09-01

    A consulting project has recently been completed that addressed a number of noise concerns in a 9-unit, 20-year-old luxury condominium building in the San Francisco Bay Area. Among other tasks, the noise levels of four bathroom plumbing functions (flushing, showering, bath filling, bath draining) were measured in adjoining units and an inventory of noise concerns was collected. This paper reports the measured noise levels (nearly a 20-dBA range for every function!) and looks at the corresponding resident assessments not always clearly correlated with sound-pressure level.

  17. Pressure Inactivation of Vibrio parahaemolyticus in Oysters- Influence of Pressure level and Treatment Temperature

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The overall objective of this study was to develop processing parameters (pressure level, time, and temperature) needed to achieve a 5-log reduction of V. parahaemolyticus within live oysters (Crassostrea virginica). Ten strains of V. parahaemolyticus were separately tested for their resistances to...

  18. Wind turbine sound pressure level calculations at dwellings.

    PubMed

    Keith, Stephen E; Feder, Katya; Voicescu, Sonia A; Soukhovtsev, Victor; Denning, Allison; Tsang, Jason; Broner, Norm; Leroux, Tony; Richarz, Werner; van den Berg, Frits

    2016-03-01

    This paper provides calculations of outdoor sound pressure levels (SPLs) at dwellings for 10 wind turbine models, to support Health Canada's Community Noise and Health Study. Manufacturer supplied and measured wind turbine sound power levels were used to calculate outdoor SPL at 1238 dwellings using ISO [(1996). ISO 9613-2-Acoustics] and a Swedish noise propagation method. Both methods yielded statistically equivalent results. The A- and C-weighted results were highly correlated over the 1238 dwellings (Pearson's linear correlation coefficient r > 0.8). Calculated wind turbine SPLs were compared to ambient SPLs from other sources, estimated using guidance documents from the United States and Alberta, Canada. PMID:27036282

  19. Maintaining Optimal Surgical Conditions With Low Insufflation Pressures is Possible With Deep Neuromuscular Blockade During Laparoscopic Colorectal Surgery

    PubMed Central

    Kim, Myoung Hwa; Lee, Ki Young; Lee, Kang-Young; Min, Byung-Soh; Yoo, Young Chul

    2016-01-01

    Abstract Carbon dioxide (CO2) absorption and increased intra-abdominal pressure can adversely affect perioperative physiology and postoperative recovery. Deep muscle relaxation is known to improve the surgical conditions during laparoscopic surgery. We aimed to compare the effects of deep and moderate neuromuscular block in laparoscopic colorectal surgery, including intra-abdominal pressure. In this prospective, double-blind, parallel-group trial, 72 adult patients undergoing laparoscopic colorectal surgery were randomized using an online randomization generator to achieve either moderate (1–2 train-of-four response, n = 36) or deep (1–2 post-tetanic count, n = 36) neuromuscular block by receiving a continuous infusion of rocuronium. Adjusted intra-abdominal pressure, which was titrated by a surgeon with maintaining the operative field during pneumoperitoneum, was recorded at 5-minute intervals. Perioperative hemodynamic parameters and postoperative outcomes were assessed. Six patients from the deep and 5 from the moderate neuromuscular block group were excluded, leaving 61 for analysis. The average adjusted IAP was lower in the deep compared to the moderate neuromuscular block group (9.3 vs 12 mm Hg, P < 0.001). The postoperative pain scores (P < 0.001) and incidence of postoperative shoulder tip pain were lower, whereas gas passing time (P = 0.002) and sips of water time (P = 0.005) were shorter in the deep neuromuscular block than in the moderate neuromuscular block group. Deep neuromuscular blocking showed several benefits compared to conventional moderate neuromuscular block, including a greater intra-abdominal pressure lowering effect, whereas surgical conditions are maintained, less severe postoperative pain and faster bowel function recovery. PMID:26945393

  20. Investigation on Furan Levels in Pressure-Cooked Foods.

    PubMed

    Arisseto, Adriana P; Vicente, Eduardo; Toledo, Maria Cecília F

    2013-01-01

    Furan is a food processing contaminant classified as possibly carcinogenic to humans. As the occurrence of furan has been reported in a variety of foods processed in sealed containers, the objective of this work was to investigate if the contaminant can be found in home-cooked foods prepared in a pressure cooker. For that, several foods including beans, soy beans, whole rice, beef, pork, potato, and cassava were pressure-cooked and analyzed for the furan content by gas chromatography coupled to mass spectrometry preceded by a headspace solid phase microextraction (HS-SPME-GC/MS). Furan was not found above the limit of quantification in the pressure-cooked samples. No furan has either been found in reheated samples after 24 hours under cold storage. Although levels up to 173 μg/kg were already reported for commercial canned/jarred foods, it seems that the cooking in a pressure cooker may not represent a concern in relation to the occurrence of furan in foods. PMID:26962536

  1. Influence of negative pressurization on airborne microbial and radon levels

    SciTech Connect

    Kalliokoski, P.; Korhonen, P.; Kokotti, H.; Pasanen, A.L.; Rautiala, S.; Rantamaeki, J.

    1999-07-01

    The negative pressure inside a building is the main driving force for the entry of both radon and fungal spores. This study was conducted to test the suitability of depressurization to facilitate simultaneously the detection of fungal growth within the lower parts of building envelope and the risk of radon entry. Pressure difference was increased in three steps to 24--28 Pa in two wooden buildings known to suffer from long-term water damages. At the end, pulses of negative pressure were generated. Airborne viable fungal counts, radon and particle counts were followed during the tests together with the ventilation rate and particle count. The absolute concentrations of the impurities studied did not increase significantly or even decreased during the tests due to enhanced ventilation. However, when the increase in the ventilation rate was taken into consideration it was found that the entry rate of all the contaminants increased. The changes were larger in the tighter building where the radon entry rate increased systematically with the pressure difference reaching finally 13.8-fold level compared to the initial value. In the less tight building, the corresponding highest radon entry rate ratio was 9.5. Very large increases, up to 42-fold, were observed in the viable spore count ratio in the tighter building during the tests. In the leaky building, the changes were again considerably smaller; the maximum ratio was 4.2. Increases in particle emissions were smaller than those observed in fungal counts. The pulses were less effective than continuous depressurization. The results show that negative pressurization can be used to increase the release of fungal spores in order to detect hidden fungal growth. This kind of test is especially effective if there are no major leaks in the clean part of the building envelope. The method allows simultaneous rapid checking of need for radon mitigation.

  2. Increased Intraocular Pressure and Hyperglycemic Level in Diabetic Patients

    PubMed Central

    Hymowitz, Maggie B.; Chang, Donny; Feinberg, Edward B.; Roy, Sayon

    2016-01-01

    Purpose To determine whether hyperglycemic levels as determined from high hemoglobin A1c (HbA1c) levels influence intraocular pressure (IOP) in patients with non-proliferative diabetic retinopathy (NPDR). Methods A retrospective chart review was performed on subjects with a diagnosis of NPDR and a corresponding HbA1c level measured within 90 days before or after an IOP measurement over a two-year period. Exclusion criteria included a diagnosis of glaucoma or treatment with IOP lowering medications or oral or topical steroids. Results Using 14.5mmHg as a baseline mean value for IOP, 42 subjects had an IOP < 14.5mmHg and mean HbA1c of 8.1±1.1, while 72 subjects had an IOP ≥ 14.5mmHg and a mean HbA1c of 9.0±2.1. Although there was an overlap in the confidence intervals, a significant difference (P = 0.01) in the mean HbA1c level was observed in regression analysis between the two groups. Importantly, diabetic subjects with elevated HbA1c levels rarely (<1%) exhibited reduced IOP levels. Conclusions Diabetic subjects with elevated HbA1c levels exhibited significantly higher IOPs compared to those with lower HbA1c levels. Findings from this study indicate an association between hyperglycemia and elevated IOP and that poor glycemic control may contribute to increased IOP levels in long-term diabetic patients. PMID:27002725

  3. Activity Restrictions after Gynecologic Surgery: Is There Evidence?

    PubMed Central

    Nygaard, Ingrid E.; Hamad, Nadia M.; Shaw, Janet M.

    2013-01-01

    Introduction Many surgeons recommend rest and restricting activities to their patients after surgery. The aim of this review is to summarize the literature regarding types of activities gynecologic surgeons restrict and intra-abdominal pressure during specific activities and to provide an overview of negative effects of sedentary behavior (rest). Methods We searched Pubmed and Scopus for years 1970 until present and excluded studies that described recovery of activities of daily living after surgery as well as those that assessed intra-abdominal pressure for other reasons such as abdominal compartment syndrome and hypertension. For our review of intra-abdominal pressure, we excluded studies that did not include a generally healthy population, or did not report maximal intra-abdominal pressures. Results We identified no randomized trial or prospective cohort study that studied the association between post-operative activity and surgical success after pelvic floor repair. The ranges of intra-abdominal pressures during specific activities are large and such pressures during activities commonly restricted and not restricted after surgery overlap considerably. There is little concordance in mean peak intra-abdominal pressures across studies. Intra-abdominal pressure depends on many factors, but not least the manner in which it is measured and reported. Conclusions Given trends towards shorter hospital stays and off work intervals, which both predispose women to higher levels of physical activity, we urge research efforts towards understanding the role of physical activity on recurrence of pelvic organ prolapse and urinary incontinence after surgery. PMID:23340879

  4. Serum testosterone levels and arterial blood pressure in the elderly.

    PubMed

    Fogari, Roberto; Preti, Paola; Zoppi, Annalisa; Fogari, Elena; Rinaldi, Andrea; Corradi, Luca; Mugellini, Amedeo

    2005-08-01

    The aim of this study was to evaluate the relationship between serum testosterone levels and arterial blood pressure (BP) in the elderly. We studied 356 non-diabetic, non-smoking, non-obese men aged 60 to 80 years and untreated for hypertension. All subjects were evaluated in the morning after an overnight fast. Evaluation included measurements of the following: BP (by mercury sphygmomanometer, Korotkoff I and V), body weight, height and free testosterone (T) plasma levels (by radioimmunoassay). According to the BP values, the subjects were classified as normotensives (NT; n=112; SBP/DBP<140/90 mmHg), systolic and diastolic hypertensives (HT; n=127; SBP/DBP>140/90 mmHg), and isolated systolic hypertensives (ISH; n=117; SBP>140 mmHg and DBP<90 mmHg). T values decreased with increasing age in all 3 groups and was significantly lower in HT (-15%) and ISH men (-21%) than in NT men (p<0.05). In each group, the T levels showed a highly significant negative correlation with BMI (p<0.001). A significant negative correlation was also found between T levels and SBP in NT (r=-0.35, p<0.001), ISH (r=-0.67, p<0.001), and HT (r=-0.19, p<0.05) men, whereas a negative correlation with DBP was observed only in the NT men (r=-0.19, p<0.05). Adjusting for the BMI confirmed a significant difference in plasma T levels between ISH and NT men, but not between HT and NT men. Multiple regression analysis employing BP as a dependent variable confirmed a strong relationship between T levels and SBP in all 3 groups, whereas a significant relationship between T levels and DBP was found only in NT men. In conclusion, although further studies are needed to clarify the relationship between plasma T levels and BP, our findings suggest that in elderly men with ISH, the reduced plasma levels of testosterone might contribute to the increased arterial stiffness typical of these subjects. PMID:16392765

  5. Sound pressure level gain in an acoustic metamaterial cavity.

    PubMed

    Song, Kyungjun; Kim, Kiwon; Hur, Shin; Kwak, Jun-Hyuk; Park, Jihyun; Yoon, Jong Rak; Kim, Jedo

    2014-01-01

    The inherent attenuation of a homogeneous viscous medium limits radiation propagation, thereby restricting the use of many high-frequency acoustic devices to only short-range applications. Here, we design and experimentally demonstrate an acoustic metamaterial localization cavity which is used for sound pressure level (SPL) gain using double coiled up space like structures thereby increasing the range of detection. This unique behavior occurs within a subwavelength cavity that is 1/10(th) of the wavelength of the incident acoustic wave, which provides up to a 13 dB SPL gain. We show that the amplification results from the Fabry-Perot resonance of the cavity, which has a simultaneously high effective refractive index and effective impedance. We also experimentally verify the SPL amplification in an underwater environment at higher frequencies using a sample with an identical unit cell size. The versatile scalability of the design shows promising applications in many areas, especially in acoustic imaging and underwater communication. PMID:25502279

  6. General circulation model simulations of winter and summer sea-level pressures over North America

    USGS Publications Warehouse

    McCabe, G.J., Jr.; Legates, D.R.

    1992-01-01

    In this paper, observed sea-level pressures were used to evaluate winter and summer sea-level pressures over North America simulated by the Goddard Institute for Space Studies (GISS) and the Geophysical Fluid Dynamics Laboratory (GFDL) general circulation models. The objective of the study is to determine how similar the spatial and temporal distributions of GCM-simulated daily sea-level pressures over North America are to observed distributions. Overall, both models are better at reproducing observed within-season variance of winter and summer sea-level pressures than they are at simulating the magnitude of mean winter and summer sea-level pressures. -from Authors

  7. 16 CFR 1500.47 - Method for determining the sound pressure level produced by toy caps.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Method for determining the sound pressure... ENFORCEMENT REGULATIONS § 1500.47 Method for determining the sound pressure level produced by toy caps. (a... of the explosive. Measure the peak sound pressure level at each of the six designated orientations...

  8. Contact Pressure Level Indication Using Stepped Output Tactile Sensors

    PubMed Central

    Choi, Eunsuk; Sul, Onejae; Kim, Juyoung; Kim, Kyumin; Kim, Jong-Seok; Kwon, Dae-Yong; Choi, Byong-Deok; Lee, Seung-Beck

    2016-01-01

    In this article, we report on a novel diaphragm-type tactile pressure sensor that produces stepwise output currents depending on varying low contact pressures. When contact pressures are applied to the stepped output tactile sensor (SOTS), the sensor’s suspended diaphragm makes contact with the substrate, which completes a circuit by connecting resistive current paths. Then the contact area, and therefore the number of current paths, would determine the stepped output current produced. This mechanism allows SOTS to have high signal-to-noise ratio (>20 dB) in the 3–500 Hz frequency range at contact pressures below 15 kPa. Moreover, since the sensor’s operation does not depend on a material’s pressure-dependent electrical properties, the SOTS is able to demonstrate high reproducibility and reliability. By forming a 4 × 4 array of SOTS with a surface bump structure, we demonstrated shear sensing as well as surface (1 × 1 cm2) pressure mapping capabilities. PMID:27070626

  9. Contact Pressure Level Indication Using Stepped Output Tactile Sensors.

    PubMed

    Choi, Eunsuk; Sul, Onejae; Kim, Juyoung; Kim, Kyumin; Kim, Jong-Seok; Kwon, Dae-Yong; Choi, Byong-Deok; Lee, Seung-Beck

    2016-01-01

    In this article, we report on a novel diaphragm-type tactile pressure sensor that produces stepwise output currents depending on varying low contact pressures. When contact pressures are applied to the stepped output tactile sensor (SOTS), the sensor's suspended diaphragm makes contact with the substrate, which completes a circuit by connecting resistive current paths. Then the contact area, and therefore the number of current paths, would determine the stepped output current produced. This mechanism allows SOTS to have high signal-to-noise ratio (>20 dB) in the 3-500 Hz frequency range at contact pressures below 15 kPa. Moreover, since the sensor's operation does not depend on a material's pressure-dependent electrical properties, the SOTS is able to demonstrate high reproducibility and reliability. By forming a 4 × 4 array of SOTS with a surface bump structure, we demonstrated shear sensing as well as surface (1 × 1 cm²) pressure mapping capabilities. PMID:27070626

  10. Inconsistencies in sea level pressure trends between different atmospheric products. Impact on sea level trend estimation

    NASA Astrophysics Data System (ADS)

    Gomis, D.; Jordà, G.

    2012-04-01

    Long term climate datasets are of great importance to understand the processes behind climate variability, to evaluate the performance of climate models and to identify signals of climate change. Among the different atmospheric variables, sea level pressure (SLP) is the basic dynamical variable and is the most widely analyzed quantity. From the ocean perspective, SLP is of crucial importance for a dynamical interpretation of sea level records. In order to isolate the contribution to sea level variability of circulation and heat and freshwater contents, a common practice is to remove the sea level fluctuations induced by SLP. At seasonal and longer time scales, sea level is expected to react as an inverted barometer (IB) to changes in SLP. Therefore, provided that accuracy of available SLP data is high enough, the atmospheric contribution to sea level variability can be isolated and removed from sea level records. This is routinely done for tide gauge records, altimetry or sea level reconstructions. Different atmospheric gridded products spanning the last decades are nowadays available. On the one hand, there are historical SLP datasets where observations from land stations and ocean observations have been interpolated into a regular grid. On the other hand, there are reanalyses where an atmospheric model is run assimilating the historical data. Both kind of products have been extensively used in recent years either directly (i.e. to analyse the SLP evolution) or indirectly (i.e. through the removal of IB effect on sea level records). However, it is well known that the quality of those products may not be homogeneous on time. In this contribution, we compare long term SLP trends from different atmospheric products (reanalysis and gridded historical datasets), and evaluate the uncertainties introduced by them in the sea level trend estimations. The results show that discrepancies between datasets can induce an uncertainty up to 0.5 mm/yr for the period 1958-2001 on

  11. Laboratory evaluation of the pressure water level data logger manufactured by Infinities USA, Inc.: results of pressure and temperature tests

    USGS Publications Warehouse

    Carnley, Mark V.

    2015-01-01

    The Pressure Water Level Data Logger manufactured by Infinities USA, Inc., was evaluated by the U.S. Geological Survey (USGS) Hydrologic Instrumentation Facility for conformance with the manufacturer’s stated accuracy specifications for measuring pressure throughout the device’s operating temperature range and with the USGS accuracy requirements for water-level measurements. The Pressure Water Level Data Logger (Infinities Logger) is a submersible, sealed, water-level sensing device with an operating pressure range of 0 to 11.5 feet of water over a temperature range of −18 to 49 degrees Celsius. For the pressure range tested, the manufacturer’s accuracy specification of 0.1 percent of full scale pressure equals an accuracy of ±0.138 inch of water. Three Infinities Loggers were evaluated, and the testing procedures followed and results obtained are described in this report. On the basis of the test results, the device is poorly compensated for temperature. For the three Infinities Loggers, the mean pressure differences varied from –4.04 to 5.32 inches of water and were not within the manufacturer’s accuracy specification for pressure measurements made within the temperature-compensated range. The device did not meet the manufacturer’s stated accuracy specifications for pressure within its temperature-compensated operating range of –18 to 49 degrees Celsius or the USGS accuracy requirements of no more than 0.12 inch of water (0.01 foot of water) or 0.10 percent of reading, whichever is larger. The USGS accuracy requirements are routinely examined and reported when instruments are evaluated at the Hydrologic Instrumentation Facility. The estimated combined measurement uncertainty for the pressure cycling test was ±0.139 inch of water, and for temperature, the cycling test was ±0.127 inch of water for the three Infinities Loggers.

  12. The global historical climatology network: Long-term monthly temperature, precipitation, sea level pressure, and station pressure data

    SciTech Connect

    Vose, R.S.; Schmoyer, R.L.; Steurer, P.M.; Peterson, T.C.

    1992-12-31

    This NDP contains monthly temperature, precipitation, sea level pressure, and station pressure data for thousands of meteorological stations worldwide. The database was compiled from pre-existing national, regional, and global collections of data as a part of the Global Historical Climatology Network (CHCN) project. It contains data from roughly 6000 temperature stations, 7500 precipitation stations, 1800 sea level pressure stations, and 1800 station pressure stations. Each station has at least 10 years of data, and about 40% have more than 50 years of data. Spatial coverage is good over most of the globe, particularly for the United States and Europe. Data gaps are evident over the Amazon rainforest, the Sahara desert, Greenland, and Antarctica.

  13. [Corrrelation between blood pressure levels in patients with glaucoma (Literature review)].

    PubMed

    Ovchinnikov, Yu V; Kuroedov, A V; Baranova, N A; Ibragimova, F M

    2016-01-01

    The problem of correlation between blood pressure levels and intraocular pressure is one of the most talked about. Both, Russian and foreign literature, reflects the heterogeneity of views on the impact of blood pressure changes into the level of intraocular. pressure. At the same time it underestimated the role of systemic cardiovascular changes in the deterioration of visual function in case of primary open-angle glaucoma. Numerous data demonstrate the role of additional factors than average blood pressure levels in advance of glaucoma. More and more researchers tend to assess not only intraocular pressure, but also perfusion pressure as a risk predictor of advance of glaucoma. Correlation between blood pressure level and intraocular pressure has a particular relevance due to the significant improvement of the range of cardiovascular drugs that can affect on intraocular pressure indictors. A number of literature data confirm the need to research variations in blood pressure levels during the day and types of therapy that patients receive. PMID:27120953

  14. Understanding the relation between wind- and pressure-driven sea level variability

    NASA Technical Reports Server (NTRS)

    Ponte, Rui M.

    1994-01-01

    Sea surface adjustment to combined wind and pressure forcing is examined using numerical solutions to the shallow water equations. The experiments use coastal geometry and bottom topography representative of the North Atlantic and are forced by realistic barometric pressure and wind stress fields. The repsonse to pressure is essentially static or close to the inverted barometer solution at periods longer than a few days and dominates the sea level variability, with wind-driven sea level signals being relatively small. With regard to the dynamic signals, wind-driven fluctuations dominate at long periods, as expected from quasi-geostrophic theory. Pressure becomes more important than wind stress as a source of dynamic signals only at periods shorter than approximately three days. Wind- and pressure-driven sea level fluctuations are anticorrelated over most regions. Hence, regressions of sea level on barometric pressure yield coefficients generally smaller than expected for the inverted barometer response known to be the case in the model. In the regions of significant wind-pressure correlation effects, to infer the correct pressure reponse using statistical methods, input fields must include winds as well as pressure. Because of the nonlocal character of the wind response, multivariate statistical models with local wind driving as input are not very successful. Inclusion of nonlocal wind variability over extensive regions is necessary to extract the correct pressure response. Implications of these results to the interpretation of sea level observations are discussed.

  15. Prediction of light aircraft interior sound pressure level using the room equation

    NASA Technical Reports Server (NTRS)

    Atwal, M.; Bernhard, R.

    1984-01-01

    The room equation is investigated for predicting interior sound level. The method makes use of an acoustic power balance, by equating net power flow into the cabin volume to power dissipated within the cabin using the room equation. The sound power level transmitted through the panels was calculated by multiplying the measured space averaged transmitted intensity for each panel by its surface area. The sound pressure level was obtained by summing the mean square sound pressures radiated from each panel. The data obtained supported the room equation model in predicting the cabin interior sound pressure level.

  16. GSOD Based Daily Global Mean Surface Temperature and Mean Sea Level Air Pressure (1982-2011)

    SciTech Connect

    Xuan Shi, Dali Wang

    2014-05-05

    This data product contains all the gridded data set at 1/4 degree resolution in ASCII format. Both mean temperature and mean sea level air pressure data are available. It also contains the GSOD data (1982-2011) from NOAA site, contains station number, location, temperature and pressures (sea level and station level). The data package also contains information related to the data processing methods

  17. How male sound pressure level influences phonotaxis in virgin female Jamaican field crickets (Gryllus assimilis)

    PubMed Central

    Pacheco, Karen

    2014-01-01

    Understanding female mate preference is important for determining the strength and direction of sexual trait evolution. The sound pressure level (SPL) acoustic signalers use is often an important predictor of mating success because higher sound pressure levels are detectable at greater distances. If females are more attracted to signals produced at higher sound pressure levels, then the potential fitness impacts of signalling at higher sound pressure levels should be elevated beyond what would be expected from detection distance alone. Here we manipulated the sound pressure level of cricket mate attraction signals to determine how female phonotaxis was influenced. We examined female phonotaxis using two common experimental methods: spherical treadmills and open arenas. Both methods showed similar results, with females exhibiting greatest phonotaxis towards loud sound pressure levels relative to the standard signal (69 vs. 60 dB SPL) but showing reduced phonotaxis towards very loud sound pressure level signals relative to the standard (77 vs. 60 dB SPL). Reduced female phonotaxis towards supernormal stimuli may signify an acoustic startle response, an absence of other required sensory cues, or perceived increases in predation risk. PMID:24949249

  18. A novel technique towards deployment of hydrostatic pressure based level sensor in nuclear fuel reprocessing facility

    NASA Astrophysics Data System (ADS)

    Praveen, K.; Rajiniganth, M. P.; Arun, A. D.; Sahoo, P.; Satya Murty, S. A. V.

    2016-02-01

    A novel approach towards deployment of a hydrostatic pressure based level monitoring device is presented for continuous monitoring of liquid level in a reservoir with high resolution and precision. Some of the major drawbacks such as spurious information of measured level due to change in ambient temperature, requirement of high resolution pressure sensor, and bubbling effect by passing air or any gaseous fluid into the liquid are overcome by using such a newly designed hydrostatic pressure based level monitoring device. The technique involves precise measurement of hydrostatic pressure exerted by the process liquid using a high sensitive pulsating-type differential pressure sensor (capacitive type differential pressure sensor using a specially designed oil manometer) and correlating it to the liquid level. In order to avoid strong influence of temperature on liquid level, a temperature compensation methodology is derived and used in the system. A wireless data acquisition feature has also been provided in the level monitoring device in order to work in a remote area such as a radioactive environment. At the outset, a prototype level measurement system for a 1 m tank is constructed and its test performance has been well studied. The precision, accuracy, resolution, uncertainty, sensitivity, and response time of the prototype level measurement system are found to be less than 1.1 mm in the entire range, 1%, 3 mm, <1%, 10 Hz/mm, and ˜4 s, respectively.

  19. A novel technique towards deployment of hydrostatic pressure based level sensor in nuclear fuel reprocessing facility.

    PubMed

    Praveen, K; Rajiniganth, M P; Arun, A D; Sahoo, P; Murty, S A V Satya

    2016-02-01

    A novel approach towards deployment of a hydrostatic pressure based level monitoring device is presented for continuous monitoring of liquid level in a reservoir with high resolution and precision. Some of the major drawbacks such as spurious information of measured level due to change in ambient temperature, requirement of high resolution pressure sensor, and bubbling effect by passing air or any gaseous fluid into the liquid are overcome by using such a newly designed hydrostatic pressure based level monitoring device. The technique involves precise measurement of hydrostatic pressure exerted by the process liquid using a high sensitive pulsating-type differential pressure sensor (capacitive type differential pressure sensor using a specially designed oil manometer) and correlating it to the liquid level. In order to avoid strong influence of temperature on liquid level, a temperature compensation methodology is derived and used in the system. A wireless data acquisition feature has also been provided in the level monitoring device in order to work in a remote area such as a radioactive environment. At the outset, a prototype level measurement system for a 1 m tank is constructed and its test performance has been well studied. The precision, accuracy, resolution, uncertainty, sensitivity, and response time of the prototype level measurement system are found to be less than 1.1 mm in the entire range, 1%, 3 mm, <1%, 10 Hz/mm, and ∼4 s, respectively. PMID:26931895

  20. Differences in heartbeat awareness among males with higher and lower levels of systolic blood pressure.

    PubMed

    O'Brien, W H; Reid, G J; Jones, K R

    1998-06-01

    Recent empirical findings related to the baroreceptor hypothesis indicate that elevated heart rate, pulse pressure, and blood pressure may dampen exteroception and interoception. We thus predicted that persons with elevated systolic blood pressure would be less able to accurately perceive their heartbeats and profit from feedback training. This study examined the plausibility of this hypothesis by exposing 57 male students (11 with elevated SBP levels and 46 with normotensive SBP levels) to the Whitehead heartbeat perception task with, and without, feedback training. Results indicated that participants with elevated SBP levels were more able to accurately perceive their heartbeats prior to, and after, feedback training. Participants with elevated SBP levels also showed a significant increase in heartbeat perception accuracy when they were provided with feedback training while participants with normotensive blood pressure levels did not show a significant response to feedback training. These findings are interpreted in terms of the ballistic perception model of cardiac awareness. PMID:9641248

  1. Calculating far-field radiated sound pressure levels from NASTRAN output

    NASA Technical Reports Server (NTRS)

    Lipman, R. R.

    1986-01-01

    FAFRAP is a computer program which calculates far field radiated sound pressure levels from quantities computed by a NASTRAN direct frequency response analysis of an arbitrarily shaped structure. Fluid loading on the structure can be computed directly by NASTRAN or an added-mass approximation to fluid loading on the structure can be used. Output from FAFRAP includes tables of radiated sound pressure levels and several types of graphic output. FAFRAP results for monopole and dipole sources compare closely with an explicit calculation of the radiated sound pressure level for those sources.

  2. Nasal high-flow therapy delivers low level positive airway pressure

    PubMed Central

    Parke, R.; McGuinness, S.; Eccleston, M.

    2009-01-01

    Background The aim of this prospective study was to determine whether a level of positive airway pressure was generated in participants receiving nasal high flow (NHF) delivered by the Optiflow™ system (Fisher and Paykel Healthcare Ltd, Auckland, New Zealand) in a cardiothoracic and vascular intensive care unit (ICU). Methods Nasopharyngeal airway pressure was measured in 15 postoperative cardiac surgery adult patients who received both NHF and standard facemask therapy at a flow rate of 35 litre min−1. Measurements were repeated in the open mouth and closed mouth positions. Mean airway pressure was determined by averaging the pressures at the peak of inspiration of each breath within a 1 min period, allowing the entire pressure profile of each breath to be included within the calculation. Results Low level positive pressure was demonstrated with NHF at 35 litre min−1 with mouth closed when compared with a facemask. NHF generated a mean nasopharyngeal airway pressure of mean (sd) 2.7 (1.04) cm H2O with the mouth closed. Airway pressure was significantly higher when breathing with mouth closed compared with mouth open (P≤0.0001). Conclusions This study demonstrated that a low level of positive pressure was generated with NHF at 35 litre min−1 of gas flow. This is consistent with results obtained in healthy volunteers. Australian Clinical Trials Registry www.actr.org.au ACTRN012606000139572. PMID:19846404

  3. [Effect of lipril on the level of blood pressure in rats with spontaneus blood hypertention].

    PubMed

    Zahorodnyĭ, M I

    2007-01-01

    The author studied influence of Ukrainian antyhypertensive drug--Lipril (Uzynopryl) on the level of blood pressure in rats with spontaneus blood hypertention. It was sound that daily (during 90 days) application of Lipril at 10 mg/kg per os decreases considerably blood pressure in rats. PMID:17682519

  4. Temperature and pressure effects on capacitance probe cryogenic liquid level measurement accuracy

    NASA Technical Reports Server (NTRS)

    Edwards, Lawrence G.; Haberbusch, Mark

    1993-01-01

    The inaccuracies of liquid nitrogen and liquid hydrogen level measurements by use of a coaxial capacitance probe were investigated as a function of fluid temperatures and pressures. Significant liquid level measurement errors were found to occur due to the changes in the fluids dielectric constants which develop over the operating temperature and pressure ranges of the cryogenic storage tanks. The level measurement inaccuracies can be reduced by using fluid dielectric correction factors based on measured fluid temperatures and pressures. The errors in the corrected liquid level measurements were estimated based on the reported calibration errors of the temperature and pressure measurement systems. Experimental liquid nitrogen (LN2) and liquid hydrogen (LH2) level measurements were obtained using the calibrated capacitance probe equations and also by the dielectric constant correction factor method. The liquid levels obtained by the capacitance probe for the two methods were compared with the liquid level estimated from the fluid temperature profiles. Results show that the dielectric constant corrected liquid levels agreed within 0.5 percent of the temperature profile estimated liquid level. The uncorrected dielectric constant capacitance liquid level measurements deviated from the temperature profile level by more than 5 percent. This paper identifies the magnitude of liquid level measurement error that can occur for LN2 and LH2 fluids due to temperature and pressure effects on the dielectric constants over the tank storage conditions from 5 to 40 psia. A method of reducing the level measurement errors by using dielectric constant correction factors based on fluid temperature and pressure measurements is derived. The improved accuracy by use of the correction factors is experimentally verified by comparing liquid levels derived from fluid temperature profiles.

  5. Can Population-Level Laterality Stem from Social Pressures? Evidence from Cheek Kissing in Humans

    PubMed Central

    Chapelain, Amandine; Pimbert, Pauline; Aube, Lydiane; Perrocheau, Océane; Debunne, Gilles; Bellido, Alain; Blois-Heulin, Catherine

    2015-01-01

    Despite extensive research, the origins and functions of behavioural laterality remain largely unclear. One of the most striking unresolved issues is the fact that laterality generally occurs at the population-level. Why would the majority of the individuals of a population exhibit the same laterality, while individual-level laterality would yet provide the advantages in terms of improving behavioural efficiency? Are social pressures the key factor? Can social pressures induce alignment of laterality between the individuals of a population? Can the effect of social pressures overpass the effect of other possible determining factors (e.g. genes)? We tested this important new hypothesis in humans, for the first time. We asked whether population-level laterality could stem from social pressures. Namely, we assessed social pressures on laterality in an interactive social behaviour: kissing on the cheek as a greeting. We performed observations in 10 cities of France. The observations took place in spots where people of the city meet and greet each other. We showed that: a) there is a population-level laterality for cheek kissing, with the majority of individuals being aligned in each city, and b) there is a variation between populations, with a laterality that depends on the city. These results were confirmed by our complementary data from questionnaires and internet surveys. These findings show that social pressures are involved in determining laterality. They demonstrate that population-level laterality can stem from social pressures. PMID:26270648

  6. Does temperature affect the accuracy of vented pressure transducer in fine-scale water level measurement?

    NASA Astrophysics Data System (ADS)

    Liu, Z.; Higgins, C. W.

    2015-03-01

    Submersible pressure transducers have been utilized for collecting water level data since the early 1960s. Together with a digital data logger, it is a convenient way to record water level fluctuations for long-term monitoring. Despite the wide use of pressure transducers for water level monitoring, little has been reported regarding their accuracy and performance under field conditions. The effects of temperature fluctuations on the output of vented pressure transducers were considered in this study. The pressure transducers were tested under both laboratory and field conditions. The results of this study indicate that temperature fluctuation has a strong effect on the transducer output. Rapid changes in temperature introduce noise and fluctuations in the water level readings under a constant hydraulic head while the absolute temperature is also related to sensor errors. The former is attributed to venting and the latter is attributed to temperature compensation effects in the strain gauges. Individual pressure transducers responded differently to the thermal fluctuations in the same testing environment. In the field of surface hydrology, especially when monitoring fine-scale water level fluctuations, ignoring or failing to compensate for the temperature effect can introduce considerable error into pressure transducer readings. It is recommended that a performance test for the pressure transducer is conducted before field deployment.

  7. Does temperature affect the accuracy of vented pressure transducer in fine-scale water level measurement?

    NASA Astrophysics Data System (ADS)

    Liu, Z.; Higgins, C. W.

    2014-09-01

    Submersible pressure transducers have been utilized for collecting water level data since early 1960s. Together with a digital datalogger, it is a convenient way to record water level fluctuations for long-term monitoring. Despite the widely use of pressure transducers for water level monitoring, little has been reported for their accuracy and performance under field conditions. The effect of temperature fluctuations on the output of vented pressure transducers were discussed in this study. The pressure transducer was tested under both laboratory and field conditions. The results of this study indicate that temperature fluctuation has a strong effect on the transducer output. Rapid changes in temperature introduce noise and fluctuations in the water level readings under a constant hydraulic head while the absolute temperature is also related to sensor errors. The former is attributed to venting and the latter is attributed to temperature compensation effect in the strain gauges. Individual pressure transducers responded differently to the thermal fluctuations in the same testing environment. In the field of surface hydrology, especially when monitoring fine-scale water level fluctuations, ignoring or failing to compensate for the temperature effect can introduce considerable error into pressure transducer readings. It is recommended that a performance test for the pressure transducer is conducted before field deployment.

  8. The relationship between sea-level and bottom pressure variability in an eddy permitting ocean model

    NASA Astrophysics Data System (ADS)

    Bingham, Rory J.; Hughes, Chris W.

    2008-02-01

    We investigate the relationship between sea-level (after application of an inverse-barometer correction) and ocean bottom pressure, in an eddy-permitting ocean model. We find the presence of eddies can disrupt this relationship even on timescales as short as 10-20 days, but only in the regions of most energetic eddy variability. Away from eddies, the relationship is similar to that seen in a coarser-resolution model, with a tight relationship between sea-level and bottom pressure at high frequencies, but with significant correlations between sea-level and bottom pressure at interannual timescales seen only in shelf sea regions. In the deep ocean, regions where sea-level and bottom pressure remain related out to the longest timescales are in the Arctic Ocean and regions of the Southern Ocean, where particularly large amplitude barotropic fluctuations are found but where the mesoscale signal is weak.

  9. Correlation of combustor acoustic power levels inferred from internal fluctuating pressure measurements

    NASA Technical Reports Server (NTRS)

    Vonglahn, U. H.

    1978-01-01

    Combustion chamber acoustic power levels inferred from internal fluctuating pressure measurements are correlated with operating conditions and chamber geometries over a wide range. The variables include considerations of chamber design (can, annular, and reverse-flow annular) and size, number of fuel nozzles, burner staging and fuel split, airflow and heat release rates, and chamber inlet pressure and temperature levels. The correlated data include those obtained with combustion component development rigs as well as engines.

  10. The preoperative intraocular pressure level predicts the amount of underestimated intraocular pressure after LASIK for myopia

    PubMed Central

    Chihara, E; Takahashi, H; Okazaki, K; Park, M; Tanito, M

    2005-01-01

    Aims: To evaluate the statistical significance of the parameters that affect underestimation of intraocular pressure (IOP) after laser in situ keratomileusis (LASIK) for myopia. Methods: In this prospective case series study, patient age, axial length, preoperative corneal curvature, preoperative central corneal thickness (CCT), preoperative IOP, and ablation depth were studied to determine whether they affect the underestimation of IOP in the right eyes of 100 consecutive patients who underwent LASIK. Results: The preoperative IOP was the most important parameter for an amount of underestimated Goldmann applanation tonometric IOP (GAT) and non-contact tonometric IOP (ncIOP) at 1 month (r = 0.654, p<0.0001, R2 = 0.427, and r = 0.694, p<0.0001, R2 = 0.481, respectively) and 3 months (r = 0.637, p<0.0001, R2 = 0.406, and r = 0.726, p<0.0001, R2 = 0.527, respectively). Patient age was statistically significant for underestimating the GAT at 1 month, and both the ablation depth and CCT were statistically significant parameters for underestimating the ncIOP at 1 month and at 3 months by stepwise multiple regression analysis (F>4.000). However, these parameters had small bivariate correlation coefficients, and were considered as minor parameters. Conclusion: Preoperative IOP is the most important parameter that affects an underestimation of IOP after LASIK for myopia. Eyes with a higher true IOP have a larger underestimation of the IOP after LASIK for myopia. From these results, the importance of the modulus of elasticity on IOP measurements was discussed. PMID:15665345

  11. High sound pressure levels in Bavarian discotheques remain after introduction of voluntary agreements.

    PubMed

    Twardella, Dorothee; Wellhoefer, Andrea; Brix, Jutta; Fromme, Hermann

    2008-01-01

    While no legal rules or regulations exist in Germany, voluntary measures were introduced to achieve a reduction of sound pressure levels in discotheques to levels below 100 dB(A). To evaluate the current levels in Bavarian discotheques and to find out whether these voluntary measures ensured compliance with the recommended limits, sound pressure levels were measured in 20 Bavarian discotheques between 11 p.m. and 2 a.m. With respect to the equivalent continuous A-weighted sound pressure level for each 30-minute period (L Aeq,30min ), only 4/20 discotheques remained below the limit of 100 dB(A) in all time periods. Ten discotheques had sound pressure levels below 100 dB(A) for the total measurement period (L Aeq,180min ). None of the evaluated factors (weekday, size, estimated age of attendees, the use of voluntary measures such as participation of disc jockeys in a tutorial, or the availability of a sound level meter for the DJs) was significantly associated with the maximal L Aeq, 30min . Thus, the introduction of voluntary measures was not sufficient to ensure compliance with the recommended limits of sound pressure levels. PMID:19075456

  12. Modeling the barotropic response of the Mediterranean sea level to atmospheric pressure forcing

    NASA Astrophysics Data System (ADS)

    Natsiopoulos, Dimitrios A.; Vergos, Georgios S.; Tziavos, Ilias N.

    2014-05-01

    An important characteristic of the Earth's atmosphere with direct impact on the marine environmental and Earth's gravity field are the variations of atmospheric pressure as it often determines wind and weather patterns across the globe. Variations in atmospheric pressure and especially low atmospheric systems affect the values of radar altimeter sea level anomalies (SLA). This response of sea level is closed to the Inverse Barometer (IB) correction given by the altimeters within their geophysical data records. In this work, altimetric data sets from the satellite remote sensing mission of Jason-2, along with their total IB corrections acquired by the on-board altimeters, have been used for a period of forty days between October and November 2013. This period was characterized by extreme low-pressure fields over the Mediterranean Sea and especially in the area of the Ionian and Adriatic Seas and over the island of Rhodes, Greece. The Jason-2 along-track records of the SLA have been used to study both the sea level response to atmospheric pressure change over short time scales (such as ten days) and examine if the barometer correction (local and global) given by the altimeter is close to the expected response (-1 cm/mbar) of sea level to atmospheric pressure change. For the latter, atmospheric pressure data for the period under study were available from the Live Access Server (LAS) of NOAA, as well, provided at four times per day intervals in a grid format. From the LAS atmospheric pressure data, the IB effect was computed and compared with the one provided by the altimeter for its external evaluation. Finally, a regional multiple regression analysis between sea level anomalies, the LAS atmospheric pressure and wind speed components is carried out to model the barotropic response of the Mediterranean to atmospheric wind and pressure forcing.

  13. Sporadic intra-abdominal desmoid tumor: a unusual presentation.

    PubMed

    Lasseur, Antoinette; Pasquer, Arnaud; Feugier, Patrick; Poncet, Gilles

    2016-01-01

    Desmoid tumors are rare potentially aggressive benign tumors. Various etiologies and recurrent factors have been presented and discussed. A case of an abdominal desmoid tumor with vascular mesenteric invasion in a 32-year-old female, over 2 years after pregnancy is presented. Pre-operative biopsy was not contributive, diagnosis was made after surgery. Resection required two vascular bypasses. Desmoid tumors appear frequently in women of child-bearing age (during or after pregnancy), hormonal signaling is probably involved, but pathways remain unknown. Multiple predictive factors of recurrence are discussed but not strongly identified due to underpowered studies: resection margins, age, sex, tumor's size and location. Recent development is in favor of a non-aggressive treatment such as 'wait and see' procedures. Without radical treatment, these tumors could generate bowel compression or perforation. Due to their location and high risk of complication, surgery is the most fitted option. PMID:27150282

  14. Sporadic intra-abdominal desmoid tumor: a unusual presentation

    PubMed Central

    Lasseur, Antoinette; Pasquer, Arnaud; Feugier, Patrick; Poncet, Gilles

    2016-01-01

    Desmoid tumors are rare potentially aggressive benign tumors. Various etiologies and recurrent factors have been presented and discussed. A case of an abdominal desmoid tumor with vascular mesenteric invasion in a 32-year-old female, over 2 years after pregnancy is presented. Pre-operative biopsy was not contributive, diagnosis was made after surgery. Resection required two vascular bypasses. Desmoid tumors appear frequently in women of child-bearing age (during or after pregnancy), hormonal signaling is probably involved, but pathways remain unknown. Multiple predictive factors of recurrence are discussed but not strongly identified due to underpowered studies: resection margins, age, sex, tumor’s size and location. Recent development is in favor of a non-aggressive treatment such as ‘wait and see’ procedures. Without radical treatment, these tumors could generate bowel compression or perforation. Due to their location and high risk of complication, surgery is the most fitted option. PMID:27150282

  15. Testicular ascent as a mechanism for intra-abdominal torsion.

    PubMed

    Plitt, David C; Fotos, Joseph S; Hulse, Michael A; Neutze, Janet A

    2010-01-01

    Testicular ascent, while uncommon, can occur. A testicle that has ascended out of the scrotum can torse and may present as an acute inguinal mass or acute abdomen. Testicle ascent can occur even if previous intra-scrotal location has been documented. PMID:27307855

  16. [Disease picture of intra-abdominal hernias in childhood].

    PubMed

    Waldschmidt, J; Pankrath, K; Charissis, G

    1985-01-01

    Through the demonstration of 3 cases (6-year-old-girl with right mesenterico-parietal hernia; 2 year-old-boy with a transverso-mesocolic hernia; 10-months-old-boy with a hernia in the mesenterium of a M.D.) we discuss the problems of intraabdominal hernia. The evaluation of the disease can take many forms. Only one third of the children remains without symptoms; the other third has a chronic evaluation and the last third an acute abdomen. Once diagnosed internal hernia must soon be operated. PMID:4058161

  17. Intra-abdominal fluid aspirate from a dog.

    PubMed

    Crippa, Valentina; Ghisleni, Gabriele; Avallone, Giancarlo; Caniatti, Mario

    2016-02-01

    A 12-year-old, neutered female, Siberian husky, was presented with a 6-months history of progressive abdominal distension, anorexia, and weight loss. The dog appeared normal on physical examination except for marked abdominal distension. A fluid wave was balloted strongly suggesting an abdominal effusion. Ultrasound examination confirmed this clinical finding. Results of the CBC included mild nonregenerative anemia, with an RBC count of 4.9 × 10(6)/µL (reference interval 5.5-8.5 × 10(6)/µL), hemoglobin concentration of 12 g/dL (reference interval 12-18 g/dL), HCT of 36% (reference interval 37-55%), and reticulocytes <60,000/µL. No abnormalities in serum chemistry were detected. PMID:26668089

  18. Ultrasonic liquid-level detector for varying temperature and pressure environments

    DOEpatents

    Anderson, R.L.; Miller, G.N.

    1981-10-26

    An ultrasonic liquid level detector for use in varying temperature and pressure environments, such as a pressurized water nuclear reactor vessel, is provided. The detector employs ultrasonic extensional and torsional waves launched in a multiplexed alternating sequence into a common sensor. The sensor is a rectangular cross section stainless steel rod which extends into the liquid medium whose level is to be detected. The sensor temperature derived from the extensional wave velocity measurements is used to compensate for the temperature dependence of the torsional wave velocity measurements which are also level dependent. The torsional wave velocity measurements of a multiple reflection sensor then provide a measurement of liquid level over a range of several meters with a small uncertainty over a temperature range of 20 to 250/sup 0/C and pressures up to 15 MPa.

  19. The Global Historical Climatology Network: Long-term monthly temperature, precipitation, sea level pressure, and station pressure data

    SciTech Connect

    Vose, R.S.; Schmoyer, R.L.; Steurer, P.M.; Peterson, T.C.; Heim, R.; Karl, T.R.; Eischeid, J.K.

    1992-07-01

    Interest in global climate change has risen dramatically during the last several years. In a similar fashion, the number of data sets available to study global change has also increased. Unfortunately, these data sets have been compiled by many different organizations/researchers, making it confusing and time consuming for individual researchers to acquire the ``best`` data. In response to this rapid growth in the number of global data sets, the Carbon Dioxide Information Analysis Center (CDIAC) and the National Climatic Data Center (NCDC) commenced the Global Historical Climatology Network (GHCN) project. The purpose of this project is to compile an improved global base-line data set of long-term monthly mean temperature, precipitation, sea level pressure, and station pressure for a dense network. of worldwide meteorological stations. Specifically, the GHCN project seeks to consolidate the numerous preexisting national-, regional-, and global-scale data sets into a single global climate data base that can be updated, enhanced, and distributed at regular intervals. The first version of the GHCN data base was completed during the summer of 1992. It contains 6039 temperature, 7533 precipitation, 1883 sea level pressure, and 1873 station pressure stations. All stations have at least 10 years of data, 40% have more than 50 years of data, and 10% have more than 100 years of data. Spatial coverage is good over most of the globe, particularly for the United States and central Europe. In comparison to other major global data sets, dramatic improvements are evident over South America, Africa, and Asia. The GHCN data base is available as a Numeric Data Package (NDP) from CDIAC. The NDP consists of this document and two magnetic tapes that contain machine-readable data files and accompanying retrieval codes. This document describes, in detail, both the GHCN data base and the contents of the magnetic tap

  20. The Global Historical Climatology Network: Long-term monthly temperature, precipitation, sea level pressure, and station pressure data

    SciTech Connect

    Vose, R.S. . Energy, Environment and Resources Center); Schmoyer, R.L. ); Steurer, P.M.; Peterson, T.C.; Heim, R.; Karl, T.R. ); Eischeid, J.K. . Cooperative Inst. for Research in Environmental Sciences)

    1992-07-01

    Interest in global climate change has risen dramatically during the last several years. In a similar fashion, the number of data sets available to study global change has also increased. Unfortunately, these data sets have been compiled by many different organizations/researchers, making it confusing and time consuming for individual researchers to acquire the best'' data. In response to this rapid growth in the number of global data sets, the Carbon Dioxide Information Analysis Center (CDIAC) and the National Climatic Data Center (NCDC) commenced the Global Historical Climatology Network (GHCN) project. The purpose of this project is to compile an improved global base-line data set of long-term monthly mean temperature, precipitation, sea level pressure, and station pressure for a dense network. of worldwide meteorological stations. Specifically, the GHCN project seeks to consolidate the numerous preexisting national-, regional-, and global-scale data sets into a single global climate data base that can be updated, enhanced, and distributed at regular intervals. The first version of the GHCN data base was completed during the summer of 1992. It contains 6039 temperature, 7533 precipitation, 1883 sea level pressure, and 1873 station pressure stations. All stations have at least 10 years of data, 40% have more than 50 years of data, and 10% have more than 100 years of data. Spatial coverage is good over most of the globe, particularly for the United States and central Europe. In comparison to other major global data sets, dramatic improvements are evident over South America, Africa, and Asia. The GHCN data base is available as a Numeric Data Package (NDP) from CDIAC. The NDP consists of this document and two magnetic tapes that contain machine-readable data files and accompanying retrieval codes. This document describes, in detail, both the GHCN data base and the contents of the magnetic tap

  1. Interactions of several genetic polymorphisms and alcohol consumption on blood pressure levels.

    PubMed

    Yin, Rui-Xing; Aung, Lynn Htet Htet; Long, Xing-Jiang; Yan, Ting-Ting; Cao, Xiao-Li; Huang, Feng; Wu, Jin-Zhen; Yang, De-Zhai; Lin, Wei-Xiong; Pan, Shang-Ling

    2015-01-01

    This study aimed to detect the interactions of several single nucleotide polymorphisms (SNPs) and alcohol consumption on blood pressure levels. Genotypes of 10 SNPs in the ATP-binding cassette transporter A1 (ABCA-1), acyl-CoA:cholesterol acyltransferase-1 (ACAT-1), low density lipoprotein receptor (LDLR), hepatic lipase gene (LIPC), endothelial lipase gene (LIPG), methylenetetrahydrofolate reductase (MTHFR), the E3 ubiquitin ligase myosin regulatory light chain-interacting protein (MYLIP), proprotein convertase subtilisin-like kexin type 9 (PCSK9), peroxisome proliferator-activated receptor delta (PPARD), and Scavenger receptor class B type 1 (SCARB1) genes were determined in 616 nondrinkers and 608 drinkers. The genotypic frequencies of LDLR rs5925, LIPC rs2070895, MTHFR rs1801133, and MYLIP rs3757354 SNPs were significantly different between nondrinkers and drinkers. The levels of systolic blood pressure (ABCA-1 rs2066715 and rs2070895), diastolic blood pressure (rs2070895), and pulse pressure (PP) (rs2066715, ACAT-1 rs1044925, and rs1801133) in nondrinkers, and systolic blood pressure (rs1044925 and SCARB1 rs5888), diastolic blood pressure (rs1044925 and LIPG rs2000813), and PP (PCSK9 rs505151 and rs5888) in drinkers were different among the genotypes (P < 0.005-0.001). The interactions of several SNPs and alcohol consumption on systolic blood pressure (rs2066715, rs1044925, rs5925, rs2070895, rs1801133, rs3757354, PPARD rs2016520, and rs5888), diastolic blood pressure (rs2066715, rs1044925, rs5925, rs2000813, rs3757354, and rs2016520), and PP (rs1044925, rs2070895, rs1801133, rs3757354, rs505151, and rs5888) were observed (P < 0.005-0.001). The differences in blood pressure levels between the nondrinkers and drinkers might be partially attributed to the interactions of these SNPs and alcohol consumption. PMID:26354227

  2. Relationship of blood lead levels to blood pressure in exhaust battery storage workers.

    PubMed

    Fenga, Concettina; Cacciola, Anna; Martino, Lucia Barbaro; Calderaro, Santina Ricciardo; Di Nola, Carmelina; Verzera, Aurelio; Trimarchi, Giuseppe; Germanò, Domenico

    2006-04-01

    Several researches has focused the hypothesis that low blood lead levels could be associated with an increased risk of hypertension. To assess the relation between occupational lead exposure and elevated blood pressure a group of 27 workers, age range from 27 to 62 years, mean (SD) 36.52 (+/- 8.16) yr; length of employment mean (DS) 2.97 (+/- 1.67) yr, were recruited as study subjects. The following variables were measured: blood lead concentration (BPb), delta-Aminolevulinic Acid Dehydratase (ALAD) activity, Zinc Protoporphirin (ZPP), creatinine, hematocrit, Body Mass Index (BMI) and Systolic Blood Pressure (SBP) and Diastolic Blood (DBP) Pressure. The results showed that long term occupational exposure was related to a slight increase of systolic and diastolic blood pressure among workers who had been exposed to higher level of lead with respect to workers exposed to lower level of lead. Furthermore, blood lead concentration (BPb) and ZPP resulted higher among workers exposed to higher level of ambient lead, while in the same group of workers ALAD activity resulted more inhibited. The authors concluded long term cumulative lead exposure can significantly increase blood pressure in low level Pb exposed workers. PMID:16716009

  3. BOREAS AFM-5 Level-2 Upper Air Network Standard Pressure Level Data

    NASA Technical Reports Server (NTRS)

    Barr, Alan; Hrynkiw, Charmaine; Hall, Forrest G. (Editor); Newcomer, Jeffrey A. (Editor); Smith, David E. (Technical Monitor)

    2000-01-01

    The BOREAS AFM-5 team collected and processed data from the numerous radiosonde flights during the project. The goals of the AFM-05 team were to provide large-scale definition of the atmosphere by supplementing the existing AES aerological network, both temporally and spatially. This data set includes basic upper-air parameters interpolated at 0.5 kiloPascal increments of atmospheric pressure from data collected from the network of upper-air stations during the 1993, 1994, and 1996 field campaigns over the entire study region. The data are contained in tabular ASCII files. The data files are available on a CD-ROM (see document number 20010000884) or from the Oak Ridge National Laboratory (ORNL) Distributed Active Archive Center (DAAC).

  4. High Pressure Studies of the Second Landau Level Region of a Two-Dimensional Electron System

    NASA Astrophysics Data System (ADS)

    Schreiber, Katherine; Samkharadze, Nodar; Gardner, Geoffrey; Fradkin, Eduardo; Manfra, Michael; Csathy, Gabor

    Hydrostatic pressure has become a prevalent tool in condensed matter systems because the application of pressure to crystalline structures results in the shrinking of the lattice constant. This allows one to tune the Bloch wavefunction of the electrons and therefore all band parameters such as effective carrier mass, carrier density, and effective g-factor. In this manner, pressure acts as a probe into various strongly interacting electronic states. Motivated in particular by the capability to discern the spin polarization of quantum Hall states, we apply hydrostatic pressure up to 10 kbar to a two dimensional electron system (2DES) in a high-mobility GaAs/AlGaAs quantum well. This 2DES is subjected to milliKelvin temperatures and strong magnetic fields to observe the effect of pressure on fractional quantum Hall states, especially those in higher Landau levels, a regime not previously studied under pressure. We report our findings, focusing on the observation of a pressure-driven transition from a fractional quantum Hall state to the quantum Hall nematic phase in the second Landau level. Grants: Researchers at Purdue and N. Samkharadze: US DOE, Office of Basic Energy Sciences, Division of Materials Sciences and Engineering, DE-SC0006671. E. Fradkin: US NSF, DMR 1408713.

  5. Reading pulmonary vascular pressure tracings. How to handle the problems of zero leveling and respiratory swings.

    PubMed

    Kovacs, Gabor; Avian, Alexander; Pienn, Michael; Naeije, Robert; Olschewski, Horst

    2014-08-01

    The accuracy of pulmonary vascular pressure measurements is of great diagnostic and prognostic relevance. However, there is variability of zero leveling procedures, and the current recommendation of end-expiratory reading may not always be adequate. A review of physiological and anatomical data, supported by recent imaging, leads to the practical recommendation of zero leveling at the cross-section of three transthoracic planes, which are, respectively midchest frontal, transverse through the fourth intercostal space, and midsagittal. As for the inevitable respiratory pressure swings, end-expiratory reading at functional residual capacity allows for minimal influence of elastic lung recoil on pulmonary pressure reading. However, hyperventilation is associated with changes in end-expiratory lung volume and increased intrathoracic pressure, eventually exacerbated by expiratory muscle contraction and dynamic hyperinflation, all increasing pulmonary vascular pressures. This problem is amplified in patients with obstructed airways. With the exception of dynamic hyperinflation states, it is reasonable to assume that negative inspiratory and positive expiratory intrathoracic pressures cancel each other out, so averaging pulmonary vascular pressures over several respiratory cycles is most often preferable. This recommendation may be generalized for the purpose of consistency and makes sense, as pulmonary blood flow measurements are not corrected for phasic inspiratory and expiratory changes in clinical practice. PMID:24869464

  6. An analysis of collegiate band directors' exposure to sound pressure levels

    NASA Astrophysics Data System (ADS)

    Roebuck, Nikole Moore

    Noise-induced hearing loss (NIHL) is a significant but unfortunate common occupational hazard. The purpose of the current study was to measure the magnitude of sound pressure levels generated within a collegiate band room and determine if those sound pressure levels are of a magnitude that exceeds the policy standards and recommendations of the Occupational Safety and Health Administration (OSHA), and the National Institute of Occupational Safety and Health (NIOSH). In addition, reverberation times were measured and analyzed in order to determine the appropriateness of acoustical conditions for the band rehearsal environment. Sound pressure measurements were taken from the rehearsal of seven collegiate marching bands. Single sample t test were conducted to compare the sound pressure levels of all bands to the noise exposure standards of OSHA and NIOSH. Multiple regression analysis were conducted and analyzed in order to determine the effect of the band room's conditions on the sound pressure levels and reverberation times. Time weighted averages (TWA), noise percentage doses, and peak levels were also collected. The mean Leq for all band directors was 90.5 dBA. The total accumulated noise percentage dose for all band directors was 77.6% of the maximum allowable daily noise dose under the OSHA standard. The total calculated TWA for all band directors was 88.2% of the maximum allowable daily noise dose under the OSHA standard. The total accumulated noise percentage dose for all band directors was 152.1% of the maximum allowable daily noise dose under the NIOSH standards, and the total calculated TWA for all band directors was 93dBA of the maximum allowable daily noise dose under the NIOSH standard. Multiple regression analysis revealed that the room volume, the level of acoustical treatment and the mean room reverberation time predicted 80% of the variance in sound pressure levels in this study.

  7. Determining the response of sea level to atmospheric pressure forcing using TOPEX/POSEIDON data

    NASA Technical Reports Server (NTRS)

    Fu, Lee-Lueng; Pihos, Greg

    1994-01-01

    The static response of sea level to the forcing of atmospheric pressure, the so-called inverted barometer (IB) effect, is investigated using TOPEX/POSEIDON data. This response, characterized by the rise and fall of sea level to compensate for the change of atmospheric pressure at a rate of -1 cm/mbar, is not associated with any ocean currents and hence is normally treated as an error to be removed from sea level observation. Linear regression and spectral transfer function analyses are applied to sea level and pressure to examine the validity of the IB effect. In regions outside the tropics, the regression coefficient is found to be consistently close to the theoretical value except for the regions of western boundary currents, where the mesoscale variability interferes with the IB effect. The spectral transfer function shows near IB response at periods of 30 degrees is -0.84 +/- 0.29 cm/mbar (1 standard deviation). The deviation from = 1 cm /mbar is shown to be caused primarily by the effect of wind forcing on sea level, based on multivariate linear regression model involving both pressure and wind forcing. The regression coefficient for pressure resulting from the multivariate analysis is -0.96 +/- 0.32 cm/mbar. In the tropics the multivariate analysis fails because sea level in the tropics is primarily responding to remote wind forcing. However, after removing from the data the wind-forced sea level estimated by a dynamic model of the tropical Pacific, the pressure regression coefficient improves from -1.22 +/- 0.69 cm/mbar to -0.99 +/- 0.46 cm/mbar, clearly revealing an IB response. The result of the study suggests that with a proper removal of the effect of wind forcing the IB effect is valid in most of the open ocean at periods longer than 20 days and spatial scales larger than 500 km.

  8. Association of Blood Lead level with Elevated Blood Pressure in Hypertensive Patients

    PubMed Central

    Alghasham, Abdullah A.; Meki, Abdel-Raheim M.A.; Ismail, Hisham A.S.

    2011-01-01

    Background: Lead is a metal with many important industrial uses. The relationship between lead exposure and the rise of blood pressure has received a great deal of attention as it was implicated that the mortality from cardiovascular diseases might be reduced by lowering lead levels in the environment. Objectives: The study was to investigate the correlation between the blood lead (B-Pb) levels and the values of blood pressure in hypertensive patients. Moreover, the plasma activities of angiotensin converting enzyme (ACE), plasma levels of nitric oxide (NO), total antioxidants (TAOX) and malondialdehyde (MDA) were estimated to investigate the correlations between the measured parameters and B-Pb levels in hypertensive patients. Methods: Fifty-five hypertensive patients were compared with fifty-three age and sex matched control group. The B-Pb levels were detected by flame atomic absorption spectrometry. The plasma levels of ACE activities, NO, TAOX and MDA were measured by colorimetric methods. Results: In the hypertensive patients, B-Pb levels were significantly higher than controls. Concomitantly, the plasma levels of ACE activities and MDA were significantly increased while the plasma levels of NO and TAOX were significantly reduced in the hypertensive patients in comparison with controls. There were significant positive correlations between B-Pb and each of MDA, and systolic as well as diastolic blood pressure. Conversely, a significant negative correlation was found between B-Pb and NO. Conclusions: Our study indicated that a positive relationship exists between blood pressure and B-Pb levels. The increased B-Pb levels were associated with oxidative stress. Moreover, The B-Pb level was negatively correlated with NO and this may clarify the implication of Pb as leading risk factor for the cardiovascular diseases and hypertension. These findings provide support for continued efforts to reduce lead concentration in the population at Qassim region. PMID:22489226

  9. Pressure Dependence of Excitation Cross Sections for Resonant Levels of Rare Gases

    NASA Astrophysics Data System (ADS)

    Stewart, Michael D.; Chilton, J. Ethan; Lin, Chun C.

    2000-06-01

    In the rare gases, the excited n'p^5ns and n'p^5nd levels with J = 1 are optically coupled to ground as well as lower lying p levels. Resonant photons emitted when the atom decays to ground can be reabsorbed by another ground-state atom. At low gas pressures this reabsorption occurs infrequently, but at higher pressures becomes increasingly likely until the resonant transition is completely suppressed. This enhances the cascade transitions into lower p levels, resulting in pressure dependent optical emission cross sections. This reabsorption process can be understood quantitatively with a model developed by Heddle et al(D. W. O. Heddle and N. J. Samuel, J. Phys. B 3), 1593 (1970).. The radiation from transitions into the nonresonant levels often lie in the ir, while the resonant radiation is always in the uv spectral region. Using a Fourier-transform spectrometer, one can measure the cross sections for the ir transitions as a function of pressure. The Heddle model can be fit to these data with the use of theoretical values for the Einstein A coefficients. This provides a test of the accuracy of calculated A values. Discussion will include cross section measurements for Ne, Ar, and Kr excited by electron impact over a range of gas pressures.

  10. Bivariate wavelet-based clustering of sea-level and atmospheric pressure time series

    NASA Astrophysics Data System (ADS)

    Barbosa, Susana; Gouveia, Sonia; Scotto, Manuel; Alonso, Andres

    2015-04-01

    The atmospheric pressure is responsible for a downward force acting on the sea surface which is compensated, to some extent, by corresponding sea-level variations. The static response of the sea surface can be linearly modelled, a decrease (increase) in atmospheric pressure of 1 mb raising (depressing) sea level by 1 cm. However, the dynamic sea surface response to atmospheric pressure loading, associated with ocean dynamics and wind effects, is scale-dependent and difficult to establish. The present study addresses the co-variability of sea-level and pressure time series in the Baltic Sea from the bivariate analysis of tide gauge and reanalysis records. The time series are normalised by the corresponding standard deviation and the wavelet covariance is computed as a measure of the association between sea-level and pressure across scales. A clustering procedure using a dissimilarity matrix based on the wavelet covariance is then implemented. Different classical clustering techniques, including average, single and complete linkage criteria are applied and the group linkage is selected in order to maximise the dendrogram's goodness-of-fit.

  11. Evaluation of pressure transducers to measure surface level in the waste storage tanks

    SciTech Connect

    Peters, T.J.; Colson, J.B.

    1994-06-01

    This report describes the results of tests conducted at the Pacific Northwest Laboratory (PNL) to determine if pressure transducers can be used to measure the surface level in the waste tanks. A survey was first conducted to evaluate which, if any, commercially available pressure transducers were available that could meet the requirements for use in the waste tanks. More than 35 companies were contacted to determine if they manufactured a pressure transducer that could be used in the 101-SY waste tank. The three basic requirements for a pressure transducer for this application were that they were radiation-hardened, could withstand a caustic environment, and were certified to be intrinsically safe. No manufacturer was able to meet all three of these requirements with a commercially available product. Seven companies were able to meet the requirements for being radiation-hardened and being able to withstand the caustic environment. However, only two of the nine companies were willing to supply a pressure transducer for laboratory testing. The two pressure transducers that were tested in this program were the VEGA D36-38 from HiTech Technologies, Inc., and the KP-1911-A from Kaman Instrumentation Corporation. Pressure transducers operate on the principle that the pressure at the location of a sensor increases directly with the depth of the liquid above it. A liquid is required in order for these devices to operate. For these tests, water was first used to determine the ideal operation of the devices, then the devices were placed in a 101-SY waste tank simulant. The simulant had a specific gravity of 1.96 and had the consistency similar to the convective layer in the 101-SY waste tank. In order to determine the surface level with pressure transducers, the density of the material needs to be known.

  12. Force-endurance capabilities of extravehicular activity (EVA) gloves at different pressure levels

    NASA Technical Reports Server (NTRS)

    Bishu, Ram R.; Klute, Glenn K.

    1993-01-01

    The human hand is a very useful multipurpose tool in all environments. However, performance capabilities are compromised considerably when gloves are donned. This is especially true to extravehicular activity (EVA) gloves. The primary intent was to answer the question of how long a person can perform tasks requiring certain levels of exertion. The objective was to develop grip force-endurance relations. Six subjects participated in a factorial experiment involving three hand conditions, three pressure differentials, and four levels of force exertion. The results indicate that, while the force that could be exerted depended on the glove, pressure differential, and the level of exertion, the endurance time at any exertion level depended just on the level of exertion expressed as a percentage of maximum exertion possible at that condition. The impact of these findings for practitioners as well as theoreticians is discussed.

  13. Dietary Oily Fish Intake and Blood Pressure Levels: A Population-Based Study.

    PubMed

    Del Brutto, Oscar H; Mera, Robertino M; Gillman, Jennifer; Castillo, Pablo R; Zambrano, Mauricio; Ha, Jung-Eun

    2016-04-01

    The effect of fish consumption on blood pressure is controversial. The authors measured blood pressure and calculated oily fish servings per week in 677 community-dwellers aged 40 years and older living in rural coastal Ecuador. Using regression models with linear splines, the authors evaluated whether dietary fish intake was related to blood pressure levels, after adjusting for relevant confounders. Mean oily fish consumption was 9.1±5.6 servings per week. There was a nonlinear relationship between systolic pressure and fish servings. In the group of individuals consuming up to five servings per week, each serving significantly reduced systolic pressure by 2.3 mm Hg (P=.020). Any extra serving provided no further effects. The study shows an inverse relationship between oily fish consumption and systolic pressure. Currently recommended amounts of dietary oily fish intake per week (1-2 servings) might be insufficient to exert beneficial effects of fish in the control of blood pressure. PMID:26395549

  14. A Lateral Differential Resonant Pressure Microsensor Based on SOI-Glass Wafer-Level Vacuum Packaging

    PubMed Central

    Xie, Bo; Xing, Yonghao; Wang, Yanshuang; Chen, Jian; Chen, Deyong; Wang, Junbo

    2015-01-01

    This paper presents the fabrication and characterization of a resonant pressure microsensor based on SOI-glass wafer-level vacuum packaging. The SOI-based pressure microsensor consists of a pressure-sensitive diaphragm at the handle layer and two lateral resonators (electrostatic excitation and capacitive detection) on the device layer as a differential setup. The resonators were vacuum packaged with a glass cap using anodic bonding and the wire interconnection was realized using a mask-free electrochemical etching approach by selectively patterning an Au film on highly topographic surfaces. The fabricated resonant pressure microsensor with dual resonators was characterized in a systematic manner, producing a quality factor higher than 10,000 (~6 months), a sensitivity of about 166 Hz/kPa and a reduced nonlinear error of 0.033% F.S. Based on the differential output, the sensitivity was increased to two times and the temperature-caused frequency drift was decreased to 25%. PMID:26402679

  15. A Lateral Differential Resonant Pressure Microsensor Based on SOI-Glass Wafer-Level Vacuum Packaging.

    PubMed

    Xie, Bo; Xing, Yonghao; Wang, Yanshuang; Chen, Jian; Chen, Deyong; Wang, Junbo

    2015-01-01

    This paper presents the fabrication and characterization of a resonant pressure microsensor based on SOI-glass wafer-level vacuum packaging. The SOI-based pressure microsensor consists of a pressure-sensitive diaphragm at the handle layer and two lateral resonators (electrostatic excitation and capacitive detection) on the device layer as a differential setup. The resonators were vacuum packaged with a glass cap using anodic bonding and the wire interconnection was realized using a mask-free electrochemical etching approach by selectively patterning an Au film on highly topographic surfaces. The fabricated resonant pressure microsensor with dual resonators was characterized in a systematic manner, producing a quality factor higher than 10,000 (~6 months), a sensitivity of about 166 Hz/kPa and a reduced nonlinear error of 0.033% F.S. Based on the differential output, the sensitivity was increased to two times and the temperature-caused frequency drift was decreased to 25%. PMID:26402679

  16. Community Characteristics are Associated with Blood Pressure Levels in a Racially Integrated Community.

    PubMed

    Samuel, L J; Thorpe, R J; Bower, K M; LaVeist, T A

    2015-06-01

    Community problems have been associated with higher, and community resources and social cohesion with lower, blood pressure. However, prior studies have not accounted for potential confounding by residential racial segregation. This study tested associations between community characteristics and blood pressure levels and prevalent hypertension in a racially integrated community. The Exploring Health Disparities in Integrated Communities Study measured blood pressure in residents of two contiguous racially integrated and low-income US Census Tracts. Community characteristics included a standardized community problem score and binary indicators for community social cohesion, having a community leader available, and having at least one community resource observed on the participant's block. In adjusted models, greater community problems and proximity to resources were associated with lower systolic (β = -2.020, p = 0.028; β = -4.132, p = 0.010) and diastolic (β = -1.261, p = 0.038; β = -2.290, 0.031) blood pressure, respectively, among whites (n = 548). Social cohesion was associated with higher systolic (β = 4.905, p = 0.009) and diastolic blood pressure (β = 3.379, p = 0.008) among African Americans (n = 777). In one racially integrated low-income community, community characteristics were associated with blood pressure levels, and associations differed by race. Directions of associations for two findings differed from prior studies; greater community problem was associated with lower blood pressure in whites and community social cohesion was associated with higher blood pressure in African Americans. These findings may be due to exposure to adverse environmental conditions and hypertensive risk factors in this low-income community. PMID:25665523

  17. Bilayer graphene under pressure: Electron-hole symmetry breaking, valley Hall effect, and Landau levels

    NASA Astrophysics Data System (ADS)

    Munoz, F.; Collado, H. P. Ojeda; Usaj, Gonzalo; Sofo, Jorge O.; Balseiro, C. A.

    2016-06-01

    The electronic structure of bilayer graphene under pressure develops very interesting features with an enhancement of the trigonal warping and a splitting of the parabolic touching bands at the K point of the reciprocal space into four Dirac cones, one at K and three along the T symmetry lines. As pressure is increased, these cones separate in reciprocal space and in energy, breaking the electron-hole symmetry. Due to their energy separation, their opposite Berry curvature can be observed in valley Hall effect experiments and in the structure of the Landau levels. Based on the electronic structure obtained by density functional theory, we develop a low energy Hamiltonian that describes the effects of pressure on measurable quantities such as the Hall conductivity and the Landau levels of the system.

  18. An occultation satellite system for determining pressure levels in the atmosphere

    NASA Technical Reports Server (NTRS)

    Morrison, A. R.; Vngar, S. G.; Lusignan, B. B.

    1974-01-01

    A two-satellite microwave occultation system is described that will fix, as an absolute function of altitude, the pressure-temperature profile generated by a passive infrared sounder. The 300 mb pressure level is determined to within 24 m rms, assuming the temperture errors produced by the infrared sensor are not greater than 2 K rms. Error caused by water vapor in the radio path is corrected by climatological adjustments. A ground test of the proposed system is described. A microwave signal propagating between two mountain tops was found to be subject to periods of intense fading. Computer analysis of the raypath between the transmitting and receiving stations indicates that multipath and defocusing were responsible for this fading. It is unlikely that an operational pressure-reference-level system will be subject to the deep fades observed in the ground test, because the phenomena are associated with lower altitudes than the closest approach altitude of an occultation-system raypath.

  19. THE HABITABLE ZONE OF EARTH-LIKE PLANETS WITH DIFFERENT LEVELS OF ATMOSPHERIC PRESSURE

    SciTech Connect

    Vladilo, Giovanni; Murante, Giuseppe; Silva, Laura; Provenzale, Antonello; Ferri, Gaia; Ragazzini, Gregorio

    2013-04-10

    As a contribution to the study of the habitability of extrasolar planets, we implemented a one-dimensional energy balance model (EBM), the simplest seasonal model of planetary climate, with new prescriptions for most physical quantities. Here we apply our EBM to investigate the surface habitability of planets with an Earth-like atmospheric composition but different levels of surface pressure. The habitability, defined as the mean fraction of the planet's surface on which liquid water could exist, is estimated from the pressure-dependent liquid water temperature range, taking into account seasonal and latitudinal variations of surface temperature. By running several thousands of EBM simulations we generated a map of the habitable zone (HZ) in the plane of the orbital semi-major axis, a, and surface pressure, p, for planets in circular orbits around a Sun-like star. As pressure increases, the HZ becomes broader, with an increase of 0.25 AU in its radial extent from p = 1/3 to 3 bar. At low pressure, the habitability is low and varies with a; at high pressure, the habitability is high and relatively constant inside the HZ. We interpret these results in terms of the pressure dependence of the greenhouse effect, the efficiency of horizontal heat transport, and the extent of the liquid water temperature range. Within the limits discussed in the paper, the results can be extended to planets in eccentric orbits around non-solar-type stars. The main characteristics of the pressure-dependent HZ are modestly affected by variations of planetary properties, particularly at high pressure.

  20. Interactions of several lipid-related gene polymorphisms and cigarette smoking on blood pressure levels.

    PubMed

    Yin, Rui-Xing; Wu, Dong-Feng; Wu, Jin-Zhen; Cao, Xiao-Li; Aung, Lynn Htet Htet; Miao, Lin; Long, Xing-Jiang; Liu, Wan-Ying; Zhang, Lin; Li, Meng

    2012-01-01

    The interactions of single nucleotide polymorphisms (SNPs) and cigarette smoking on blood pressure levels are limited. The present study was undertaken to detect nine lipid-related SNPs and their interactions with cigarette smoking on blood pressure levels. Genotyping of ATP-binding cassette transporter A1 (ABCA-1) V825I, acyl-CoA:cholesterol acyltransferase-1 (ACAT-1) rs1044925, low density lipoprotein receptor (LDL-R) AvaⅡ, hepatic lipase gene (LIPC) -250G>A, endothelial lipase gene (LIPG) 584C>T, methylenetetrahydrofolate reductase (MTHFR) 677C>T, proprotein convertase subtilisin-like kexin type 9 (PCSK9) E670G, peroxisome proliferator-activated receptor delta (PPARD) +294T>C, and Scavenger receptor class B type 1 (SCARB1) rs5888 was performed in 935 nonsmokers and 845 smokers. The interactions were detected by factorial regression analysis. The frequencies of genotypes (ACAT-1 and LIPG), alleles (ABCA-1), and both genotypes and alleles (LDL-R, LIPC, PPARD and SCARB1) were different between nonsmokers and smokers (P < 0.05-0.001). The levels of pulse pressure (PP, ABCA-1), and systolic, diastolic blood pressure (SBP, DBP) and PP (LIPC) in nonsmokers were different among the genotypes (P < 0.01-0.001). The levels of SBP (ABCA-1, ACAT-1, LIPG and PCSK9), DBP (ACAT-1, LDL-R, LIPC, PCSK9 and PPARD), and PP (LIPC, LIPG, MTHFR and PCSK9) in smokers were different among the genotypes (P < 0.01-0.001). The SNPs of ABCA-1, ACAT-1 and PCSK9; ACAT-1, LDL-R, MTHFR and PCSK9; and ABCA-1, LIPC, PCSK9 and PPARD were shown interactions with cigarette smoking to influence SBP, DBP and PP levels (P < 0.05-0.001); respectively. The differences in blood pressure levels between the nonsmokers and smokers might partly result from different interactions of several SNPs and cigarette smoking. PMID:22606049

  1. Carotid baroreceptor influence on forearm vascular resistance during low level lower body negative pressure

    NASA Technical Reports Server (NTRS)

    Thompson, Cynthia A.; Ludwig, David A.; Convertino, Victor A.

    1991-01-01

    The degree of forearm vasoconstriction induced by low levels of lower body negative pressure (LBNP) provides a measure of the responsiveness of the cardiopulmonary baroreflex. The validity of this measurement is based on the assumption that this vasoconstriction response is not influenced by unloading of carotid baroreceptors. To test the hypothesis that arterial baroreceptor unloading does not alter the degree of forearm vascular resistance during low levels of LBNP, 12 subjects were exposed to -15 and -20 mm Hg LBNP with and without additional artificial (+ 10 mm Hg neck pressure) unloading of the carotid baroreceptors. There was no measurable influence of carotid unloading on forearm vascular resistance at either level of LBNP. It is concluded that forearm vascular resistance measured during cardiopulmonary baroreceptor unloading is unaffected by carotid baroreceptor unloading within the magnitude encountered during low levels of LBNP.

  2. Effect of Different Levels of Pressure Relieving Air-Mattress Firmness on Cough Strength

    PubMed Central

    Kamikawa, Norimichi; Taito, Shunsuke; Takahashi, Makoto; Sekikawa, Kiyokazu; Hamada, Hironobu

    2016-01-01

    Cough is an important host-defense mechanism. The elderly and patients who are severely ill cannot cough effectively when lying in the supine position. Furthermore, pressure relieving air-mattresses are recommended for preventing the development of pressure ulcers. In this study, we clarified whether or not the cough peak flow (CPF), an index of cough strength, is affected by different firmness levels of a pressure relieving air-mattress in healthy volunteers in the supine position. Fifty-two healthy young men participated. All the measurements were carried out on each participant in the supine position on a pressure relieving air-mattress. The participants were assessed at two firmness levels, a “hard” and “soft” mode. The CPF, forced vital capacity (FVC), maximal expiratory pressure (PEmax), and maximal inspiratory pressure (PImax) were determined for each mode. The sinking distance of the body into the mattress was measured without any activity and the difference between the sinking distances of the two firmness levels was determined. The CPF, FVC, PEmax, and PImax were determined for each mode. The sinking distance of the body into the mattress was measured and the difference between the sinking distances of the two firmness levels was determined. The CPF, FVC, PEmax and PImax values of the participants coughing on the mattress were significantly lower when the mattress was in “soft” than in “hard” mode. The differences between the sinking distances of the mattress in “soft” and “hard” modes were larger for the anterior superior iliac spine. A harder mattress may lead to increased CPF in healthy young men lying in the supine position, and increased CPF may be important for host defense. PMID:26741497

  3. Effect of Different Levels of Pressure Relieving Air-Mattress Firmness on Cough Strength.

    PubMed

    Kamikawa, Norimichi; Taito, Shunsuke; Takahashi, Makoto; Sekikawa, Kiyokazu; Hamada, Hironobu

    2016-01-01

    Cough is an important host-defense mechanism. The elderly and patients who are severely ill cannot cough effectively when lying in the supine position. Furthermore, pressure relieving air-mattresses are recommended for preventing the development of pressure ulcers. In this study, we clarified whether or not the cough peak flow (CPF), an index of cough strength, is affected by different firmness levels of a pressure relieving air-mattress in healthy volunteers in the supine position. Fifty-two healthy young men participated. All the measurements were carried out on each participant in the supine position on a pressure relieving air-mattress. The participants were assessed at two firmness levels, a "hard" and "soft" mode. The CPF, forced vital capacity (FVC), maximal expiratory pressure (PEmax), and maximal inspiratory pressure (PImax) were determined for each mode. The sinking distance of the body into the mattress was measured without any activity and the difference between the sinking distances of the two firmness levels was determined. The CPF, FVC, PEmax, and PImax were determined for each mode. The sinking distance of the body into the mattress was measured and the difference between the sinking distances of the two firmness levels was determined. The CPF, FVC, PEmax and PImax values of the participants coughing on the mattress were significantly lower when the mattress was in "soft" than in "hard" mode. The differences between the sinking distances of the mattress in "soft" and "hard" modes were larger for the anterior superior iliac spine. A harder mattress may lead to increased CPF in healthy young men lying in the supine position, and increased CPF may be important for host defense. PMID:26741497

  4. The Measurement of the Oral and Nasal Sound Pressure Levels of Speech

    ERIC Educational Resources Information Center

    Clarke, Wayne M.

    1975-01-01

    A nasal separator was used to measure the oral and nasal components in the speech of a normal adult Australian population. Results indicated no difference in oral and nasal sound pressure levels for read versus spontaneous speech samples; however, females tended to have a higher nasal component than did males. (Author/TL)

  5. Assessment of Knowledge and Level of Satisfaction of Nursing Undergraduates in a Pressure Ulcer Online Course

    PubMed Central

    Aroldi, Juscilynne B. C.; Peres, Heloisa H. H.

    2012-01-01

    The objective of this study is to identify the effectiveness of two different educational modalities in an online course on pressure ulcers by comparing the degree of knowledge and level of satisfaction of nursing undergraduate students. The result will ground the adoption of Information and Communication Technologies in the teaching process in nursing. PMID:24199036

  6. Data quality assurance in pressure transducer-based automatic water level monitoring

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Submersible pressure transducers integrated with data loggers have become relatively common water-level measuring devices used in flow or well water elevation measurements. However, drift, linearity, hysteresis and other problems can lead to erroneous data. Researchers at the USDA-ARS in Watkinsvill...

  7. Love Deprivation and Blood Pressure Levels among a College Population: A Preliminary Investigation.

    ERIC Educational Resources Information Center

    Sisca, Samuel S.; And Others

    1985-01-01

    Viewed within the general context of Selye's theory of environmentally induced stress, we tested the hypothesis that blood pressure levels would vary inversely with the degree of loving responses our subjects received from those with whom they interact on a frequent basis. Preliminary data support this hypothesis, especially among our older…

  8. A national project to evaluate and reduce high sound pressure levels from music.

    PubMed

    Ryberg, Johanna Bengtsson

    2009-01-01

    The highest recommended sound pressure levels for leisure sounds (music) in Sweden are 100 dB LAeq and 115 dB LAFmax for adults, and 97 dB LAeq and 110 dB LAFmax where children under the age of 13 have access. For arrangements intended for children, levels should be consistently less than 90 dB LAeq. In 2005, a national project was carried out with the aim of improving environments with high sound pressure levels from music, such as concert halls, restaurants, and cinemas. The project covered both live and recorded music. Of Sweden's 290 municipalities, 134 took part in the project, and 93 of these carried out sound measurements. Four hundred and seventy one establishments were investigated, 24% of which exceeded the highest recommended sound pressure levels for leisure sounds in Sweden. Of festival and concert events, 42% exceeded the recommended levels. Those who visit music events/establishments thus run a relatively high risk of exposure to harmful sound levels. Continued supervision in this field is therefore crucial. PMID:19414933

  9. Several lipid-related gene polymorphisms interact with overweight/obesity to modulate blood pressure levels.

    PubMed

    Yin, Rui-Xing; Wu, Dong-Feng; Aung, Lynn Htet Htet; Yan, Ting-Ting; Cao, Xiao-Li; Long, Xing-Jiang; Miao, Lin; Liu, Wan-Ying; Zhang, Lin; Li, Meng

    2012-01-01

    Little is known about the interactions of single nucleotide polymorphisms (SNPs) and overweight/obesity on blood pressure levels. The present study was undertaken to detect 10 lipid-related gene SNPs and their interactions with overweight/obesity on blood pressure levels. Genotyping of ATP-binding cassette transporter A1 (ABCA-1) V825I, acyl-CoA:cholesterol acyltransferase-1 (ACAT-1) rs1044925, low density lipoprotein receptor (LDL-R) AvaII hepatic lipase gene (LIPC) -250G > A, endothelial lipase gene (LIPG) 584C > T, methylenetetrahydrofolate reductase (MTHFR) 677C > T, the E3 ubiquitin ligase myosin regulatory light chain-interacting protein (MYLIP) rs3757354, proprotein convertase subtilisin-like kexin type 9 (PCSK9) E670G, peroxisome proliferator-activated receptor delta (PPARD) +294T > C, and Scavenger receptor class B type 1 (SCARB1) rs5888 was performed in 978 normal weight and 751 overweight/obese subjects. The interactions were detected by factorial regression analysis. The genotypes of ACAT-1 AC, LIPC GA and AA, and SCARB1 TT; LDL-R A-A- and LIPC GA; and SCARB1 TT were interacted with overweight/obesity to increase systolic, diastolic blood pressure (SBP, DBP) and pulse pressure (PP) levels; respectively. The genotypes of ACAT-1 CC; ACAT-1 AA and CC were interacted with overweight/obesity to decrease SBP, PP levels (p < 0.01-0.001); respectively. The differences in blood pressure levels between normal weight and overweight/obese subjects might partly result from different interactions of several SNPs and overweight/obesity. PMID:23109900

  10. Several Lipid-Related Gene Polymorphisms Interact with Overweight/Obesity to Modulate Blood Pressure Levels

    PubMed Central

    Yin, Rui-Xing; Wu, Dong-Feng; Aung, Lynn Htet Htet; Yan, Ting-Ting; Cao, Xiao-Li; Long, Xing-Jiang; Miao, Lin; Liu, Wan-Ying; Zhang, Lin; Li, Meng

    2012-01-01

    Little is known about the interactions of single nucleotide polymorphisms (SNPs) and overweight/obesity on blood pressure levels. The present study was undertaken to detect 10 lipid-related gene SNPs and their interactions with overweight/obesity on blood pressure levels. Genotyping of ATP-binding cassette transporter A1 (ABCA-1) V825I, acyl-CoA:cholesterol acyltransferase-1 (ACAT-1) rs1044925, low density lipoprotein receptor (LDL-R) AvaII hepatic lipase gene (LIPC) −250G > A, endothelial lipase gene (LIPG) 584C > T, methylenetetrahydrofolate reductase (MTHFR) 677C > T, the E3 ubiquitin ligase myosin regulatory light chain-interacting protein (MYLIP) rs3757354, proprotein convertase subtilisin-like kexin type 9 (PCSK9) E670G, peroxisome proliferator-activated receptor delta (PPARD) +294T > C, and Scavenger receptor class B type 1 (SCARB1) rs5888 was performed in 978 normal weight and 751 overweight/obese subjects. The interactions were detected by factorial regression analysis. The genotypes of ACAT-1 AC, LIPC GA and AA, and SCARB1 TT; LDL-R A-A- and LIPC GA; and SCARB1 TT were interacted with overweight/obesity to increase systolic, diastolic blood pressure (SBP, DBP) and pulse pressure (PP) levels; respectively. The genotypes of ACAT-1 CC; ACAT-1 AA and CC were interacted with overweight/obesity to decrease SBP, PP levels (p < 0.01–0.001); respectively. The differences in blood pressure levels between normal weight and overweight/obese subjects might partly result from different interactions of several SNPs and overweight/obesity. PMID:23109900

  11. Linking Myometrial Physiology to Intrauterine Pressure; How Tissue-Level Contractions Create Uterine Contractions of Labor

    PubMed Central

    Young, Roger C.; Barendse, Peter

    2014-01-01

    The mechanisms used to coordinate uterine contractions are not known. We develop a new model based on the proposal that there is a maximum distance to which action potentials can propagate in the uterine wall. This establishes “regions”, where one action potential burst can rapidly recruit all the tissue. Regions are recruited into an organ-level contraction via a stretch-initiated contraction mechanism (myometrial myogenic response). Each uterine contraction begins with a regional contraction, which slightly increases intrauterine pressure. Higher pressure raises tension throughout the uterine wall, which initiates contractions of more regions and further increases pressure. The positive feedback synchronizes regional contractions into an organ-level contraction. Cellular automaton (CA) simulations are performed with Mathematica. Each “cell” is a region that is assigned an action potential threshold. An anatomy sensitivity factor converts intrauterine pressure to regional tension through the Law of Laplace. A regional contraction occurs when regional tension exceeds regional threshold. Other input variables are: starting and minimum pressure, burst and refractory period durations, enhanced contractile activity during an electrical burst, and reduced activity during the refractory period. Complex patterns of pressure development are seen that mimic the contraction patterns observed in laboring women. Emergent behavior is observed, including global synchronization, multiple pace making regions, and system memory of prior conditions. The complex effects of nifedipine and oxytocin exposure are simulated. The force produced can vary as a nonlinear function of the number of regions. The simulation directly links tissue-level physiology to human labor. The concept of a uterine pacemaker is re-evaluated because pace making activity may occur well before expression of a contraction. We propose a new classification system for biological CAs that parallels the 4

  12. Mild neurotrauma indicates a range-specific pressure response to low level shock wave exposure.

    PubMed

    Vandevord, Pamela J; Bolander, Richard; Sajja, Venkata Siva Sai Sujith; Hay, Kathryn; Bir, Cynthia A

    2012-01-01

    Identifying the level of overpressure required to create physiological deficits is vital to advance prevention, diagnostic, and treatment strategies for individuals exposed to blasts. In this study, a rodent model of primary blast neurotrauma was employed to determine the pressure at which acute neurological alterations occurred. Rats were exposed to a single low intensity shock wave at a pressure of 0, 97, 117, or 153 kPa. Following exposure, rats were assessed for acute cognitive alterations using the Morris water maze and motor dysfunction using the horizontal ladder test. Subsequently, histological analyses of three brain regions (primary motor cortex, the hippocampal dentate gyrus region, and the posteromedial cortical amygdala) were conducted. Histological parameters included measuring the levels of glial fibrillary acidic protein (GFAP) to identify astrocyte activation, cleaved caspase-3 for early apoptosis identification and Fluoro-Jade B (FJB) which labels degenerating neurons within the brain tissue. The results demonstrated that an exposure to a single 117 kPa shock wave revealed a significant change in overall neurological deficits when compared to controls and the other pressures. The animals showed significant alterations in water maze parameters and a histological increase in the number of GFAP, caspase-3, and FJB-positive cells. It is suggested that when exposed to a low level shock wave, there may be a biomechanical response elicited by a specific pressure range which can cause low level neurological deficits within the rat. These data indicate that neurotrauma induced from a shock wave may lead to cognitive deficits in short-term learning and memory of rats. Additional histological evidence supports significant and diffuse glial activation and cellular damage. Further investigation into the biomechanical aspects of shock wave exposure is required to elucidate this pressure range-specific phenomenon. PMID:21994066

  13. Simplified combustion noise theory yielding a prediction of fluctuating pressure level

    NASA Technical Reports Server (NTRS)

    Huff, R. G.

    1984-01-01

    The first order equations for the conservation of mass and momentum in differential form are combined for an ideal gas to yield a single second order partial differential equation in one dimension and time. Small perturbation analysis is applied. A Fourier transformation is performed that results in a second order, constant coefficient, nonhomogeneous equation. The driving function is taken to be the source of combustion noise. A simplified model describing the energy addition via the combustion process gives the required source information for substitution in the driving function. This enables the particular integral solution of the nonhomogeneous equation to be found. This solution multiplied by the acoustic pressure efficiency predicts the acoustic pressure spectrum measured in turbine engine combustors. The prediction was compared with the overall sound pressure levels measured in a CF6-50 turbofan engine combustor and found to be in excellent agreement.

  14. Analysis of heart rate variability in individuals subjected to different positive end expiratory pressure levels using expiratory positive airway pressure

    PubMed Central

    Pinto, Thiago Lorentz; Costa, Ivan Peres; Kawaguchi, Leandro Yukio Alves; de Carvalho, Flávio Aimbire Soares; de Carvalho, Regiane Albertini

    2013-01-01

    Introduction The increase in the number of studies has led to greater security in the application of this method and the determination of its effectiveness in adults.. The purpose of the present study was to evaluate heart rate variability in healthy individuals submitted to different levels of positive expiratory pressure using an expiratory positive airway pressure (EPAP) device. Material and methods The study involved 27 healthy male individuals ranging in age from 20 to 35 years. Patient histories were taken and the subjects were submitted to a physical examination. The volunteers were monitored using the Polar 810s® and submitted to the EPAP experiment. Analyses were performed on variables of the frequency domain. Sympathetic and parasympathetic bands and their relationship with sympathovagal response were also analyzed. Results The mean value of this variable was 526.89 (55.50) ms2 in the first period, 2811.0 (721.10) ms2 in the fourth period and 726.52 (123.41) ms2 in the fifth period. Regarding the parasympathetic area, significant differences were detected when Periods 1 and 5 (no load) were compared with periods in which the individuals were subjected to the use of the therapy. Sympathetic and parasympathetic areas together, a significant difference was detected regarding the sympathetic/parasympathetic ratio in the comparison between Periods 1 and 4 (p < 0.01) as well as Periods 2 and 4 (p < 0.05). Conclusions The findings of the present study suggest that the therapeutic use of EPAP significantly alters the parameters of heart rate variability in the frequency domain, highlighting the importance of monitoring and care during the practice of EPAP. PMID:24049524

  15. Fermi level pinning in Fe-doped PbTe under pressure

    SciTech Connect

    Skipetrov, E. P. Kruleveckaya, O. V.; Skipetrova, L. A.; Slynko, E. I.; Slynko, V. E.

    2014-07-14

    We synthesize an iron-doped PbTe single-crystal ingot and investigate the phase and the elemental composition as well as galvanomagnetic properties in weak magnetic fields (4.2 K≤T≤300 K, B ≤ 0.07 T) of Pb{sub 1−y}Fe{sub y}Te alloys upon varying the iron content, at atmospheric pressure and under hydrostatic compression up to 10 kilobars. We find an increase of iron concentration along the length of the ingot and the appearance of microscopic inclusions enriched with iron in the heavily doped samples. Lightly doped alloys are characterized by the p-type metal conductivity. An increase of the iron impurity content leads to a decrease in the free hole concentration, a stabilization of galvanomagnetic parameters, indicating the pinning of the Fermi energy by the iron resonant impurity level lying under the bottom of the valence band, and to the p-n inversion of the conductivity type. Under pressure, the free hole concentration in the sample, in which the stabilization of galvanomagnetic parameters takes place, increases by approximately a factor of four due to the flow of electrons from the valence band to the iron-induced resonant level. Using the two-band Kane and the six-band Dimmock dispersion relations, the pressure dependence of the Fermi energy is calculated. The model of the electronic structure rearrangement of Pb{sub 1−y}Fe{sub y}Te under pressure is proposed. The energy position and the pressure coefficient of the resonant iron impurity level are determined.

  16. Strongly correlated valence electrons and core-level chemical bonding of Lithium at terapascal pressures

    NASA Astrophysics Data System (ADS)

    Hu, Anguang; Zhang, Fan

    2015-03-01

    As the simplest pure metal, lithium exhibits some novel properties on electrical conductivity and crystal structures under high pressure. All-electron density functional theory simulations, recently developed by using the linear combination of localized Slater atomic orbitals, revealed that the bandwidth of its valence bands remains almost unchanged within about 3.5 eV even up to a terapascal pressure range. This indicates that the development from delocalized to strongly correlated electronic systems takes place under compression, resulting in metal-semiconductor and superconductivity transitions together with a sequence of new high-pressure crystal phases, discovered experimentally. In contrast to the valence bands, the core-level bands become broadening up to about 10 eV at terapascal pressures. It means the transformation from chemical non-bonding to bonding for core electrons. Thus, dense lithium under compression can be characterized as core-level chemical bonding and a completely new class of strongly correlated materials with narrow bands filled in s-electron shells only.

  17. Water-Level Responses to Barometric-Pressure Fluctuations in Wells in Semi-Confined Aquifers

    NASA Astrophysics Data System (ADS)

    Jin, W.; Butler, J. J.

    2009-12-01

    Hydrologists have long recognized that changes in barometric pressure can produce changes in water levels in wells. The relationship between barometric pressure and water level has traditionally been characterized using the barometric efficiency (BE), the ratio of the change in water level to the change in barometric pressure head. Although BE has proven to be an effective means of characterizing the short-term response of a well to a change in barometric pressure, the barometric response function (BRF) is a more effective means to characterize the longer-term response. The BRF, which can be determined through a regression deconvolution procedure developed by Rasmussen and co-workers (Rasmussen and Crawford, 1997; Toll and Rasmussen, 2007), characterizes the water level response over time to a step change in barometric pressure, essentially BE as a function of the time since the imposed load. We have extended earlier work of Rasmussen and Spane (Rasmussen and Crawford, 1997; Spane, 2002) to show that the BRF can be utilized to glean important insights into semi-confined aquifer systems. The form of the BRF indicates the degree of aquifer confinement, while a comparison of BRFs from different wells provides insight into aquitard continuity. Recently, we have developed a new approach for estimating aquitard K by fitting type curves to experimentally determined BRFs. We will demonstrate the power of the BRF using field data from a long-term monitoring site of the Kansas Geological Survey at which a four-day pumping test has previously been performed. The aquitard K estimates obtained from the BRFs are in good agreement at this site with the estimate determined from the pumping test. We will also show how the BRF for a well in a semi-confined aquifer can be used to gain insights into conditions in the overlying unconfined aquifer and vadose zone. Although the BE is considered an invariant parameter of a well, we will show that the BRF of a well in a semi

  18. Lava lake level as a gauge of magma reservoir pressure and eruptive hazard

    USGS Publications Warehouse

    Patrick, Matthew R.; Anderson, Kyle R.; Poland, Michael P.; Orr, Tim R.; Swanson, Donald A.

    2015-01-01

    Forecasting volcanic activity relies fundamentally on tracking magma pressure through the use of proxies, such as ground surface deformation and earthquake rates. Lava lakes at open-vent basaltic volcanoes provide a window into the uppermost magma system for gauging reservoir pressure changes more directly. At Kīlauea Volcano (Hawaiʻi, USA) the surface height of the summit lava lake in Halemaʻumaʻu Crater fluctuates with surface deformation over short (hours to days) and long (weeks to months) time scales. This correlation implies that the lake behaves as a simple piezometer of the subsurface magma reservoir. Changes in lava level and summit deformation scale with (and shortly precede) changes in eruption rate from Kīlauea's East Rift Zone, indicating that summit lava level can be used for short-term forecasting of rift zone activity and associated hazards at Kīlauea.

  19. Oyster Creek RETRAN model benchmark to pressure and level perturbation tests

    SciTech Connect

    Alammar, M.A.

    1986-01-01

    As part of GPU Nuclear's program to establish an in-house reload capability for Oyster Creek, the RETRAN-02 MOD4 SPL Computer Code has been chosen to analyze Chapter 15 Final Safety Analysis Report transients. To qualify Oyster Creek RETRAN model, a series of startup tests has been chosen to benchmark the model. Two of those tests, involved water level and vessel pressure perturbations at 100% power. Both tests were analyzed using point kinetics and one-dimensional kinetics with no noticeable impact on level or pressure. A small impact was noticed on power but was thought to be of minor significance. This is because for such mild transients the neutron flux shape function does not change appreciably throughout the transient.

  20. Ocean Bottom Pressure Records at the Permanent Service for Mean Sea Level

    NASA Astrophysics Data System (ADS)

    Hibbert, Angela; Matthews, Andrew; Hughes, Chris W.; Tamisiea, Mark E.

    2014-05-01

    As part of a research effort funded by the U.K. Natural Environment Research Council, the Permanent Service for Mean Sea Level (PSMSL) has been developing a repository of data from in-situ ocean bottom pressure recorders (OBPRs) from all possible sources. The data are being processed to a common format using a consistent methodology so that time series are directly comparable. Efforts are also being made to ensure that data are accompanied by comprehensive metadata. The OBPR data are supplied primarily for hourly and daily intervals, making them ideal for studies of tidal to seasonal variability. In addition, because bottom pressure recorders measure changes in ocean mass, these data are an ideal complement to GRACE satellite data and a useful accompaniment to sea level data from tide gauges and altimetry. Consequently, it is anticipated that the PSMSL OBPR repository will become a valuable product to the scientific community.

  1. Relationship between sea-level pressure and sea-level height in the Camargue (French Mediterranean coast)

    NASA Astrophysics Data System (ADS)

    Moron, V.; Ullmann, A.

    2005-09-01

    A statistical study of daily maximum sea-level height at one station (Grau de la Dent) in the Camargue (Rhône delta, French Mediterranean coast) and daily sea-level pressure (SLP) at 12 h UTC over the eastern North Atlantic is used to identify the meteorological conditions associated with sea-level variations in the Camargue for the winters 1974-75 to 2000-01. Mean SLP composites during and 5 days before major surge events (defined as those with a daily maximum sea-level height >80 cm) suggest the dominant influence of storms, moving northwest to southeast across the North Atlantic and strengthening as they approach the Bay of Biscay. During such storms, strong onshore winds may persist for up to 4-5 days. These winds tend to strengthen from 3 days to 1 day before the surge events. The mean October-March correlation between daily maximum sea-level height in the Camargue and SLP averaged over the Bay of Biscay (10°W-0°, 40-50°N) is strong (r = 0.69). A methodology is developed for assessing the low-frequency SLP variability impact on sea-level height in the Camargue. A cross-validated linear regression is used to hindcast the interannual and intraseasonal variability of the monthly 75th and 90th percentiles of the daily maximum sea-level height from the monthly mean SLP over the Bay of Biscay. The linear correlation between the cross-validated hindcast and observed time series is 0.83 (0.77) for the 75th (90th) percentile on the 1974-75 to 2000-01 period. The mean bias error, reflecting systematic errors in predicting the monthly percentiles, is close to zero.

  2. Mediterranean sea level oscillations as a response to the atmospheric pressure variations, altimetric implications

    NASA Astrophysics Data System (ADS)

    Gomez-Enri, Jesus; Bruno Mejias, Miguel; Villares Duran, Pilar

    2004-02-01

    The real sea level response to atmospheric pressure variations is quantified and compared with the one deduced from the isostatic assumption, which is normally used to correct the effect of the atmospheric pressure oscillations in the ocean, the so-called Inverse Barometer Correction (IBC). We have analysed the first four years of ERS-2 altimetric records in the Mediterranean Sea. We obtained the regression coefficients at each geographical point of the satellite tracks and in the crossover track points, estimating the relation between the surface atmospheric pressure and the sea level anomalies. The geographical distribution of the regression coefficients obtained, demonstrates that there are important local deviations from the hypothetical value (-0.998 cm/bar), being more evident when we reduce the time sampling from 35 days to 10.5 days. We have obtained the variance associated to the inverse barometer correction, and the one obtained by using the individual regression coefficients obtained at each geographical position in both, collinear and crossover method. We observe a variance reduction of approximately 30% in the sea level anomalies series, when barometric corrections are applied, in the case of collinear track method, and around 15% when we use the crossover track method. We have also quantified the difference in the variance reduction of the sea level anomalies when the standard IBC and the atmospheric pressure correction (use of the regression coefficients estimated on each geographical position, instead of the isostatic value: -0.998 cm/mbar) are applied. We also observe a reduction of approximately 2% in the variance when the atmospheric correction is applied, instead of IBC (in both cases, CM and XM).

  3. Borehole water level response to barometric pressure as an indicator of aquifer vulnerability

    NASA Astrophysics Data System (ADS)

    Hussein, Mahmoud E. A.; Odling, Noelle E.; Clark, Roger A.

    2013-10-01

    The response of borehole water levels to barometric pressure changes in semiconfined aquifers can be used to determine barometric response functions from which aquifer and confining layer properties can be obtained. Following earlier work on barometric response functions and aquifer confinement, we explore the barometric response function as a tool to improve the assessment of groundwater vulnerability in semiconfined aquifers, illustrated through records from two contrasting boreholes in the semiconfined Chalk Aquifer, East Yorkshire, UK. After removal of recharge and Earth tide influences on the water level signal, barometric response functions were estimated and aquifer and confining layer properties determined through an analytical model of borehole water level response to barometric pressure. A link between the thickness and vertical diffusivity of the confining layer determined from the barometric response function, and groundwater vulnerability is proposed. The amplitude spectrum for barometric pressure and instrument resolution favor determination of the barometric response function at frequencies to which confining layer diffusivities are most sensitive. Numerical modeling indicates that while the high frequency response reflects confining layer properties in the immediate vicinity of the borehole, the low frequency response reflects vertical, high diffusivity pathways though the confining layer some hundreds of meters distant. A characteristic time scale parameter, based on vertical diffusivities and thicknesses of the saturated and unsaturated confining layer, is introduced as a measure of semiconfined aquifer vulnerability. The study demonstrates that the barometric response function has potential as a tool for quantitative aquifer vulnerability assessment in semiconfined aquifers.

  4. Adjacent segment disc pressures following two-level cervical disc replacement versus simulated anterior cervical fusion.

    PubMed

    Laxer, Eric B; Darden, Bruce V; Murrey, Daniel B; Milam, R Alden; Rhyne, Alfred L; Claytor, Brian; Nussman, Donna S; Powers, Timothy W; Davies, Matthew A; Bryant, S Chad; Larsen, Scott P; Bhatt, Meghal; Brodziak, John; Polic, Jelena

    2006-01-01

    Anterior cervical fusion (ACF) has been shown to alter the biomechanics of adjacent segments of the cervical spine. The goal of total disc replacement is to address pathology at a given disc with minimal disruption of the operated or adjacent segments. This study compares the pressure within discs adjacent to either a two-level simulated ACDF or a two-level total disc replacement with the ProDisc-C. A special automated motion testing apparatus was constructed. Four fresh cadaveric cervical spine specimens were affixed to the test stand and tested in flexion and extension under specific loads. Intradiscal, miniature strain-gauge-based transducers were placed in the discs above and below the "treated" levels. The specimens were then tested in flexion and extension. Pressure and overall angular displacement were measured. In the most extreme and highest quality specimen the difference at C3/C4 registered 800 kPa and the difference at C6/C7 registered 50 kPa. This same quality specimen treated with the ProDisc reached a flexion angle at much lower moments, 24.3 degrees at 5 N-m, when compared to the the SACF 12.2 degrees at 8.6 N-m. Therefore, the moment needed to achieve 15 degrees of flexion with the SACF treatment was 5.5 N-m and the ProDisc treatment was only 2.9 N-m. This initial data would indicate that adjacent level discs experience substantially lower pressure after two-level disc replacement when compared to two-level SACF. Additional testing to further support these observations is ongoing. PMID:17108473

  5. Intestinal and plasma VEGF levels in cirrhosis: the role of portal pressure

    PubMed Central

    Huang, Hui-Chun; Haq, Omar; Utsumi, Teruo; Sethasine, Supatsri; Abraldes, Juan G; Groszmann, Roberto J; Iwakiri, Yasuko

    2012-01-01

    Abstract Increased levels of intestinal VEGF are thought to worsen portal hypertension. The cause of the increase in the level of intestinal VEGF found during cirrhosis is not known. The aim of this study is to demonstrate a relationship between portal pressure (PP) and intestinal/ plasma VEGF levels in different stages of fibrosis/cirrhosis. In this experiment, rats were exposed to carbon tetrachloride (CCl4) for 6, 8 and 12 weeks. At the end of exposure, the three groups of rats exhibited three different stages of pathology: non-cirrhotic, early fibrotic and cirrhotic, respectively. For those rats and their age-matched controls, PP and intestinal/plasma VEGF levels were measured. Rats inhaling CCl4 for 12 weeks developed portal hypertension (18.02 ± 1.07 mmHg), while those exposed for 6 weeks (7.26 ± 0.58 mmHg) and for 8 weeks (8.55 ± 0.53 mmHg) did not. The rats exposed for 12 weeks also showed a 40% increase in the level of intestinal VEGF compared to the controls (P < 0.05), while those rats exposed to CCl4 inhalation for 6 and 8 weeks did not. There was a significant positive correlation between PP and intestinal VEGF levels (r2 = 0.4, P < 0.005). Plasma VEGF levels were significantly elevated in those rats exposed to 12 weeks of CCl4 inhalation (63.7 pg/ml, P < 0.01), compared to the controls (8.5 pg/ml). However, no correlation was observed between PP and plasma VEGF levels. It is concluded that portal pressure modulates intestinal VEGF levels during the development of cirrhosis. PMID:21801303

  6. Measurement and analysis of 8-hour time-weighted average sound pressure levels in a vivarium decontamination facility.

    PubMed

    Pate, William; Charlton, Michael; Wellington, Carl

    2013-01-01

    Occupational noise exposure is a recognized hazard for employees working near equipment and processes that generate high levels of sound pressure. High sound pressure levels have the potential to result in temporary or permanent alteration in hearing perception. The cleaning of cages used to house laboratory research animals is a process that uses equipment capable of generating high sound pressure levels. The purpose of this research study was to assess occupational exposure to sound pressure levels for employees operating cage decontamination equipment. This study reveals the potential for overexposure to hazardous noise as defined by the Occupational Safety and Health Administration (OSHA) permissible exposure limit and consistent surpassing of the OSHA action level. These results emphasize the importance of evaluating equipment and room design when acquiring new cage decontamination equipment in order to minimize employee exposure to potentially hazardous noise pressure levels. PMID:23566325

  7. Pressure-induced crossing of the core levels in 5 d metals

    NASA Astrophysics Data System (ADS)

    Tal, Alexey A.; Katsnelson, Mikhail I.; Ekholm, Marcus; Jönsson, H. Johan M.; Dubrovinsky, Leonid; Dubrovinskaia, Natalia; Abrikosov, Igor A.

    2016-05-01

    A pressure-induced interaction between core electrons, the core-level crossing (CLC) transition, has been observed in hcp Os at P ≈400 GPa [L. Dubrovinsky et al., Nature (London) 525, 226 (2015)], 10.1038/nature14681. By carrying out a systematic theoretical study for all metals of the 5 d series (Hf, Ta, W, Re, Os, Ir, Pt, Au) we have found that the CLC transition is a general effect for this series of metals. While in Pt it occurs at ≈1500 GPa , at a pressure substantially higher than in Os, in Ir it occurs already at 80 GPa. Moreover, we predict that in Re the CLC transition may take place already at ambient pressure. We explain the effect of the CLC and analyze the shift of the transition pressure across the series within the Thomas-Fermi model. In particular, we show that the effect has many common features with the atomic collapse in rare-earth elements.

  8. Association of low-level blood lead and blood pressure in NHANES 1999-2006

    SciTech Connect

    Scinicariello, Franco; Abadin, Henry G.; Edward Murray, H.

    2011-11-15

    This study investigated whether low blood-lead levels ({<=}10 {mu}g/dL) were associated with blood pressure (BP) outcomes. The authors analyzed data from National Health and Nutrition Examination Survey 1999-2006 and participants aged 20 years or older. Outcome variables were systolic and diastolic BP measurements, pulse pressure, and hypertension status. Multivariable linear and logistic regressions stratified by race/ethnicity and gender were performed. Blood lead levels (BLL) were significantly correlated with higher systolic BP among black men and women, but not white or Mexican-American participants. BLLs were significantly associated with higher diastolic BPs among white men and women and black men, whereas, a negative association was observed in Mexican-American men that had, also, a wider pulse pressure. Black men in the 90th percentile of blood lead distribution (BLL{>=}3.50 {mu}g/dL) compared to black men in the 10th percentile of blood lead distribution (BLL{<=}0.7 {mu}g/dL) had a significant increase of risk of having hypertension (adjusted POR=2.69; 95% CI: 1.08-6.72). In addition, blood cadmium was significantly associated with hypertension and systolic and diastolic blood. This study found that, despite the continuous decline in blood lead in the U.S. population, lead exposure disparities among race and gender still exist.

  9. Role of borehole pressure containment on surface ground vibration levels at close scaled distances

    SciTech Connect

    Taqieddin, S.A.

    1982-01-01

    A total of 84 reduced-scale single-hole test blasts were conducted to study the effects of collar stemming length, primer location, geophone orientation, and indirectly the borehole and detonation pressures on the generation of ground vibrations. Extra 60% dynamite and black powder explosives were tested. Charges of 144.5 and 276.5 gm having diameters of 0.5-, 0.75-, and 1.00-inch were confined within holes drilled in Jefferson City dolomite rock. Three collar stemming lengths, bottom and collar priming and two different orientation of joints were employed. Particle velocity measured by a recording seismograph, with its geophone placed at constant 15 feet, was used throughout this study. It was found at the close scaled-distances employed in this study that collar stemming length has a reciprocal relationship with the levels of ground vibration up to an optimum value beyond which it has minimal effect. Also, the length of collar stemming needed to suppress ground vibration is less than that needed to contain air blast and was dependent on charge diameter. It was also found that collar-primed charges produced higher levels of ground vibration than did the bottom-primed charges, and ground vibrations attenuated more rapidly parallel to the geologic jointing direction. Lastly it was found that the primary cause of ground vibrations was the explosive borehole pressure with little or no effect produced by detonation pressure.

  10. Effects of zero reference position on bladder pressure measurements: an observational study

    PubMed Central

    2012-01-01

    Background Although the World Society for Abdominal Compartment Syndrome in its guidelines recommends midaxillary line (MAL) as zero reference level in intra-abdominal pressure (IAP) measurements in aiming at standardizing the technique, evidence supporting this suggestion is scarce. The aim of this study is to study if the zero reference position influences bladder pressure measurements as estimate for IAP. Methods The IAP of 100 surgical patients was measured during the first 24 h of admission to the surgical intensive care unit of General Calixto Garcia Hospital in Havana (Cuba) following laparotomy. The period was January 2009 to January 2010. The IAP was measured twice with a six-hour interval using the transurethral technique with a priming volume of 25 ml. IAP was first measured with the zero reference level placed at MAL (IAPMAL), followed by a second measurement at the level of the symphysis pubis (SP) after 3 minutes (IAPSP). Correlations were made between IAP and body mass index (BMI), type of surgery, gender, and age. Results Mean IAPMAL was 8.5 ± 2.8 mmHg vs. IAPSP 6.5 ± 2.8 mmHg (p < 0.0001). The bias between measurements was 2.0 ± 1.5, 95% confidence interval of 1.4 to 3.0, upper limit of 4.9, lower limit of -0.9, and a percentage error of 35.1%. IAPMAL was consistently higher than IAPSP regardless of the type of surgery. The BMI correlated with IAP values regardless of the zero reference level (R2 = 0.4 and 0.3 with IAPMAL and IAPSP respectively, p < 0.0001). Conclusions The zero reference level has an important impact on IAP measurement in surgical patients after laparotomy and can potentially lead to over or underestimation. Further anthropometric studies are needed with regard to the relative MAL and SP zero reference position in relation to the theoretical ideal reference level at midpoint of the abdomen. Until better evidence is available, MAL remains the recommended zero reference position due to its best anatomical localization at iliac

  11. [Physical activity level and home blood pressure measurement: Pilot study "Acti-HTA"].

    PubMed

    Sosner, P; Ott, J; Steichen, O; Bally, S; Krummel, T; Brucker, M; Lequeux, B; Dourmap, C; Llaty, P; Le Coz, S; Baguet, S; Miranne, A; Labrunée, M; Gremeaux, V; Lopez-Sublet, M

    2015-06-01

    While physical activity (PA) is recommended for high blood pressure management, the level of PA practice of hypertensive patients remains unclear. We aimed to assess the association between the level of both PA and blood pressure of individuals consulting in 9 hypertension specialist centres. Eighty-five hypertensive patients were included (59 ± 14 years, 61% men, 12% smokers, 29% with diabetes). Following their consultation, they performed home blood pressure measurement (HBPM) over 7 days (2 in the morning+2 in the evening), they wrote in a dedicated form their daily activities to estimate the additional caloric expenditure using Acti-MET device (built from International physical Activity Questionnaire [IPAQ]). Thus, patients completed a self-administered questionnaire "score of Dijon" (distinguishing active subjects with a score>20/30, from sedentary<10/30). Subjects with normal HBPM value (<135/85 mm Hg) (55% of them) compared to those with high HBPM were older, had a non-significant trend towards higher weekly caloric expenditure (4959 ± 5045 kcal/week vs. 4048 ± 4199 kcal/week, P=0.3755) and score of Dijon (19.44 ± 5.81 vs. 18.00 ± 4.32, P=0.2094) with a higher proportion of "active" subjects (48.9% vs. 34.2%, P=0.1773). In conclusion, our results demonstrate a "tendency" to a higher level of reported PA for subjects whose hypertension was controlled. This encourages us to continue with a study that would include more subjects, which would assess PA level using an objective method such as wearing an accelerometer sensor. PMID:26047874

  12. Anarctic gridded sea level pressure data: An analysis and reconstruction back to 1957

    SciTech Connect

    Jones, P.D.; Wigley, T.M.L.

    1988-12-01

    The reliability of the Australian (June 1972--April 1985) and NOTOS (1957--62) gridded monthly-mean, mean sea level pressure datasets over Antarctica is examined by comparison with station data from 29 sites over the continent. After rejecting about 30% of the months in both sets of gridded data, the remaining ''good'' months are used in a principal component regression technique to reconstruct gridded data from the station data for 1957 to 1985. The regression technique uses the ''good'' Australian data for calibration and verifies the statistical relationships developed between station and grid point pressure data with the ''good'' NOTOS data. The reconstructions are shown to be reliable over all of Antarctica between 60/sup 0/ and 75 /sup 0/S except in the area to the east of the Ross Sea and adjacent areas of the southern Pacific Ocean.

  13. Association between Glucose Levels and Intraocular Pressure: Pre- and Postprandial Analysis in Diabetic and Nondiabetic Patients

    PubMed Central

    Pimentel, Luis Guilherme Milesi; Gracitelli, Carolina P. B.; da Silva, Leticia Sant'Ana Cardoso; Souza, Aline Katia Siqueira; Prata, Tiago Santos

    2015-01-01

    The aim of this study was to evaluate the relationship between glucose levels and intraocular pressure (IOP) fluctuation in diabetic and nondiabetic patients. Seventeen nondiabetic and 20 diabetic subjects underwent a complete ophthalmic examination, capillary glucose testing, and applanation tonometry in two distinct situations: first, fasting for at least 8 hours and, second, postprandial measurements. Baseline glucose levels were higher in diabetic patients (P < 0.001). Postprandial IOP was significantly higher than baseline IOP in diabetic (P < 0.001) and nondiabetic patients (P = 0.006). Postprandial glucose levels were significantly higher than baseline measurements in both diabetic (P = 0.005) and nondiabetic patients (P = 0.015). There was a significant association between glucose levels variation and IOP change in both diabetic patients (R2 = 0.540; P < 0.001) and nondiabetic individuals (R2 = 0.291; P = 0.025). There is also a significant association between the baseline glucose levels and IOP change in diabetic group (R2 = 0.445; P = 0.001). In a multivariable model, the magnitude of glucose level change remained significantly associated with IOP variation even including age, baseline IOP, ancestry, and gender as a confounding factor (P < 0.001). We concluded that there is a significant association between blood glucose levels and IOP variation, especially in diabetic patients. PMID:25642344

  14. Effect of external pressure environment on the internal noise level due to a source inside a cylindrical tank

    NASA Technical Reports Server (NTRS)

    Clevenson, S. A.; Roussos, L. A.

    1984-01-01

    A small cylindrical tank was used to study the effect on the noise environment within a tank of conditions of atmospheric (sea level) pressure or vacuum environments on the exterior. Experimentally determined absorption coefficients were used to calculate transmission loss, transmissibility coefficients and the sound pressure (noise) level differences in the interior. The noise level differences were also measured directly for the two exterior environments and compared to various analytical approximations with limited agreement. Trend study curves indicated that if the tank transmission loss is above 25 dB, the difference in interior noise level between the vacuum and ambient pressure conditions are less than 2 dB.

  15. Noise trauma induced by a mousetrap--sound pressure level measurement of vole captive bolt devices.

    PubMed

    Frank, Matthias; Napp, Matthias; Lange, Joern; Grossjohann, Rico; Ekkernkamp, Axel; Beule, Achim G

    2010-05-01

    While ballistic parameters of vole captive bolt devices have been reported, there is no investigation on their hazardous potential to cause noise trauma. The aim of this experimental study was to measure the sound pressure levels of vole captive bolt devices. Two different shooting devices were examined with a modular precision sound level meter on an outdoor firing range. Measurements were taken in a semi-circular configuration with measuring points 0 degrees in front of the muzzle, 90 degrees at right angle of the muzzle, and 180 degrees behind the shooting device. Distances between muzzle and microphone were 0.5, 1, 2, 10, and 20 m. Sound pressure levels exceeded 130 dB(C) at any measuring point within the 20-m area. Highest measurements (more than 172 dB[C]) were taken in the 0 degrees direction at the 0.5-m distance for both shooting devices proving the hazardous potential of these gadgets to cause noise trauma. PMID:20345785

  16. Active Negative Pressure Peritoneal Therapy After Abbreviated Laparotomy

    PubMed Central

    Roberts, Derek J.; Faris, Peter D.; Ball, Chad G.; Kubes, Paul; Tiruta, Corina; Xiao, Zhengwen; Holodinsky, Jessalyn K.; McBeth, Paul B.; Doig, Christopher J.; Jenne, Craig N.

    2015-01-01

    Objective: To determine whether active negative pressure peritoneal therapy with the ABThera temporary abdominal closure device reduces systemic inflammation after abbreviated laparotomy. Background: Excessive systemic inflammation after abdominal injury or intra-abdominal sepsis is associated with poor outcomes. Methods: We conducted a single-center, randomized controlled trial. Forty-five adults with abdominal injury (46.7%) or intra-abdominal sepsis (52.3%) were randomly allocated to the ABThera (n = 23) or Barker's vacuum pack (n = 22). On study days 1, 2, 3, 7, and 28, blood and peritoneal fluid were collected. The primary endpoint was the difference in the plasma concentration of interleukin-6 (IL-6) 24 and 48 hours after temporary abdominal closure application. Results: There was a significantly lower peritoneal fluid drainage from the ABThera at 48 hours after randomization. Despite this, there was no difference in plasma concentration of IL-6 at baseline versus 24 (P = 0.52) or 48 hours (P = 0.82) between the groups. There was also no significant intergroup difference in the plasma concentrations of IL-1β, −8, −10, or −12 p70 or tumor necrosis factor α between these time points. The cumulative incidence of primary fascial closure at 90 days was similar between groups (hazard ratio, 1.6; 95% confidence interval, 0.82–3.0; P = 0.17). However, 90-day mortality was improved in the ABThera group (hazard ratio, 0.32; 95% confidence interval, 0.11–0.93; P = 0.04). Conclusions: This trial observed a survival difference between patients randomized to the ABThera versus Barker's vacuum pack that did not seem to be mediated by an improvement in peritoneal fluid drainage, fascial closure rates, or markers of systemic inflammation. Trial Registration: ClinicalTrials.gov identifier NCT01355094. PMID:25536308

  17. Development of a nuclear technique for monitoring water levels in pressurized vehicles

    NASA Technical Reports Server (NTRS)

    Singh, J. J.; Davis, W. T.; Mall, G. H.

    1983-01-01

    A new technique for monitoring water levels in pressurized stainless steel cylinders was developed. It is based on differences in attenuation coefficients of water and air for Cs137 (662 keV) gamma rays. Experimentally observed gamma ray counting rates with and without water in model reservoir cylinder were compared with corresponding calculated values for two different gamma ray detection theshold energies. Calculated values include the effects of multiple scattering and attendant gamma ray energy reductions. The agreement between the measured and calculated values is reasonably good. Computer programs for calculating angular and spectral distributions of scattered radition in various media are included.

  18. Effects of Pressure on Optically Active Deep Levels in Phosphorus Doped ZnSe

    NASA Astrophysics Data System (ADS)

    Weinstein, B. A.; Iota, V.

    1998-03-01

    We report high pressure photoluminescence (PL) and PL-excitation (PLE) studies at 8K of the 'midgap' emission in P-doped ZnSe using a diamond-cell with He medium. The dominant emission at low pressure is due to donor-acceptor-pair (DAP) transitions between shallow donors and deep trigonally relaxed P_Se acceptors.(J. Davies, et al., J. Luminescence 18/19, 322 (1979)) Its PL and PLE peaks shift by 8.2meV/kbar and 5.9meV/kbar, respectively -- Stokes shift decreasing with pressure. At 35kbar a new PL band, shifting to lower energy (-5.4meV/kbar), emerges from above the absorption edge, and concurrently the original DAP PL quenches. This shows that a resonant level, a deep donor or possibly a P_Se antibonding state,(R. Watts, et al., Phys. Rev. B3), 404 (1971) crosses the conduction edge into the gap. A third PL band is seen only with internse UV excitation. It occurs initially as a high energy shoulder of the original DAP peak, but shifts more rapidly upward (9.4meV/kbar) until it crosses the edge and quenches at 40kbar. We discuss candidates for this band, including donor-P_Se complexes, and we compare our results to similar work on the Zn vacancy in ZnSe. (figures)

  19. [Blood pressure levels of Suruí indigenous adults in Rondônia, Brazil].

    PubMed

    Tavares, Felipe Guimarães; Coimbra Junior, Carlos Everaldo Alvares; Cardoso, Andrey Moreira

    2013-05-01

    Indigenous peoples in Brazil are experiencing rapid epidemiologic and nutritional transition, with non-communicable diseases such as hypertension emerging in their health profile. A cross-sectional study was conducted in 9 Suruí Indian villages (n-251 subjects) in Rondônia, Brazilian Amazon, in 2005, in order to assess blood pressure levels in adults (>20 years of age), as well as to investigate its possible relationship with nutritional and socioeconomic status (SES). Mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were higher in men. On average, an increase in SBP of 7.9 mmHg and of 1.4 mmHg in women and men, respectively, was detected. SBP was positively correlated with waist-hip ratio (WHR) in both sexes and with age in women. DBP showed statistically significant correlations with all anthropometric variables, except height and arm muscle area. The prevalence of hypertension was 2.8% (M: 2.4%, F: 3.1%), being higher in subjects > 40 years with PC or high WHR, especially in women and also in the group that manifested lower SES. The study concludes that hypertension is an emerging health problem among the Suruí. PMID:23670468

  20. Prognostic significance of carcinoembryonic antigen in colorectal carcinoma. Serum levels before and after resection and before recurrence.

    PubMed

    Chu, D Z; Erickson, C A; Russell, M P; Thompson, C; Lang, N P; Broadwater, R J; Westbrook, K C

    1991-03-01

    The use of carcinoembryonic antigen was evaluated in 425 patients with a mean follow-up of 48 months. The preoperative and postoperative carcinoembryonic antigen levels were predictive of recurrence and survival independent of the tumor stage. In a multivariate regression analysis of age, location, tumor stage, and preoperative and postoperative carcinoembryonic antigen levels, the latter three factors were significant prognostic variables with respect to the adjusted survival. Recurrent disease was found in 42% of patients, excluding patients with stage IV disease. The carcinoembryonic antigen level at recurrence was greater than 5 ng/mL in 79% of the patients and in 89% of the intra-abdominal recurrences. Carcinoembryonic antigen level at recurrence was not predictive of postrecurrence survival except in the subgroup of locoregional disease. The life span in patients with liver and lung metastases was not influenced by carcinoembryonic antigen level at recurrence. Preoperative and postoperative carcinoembryonic antigen levels can indicate a poorer prognostic group of patients with colorectal cancer who may benefit from adjuvant treatment. The carcinoembryonic antigen at recurrence can be used effectively to diagnose intra-abdominal recurrences and project survival after development of local/regional disease. PMID:1998473

  1. Sea level pressure variability in the Amundsen Sea region inferred from a West Antarctic glaciochemical record

    NASA Astrophysics Data System (ADS)

    Kreutz, K. J.; Mayewski, P. A.; Pittalwala, I. I.; Meeker, L. D.; Twickler, M. S.; Whitlow, S. I.

    2000-02-01

    Using European Center for Medium-Range Weather Forecasts (ECMWF) numerical operational analyses, sea ice extent records, and station pressure data, we investigate the influence of sea level pressure variability in the Amundsen Sea region on a West Antarctic (Siple Dome) glaciochemical record. Empirical orthogonal function analysis of the high-resolution Siple Dome multivariate ice core chemical time series record (SDEOF1) documents lower tropospheric transport of sea-salt aerosols to the site. During 1985-1994 the SDEOF1 record of high (low) aerosol transport corresponds to anomalously low (high) sea level pressure (SLP) in the Amundsen Sea region. Spatial correlation patterns between ECMWF monthly SLP fields and the annual SDEOF1 record suggest that a majority of sea-salt aerosol is transported to Siple Dome during spring (September, October, and November). Analysis of zonal and meridional wind fields supports the SLP/SDEOF1 correlation and suggests the SDEOF1 record is sensitive to changes in regional circulation strength. No relationship is found between sea ice extent and the SDEOF1 record for the period 1973-1994. To investigate the SDEOF1 record prior to ECMWF coverage, a spring transpolar index (STPI) is created, using normalized SLP records from the New Zealand and South America/Antarctic Peninsula sectors, and is significantly correlated (at least 95% c.l.) with the SDEOF1 record on an annual (r = 0.32, p < 0.001) and interannual (3 years; r = 0.51, p < 0.001) basis. Dominant periodicities (3.3 and 7.1 years) in the annual SDEOF1 record (1890-1994 A.D.) suggest that a portion of the recorded interannual variability may be related tropical/extratropical ENSO teleconnections. Changes in the periodic structure of the full (850-1994 A.D.) Siple Dome record suggests a shift in SLP forcing during the Little Ice Age (˜1400-1900 A.D.) interval.

  2. Does the accuracy of fine-scale water level measurements by vented pressure transducers permit for diurnal evapotranspiration estimation?

    NASA Astrophysics Data System (ADS)

    Gribovszki, Zoltán; Kalicz, Péter; Szilágyi, József

    2013-04-01

    Evapotranspiration (ET) estimation methods based on diurnal water level (surface or groundwater) fluctuations are sensitive to measurement accuracy (McLaughlin and Cohen, 2011; Cuevas et al., 2010). Water level fluctuations are often measured by pressure transducers of varying design and precision. Available total pressure transducers require a compensation for barometric pressure change supplied by barometric pressure transducers. Recently McLaughlin and Cohen (2011) as well as Cuevas et al. (2010) analyzed the 'thermal artifacts' of such transducer-pair data questioning the applicability of sub-daily water level measurements in non-buffered thermal mode for diurnal ET estimation. Similar problems should not, in principle, occur for so-called vented pressure transducers. With the help of ancillary manual measurements, this study verifies the accuracy of vented pressure transducer obtained ultra-fine scale (temporal resolution of 1-10 min) stream- and groundwater level data. Thermal effects were examined by a statistical analysis of concurrent water level and temperature data. The results support the thermal artifact-free nature of vented pressure transducers and therefore their suitability for diurnal ET estimation purposes when proper maintenance and periodic calibrations are provided. In the lack of such measures, diurnal temperature changes can induce errors in vented pressure transducer readings as well.

  3. Effects of mean flow convection, quadrupole sources and vortex shedding on airfoil overall sound pressure level

    NASA Astrophysics Data System (ADS)

    Wolf, William R.; Azevedo, João L. F.; Lele, Sanjiva K.

    2013-12-01

    This paper presents a further analysis of results of airfoil self-noise prediction obtained in the previous work using large eddy simulation and acoustic analogy. The physical mechanisms responsible for airfoil noise generation in the aerodynamic flows analyzed are a combination of turbulent and laminar boundary layers, as well as vortex shedding (VS) originated due to trailing edge bluntness. The primary interest here consists of evaluating the effects of mean flow convection, quadrupole sources and vortex shedding tonal noise on the overall sound pressure level (OASPL) of a NACA0012 airfoil at low and moderate freestream Mach numbers. The overall sound pressure level is the measured quantity which eventually would be the main concern in terms of noise generation for aircraft and wind energy companies, and regulating agencies. The Reynolds number based on the airfoil chord is fixed at Rec=408,000 for all flow configurations studied. The results demonstrate that, for moderate Mach numbers, mean flow effects and quadrupole sources considerably increase OASPL and, therefore, should be taken into account in the acoustic prediction. For a low Mach number flow with vortex shedding, it is observed that OASPL is higher when laminar boundary layer separation is the VS driving mechanism compared to trailing edge bluntness.

  4. Influence of Oxygen Partial Pressure on the Fermi Level of ZnO Films Investigated by Kelvin Probe Force Microscopy

    NASA Astrophysics Data System (ADS)

    Su, Ting; Zhang, Hai-Feng

    2012-12-01

    The influence of oxygen partial pressure on the Fermi level of ZnO films prepared by pulsed laser deposition is investigated. The contact potential difference of the ZnO films fabricated under various oxygen partial pressures is studied systematically using Kelvin probe force microscopy. The Fermi level shifted by 0.35 eV as oxygen partial pressure increased. This indicates a significant change in the electronic structure and energy balance in ZnO films. This fact provides a consistent explanation that the changes in carrier concentration, resistivity and mobility of ZnO films are attributed to oxygen vacancy induced shift of the Fermi level.

  5. High-Level Pressure Support Ventilation Attenuates Ventilator-Induced Diaphragm Dysfunction in Rabbits

    PubMed Central

    Ge, Huiqing; Xu, Peifeng; Zhu, Tao; Lu, Zhihua; Yuan, Yuehua; Zhou, Jiancang

    2015-01-01

    Abstract: Background: The effects of different modes of mechanical ventilation in the same ventilatory support level on ventilator-induced diaphragm dysfunction onset were assessed in healthy rabbits. Methods: Twenty New Zealand rabbits were randomly assigned to 4 groups (n = 5 in each group). Group 1: no mechanical ventilation; group 2: controlled mechanical ventilation (CMV) for 24 hours; group 3: assist/control ventilation (A/C) mode for 24 hours; group 4: high-level pressure support ventilation (PSV) mode for 24 hours. Heart rate, mean arterial blood pressure, PH, partial pressure of arterial oxygen/fraction of inspired oxygen and partial pressure of arterial carbon dioxide were monitored and diaphragm electrical activity was analyzed in the 4 groups. Caspase-3 was evaluated by protein analysis and diaphragm ultra structure was assessed by electron microscopy. Results: The centroid frequency and the ratio of high frequency to low frequency were significantly reduced in the CMV, A/C and PSV groups (P < 0.001). The percent change in centroid frequency was significantly lower in the PSV group than in the CMV and A/C groups (P = 0.001 and P = 0.028, respectively). Electromyography of diaphragm integral amplitude decreased by 90% ± 1.48%, 67.8% ± 3.13% and 70.2% ± 4.72% in the CMV, A/C and PSV groups, respectively (P < 0.001). Caspase-3 protein activation was attenuated in the PSV group compared with the CMV and A/C groups (P = 0.035 and P = 0.033, respectively). Irregular swelling of mitochondria along with fractured and fuzzy cristae was observed in the CMV group, whereas mitochondrial cristae were dense and rich in the PSV group. The mitochondrial injury scores (Flameng scores) in the PSV group were the lowest among the 3 ventilatory groups (0.93 ± 0.09 in PSV versus 2.69 ± 0.05 in the CMV [P < 0.01] and PSV versus A/C groups [2.02 ± 0.08, P < 0.01]). Conclusions: The diaphragm myoelectric activity was reduced in the PSV group, although excessive oxidative

  6. Intraocular pressure (IOP) in relation to four levels of daily geomagnetic and extreme yearly solar activity.

    PubMed

    Stoupel, E; Goldenfeld, M; Shimshoni, M; Siegel, R

    1993-02-01

    The link between geomagnetic field activity (GMA), solar activity and intraocular pressure (IOP) in healthy individuals was investigated. The IOP of 485 patients (970 eyes) was recorded over three nonconsecutive years (1979, 1986, 1989) which were characterized by maximal solar activity (1979, 1989) or minimal solar activity (1986). The measurements were also correlated with four categories of GMA activity: quiet (level I0), unsettled (II0), active (III0), and stormy (IV0). Participants were also differentiated by age and sex. We found that IOP was lowest on days of level IV0 (stromy) GMA. The drop in IOP concomitant with a decrease in GMA level was more significant during periods of low solar activity and in persons over 65 years of age. There was a trend towards higher IOP values on days of levels II0 and IV0 GMA in years of high solar activity. Differences between the sexes and among individuals younger than 65 years were not significant. Our results show an interesting aspect of environmental influence on the healthy population. PMID:8468099

  7. Effects of nitrendipine on blood pressure and blood ciclosporin A level in patients with posttransplant hypertension.

    PubMed

    Copur, M S; Tasdemir, I; Turgan, C; Yasavul, U; Caglar, S

    1989-01-01

    In order to evaluate the antihypertensive effectiveness and interaction with ciclosporin A (CS-A) nitrendipine, a dihydropyridine derivative calcium entry blocking agent, was used in 16 (13 men, 3 women) hypertensive renal posttransplant patients followed by the Nephrology Department of Hacettepe University Hospital. The patients did not receive any antihypertensive drug for a 7-day period. They were then given 20 mg/day nitrendipine for 3 weeks. At the end of this period, mean (+/- SE) supine blood pressure fell from 163/108 +/- 3.6/1.87 to 141/87 +/- 3.8/2.2 mm Hg (p less than 0.01), while the heart rate was unchanged. 14 of 16 patients achieved full control of blood pressure levels with 20 mg/day nitrendipine, and only 2 patients needed a higher dosage of 30 mg/day (20 + 10 mg). After 3 weeks of treatment no significant variations in blood chemistry or renal functional parameters were noticed. There was also no difference between blood CS-A levels before and after treatment with nitrendipine (218.06 +/- 33 vs. 222.68 +/- 26 ng/ml, p greater than 0.05). We conclude that short-term therapy with nitrendipine in renal post-transplant patients does not appear to be harmful and longer term studies are needed to fully evaluate safety and efficacy of this drug. Because it influences neither blood chemistry nor renal functional parameters and blood CS-A level, it may be preferable to other calcium channel blocking agents in this group of patients. PMID:2662047

  8. COMPARISON OF VENTED AND ABSOLUTE PRESSURE TRANSDUCERS FOR WATER-LEVEL MONITORING IN HANFORD SITE CENTRAL PLATEAU WELLS

    SciTech Connect

    MCDONALD JP

    2011-09-08

    Automated water-level data collected using vented pressure transducers deployed in Hanford Site Central Plateau wells commonly display more variability than manual tape measurements in response to barometric pressure fluctuations. To explain this difference, it was hypothesized that vented pressure transducers installed in some wells are subject to barometric pressure effects that reduce water-level measurement accuracy. Vented pressure transducers use a vent tube, which is open to the atmosphere at land surface, to supply air pressure to the transducer housing for barometric compensation so the transducer measurements will represent only the water pressure. When using vented transducers, the assumption is made that the air pressure between land surface and the well bore is in equilibrium. By comparison, absolute pressure transducers directly measure the air pressure within the wellbore. Barometric compensation is achieved by subtracting the well bore air pressure measurement from the total pressure measured by a second transducer submerged in the water. Thus, no assumption of air pressure equilibrium is needed. In this study, water-level measurements were collected from the same Central Plateau wells using both vented and absolute pressure transducers to evaluate the different methods of barometric compensation. Manual tape measurements were also collected to evaluate the transducers. Measurements collected during this study demonstrated that the vented pressure transducers over-responded to barometric pressure fluctuations due to a pressure disequilibrium between the air within the wellbores and the atmosphere at land surface. The disequilibrium is thought to be caused by the relatively long time required for barometric pressure changes to equilibrate between land surface and the deep vadose zone and may be exacerbated by the restriction of air flow between the well bore and the atmosphere due to the presence of sample pump landing plates and well caps. The

  9. Variable day/night bias in 24-h non-invasive finger pressure against intrabrachial artery pressure is removed by waveform filtering and level correction.

    PubMed

    Westerhof, Berend E; Guelen, Ilja; Parati, Gianfranco; Groppelli, Antonella; van Montfrans, Gert A; Wieling, Wouter; Wesseling, Karel H; Bos, Willem Jan W

    2002-10-01

    BACKGROUND Twenty-four-hour finger arterial pressure (FAP) recordings show a negative bias against intrabrachial artery pressure (BAP) and the bias is greater during the night, thereby overestimating the nocturnal blood pressure dip. We have available a methodology with which to reconstruct BAP from FAP by waveform filtering (transfer function) and generalized level (bias) correction that reduces the bias for short-term blood pressure records. OBJECTIVE To investigate if this methodology also decreases the extra bias during the night, thereby yielding a better estimate of the nocturnal dip. METHODS Twenty-four-hour FAP and BAP blood pressure recordings were simultaneously obtained in eight healthy normotensive volunteers and 14 patients with hypertension (ages 19-60 years), during standardized scheduled activities. The data were analysed off-line, applying the brachial reconstruction technique (reBAP) consisting of a waveform filter and level correction. Simultaneous beats yielded systolic, diastolic and mean pressures that were averaged per 30 min, per day, per night, per activity, over the 24-h period, and for volunteers and patients separately. RESULTS Over the full 24 h, FAP systolic, diastolic and mean values for the total group differed from BAP by +1 +/- 10, -8 +/- 7 and -10 +/- 8 mmHg (mean +/- SD), respectively. Similarly, reBAPs differed by +1 +/- 11, -2 +/- 7 and -2 +/- 7 mmHg. BAPs dipped by 20 +/- 8, 13 +/- 6 and 15 +/- 6 mmHg, respectively, during the night. These dips were overestimated by +8, +4 and +4 mmHg by FAP, but not by reBAP: -1, +1 and +1 mmHg. The volunteer and the patient groups showed slight differences in results, but these were not statistically significant. CONCLUSIONS The generalized reconstruction technique to obtain near-brachial pressure from non-invasive FAP almost completely removed bias over the full 24-h day-night period and improved tracking of diurnal changes for all three blood pressure values. PMID:12359976

  10. Blood pressure (BP) assessment-from BP level to BP variability.

    PubMed

    Feber, Janusz; Litwin, Mieczyslaw

    2016-07-01

    The assessment of blood pressure (BP) can be challenging in children, especially in very young individuals, due to their variable body size and lack of cooperation. In the absence of data relating BP with cardiovascular outcomes in children, there is a need to convert absolute BP values (in mmHg) into age-, gender- and height appropriate BP percentiles or Z-scores in order to compare a patient's BP with the BP of healthy children of the same age, but also of children of different ages. Traditionally, the interpretation of BP has been based mainly on the assessment of the BP level obtained by office, home or 24-h BP monitoring. Recent studies suggest that it is not only BP level (i.e. average BP) but also BP variability that is clinically important for the development of target organ damage, including the progression of chronic kidney disease. In this review we describe current methods to evaluate of BP level, outline available methods for BP variability assessment and discuss the clinical consequences of BP variability, including its potential role in the management of hypertension. PMID:26201477

  11. Springtime large-scale sea level pressure-wind gusts interactions over the Iberian Peninsula

    NASA Astrophysics Data System (ADS)

    Martin, M. L.; Valero, F.; Pascual, A.; Morata, A.; Luna, M. Y.; Sebastian, L. I.

    2010-09-01

    The purpose of this work is to study the springtime relationships between the mean sea level pressure field over the North Atlantic and the regional wind gusts over the Iberian Peninsula. The Singular Value Decomposition analysis is used to identify the main atmospheric circulation patterns linked to gust wind speed anomaly configurations. After applied a Monte Carlo procedure, the statistical significance of the modes is investigated, obtaining two first leading modes. Iberian above-normal gust wind speeds is related in the first covariability mode to the Scandinavian pattern. Positive (negative) wind gust correlations over the northern (southern) Iberia are related to reinforced spring NAO pattern in the second covariability mode. True relationships between large-scale atmospheric field and gust wind speeds are studied by means of composite maps, giving average atmospheric circulation associated with coherent wind gust variability over Iberia.

  12. Study on osteogenesis promoted by low sound pressure level infrasound in vivo and some underlying mechanisms.

    PubMed

    Long, Hua; Zheng, Liheng; Gomes, Fernando Cardoso; Zhang, Jinhui; Mou, Xiang; Yuan, Hua

    2013-09-01

    To clarify the effects of low sound pressure level (LSPL) infrasound on local bone turnover and explore its underlying mechanisms, femoral defected rats were stabilized with a single-side external fixator. After exposure to LSPL infrasound for 30min twice everyday for 6 weeks, the pertinent features of bone healing were assessed by radiography, peripheral quantitative computerized tomography (pQCT), histology and immunofluorescence assay. Infrasound group showed a more consecutive and smoother process of fracture healing and modeling in radiographs and histomorphology. It also showed significantly higher average bone mineral content (BMC) and bone mineral density (BMD). Immunofluorescence showed increased expression of calcitonin gene related peptide (CGRP) and decreased Neuropeptide Y (NPY) innervation in microenvironment. The results suggested the osteogenesis promotion effects of LSPL infrasound in vivo. Neuro-osteogenic network in local microenvironment was probably one target mediating infrasonic osteogenesis, which might provide new strategy to accelerate bone healing and remodeling. PMID:23770453

  13. Gas pressure and electron density at the level of the active zone of hollow cathode arc discharges

    NASA Technical Reports Server (NTRS)

    Minoo, M. H.

    1984-01-01

    A model for the longitudinal variations of the partial pressures of electrons, ions, and neutral particles is proposed as a result of an experimental study of pressure variations at the level of the active zone as a function of the various discharge parameters of a hollow cathode arc. The cathode region where the temperature passes through its maximum is called active zone. The proposed model embodies the very important variations which the partial electron and neutral particles pressures undergo at the level of the active zone.

  14. Portal pressure and blood nitric oxide levels as predictors of outcome in biliary atresia

    PubMed Central

    Khanna, Vikram; Bhatnagar, Veereshwar; Agarwala, Sandeep; Srinivas, Maddur; Das, Nibhriti; Singh, Manoj Kumar

    2016-01-01

    Aim: To evaluate the incidence of portal hypertension (PHT) in biliary atresia (BA) patients and to monitor its progress after Kasai portoenterostomy (KP) by measuring nitric oxide (NO) levels in peripheral blood. Materials and Methods: A prospective cross-sectional study conducted over a period of 2 years. Intraoperative portal pressure (PP) and blood NO levels at presentation, 1-month, 3-month, and 6-month follow-up, were correlated with clinical and biochemical parameters in BA patients. The mean NO level in age-matched control group was 4.64 ± 2.32 μmol/L. Results: Thirty-four BA patients underwent KP over a period of 2 years. The mean age of presentation was 2.7 months (range 1-4 months). The mean intraoperative PP was 21.3 ± 5.4 mmHg. The mean PP in patients aged <60 days, 61–90 days, and >90 days was 18.53 ± 4.45 mmHg, 20.33 ± 3.07 mmHg, and 26.5 ± 5.01 mmHg, respectively. The mean PP in the patients who underwent successful KP was 16.75 ± 3.54 mmHg while for those who continued to have jaundice it was 23.94 ± 4.63 mmHg (P < 0.001). NO levels closely followed the PP as shown by the regression equation NO = 4.79 + 0.64 PP mmHg, R2 = 0.69. The mean NO level at presentation was 18.48 ± 4.17 μmol/L and at 1-month, 3-month, and 6-month follow-up was 11.94 ± 5.62 μmol/L, 10.79 ± 6.02 μmol/L, and 9.93 ± 6.53 μmol/L, respectively (P < 0.001). The difference in NO levels was also statistically significant between the patients who cleared jaundice and those with persisting jaundice. Conclusion: All BA patients had PHT at presentation. PHT worsens with age and has an adverse effect on outcome of KP. NO levels in blood closely follow PP and higher levels are associated with poor outcome. PMID:27046973

  15. Empirical estimation of peak pressure level from sound exposure level. Part II: Offshore impact pile driving noise.

    PubMed

    Lippert, Tristan; Galindo-Romero, Marta; Gavrilov, Alexander N; von Estorff, Otto

    2015-09-01

    Numerical models of underwater sound propagation predict the energy of impulsive signals and its decay with range with a better accuracy than the peak pressure. A semi-empirical formula is suggested to predict the peak pressure of man-made impulsive signals based on numerical predictions of their energy. The approach discussed by Galindo-Romero, Lippert, and Gavrilov [J. Acoust. Soc. Am. 138, in press (2015)] for airgun signals is modified to predict the peak pressure from offshore pile driving, which accounts for impact and pile parameters. It is shown that using the modified empirical formula provides more accurate predictions of the peak pressure than direct numerical simulations of the signal waveform. PMID:26428828

  16. The application of high-pressure treatment in the reduction of phosphate levels in breakfast sausages.

    PubMed

    O'Flynn, C C; Cruz-Romero, M C; Troy, D J; Mullen, A M; Kerry, J P

    2014-01-01

    This study investigated effects of high pressure (HP) treatment of pork meat at 150 or 300 MPa for 5 min before manufacturing sausages on the reduction of phosphate levels and compared to sausages manufactured with untreated pork meat (control sausages). Improvement in perceived saltiness, juiciness and overall flavour was observed in sausages manufactured using HP-treated meat at 150 MPa and 0% phosphate, compared to control sausages. Sausages manufactured using meat HP-treated at 150 MPa and 0.25% phosphate (P<0.05) improved hardness of sausages. HP-treated meat at 300 MPa and 0% phosphate decreased juiciness and adhesiveness, while at 0.25% phosphate, adversely affected emulsion stability and sensory attributes. HP treatment did not affect significantly the lightness of the sausages; however, elimination of phosphate reduced (P<0.05) the yellowness, while HP treatment at 150 MPa with 0.25 or 0.5% phosphate increased (P<0.05) redness. HP reatment at 150 MPa has potential for reducing phosphate levels in sausages without significant changes in their functionality and improved acceptability. PMID:24056406

  17. Estimation of sound pressure levels of voiced speech from skin vibration of the neck

    NASA Astrophysics Data System (ADS)

    Švec, Jan G.; Titze, Ingo R.; Popolo, Peter S.

    2005-03-01

    How accurately can sound pressure levels (SPLs) of speech be estimated from skin vibration of the neck? Measurements using a small accelerometer were carried out in 27 subjects (10 males and 17 females) who read Rainbow and Marvin Williams passages in soft, comfortable, and loud voice, while skin acceleration levels (SALs) and SPLs were simultaneously registered and analyzed every 30 ms. The results indicate that the mean SPL of voiced speech can be estimated with accuracy better than +/-2.8 dB in 95% of the cases when the subjects are individually calibrated. This makes the accelerometer an interesting sensor for SPL measurement of speech when microphones are problematic to use (e.g., noisy environments or in voice dosimetry). The estimates of equivalent SPL, which is the logarithm of averaged relative energy of voiced speech, were found to be up to 1.5 dB less accurate than the mean SPL. The estimation accuracy for instantaneous SPLs was worse than for the mean and equivalent SPLs (on average +/-6 and +/-5 dB for males and females, respectively). .

  18. Age and hypertension strongly induce aortic stiffening in rats at basal and matched blood pressure levels.

    PubMed

    Lindesay, George; Ragonnet, Christophe; Chimenti, Stefano; Villeneuve, Nicole; Vayssettes-Courchay, Christine

    2016-05-01

    Age and hypertension are major causes of large artery remodeling and stiffening, a cardiovascular risk factor for heart and kidney damage. The aged spontaneously hypertensive rat (SHR) model is recognized for human cardiovascular pathology, but discrepancies appeared in studies of arterial stiffness. We performed experiments using a robust analysis via echo tracking in 20-week adult (n = 8) and 80-week-old SHR (n = 7), with age-matched normotensive Wistar Kyoto rats (WKY, n = 6;6) at basal and matched levels of blood pressure (BP). After anesthesia with pentobarbital, abdominal aortic diameter and pressure were recorded and BP was decreased by clonidine i.v. At basal BP, aortic pulse distension, compliance, and distensibility (AD) were reduced and stiffness index increased with age and hypertension and further altered with age + hypertension. When BP was adjusted in SHR to that of normotensive rats (130 mmHg), there was no difference between 20-week-old SHR and WKY Importantly, the age effect was maintained in both WKY and SHR and accentuated by hypertension in old rats. At 130 mmHg, with similar pulse pressure in the four groups, AD (kPa(-3)) = 24.2 ± 1 in 20 weeks WKY, 19.7 ± 1.4 in 20 weeks SHR, 12.4 ± 1.3 in 80 weeks WKY and 6.6 ± 0.6 in 80 weeks SHR; distension = 7.6 ± 0.4%, 6.7 ± 0.6%, 3.7 ± 0.3%, and 1.8 ± 0.2% in the same groups. In conclusion, reduced distensibility, that is, stiffening due to age is clearly shown here in both WKY and SHR as well as a synergistic effect of age and hypertension. This technique will allow new studies on the mechanisms responsible and drug intervention. PMID:27233301

  19. Comparison of Two Levels of Pressure Support Ventilation on Success of Extubation in Preterm Neonates: A Randomized Clinical Trial

    PubMed Central

    Farhadi, Roya; Lotfi, Hamid Reza; Alipour, Abbas; Nakhshab, Maryam; Ghaffari, Vajiheh; Hashemi, Seyyed Abbas

    2016-01-01

    Background: Pressure Support Ventilation (PSV) is one of the modes of mechanical ventilation that can be used alone as a weaning strategy in neonates. However, studies on the appropriate pressure level for this mode in neonates are limited. Objectives: Because the use of adequate pressure support in this mode, keeping the appropriate neonate’s tidal volume, and preventing the respiratory complications, this study was aimed to compare extubation failure in the two levels of pressure support ventilation of 10 and 14 cmH2O when removing the neonates from the ventilator. Materials & Methods: In this randomized clinical trial 50 premature infants of 27-37 weeks with respiratory distress syndrome (RDS) were under mechanical ventilation for at least 48 hours, were randomly assigned to two groups. One group was extubated in PSV mode with pressure of 14 cmH2O and the other with 10 cmH2O. Extubation failure rate and complications such as pneumothorax, death and respiratory parameters were compared in the two groups. Results: Twenty five neonates in each group were assessed. Weaning time, extubation failure rate, and mean airway pressure was lesser in PSV of 10 cmH20 group than Level of 14 cmH2O and those differences were statistically significant (P<0.05). Difference between work of breathing, ventilation time, pneumothorax and mortality rate between two groups were not statistically significant (P>0.05). Conclusion: The results of our study show that extubation of the neonates using 10 CmH2O in PSV mode increases the success rate of extubation. Although when Volume- assured PSV can be used, it is more logical to use it for guaranteeing tidal volume, but using the appropriate level of pressure support when the PSV mode is used alone is inevitable and further studies are necessary to demonstrate the level of pressure in this mode. PMID:26383214

  20. Sound Pressure Levels Measured in a University Concert Band: A Risk of Noise-Induced Hearing Loss?

    ERIC Educational Resources Information Center

    Holland, Nicholas V., III

    2008-01-01

    Researchers have reported public school band directors as experiencing noise-induced hearing loss. Little research has focused on collegiate band directors and university student musicians. The present study measures the sound pressure levels generated within a university concert band and compares sound levels with the criteria set by the…

  1. Effects of low level laser therapy (LLLT) on pressured human osteoblasts: A histomorphologic and quantitative study

    NASA Astrophysics Data System (ADS)

    Pyo, S. J.; Song, W. W.; Kim, I. R.; Park, B. S.; Kim, C. H.; Kim, S. S.; Chung, I. K.; Kim, Y. D.

    2012-03-01

    Previous research has investigated the effects of LLLT during titanium implantation, tooth movement and bone graft using deproteinized bovine bone and recognized that these circumstances were nothing more than intentional controlled overpressure against static cells since this controlled trauma could affect cell function/malfunction, or cell recovery/apoptosis. The present preliminary study was conducted to prove if LLL would influence cell viability and cell function after excessive damage, which is enough to diminish cell numbers and distort the features of cells. Our aim is to evaluate whether low level laser irradiation (LLLi) could be helpful in the recovery of traumatized osteoblasts (pressure damaged cells) by observing the morphology and the survival rate of those cells. This model used bone cell cultures which were traumatized by a pressure with 250 G of centripetal force and observed their response to such trauma and low level laser irradiation. In this experiment, a Ga-Al-As diode LLL (IMPRA-ORT, NDLux, Seoul, KOREA) was used with a wavelength of 808 nm, a focus of 14 × 24 mm, which was wide enough to cover the whole dish surface or well within at least 2 times radiation, and an output of 100 mW. Statistical analysis showed a higher recovery rate of damaged osteoblasts in the radiation group than the non-radiation group ( p < 0.05). The nonradiation group had a very poor proliferation rate in comparison to the control group ( p < 0.05) in every time period. In the control group, actin filaments showed a random orientation and cell process branched variously around each cell. In contrast, compressed cells, these patterns were turned into thicker and shorter cytoskeletons. As time progressed, every living cell recovered from the severe stress and recovered both form and function. In summary, the present study showed the capacity of LLLT to aid the recovery of the cell skeleton and affect cell viability on overpressured osteoblasts. These results may

  2. Vascular flow reserve as a link between long-term blood pressure level and physical performance capacity in mammals.

    PubMed

    Poulsen, Christian B; Damkjær, Mads; Hald, Bjørn O; Wang, Tobias; Holstein-Rathlou, Niels-Henrik; Jacobsen, Jens Christian B

    2016-06-01

    Mean arterial pressure (MAP) is surprisingly similar across different species of mammals, and it is, in general, not known which factors determine the arterial pressure level. Mammals often have a pronounced capacity for sustained physical performance. This capacity depends on the vasculature having a flow reserve that comes into play as tissue metabolism increases. We hypothesize that microvascular properties allowing for a large vascular flow reserve is linked to the level of the arterial pressure.To study the interaction between network properties and network inlet pressure, we developed a generic and parsimonious computational model of a bifurcating microvascular network where diameter and growth of each vessel evolves in response to changes in biomechanical stresses. During a simulation, the network develops well-defined arterial and venous vessel characteristics. A change in endothelial function producing a high precapillary resistance and thus a high vascular flow reserve is associated with an increase in network inlet pressure. Assuming that network properties are independent of body mass, and that inlet pressure of the microvascular network is a proxy for arterial pressure, the study provides a conceptual explanation of why high performing animals tend to have a high MAP. PMID:27255360

  3. Sound power and pressure level measurements in the inlet and outlet of an HRSG duct

    SciTech Connect

    Jungbauer, D.E.; Unruh, J.F.; Pantermuehl, P.J.; Rose, S.

    1995-04-01

    The ever-increasing size of cogeneration facilities has mandated the need for noise abatement in the design stage. Many noise projection models are available to the industry for predicting noise levels in an adjacent to new installations. However, the models all require accurate source noise information if valid noise predictions are to be expected. As a consequence of designing one of the world`s largest cogeneration installations involving eight Model W-701 turbine units and their Heat Recovery Steam Generators (HRSGs), it became apparent that the attention between the exhaust of the Generators (HRSGs), it became apparent that the attention between the exhaust of the turbine and the outlet of the HRSGs was not well known. Not having this information posed potentially expensive noise abatement modifications during the design and construction phases. In order to verify the adequacy of scaling studies from a W-501 turbine and HRSG to the W-701 system, a comprehensive field test of an existing W-501 installation was conducted. This paper describes the design of an acoustic intensity and sound pressure probe to operate inside the high-temperature ductwork, the access engineering required, data acquisition, and final results concerning noise attenuation across the HRSG.

  4. Beneficial Effects of Dietary Nitrate on Endothelial Function and Blood Pressure Levels.

    PubMed

    d'El-Rei, Jenifer; Cunha, Ana Rosa; Trindade, Michelle; Neves, Mario Fritsch

    2016-01-01

    Poor eating habits may represent cardiovascular risk factors since high intake of fat and saturated fatty acids contributes to dyslipidemia, obesity, diabetes mellitus, and hypertension. Thus, nutritional interventions are recognized as important strategies for primary prevention of hypertension and as adjuvants to pharmacological therapies to reduce cardiovascular risk. The DASH (Dietary Approach to Stop Hypertension) plan is one of the most effective strategies for the prevention and nonpharmacological management of hypertension. The beneficial effects of DASH diet on blood pressure might be related to the high inorganic nitrate content of some food products included in this meal plan. The beetroot and other food plants considered as nitrate sources account for approximately 60-80% of the daily nitrate exposure in the western population. The increased levels of nitrite by nitrate intake seem to have beneficial effects in many of the physiological and clinical settings. Several clinical trials are being conducted to determine the broad therapeutic potential of increasing the bioavailability of nitrite in human health and disease, including studies related to vascular aging. In conclusion, the dietary inorganic nitrate seems to represent a promising complementary therapy to support hypertension treatment with benefits for cardiovascular health. PMID:27088010

  5. Beneficial Effects of Dietary Nitrate on Endothelial Function and Blood Pressure Levels

    PubMed Central

    d'El-Rei, Jenifer; Cunha, Ana Rosa; Trindade, Michelle; Neves, Mario Fritsch

    2016-01-01

    Poor eating habits may represent cardiovascular risk factors since high intake of fat and saturated fatty acids contributes to dyslipidemia, obesity, diabetes mellitus, and hypertension. Thus, nutritional interventions are recognized as important strategies for primary prevention of hypertension and as adjuvants to pharmacological therapies to reduce cardiovascular risk. The DASH (Dietary Approach to Stop Hypertension) plan is one of the most effective strategies for the prevention and nonpharmacological management of hypertension. The beneficial effects of DASH diet on blood pressure might be related to the high inorganic nitrate content of some food products included in this meal plan. The beetroot and other food plants considered as nitrate sources account for approximately 60–80% of the daily nitrate exposure in the western population. The increased levels of nitrite by nitrate intake seem to have beneficial effects in many of the physiological and clinical settings. Several clinical trials are being conducted to determine the broad therapeutic potential of increasing the bioavailability of nitrite in human health and disease, including studies related to vascular aging. In conclusion, the dietary inorganic nitrate seems to represent a promising complementary therapy to support hypertension treatment with benefits for cardiovascular health. PMID:27088010

  6. Maladaptive rumination moderates the effects of written emotional disclosure on ambulatory blood pressure levels in females

    PubMed Central

    O'Connor, Daryl B.; Ashley, Laura; Jones, Fiona; Ferguson, Eamonn

    2014-01-01

    Written emotional disclosure (WED) has beneficial effects on health outcomes. However, its effectiveness is influenced by a number of variables. This exploratory study tested whether trait rumination, which comprises brooding, a maladaptive component, and reflection, an adaptive component, moderated the effects of WED on ambulatory blood pressure (ABP) in female participants. Fifty-two participants were randomized to write about their most stressful/traumatic life experience(s) or non-emotive topics, for 20 minutes, on 3 consecutive days. Two weeks and 14 weeks later, ABP was recorded over a single day. Using hierarchical linear modelling, an effect of condition was found at 2 weeks but not at 14 weeks indicating that higher levels of ABP were observed following WED. There was also a significant condition by brooding interaction at two weeks such that higher ABP was observed in low brooders in the WED condition compared with low brooders in the control condition. However, within the WED condition, the lowest ABP was exhibited by participants high in brooding. The findings indicated that WED led to short-lived increases in ABP which disappeared in the medium term. Researchers ought to build upon this exploratory study and investigate further the potential moderating role of brooding within WED. Individual differences in brooding may account for (some of) the mixed and inconsistent findings in past WED research. PMID:25750835

  7. Temperature Humidity and Sea Level Pressure Increments Induced by 1DVAR Analysis of GPS Refractivity

    NASA Technical Reports Server (NTRS)

    Poli, Paul; Joiner, Joanna; Kursinski, Emil Robert; Einaudi, Franco (Technical Monitor)

    2001-01-01

    The Global Positioning System (GPS) transmitted signals are affected by the atmosphere. Using the radio occultation technique, where a receiver is placed on a low-Earth-orbiting platform. it is possible to perform soundings. by measuring the bending angles of the rays. The information can be converted into atmospheric refractivity. We have developed a one dimensional variational (1DVAR) analysis that uses GPS/MET 1995 refractivity and 6-hour FVDAS (Finite Volume Data Assimilation System) forecasts as background information to constrain the retrievals. The analysis increments are defined as 1DVAR minus background temperature, humidity and sea level pressure. Before assimilating the 1DVAR profiles into the FVDAS. the increments need to be understood. First, some bias could be induced in the retrievals when confronted with actual biased data: second. bias in the back-round could create undesired bias in the retrievals. Anv bias in the analyses will ultimately change the climatology of the model the retrievals will be assimilated into. We relate the increments to the reduction of the difference between observed minus computed refractivity profiles. We also point out the difference in the mean increments using backgrounds which have assimilated either NESDIS TIROS Operational Vertical Sounder (TOVS) operational retrievals or Data Assimilation Office (DAO) TOVS interactive retrievals. The climatology of the model in terms of refractivity is significantly different and this impacts the GPS 1DVAR increments. This testifies that changing the basic load of assimilated data has an influence on the impact the GPS data may have in a DAS.

  8. Is there any association between blood pressure and education level? The CroHort study.

    PubMed

    Erceg, Marijan; Ivicević-Uhernik, Ana; Kern, Josipa; Vuletić, Silvije

    2012-01-01

    The aim of this study was to explore how the association of 5-year cumulative incidence of arterial hypertension (further 5-CIAH) and education varies according to body weight, age and sex. The study was conducted on cohort of 1383 subjects aged 18+ with initially normal blood pressure (systolic < 140 mmHg and diastolic < 90 mmHg, and not taking medication). Data were collected in 2003 and repeated in 2008. Methods of descriptive statistics, chi2 test and logistic regression were used. No association between education level and hypertension development was recorded in the group of men and in the group of woman aged 65+. In the group of women with normal body weight, younger than 65 years, significantly higher 5-CIAH values were recorded in those with less than 12 years of education (32.5% [22.0 to 42.9]) compared to those with 12 or more years of education (9.6% [6.1 to 13.1]). PMID:22338760

  9. Predicting the June 2013 European Flooding based on Precipitation, Soil Moisture and Sea Level Pressure

    NASA Astrophysics Data System (ADS)

    Ionita, Monica; Dima, Mihai; Lohmann, Gerrit; Scholz, Patrick; Rimbu, Norel

    2015-04-01

    Over the past decades Europe has experienced heavy floods with major consequences for thousands of people and billions of Euros worth of damage. In particular, the summer 2013 flood in Central Europe showed how vulnerable modern society is to hydrological extremes and emphasizes once more the need for improved forecast methods of such extreme climatic events. Based on a multiple linear regression model, it is shown here that 55% of the June 2013 Elbe River extreme discharge could have been predicted using May precipitation, soil moisture and sea level pressure. Moreover, our model was able to predict more than 75% of the total Elbe River discharge for June 2013 (in terms of magnitude) by incorporating also the amount of precipitation recorded during the days prior the flood, but the predicted discharge for the June 2013 event was still underestimated by 25%. Given that all predictors used in the model are available at the end of each month, the forecast scheme can be used to predict extreme events and to provide early warnings for upcoming floods. The forecast methodology could be efficient for other rivers also, depending on their location and their climatic background.

  10. Experimental Investigation of Liquid-Level Measuring Accuracy in a Low Pressure Environment

    SciTech Connect

    Adamson, D.J.

    1996-10-01

    Dip Tubes which are used for determining liquid level in many processes at SRS will be used to measure the liquid level of the Am/Cm solution in the Feed Tank at the MPPF. The Feed Tank operates under a vacuum, therefore the Dip Tubes will operate under a vacuum. Uncertainty in how accurate the Dip Tubes would perform in a vacuum environment led to testing. The Am/Cm Melter Liquid-Feed Tank measurement test was mocked-up per Figure 1. The Feed Tank was designed to simulate actual conditions in which the Dip Tubes would measure the differential pressure. The Feed Tank was made of Stainless Steel with a Lexan window to view inside the tank during testing. The Feed Tank was built per Drawing SRT-ETF-DD-96008, Revision A. The accuracy of the Dip Tubes was checked first by filling the Feed Tank at a flow rate of 3.5 L/min and venting it to the atmosphere. Figure 2 shows that the Dip Tubes were responsive and accurate when compared to the data from the measuring scale on the view window. Then tests were conducted with 23y Hg vacuum inside the tank and water flow rates of 3.9 L/min, 1.8 L/min, and 0.7 L/min being fed to the tank. The data from each test are depicted in Figure 3, Figure 4, and Figure 5, respectively. The Dip Tubes responded accurately for the three test with a maximum error range of +0.31y to -0.19y when compared to the measuring scale located next to the view window on the Feed Tank.

  11. Earth's air pressure 2.7 billion years ago constrained to less than half of modern levels

    NASA Astrophysics Data System (ADS)

    Som, Sanjoy M.; Buick, Roger; Hagadorn, James W.; Blake, Tim S.; Perreault, John M.; Harnmeijer, Jelte P.; Catling, David C.

    2016-06-01

    How the Earth stayed warm several billion years ago when the Sun was considerably fainter is the long-standing problem of the `faint young Sun paradox'. Because of negligible O2 and only moderate CO2 levels in the Archaean atmosphere, methane has been invoked as an auxiliary greenhouse gas. Alternatively, pressure broadening in a thicker atmosphere with a N2 partial pressure around 1.6-2.4 bar could have enhanced the greenhouse effect. But fossilized raindrop imprints indicate that air pressure 2.7 billion years ago (Gyr) was below twice modern levels and probably below 1.1 bar, precluding such pressure enhancement. This result is supported by nitrogen and argon isotope studies of fluid inclusions in 3.0-3.5 Gyr rocks. Here, we calculate absolute Archaean barometric pressure using the size distribution of gas bubbles in basaltic lava flows that solidified at sea level ~2.7 Gyr in the Pilbara Craton, Australia. Our data indicate a surprisingly low surface atmospheric pressure of Patm = 0.23 +/- 0.23 (2σ) bar, and combined with previous studies suggests ~0.5 bar as an upper limit to late Archaean Patm. The result implies that the thin atmosphere was rich in auxiliary greenhouse gases and that Patm fluctuated over geologic time to a previously unrecognized extent.

  12. Effect of Buddhist meditation on serum cortisol and total protein levels, blood pressure, pulse rate, lung volume and reaction time.

    PubMed

    Sudsuang, R; Chentanez, V; Veluvan, K

    1991-09-01

    Serum cortisol and total protein levels, blood pressure, heart rate, lung volume, and reaction time were studied in 52 males 20-25 years of age practicing Dhammakaya Buddhist meditation, and in 30 males of the same age group not practicing meditation. It was found that after meditation, serum cortisol levels were significantly reduced, serum total protein level significantly increased, and systolic pressure, diastolic pressure and pulse rate significantly reduced. Vital capacity, tidal volume and maximal voluntary ventilation were significantly lower after meditation than before. There were also significant decreases in reaction time after mediation practice. The percentage decrease in reaction time during meditation was 22%, while in subjects untrained in meditation, the percentage decrease was only 7%. Results from these studies indicate that practising Dhammakaya Buddhist meditation produces biochemical and physiological changes and reduces the reaction time. PMID:1801007

  13. The effect of chronic peripheral nesfatin-1 application on blood pressure in normal and chronic restraint stressed rats: related with circulating level of blood pressure regulators.

    PubMed

    Ayada, Ceylan; Turgut, Günfer; Turgut, Sebahat; Güçlü, Zuhal

    2015-01-01

    Nesfatin is a peptide secreted by peripheral tissues, central and peripheral nervous system. It is involved in the regulation of homeostasis. Although the effects of nesfatin-1 on nutrition have been studied widely in the literature, the mechanisms of nesfatin-1 action and also relations with other physiological parameters are still not clarified well. We aimed to investigate the effect of peripheral chronic nesfatin-1 application on blood pressure regulation in normal and in rats exposed to restraint immobilization stress. In our study, three month-old male Wistar rats were used. Rats were divided into 4 groups as Control, Stress, Control+Nesfatin-1, Nesfatin-1+Stress. Angiotensinogen, angiotensin converting enzyme 2, angiotensin II, endothelin-1, endothelial nitric oxide synthase, aldosterone, cortisol, nesfatin-1 levels were determined in plasma samples by ELISA. Our results have shown that chronic peripheral nesfatin-1 administration increases blood pressure in normal and in rats exposed to chronic restraint stress. Effect of nesfatin-1 on circulating level of angiotensinogen, angiotensin converting enzyme 2, angiotensin II, endothelin-1, endothelial nitric oxide synthase, aldosterone and cortisol has been identified. We can conclude that elevated high blood pressure after chronic peripheral nesfatin-1 administration in rats exposed to chronic restraint stress may be related to decreased plasma level of endothelial nitric oxide synthase concentration. PMID:25504061

  14. Self-pressurization of a flightweight liquid hydrogen tank: Effects of fill level at low wall heat flux

    NASA Technical Reports Server (NTRS)

    Vandresar, N. T.; Hasan, M. M.; Lin, C.-S.

    1991-01-01

    Experimental results are presented for the self pressurization and thermal stratification of a 4.89 cu m liquid hydrogen storage tank subjected to low heat flux (2.0 and 3.5 W/sq m) in normal gravity. The test tank was representative of future spacecraft tankage, having a low mass to volume ratio and high performance multilayer thermal insulation. Tests were performed at fill levels of 29 and 49 pcts. (by volume) and complement previous tests at 83 pct. fill. As the heat flux increases, the pressure rise rate at each fill level exceeds the homogeneous rate by an increasing ratio. Herein, this ratio did not exceed a value of 2. The slowest pressure rise rate was observed for the 49 pct. fill level at both heat fluxes. This result is attributed to the oblate spheroidal tank geometry which introduces the variables of wetted wall area, liquid-vapor interfacial area, and ratio of side wall to bottom heating as a function of fill level or liquid depth. Initial tank thermal conditions were found to affect the initial pressure rise rate. Quasi steady pressure rise rates are independent of starting conditions.

  15. Self-pressurization of a flightweight liquid hydrogen tank - Effects of fill level at low wall heat flux

    NASA Technical Reports Server (NTRS)

    Van Dresar, N. T.; Lin, C. S.; Hasan, M. M.

    1992-01-01

    Experimental results are presented for the self pressurization and thermal stratification of a 4.89 cu m liquid hydrogen storage tank subjected to low heat flux (2.0 and 3.5 W/sq m) in normal gravity. The test tank was representative of future spacecraft tankage, having a low mass to volume ratio and high performance multilayer thermal insulation. Tests were performed at fill levels of 29 and 49 pcts. (by volume) and complement previous tests at 83 pct. fill. As the heat flux increases, the pressure rise rate at each fill level exceeds the homogeneous rate by an increasing ratio. Herein, this ratio did not exceed a value of 2. The slowest pressure rise rate was observed for the 49 pct. fill level at both heat fluxes. This result is attributed to the oblate spheroidal tank geometry which introduces the variables of wetted wall area, liquid-vapor interfacial area, and ratio of side wall to bottom heating as a function of fill level or liquid depth. Initial tank thermal conditions were found to affect the initial pressure rise rate. Quasi steady pressure rise rates are independent of starting conditions.

  16. Regional Fat Distribution and Blood Pressure Level and Variability: The Dallas Heart Study.

    PubMed

    Yano, Yuichiro; Vongpatanasin, Wanpen; Ayers, Colby; Turer, Aslan; Chandra, Alvin; Carnethon, Mercedes R; Greenland, Philip; de Lemos, James A; Neeland, Ian J

    2016-09-01

    Our aim was to investigate the associations of regional fat distribution with home and office blood pressure (BP) levels and variability. Participants in the Dallas Heart Study, a multiethnic cohort, underwent 5 BP measurements on 3 occasions during 5 months (2 in home and 1 in office) and quantification of visceral adipose tissue, abdominal subcutaneous adipose tissue, and liver fat by magnetic resonance imaging, and lower body subcutaneous fat by dual x-ray absorptiometry. The relation of regional adiposity with short-term (within-visit) and long-term (overall visits) mean BP and average real variability was assessed with multivariable linear regression. We have included 2595 participants with a mean age of 44 years (54% women; 48% black), and mean body mass index was 29 kg/m(2) Mean systolic BP/diastolic BP was 127/79 mm Hg and average real variability systolic BP was 9.8 mm Hg during 3 visits. In multivariable-adjusted models, higher amount of visceral adipose tissue was associated with higher short-term (both home and office) and long-term mean systolic BP (β[SE]: 1.9[0.5], 2.7[0.5], and 2.1[0.5], respectively; all P<0.001) and with lower long-term average real variability systolic BP (β[SE]: -0.5[0.2]; P<0.05). In contrast, lower body fat was associated with lower short-term home and long-term mean BP (β[SE]: -0.30[0.13] and -0.24[0.1], respectively; both P<0.05). Neither subcutaneous adipose tissue or liver fat was associated with BP levels or variability. In conclusion, excess visceral fat was associated with persistently higher short- and long-term mean BP levels and with lower long-term BP variability, whereas lower body fat was associated with lower short- and long-term mean BP. Persistently elevated BP, coupled with lower variability, may partially explain increased risk for cardiac hypertrophy and failure related to visceral adiposity. PMID:27432862

  17. Empirical Modeling and Stochastic Simulation of Sea-Level Pressure Variability

    NASA Astrophysics Data System (ADS)

    Kravtsov, S.; Tilinina, N.; Zyulyaeva, Y.; Gulev, S.

    2014-12-01

    The scope of this work is stochastic emulation of surrogate sea-level pressure (SLP) for the use in error estimation and statistical prediction studies. The input SLP data set whose statistics is to be emulated was taken from the 1979-2013 ERA Interim Reanalysis at full 6-hourly temporal and 0.75º spatial resolutions over the Northern Hemisphere. Upon subtracting seasonal climatology, the SLP anomalies (SLPA) were projected onto the subspace of 1000 leading empirical orthogonal functions (EOFs) of the daily-mean SLPA, which account for the vast majority (>99%) of the full 6-hourly fields' variance for each season. The main step of our methodology is the estimation of a linear autoregressive moving average (ARMA) empirical model for the daily SLPA principal components (PCs) via regularized multiple linear regression (MLR); this model was driven, at the stage of simulation, by state-dependent (multiplicative) noise. Finally, we have also developed and implemented a diagnostic statistical scheme for accurate interpolation of simulated daily SLPA anomalies to 6-hourly temporal resolution. Upon transforming the simulated 6-hourly SLPA PCs into the physical space and adding seasonal climatology, the resulting SLP variability was compared to the actual variability in the ERA Interim Reanalysis. We show that our empirical model produces independent realizations of SLP variability, which are nearly indistinguishable from the observed variability over a wide range of statistical measures; these measures include, among other things, spatial patterns of band-pass and low-pass filtered variability, as well as diverse characteristics of mid-latitude cyclone tracks.

  18. Uric acid level and elevated blood pressure in US adolescents: National Health and Nutrition Examination Survey, 1999-2006.

    PubMed

    Loeffler, Lauren F; Navas-Acien, Ana; Brady, Tammy M; Miller, Edgar R; Fadrowski, Jeffrey J

    2012-04-01

    Uric acid is associated with cardiovascular disease and cardiovascular disease risk factors in adults, including chronic kidney disease, coronary artery disease, stroke, diabetes mellitus, preeclampsia, and hypertension. We examined the association between uric acid and elevated blood pressure in a large, nationally representative cohort of US adolescents, a population with a relatively low prevalence of cardiovascular disease and cardiovascular disease risk factors. Among 6036 adolescents 12 to 17 years of age examined in the 1999-2006 National Health and Nutrition Examination Survey, the mean age was 14.5 years, 17% were obese (body mass index: ≥95th percentile), and 3.3% had elevated blood pressure. Mean serum uric acid level was 5.0 mg/dL, and 34% had a uric acid level ≥5.5 mg/dL. In analyses adjusted for age, sex, race/ethnicity, and body mass index percentile, the odds ratio of elevated blood pressure, defined as a systolic or diastolic blood pressure ≥95th percentile for age, sex, and height, for each 0.1-mg/dL increase in uric acid level was 1.38 (95% CI: 1.16-1.65). Compared with <5.5 mg/dL, participants with a uric acid level ≥5.5 mg/dL had a 2.03 times higher odds of having elevated blood pressure (95% CI: 1.38-3.00). In conclusion, increasing levels of serum uric acid are associated with elevated blood pressure in healthy US adolescents. Additional prospective studies and clinical trials are needed to determine whether uric acid is merely a marker in a complex metabolic pathway or causal of hypertension and, thus, a potential screening and therapeutic target. PMID:22353609

  19. Efficacy and safety of active negative pressure peritoneal therapy for reducing the systemic inflammatory response after damage control laparotomy (the Intra-peritoneal Vacuum Trial): study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Damage control laparotomy, or abbreviated initial laparotomy followed by temporary abdominal closure (TAC), intensive care unit resuscitation, and planned re-laparotomy, is frequently used to manage intra-abdominal bleeding and contamination among critically ill or injured adults. Animal data suggest that TAC techniques that employ negative pressure to the peritoneal cavity may reduce the systemic inflammatory response and associated organ injury. The primary objective of this study is to determine if use of a TAC dressing that affords active negative pressure peritoneal therapy, the ABThera Open Abdomen Negative Pressure Therapy System, reduces the extent of the systemic inflammatory response after damage control laparotomy for intra-abdominal sepsis or injury as compared to a commonly used TAC method that provides potentially less efficient peritoneal negative pressure, the Barker’s vacuum pack. Methods/Design The Intra-peritoneal Vacuum Trial will be a single-center, randomized controlled trial. Adults will be intraoperatively allocated to TAC with either the ABThera or Barker’s vacuum pack after the decision has been made by the attending surgeon to perform a damage control laparotomy. The study will use variable block size randomization. On study days 1, 2, 3, 7, and 28, blood will be collected. Whenever possible, peritoneal fluid will also be collected at these time points from the patient’s abdomen or TAC device. Luminex technology will be used to quantify the concentrations of 65 mediators relevant to the inflammatory response in peritoneal fluid and plasma. The primary endpoint is the difference in the plasma concentration of the pro-inflammatory cytokine IL-6 at 24 and 48 h after TAC dressing application. Secondary endpoints include the differential effects of these dressings on the systemic concentration of other pro-inflammatory cytokines, collective peritoneal and systemic inflammatory mediator profiles, postoperative fluid balance

  20. Perforated second trimester appendicitis with abdominal compartment syndrome managed with negative pressure wound therapy and open abdomen

    PubMed Central

    Turnock, Adam R.; Fleischer, Brian P.; Carney, Martin J.; Vanderlan, Wesley B.

    2016-01-01

    Abdominal compartment syndrome (ACS) is a known complication of laparotomy; however, the literature is lacking in regards to treatment of this entity in pregnant patients. We present a case of acute perforated appendicitis in a second trimester primagravida, complicated by gangrenous necrosis of the contiguous bowel with subsequent development of ACS and intra-abdominal sepsis. This was treated with a novel approach, using non-commercial negative pressure wound therapy and open abdomen technique. Gestational integrity was preserved and the patient went on to experience a normal spontaneous vaginal delivery. At 5 years post-delivery the patient has had no surgical complications and her baby has met all developmental milestones. PMID:27302498

  1. Perforated second trimester appendicitis with abdominal compartment syndrome managed with negative pressure wound therapy and open abdomen.

    PubMed

    Turnock, Adam R; Fleischer, Brian P; Carney, Martin J; Vanderlan, Wesley B

    2016-01-01

    Abdominal compartment syndrome (ACS) is a known complication of laparotomy; however, the literature is lacking in regards to treatment of this entity in pregnant patients. We present a case of acute perforated appendicitis in a second trimester primagravida, complicated by gangrenous necrosis of the contiguous bowel with subsequent development of ACS and intra-abdominal sepsis. This was treated with a novel approach, using non-commercial negative pressure wound therapy and open abdomen technique. Gestational integrity was preserved and the patient went on to experience a normal spontaneous vaginal delivery. At 5 years post-delivery the patient has had no surgical complications and her baby has met all developmental milestones. PMID:27302498

  2. Argon laser trabeculoplasty as a means of decreasing intraocular pressure from ''normal'' levels in glaucomatous eyes

    SciTech Connect

    Sharpe, E.D.; Simmons, R.J.

    1985-06-15

    The authors conducted a retrospective study of 67 patients (85 eyes) with severe glaucoma to determine whether argon laser trabeculoplasty could reduce intraocular pressures below the ''normal'' range. All patients had initial intraocular pressures of less than or equal to 19 mm Hg. Success was defined as a decrease in intraocular pressure of at least 20%, no increase in medications, stable visual field, and no subsequent glaucoma surgery. After an average follow-up period of 30 months, treatment was successful in 31 cases. One half of the failures occurred by six months and 11 failures (30%) occurred after 12 months. Sixteen patients were able to decrease their medications. Two patients achieved intraocular pressures between 6 and 9 mm Hg and 20 between 10 and 12 mm Hg.

  3. Pressure-induced Mott transition in an organic superconductor with a finite doping level.

    PubMed

    Oike, H; Miyagawa, K; Taniguchi, H; Kanoda, K

    2015-02-13

    We report the pressure study of a doped organic superconductor with a Hall coefficient and conductivity measurements. We find that maximally enhanced superconductivity and a marginal-Fermi liquid appear around a certain pressure where mobile carriers increase critically, suggesting a possible quantum phase transition between strongly and weakly correlated regimes. This observation points to the presence of a criticality in Mottness for a doped Mott insulator with tunable correlation. PMID:25723239

  4. EXPERIMENTAL STUDY OF HIGH LEVELS OF SO2 REMOVAL IN ATMOSPHERIC-PRESSURE FUIDIZED-BED COMBUSTORS

    EPA Science Inventory

    The report describes tests conducted in an atmospheric-pressure-fluidized-bed combustor (FBC) with a cross-section of 1 x 1.6 m) to demonstrate high levels of S02 removal when burning a high-sulfur coal and feeding limestone sorbent for S02 removal. The goal was to achieve 90-plu...

  5. The Influence of Fundamental Frequency and Sound Pressure Level Range on Breathing Patterns in Female Classical Singing

    ERIC Educational Resources Information Center

    Collyer, Sally; Thorpe, C. William; Callaghan, Jean; Davis, Pamela J.

    2008-01-01

    Purpose: This study investigated the influence of fundamental frequency (F0) and sound pressure level (SPL) range on respiratory behavior in classical singing. Method: Five trained female singers performed an 8-s messa di voce (a crescendo and decrescendo on one F0) across their musical F0 range. Lung volume (LV) change was estimated, and…

  6. Evidence for Skill Level Differences in the Thought Processes of Golfers During High and Low Pressure Situations

    PubMed Central

    Whitehead, Amy E.; Taylor, Jamie A.; Polman, Remco C. J.

    2016-01-01

    Two studies examined differences in the cognition of golfers with differing levels of expertise in high and low pressure situations. In study 1, six high skill and six low skill golfers performed six holes of golf, while verbalizing their thoughts using Think Aloud (TA) protocol. Higher skilled golfers’ cognitive processes centered more on planning in comparison to lower skilled golfers. Study 2 investigated whether thought processes of golfers changed in response to competitive pressure. Eight high skill and eight moderate skilled golfers, completed a practice round and a competition round whilst verbalizing thoughts using TA. To create pressure in the competition condition, participants were instructed that monetary prizes would be awarded to the top three performers and scores of all golfers would be published in a league table in the club house. When performing under competitive pressure, it was found that higher skilled golfers were more likely to verbalize technical rules compared to practice conditions, especially during putting performance. This shift in cognition toward more technical aspects of motor performance was strongly related to scores on the Decision Specific Reinvestment Scale, suggesting individuals with a higher propensity for reinvestment show the largest changes in cognition under pressure. From a practical perspective, TA can aid a player, coach or sport psychologist by allowing thought processes to be identified and investigate a performer’s thoughts when faced with the pressure of a competition. PMID:26779085

  7. Development and application of a deflagration pressure analysis code for high level waste processing

    SciTech Connect

    Hensel, S.J.; Thomas, J.K.

    1994-06-01

    The Deflagration Pressure Analysis Code (DPAC) was developed primarily to evaluate peak pressures for deflagrations in radioactive waste storage and process facilities at the Savannah River Site (SRS). Deflagrations in these facilities are generally considered to be incredible events, but it was judged prudent to develop modeling capabilities in order to facilitate risk estimates. DPAC is essentially an engineering analysis tool, as opposed to a detailed thermal hydraulics code. It accounts for mass loss via venting, energy dissipation by radiative heat transfer, and gas PdV work. Volume increases due to vessel deformation can also be included using pressure-volume data from a structural analysis of the enclosure. This paper presents an overview of the code, benchmarking, and applications at SRS.

  8. Launching a salt substitute to reduce blood pressure at the population level: a cluster randomized stepped wedge trial in Peru

    PubMed Central

    2014-01-01

    Background Controlling hypertension rates and maintaining normal blood pressure, particularly in resource-constrained settings, represent ongoing challenges of effective and affordable implementation in health care. One of the strategies being largely advocated to improve high blood pressure calls for salt reduction strategies. This study aims to estimate the impact of a population-level intervention based on sodium reduction and potassium increase – in practice, introducing a low-sodium, high-potassium salt substitute – on adult blood pressure levels. Methods/Design The proposed implementation research study includes two components: Phase 1, an exploratory component, and Phase 2, an intervention component. The exploratory component involves a triangle taste test and a formative research study designed to gain an understanding of the best implementation methods. Phase 2 involves a pragmatic stepped wedge trial design where the intervention will be progressively implemented in several clusters starting the intervention randomly at different times. In addition, we will evaluate the implementation strategy using a cost-effectiveness analysis. Discussion This is the first project in a Latin-American setting to implement a salt substitution intervention at the population level to tackle high blood pressure. Data generated and lessons learnt from this study will provide a strong platform to address potential interventions applicable to other similar low- and middle-income settings. Trial registration This study is registered in ClinicalTrials.gov NCT01960972. PMID:24667035

  9. Laboratory evaluation of the Level TROLL 100 manufactured by In-Situ Inc.: results of pressure and temperature tests

    USGS Publications Warehouse

    Carnley, Mark V.; Fulford, Janice M.; Brooks, Myron H.

    2013-01-01

    The Level TROLL 100 manufactured by In-Situ Inc. was evaluated by the U.S. Geological Survey (USGS) Hydrologic Instrumentation Facility (HIF) for conformance to the manufacturer’s accuracy specifications for measuring pressure throughout the device’s operating temperature range. The Level TROLL 100 is a submersible, sealed, water-level sensing device with an operating pressure range equivalent to 0 to 30 feet of water over a temperature range of −20 to 50 degrees Celsius (°C). The device met the manufacturer’s stated accuracy specifications for pressure within its temperature-compensated operating range of 0 to 50 °C. The device’s accuracy specifications did not meet established USGS requirements for primary water-stage sensors used in the operation of streamgages, but the Level TROLL 100 may be suitable for other hydrologic data-collection applications. As a note, the Level TROLL 100 is not designed to meet USGS accuracy requirements. Manufacturer accuracy specifications were evaluated, and the procedures followed and the results obtained are described in this report. USGS accuracy requirements are routinely examined and reported when instruments are evaluated at the HIF.

  10. Effect of antihypertensive treatment at different blood pressure levels in patients with diabetes mellitus: systematic review and meta-analyses

    PubMed Central

    Carlberg, Bo

    2016-01-01

    Objective To assess the effect of antihypertensive treatment on mortality and cardiovascular morbidity in people with diabetes mellitus, at different blood pressure levels. Design Systematic review and meta-analyses of randomised controlled trials. Data sources CENTRAL, Medline, Embase, and BIOSIS were searched using highly sensitive search strategies. When data required according to the protocol were missing but trials were potentially eligible, we contacted researchers, pharmaceutical companies, and authorities. Eligibility criteria Randomised controlled trials including 100 or more people with diabetes mellitus, treated for 12 months or more, comparing any antihypertensive agent against placebo, two agents against one, or different blood pressure targets. Results 49 trials, including 73 738 participants, were included in the meta-analyses. Most of the participants had type 2 diabetes. If baseline systolic blood pressure was greater than 150 mm Hg, antihypertensive treatment reduced the risk of all cause mortality (relative risk 0.89, 95% confidence interval 0.80 to 0.99), cardiovascular mortality (0.75, 0.57 to 0.99), myocardial infarction (0.74, 0.63 to 0.87), stroke (0.77, 0.65 to 0.91), and end stage renal disease (0.82, 0.71 to 0.94). If baseline systolic blood pressure was 140-150 mm Hg, additional treatment reduced the risk of all cause mortality (0.87, 0.78 to 0.98), myocardial infarction (0.84, 0.76 to 0.93), and heart failure (0.80, 0.66 to 0.97). If baseline systolic blood pressure was less than 140 mm Hg, however, further treatment increased the risk of cardiovascular mortality (1.15, 1.00 to 1.32), with a tendency towards an increased risk of all cause mortality (1.05, 0.95 to 1.16). Metaregression analyses showed a worse treatment effect with lower baseline systolic blood pressures for cardiovascular mortality (1.15, 1.03 to 1.29 for each 10 mm Hg lower systolic blood pressure) and myocardial infarction (1.12, 1.03 to 1.22 for each 10 mm Hg

  11. Blood pressure level impacts risk of death among HIV seropositive adults in Kenya: a retrospective analysis of electronic health records

    PubMed Central

    2014-01-01

    pressure level among HIV+ patients in Kenya is related to mortality. Low blood pressure carries the highest mortality risk. High systolic blood pressure is associated with mortality among patients whose disease is not advanced. Further investigation is needed into the cause of death for such patients. PMID:24886474

  12. Cortisol, blood pressure, and heart rate responses to food intake were independent of physical fitness levels in women.

    PubMed

    Jayasinghe, Sisitha U; Torres, Susan J; Fraser, Steve F; Turner, Anne I

    2015-11-01

    This research tested the hypothesis that women who had higher levels of physical fitness will have lower hypothalamo-pituitary-adrenal axis (cortisol) and sympatho-adrenal medullary system (blood pressure and heart rate) responses to food intake compared with women who had low levels of physical fitness. Lower fitness (n = 22; maximal oxygen consumption = 27.4 ± 1.0 mL∙kg(-1)·min(-1)) and higher fitness (n = 22; maximal oxygen consumption = 41.9 ± 1.6 mL∙kg(-1)·min(-1)) women (aged 30-50 years; in the follicular phase of the menstrual cycle) who participated in levels of physical activity that met (lower fitness = 2.7 ± 0.5 h/week) or considerably exceeded (higher fitness = 7.1 ± 1.4 h/week) physical activity guidelines made their own lunch using standardised ingredients at 1200 h. Concentrations of cortisol were measured in blood samples collected every 15 min from 1145-1400 h. Blood pressures and heart rate were also measured every 15 min between 1145 h and 1400 h. The meal consumed by the participants consisted of 20% protein, 61% carbohydrates, and 19% fat. There was a significant overall response to lunch in all of the parameters measured (time effect for all, p < 0.01). The cortisol response to lunch was not significantly different between the groups (time × treatment, p = 0.882). Overall, both groups showed the same pattern of cortisol secretion (treatment p = 0.839). Systolic blood pressure, diastolic blood pressure, mean arterial pressure, or heart rate responses (time × treatment, p = 0.726, 0.898, 0.713, and 0.620, respectively) were also similar between higher and lower fitness women. Results suggest that the physiological response to food intake in women is quite resistant to modification by elevated physical fitness levels. PMID:26499850

  13. Cardiac Reactivity and Elevated Blood Pressure Levels among Young African Americans: The Importance of Stress.

    ERIC Educational Resources Information Center

    Livingston, Ivor Lensworth; Marshall, Ronald J.

    1990-01-01

    Explores the racial differences in elevated arterial blood pressure between African American youth, especially adolescents, and their White counterparts. Argues that African American adolescents' perception of day-to-day stress is an important contributor to this condition. Considers a conceptual model of the sociopsychophysiological stress…

  14. Four-week effects of allopurinol and febuxostat treatments on blood pressure and serum creatinine level in gouty men.

    PubMed

    Kim, Hyun Ah; Seo, Young-Il; Song, Yeong W

    2014-08-01

    The aim of this study was to observe the effects of uric acid lowering therapy (UALT), febuxostat and allopurinol, on blood pressure (BP) and serum creatinine level. Post-hoc data were derived from a phase-III, randomised, double-blind, 4-week trial of male gouty patients that compared the safety and efficacy of febuxostat and allopurinol in adults with gout. The subjects were randomly assigned to one of five groups, 35-37 in each group (febuxostat: 40, 80, 120 mg/d; allopurinol: 300 mg/d; control group: placebo). Blood pressure and serum creatinine level were measured at baseline and at weeks 2 and 4. Diastolic BP and creatinine level had decreased significantly in the UALT groups compared to the control group at week 4. Diastolic BP had decreased significantly in the allopurinol group and serum creatinine level had decreased significantly in the febuxostat groups at week 4. After adjusting for confounding variables, serum uric acid changes were found to be significantly correlated with changes in serum creatinine level but were not associated with changes in systolic or diastolic BP. UALT in gouty subjects significantly decreased diastolic BP and serum creatinine level. Changes in uric acid were significantly correlated with those in serum creatinine level, suggesting the feasibility of renal function improvement through UALT in gouty men. PMID:25120316

  15. Fructose containing sugars do not raise blood pressure or uric acid at normal levels of human consumption.

    PubMed

    Angelopoulos, Theodore J; Lowndes, Joshua; Sinnett, Stephanie; Rippe, James M

    2015-02-01

    The impact of fructose, commonly consumed with sugars by humans, on blood pressure and uric acid has yet to be defined. A total of 267 weight-stable participants drank sugar-sweetened milk every day for 10 weeks as part of their usual, mixed-nutrient diet. Groups 1 and 2 had 9% estimated caloric intake from fructose or glucose, respectively, added to milk. Groups 3 and 4 had 18% of estimated caloric intake from high fructose corn syrup or sucrose, respectively, added to the milk. Blood pressure and uric acid were determined prior to and after the 10-week intervention. There was no effect of sugar type on either blood pressure or uric acid (interaction P>.05), and a significant time effect for blood pressure was noted (P<.05). The authors conclude that 10 weeks of consumption of fructose at the 50th percentile level, whether consumed as pure fructose or with fructose-glucose-containing sugars, does not promote hyperuricemia or increase blood pressure. PMID:25496265

  16. [Factors affecting the control of blood pressure and lipid levels in patients with cardiovascular disease: the PREseAP Study].

    PubMed

    Orozco-Beltrán, Domingo; Brotons, Carlos; Moral, Irene; Soriano, Nuria; Del Valle, María A; Rodríguez, Ana I; Pepió, Josep M; Pastor, Ana

    2008-03-01

    The aim of this observational study was to identify factors influencing the control of blood pressure (i.e., <140/90 mmHg, or <130/80 mmHg in diabetic patients) and low-density lipoprotein (LDL) cholesterol level (<100 mg/dL) in 1223 patients with cardiovascular disease. Overall, 70.2% of patients were men, and their mean age was 66.4 years. Blood pressure was poorly controlled in 50.9% (95% confidence interval [CI], 46.9%-54.8%) and the LDL cholesterol level was poorly controlled in 60.1% (95% CI, 56.3%-63.9%). Determinants of poor blood pressure control were diabetes, hypertension, no previous diagnosis of heart failure, previous diagnosis of peripheral artery disease or stroke, obesity, and no lipid-lowering treatment. Determinants of poor LDL cholesterol control were no lipid-lowering treatment, no previous diagnosis of ischemic heart disease, no antihypertensive treatment, and dyslipidemia. The factors affecting blood pressure control were different from those affecting LDL cholesterol control, an observation that should be taken into account when implementing treatment recommendations for achieving therapeutic objectives in secondary prevention. PMID:18361907

  17. Comparison of measured and calculated sound pressure levels around a large horizontal axis wind turbine generator

    NASA Technical Reports Server (NTRS)

    Shepherd, Kevin P.; Willshire, William L., Jr.; Hubbard, Harvey H.

    1989-01-01

    Results are reported from a large number of simultaneous acoustic measurements around a large horizontal axis downwind configuration wind turbine generator. In addition, comparisons are made between measurements and calculations of both the discrete frequency rotational harmonics and the broad band noise components. Sound pressure time histories and noise radiation patterns as well as narrow band and broadband noise spectra are presented for a range of operating conditions. The data are useful for purposes of environmental impact assessment.

  18. Hypertension`s lead connection: Does low-level exposure to lead cause high blood pressure?

    SciTech Connect

    Fackelmann, K.

    1996-06-15

    {open_quotes}Paying for the sins of the past.{close_quotes} is how researcher Howard Hu describes a proposed disease process in which lead stored for decades in the skeleton puts people at risk of high blood pressure. Previous research has linked this silvery white, poisonous metal to a host of ill effects in children, including learning disabilities, behavior problems, and brain damage. Now, Hu`s study indicates that past exposure may be causing today`s high blood pressure. If he`s right, the public health impact would be significant. {open_quotes}Tens of millions of Americans have been exposed over the years to lead,{close_quotes} says Philip J. Landrigan of Mount Sinai Medical Center in New York. {open_quotes}Adults today grew up at a time when we were still putting several hundred thousand tons of lead into gasoline each year.{close_quotes} Indeed, the men who developed high blood pressure during the recent study had in their bones lead concentrations, or lead burdens, that came from decades of everyday exposure. Such exposures resulted principally from breathing in fumes from leaded gasoline, drinking tap water from lead pipes or pipes soldered with lead, and inhaling or ingesting lead-laced paint dust or chips. This article goes on to discuss other studies and questions which still need to be answered.

  19. Investigation of the Sound Pressure Level (SPL) of earphones during music listening with the use of physical ear canal models

    NASA Astrophysics Data System (ADS)

    Aying, K. P.; Otadoy, R. E.; Violanda, R.

    2015-06-01

    This study investigates on the sound pressure level (SPL) of insert-type earphones that are commonly used for music listening of the general populace. Measurements of SPL from earphones of different respondents were measured by plugging the earphone to a physical ear canal model. Durations of the earphone used for music listening were also gathered through short interviews. Results show that 21% of the respondents exceed the standard loudness/duration relation recommended by the World Health Organization (WHO).

  20. Compliance is nonlinear over tidal volume irrespective of positive end-expiratory pressure level in surfactant-depleted piglets.

    PubMed

    Lichtwarck-Aschoff, M; Mols, G; Hedlund, A J; Kessler, V; Markström, A M; Guttmann, J; Hedenstierna, G; Sjöstrand, U H

    2000-12-01

    Between the lower and the upper inflection point of a quasistatic pressure-volume (PV) curve, a segment usually appears in which the PV relationship is steep and linear (i.e., compliance is high, with maximal volume change per pressure change, and is constant). Traditionally it is assumed that when positive end-expiratory pressure (PEEP) and tidal volume (V T) are titrated such that the end-inspiratory volume is positioned at this linear segment of the PV curve, compliance is constant over VT during ongoing ventilation. The validity of this assumption was addressed in this study. In 14 surfactant-deficient piglets, PEEP was increased from 3 cm H(2)O to 24 cm H(2)O, and the compliance associated with 10 consecutive volume increments up to full VT was determined with a modified multiple-occlusion method at the different PEEP levels. With PEEP at approximately the lower inflection point, compliance was minimal in most lungs and decreased markedly over VT, indicating overdistension. Compliance both increased and decreased within the same breath at intermediate PEEP levels. It is concluded that a PEEP that results in constant compliance over the full VT range is difficult to find, and cannot be derived from conventional respiratory-mechanical analyses; nor does this PEEP level coincide with maximal gas exchange. PMID:11112126

  1. Blood pressure levels and variance assessed by ambulatory monitoring: optimal parameters.

    PubMed

    Yates, F E; Benton, L A

    1990-01-01

    We obtained multiple ambulatory blood pressure monitoring (ABPM) records over five years from two trained, normotensive subjects experienced in wearing the apparatus. The resulting time series data on systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were used to suggest optimal parameters for monitoring by two instruments (Colin Medical Instruments ABPM-630 and Del Mar Avionics Pressurometer) and to compare two indirect methods (auscultatory and oscillometric). A 10-min sampling interval day and night provided sufficient density of data to support spectral analysis for ultradian rhythms in the frequency range of one cycle per hour to one cycle per 9 h on a 24-h record. Rhythms with major periods of approximately 3, 6, and 9 h were variously found in 94 normotensive subjects, aged 20 to 95 years, including the two trained subjects. When the monitoring period was extended to 72 h, the circadian (approximately 24 h) rhythm could be more sharply defined, as well as a 12-h harmonic. In some studies the two trained subjects wore two monitors, one on each arm, set to read simultaneously. From the simultaneous measurements on both arms, it was shown that averaging across three points (30 min of record) reduced the coefficient of variation between the two simultaneous records to 6% or less. Auscultatory and oscillometric methods were equally reliable. Echocardiographic data were obtained in five normotensive subjects and compared to their ABPM data. The ABPM records provided additional information about cardiovascular function not merely duplicating that obtained by acute stress tests, such as exercise or cold pressor responses, or echocardiography. Standards for ABPM are suggested. PMID:2221507

  2. Measuring Fluctuating Pressure Levels and Vibration Response in a Jet Plume

    NASA Technical Reports Server (NTRS)

    Osterholt, Douglas J.; Knox, Douglas M.

    2011-01-01

    The characterization of loads due to solid rocket motor plume impingement allows for moreaccurate analyses of components subjected to such an environment. Typically, test verification of predicted loads due to these conditions is widely overlooked or unsuccessful. ATA Engineering, Inc., performed testing during a solid rocket motor firing to obtain acceleration and pressure responses in the hydrodynamic field surrounding the jet plume. The test environment necessitated a robust design to facilitate measurements being made in close proximity to the jet plume. This paper presents the process of designing a test fixture and an instrumentation package that could withstand the solid rocket plume environment and protect the required instrumentation.

  3. The application of high-pressure treatment in the reduction of salt levels in reduced-phosphate breakfast sausages.

    PubMed

    O'Flynn, Claire C; Cruz-Romero, Malco C; Troy, Declan; Mullen, Anne M; Kerry, Joe P

    2014-03-01

    This study investigated the effects of high pressure (HP) treatment of pork meat before manufacturing sausages with reduced salt levels and compared them to sausages manufactured with untreated meat (control sausages). A 2×5 factorial design was set up incorporating two pressure levels (0 or 150 MPa) and five salt levels (0.5, 1.0, 1.5, 2.0 and 2.5%). Most quality attributes were affected when salt levels were reduced below 1.5%. Fat loss (FL) was (P<0.05) affected by salt level; samples with <1.5% salt had the highest FL. HP treatment increased emulsion stability and reduced cook loss (CL) compared to control sausages. Increased CL was observed when salt was reduced below 2.0%. Salt reduction below 1.5% adversely affected colour, sensory and texture attributes. Independent of salt, HP treatment affected adversely juiciness and cohesiveness while adhesiveness was improved. Overall, there is potential to manufacture sausages maintaining organoleptic and functional properties traditionally associated with sausages using HP treated meat. PMID:24334049

  4. Intermittent operation of low pressure UF membranes for sewage reuse at household level.

    PubMed

    Diamantis, Vasileios I; Anagnostopoulos, Konstantinos; Melidis, Paraschos; Ntougias, Spyridon; Aivasidis, Alexander

    2013-01-01

    A household-scale wastewater treatment system was operated with domestic sewage. The system could recover gardening/irrigation water from raw sewage or secondary effluent by low pressure ultrafiltration (UF). The UF membranes (surface area = 3.5 m(2), pore size = 0.04 μm) were operated at constant transmembrane pressure (0.13 bar). The proposed technology was examined for approximately 2 months without membrane cleaning. Membrane operation was performed periodically (one or two times per week), simulating water usage for gardening irrigation. During raw sewage filtration (chemical oxygen demand (COD) total = 242 ± 71 mg L(-1), COD soluble = 105 ± 51 mg L(-1), suspended solids = 188 ± 58 mg L(-1)), low permeate COD was achieved (52 ± 25 mg L(-1)), whereas nitrogen and phosphorus were recovered in the permeate. The water recovered during 1 h of operation displayed a gradual decrease from 42 to 22 L m(-2)h(-1) during the 50-d time period. For the secondary effluent filtration, the UF module achieved consistently a recovery rate of 39.6 ± 8.0 L m(-2)h(-1), with an average permeate COD of 37 mg L(-1). In this case, the fouling layer (cake layer) was completely reversible after the relaxation period, rendering the process suitable for unattended household applications. PMID:23985509

  5. The effect of numeracy level on completeness of home blood pressure monitoring.

    PubMed

    Rao, Vishal N; Sheridan, Stacey L; Tuttle, Laura A; Lin, Feng-Chang; Shimbo, Daichi; Diaz, Keith M; Hinderliter, Alan L; Viera, Anthony J

    2015-01-01

    Home blood pressure monitoring (HBPM) readings predict the increased risks of cardiovascular events and end-organ damage independent of office blood pressure (BP). Numeracy (the ability to handle numbers) may limit the feasibility of patients' performing HBPM. The authors analyzed data from 409 adults recruited from 12 North Carolina primary care clinics who completed a three-item numeracy assessment, the Rapid Estimate of Adult Literacy in Medicine-Short Form health literacy assessment, and HBPM over 2 weeks. Among the 409 participants, 73% were college graduates and 69% had adequate numeracy. Completion of HBPM was greater among those with adequate numeracy (96.2% vs 93.7%; P=.009) and did not correlate with health literacy scores. More participants with adequate numeracy reported completion of ≥85% of readings than those with low numeracy (95% vs 88%; P=.018). Adequate numeracy, but not high literacy, is associated with more complete HBPM reporting. Whether higher numeracy is associated with more accurate self-reported readings is an area of future research. PMID:25439279

  6. The shift of optical band gap in W-doped ZnO with oxygen pressure and doping level

    SciTech Connect

    Chu, J.; Peng, X.Y.; Dasari, K.; Palai, R.; Feng, P.

    2014-06-01

    Highlights: • CVD–PLD co-deposition technique was used. • Better crystalline of the ZnO samples causes the redshift of the optical band gap. • Higher W concentration induces blueshift of the optical band gap. - Abstract: Tungsten-doped (W-doped) zinc oxide (ZnO) nanostructures were synthesized on quartz substrates by pulsed laser and hot filament chemical vapor co-deposition technique under different oxygen pressures and doping levels. We studied in detail the morphological, structural and optical properties of W-doped ZnO by SEM, XPS, Raman scattering, and optical transmission spectra. A close correlation among the oxygen pressure, morphology, W concentrations and the variation of band gaps were investigated. XPS and Raman measurements show that the sample grown under the oxygen pressure of 2.7 Pa has the maximum tungsten concentration and best crystalline structure, which induces the redshift of the optical band gap. The effect of W concentration on the change of morphology and shift of optical band gap was also studied for the samples grown under the fixed oxygen pressure of 2.7 Pa.

  7. Bi-level positive airway pressure (BiPAP) and acute cardiogenic pulmonary oedema (ACPO) in the emergency department.

    PubMed

    Murray, Sarah

    2002-05-01

    Patients in acute respiratory failure (ARF) frequently present to the emergency department (ED). Traditionally management has involved mechanical ventilation via endotracheal intubation. Such invasive forms of treatment, however, correlate with a higher incidence of infection, mortality, length of stay and contribute to the costs of intensive care. Non-invasive positive pressure ventilation (NIPPV) such as bi-level positive airway pressure (BiPAP) may therefore provide an alternative and preferable form of treatment. Whilst contemporary literature supports the use of BiPAP in hypercapnic ARF, its role in acute hypoxaemic presentations remains elusive. Specifically, the efficacy and safety of BiPAP in the treatment of acute cardiogenic pulmonary oedema (ACPO) remains a contentious issue. The aim of this paper is to explore the physiological rationale for treatment of ACPO with BiPAP. Particular attention will focus on the comparative theoretical advantages of BiPAP in relation to continuous positive airway pressure (CPAP), and a review of recent research. Discussion will incorporate timeliness in the application of BiPAP, indicators of successful treatment, appropriate manipulation of pressure settings, nursing workload and management of patients beyond the ED. Whilst the theoretical advantages of BiPAP ventilation are acknowledged, larger randomised controlled research studies are recommended in order to clearly ensure its safe and effective application in the treatment of ACPO. PMID:12154698

  8. The effects of CO2 pneumoperitoneum on the apoptotic index in the peritoneum.

    PubMed

    Tosun, Murat; Samli, Hale; Arikan, Yüksel; Solak, Mustafa; Sahin, Ali; Söylemez, Zafer; Kalkan, Serpil

    2007-01-01

    During laparoscopic surgery, gases such as carbon dioxide (CO(2)), helium, or normal air are insufflated into the intra-abdominal cavity so the surgeon can obtain a clear surgical field; however, this insufflation technique may cause injury to the intra-abdominal organs. This study was undertaken to evaluate the effects of different pressures of CO(2) on the apoptotic index in the peritoneum during laparoscopic surgery. A total of 30 Sprague-Dawley male rats were used in the study. CO(2) was insufflated into the intra-abdominal cavity via an angiocatheter cannula by an insufflator at pressures of 10 and 20 mm Hg over 60 min. In the control group, the cannula was inserted into the intra-abdominal cavity, but no gas was insufflated. After 60 min, the rats were killed; peritoneum was harvested from the abdominal wall and was cultured in the cell culture laboratory. Apoptotic and living cells were detected immunohistochemically, and the apoptotic index was calculated and statistically analyzed. The data collected revealed that the apoptotic index increases in proportion to the level of CO(2) pressure. CO(2) pneumoperitoneum is a very useful technique. Gas pressure must be carefully set during the operation, however, or injured mesothelial cells may cause serious malfunction. PMID:17901037

  9. Head Shape and Winding Angle Optimization of Composite Pressure Vessels Based on a Multi-level Strategy

    NASA Astrophysics Data System (ADS)

    Vafaeesefat, A.; Khani, A.

    2007-11-01

    This paper presents a multi-level strategy for the optimization of composite pressure vessels with nonmetallic liners. The design variables for composite vessels include the head shape, the winding angle, the layer thickness, the number of layers, and the stacking sequence. A parameter called “modified shape factor” is introduced as an objective function. This parameter takes into account the effects of the internal pressure and volume, the vessel weight, and the composite material properties. The proposed algorithm uses genetic algorithm and finite element analysis to optimize the design parameters. As a few examples, this procedure is implemented on geodesic and ellipsoidal heads. The results show that for the given vessel conditions, the geodesic head shape with helical winding angle of nine degrees has the better performance.

  10. Effect of Reynolds number, turbulence level and periodic wake flow on heat transfer on low pressure turbine blades.

    PubMed

    Suslov, D; Schulz, A; Wittig, S

    2001-05-01

    The development of effective cooling methods is of major importance for the design of new gas turbines blades. The conception of optimal cooling schemes requires a detailed knowledge of the heat transfer processes on the blade's surfaces. The thermal load of turbine blades is predominantly determined by convective heat transfer which is described by the local heat transfer coefficient. Heat transfer is closely related to the boundary layer development along the blade surface and hence depends on various flow conditions and geometrical parameters. Particularly Reynolds number, pressures gradient and turbulence level have great impact on the boundary layer development and the according heat transfer. Therefore, in the present study, the influence of Reynolds number, turbulence intensity, and periodic unsteady inflow on the local heat transfer of a typical low pressure turbine airfoil is experimentally examined in a plane cascade. PMID:11460633

  11. A global historical Radiosondes and Tracked Balloons Archive on standard pressure levels back to the 1920s

    NASA Astrophysics Data System (ADS)

    Ramella Pralungo, L.; Haimberger, L.; Stickler, A.; Brönnimann, S.

    2013-12-01

    Long observed time series of climate state quantities are needed to extend our understanding of global weather, climate variability and monitoring not only at the Earths surface but also the free atmosphere, since climate anomalies and climate change have a three-dimensional spatial structure. Radiosonde data before 1958 and tracked balloon (PILOT) data are rarely available at standard times on standard pressure levels, which complicates their use for climate studies. This paper describes an upper air dataset on standard pressure levels at 00:00 GMT and 12:00 GMT for parameters temperature and wind. The input data sources of this dataset are the Comprehensive Historical Upper Air Network (CHUAN version 1.7), the Integrated Global Radiosonde Archive (IGRA) and upper air observations from the reanalysis datasets ERA-40 and ERA-Interim. As such it contains many data that have been digitized and collected in the EU FP7 project ERA-CLIM. Those data, which partly exist at asynoptic times and on altitude levels instead of pressure levels, have been brought to synoptic times and standard pressure levels using state of the art interpolation techniques, employing geopotential information National Oceanic and Atmosphere Administration (NOAA) 20th Century Reanalysis (NOAA 20CR) to aid the interpolation. The standardized time series have been merged if necessary, taking care that the data are traceable back to their original sources. Only time series longer than 300 days have been saved in the merged archive, since the main purpose of this dataset is to aid climatological studies. If possible WMO numbers have been given to the station records. For some records which have never been identified by a WMO number, a local ID above 100 000 has been attached. This paper describes the merging procedure, data count and data quality and how traceability of the data is ensured. It does not describe a homogenization procedure for both temperature and wind data. Homogeneity adjustments for

  12. Relation between the serum albumin level and nutrition supply in patients with pressure ulcers: retrospective study in an acute care setting.

    PubMed

    Sugino, Hirotaka; Hashimoto, Ichiro; Tanaka, Yuka; Ishida, Soshi; Abe, Yoshiro; Nakanishi, Hideki

    2014-01-01

    This retrospective study examined the validity of the commonly used serum albumin level as an indicator of nutrition status of patients with pressure ulcer(s), particularly because the serum albumin level is affected by various factors and may not be specific to malnutrition. Specifically, we investigated whether nutrition supply or inflammation affects the serum albumin level in 82 patients with pressure ulcers(s) (29 in whom pressure ulcer was present upon admission and 53 in whom pressure ulcer developed after hospital admission). Serum albumin levels, blood test including C-reactive protein (CRP) levels and blood count, caloric intake, and depth and healing of pressure ulcers were compared between various subgroups of patients. Serum albumin levels correlated with red blood cell counts and hemoglobin and CRP levels but not with caloric intake. The correlation with CRP before and after several weeks of pressure ulcer treatment was negative. The serum albumin level upon admission was higher in patients in whom the ulcer healed than in those in whom it did not heal as well as in patients who were discharged than in those who died in the hospital. The serum albumin level appears to reflect inflammation, wound healing, and disease severity rather than nutrition supply in patients with pressure ulcer. J. Med. Invest. 61: 15-21, February, 2014. PMID:24705743

  13. Enterprise-Level Motivations, Regulatory Pressures, and Corporate Environmental Management in Guangzhou, China

    NASA Astrophysics Data System (ADS)

    Tang, Shui-Yan; Li, Pansy Honying; Fryxell, Gerald E.; Lo, Carlos Wing-Hung

    2015-09-01

    This study examines the effects of internal motivations and external pressures on the integration of environmental management (EM) practices within manufacturing operations in China. The moderating role of perceptions toward the regulatory process is also considered along with comparisons between wholly Chinese-owned and foreign-owned enterprises. From a sample of 131 manufacturing companies in the Guangzhou area, it was found that the salience of fees and fines has a strong positive influence on perceptions toward the regulator (the local Environmental Protection Bureau, EPB). This also has a positive effect on perceptions toward regulations themselves for foreign-owned enterprises. Business-case motivations for EM positively shape enterprise perceptions toward regulations, whereas risk-reduction motivations have a negative effect on perceptions toward regulations in foreign-owned enterprises. Enterprise perceptions toward the regulatory process have direct effects on the integration of EM practices in wholly Chinese-owned enterprises, but in opposite directions. While positive perceptions toward regulations have positive influence, positive perceptions toward regulators (i.e., the EPB) negatively affect it. Overall, these results indicated that promoting the adoption of EM practices depends on convincing business leaders that EM practices contribute to profit making. The regulatory process can potentially promote these practices, but measures need to be taken to ensure that the regulator is not co-opted by the regulated, especially in wholly Chinese-owned enterprises.

  14. So Small, So Loud: Extremely High Sound Pressure Level from a Pygmy Aquatic Insect (Corixidae, Micronectinae)

    PubMed Central

    Sueur, Jérôme; Mackie, David; Windmill, James F. C.

    2011-01-01

    To communicate at long range, animals have to produce intense but intelligible signals. This task might be difficult to achieve due to mechanical constraints, in particular relating to body size. Whilst the acoustic behaviour of large marine and terrestrial animals has been thoroughly studied, very little is known about the sound produced by small arthropods living in freshwater habitats. Here we analyse for the first time the calling song produced by the male of a small insect, the water boatman Micronecta scholtzi. The song is made of three distinct parts differing in their temporal and amplitude parameters, but not in their frequency content. Sound is produced at 78.9 (63.6–82.2) SPL rms re 2.10−5 Pa with a peak at 99.2 (85.7–104.6) SPL re 2.10−5 Pa estimated at a distance of one metre. This energy output is significant considering the small size of the insect. When scaled to body length and compared to 227 other acoustic species, the acoustic energy produced by M. scholtzi appears as an extreme value, outperforming marine and terrestrial mammal vocalisations. Such an extreme display may be interpreted as an exaggerated secondary sexual trait resulting from a runaway sexual selection without predation pressure. PMID:21698252

  15. Enterprise-Level Motivations, Regulatory Pressures, and Corporate Environmental Management in Guangzhou, China.

    PubMed

    Tang, Shui-Yan; Li, Pansy Honying; Fryxell, Gerald E; Lo, Carlos Wing-Hung

    2015-09-01

    This study examines the effects of internal motivations and external pressures on the integration of environmental management (EM) practices within manufacturing operations in China. The moderating role of perceptions toward the regulatory process is also considered along with comparisons between wholly Chinese-owned and foreign-owned enterprises. From a sample of 131 manufacturing companies in the Guangzhou area, it was found that the salience of fees and fines has a strong positive influence on perceptions toward the regulator (the local Environmental Protection Bureau, EPB). This also has a positive effect on perceptions toward regulations themselves for foreign-owned enterprises. Business-case motivations for EM positively shape enterprise perceptions toward regulations, whereas risk-reduction motivations have a negative effect on perceptions toward regulations in foreign-owned enterprises. Enterprise perceptions toward the regulatory process have direct effects on the integration of EM practices in wholly Chinese-owned enterprises, but in opposite directions. While positive perceptions toward regulations have positive influence, positive perceptions toward regulators (i.e., the EPB) negatively affect it. Overall, these results indicated that promoting the adoption of EM practices depends on convincing business leaders that EM practices contribute to profit making. The regulatory process can potentially promote these practices, but measures need to be taken to ensure that the regulator is not co-opted by the regulated, especially in wholly Chinese-owned enterprises. PMID:25948155

  16. Fundamental frequency, sound pressure level and vocal dose of a vocal loading test in comparison to a real teaching situation.

    PubMed

    Echternach, Matthias; Nusseck, Manfred; Dippold, Sebastian; Spahn, Claudia; Richter, Bernhard

    2014-12-01

    Vocal loading capacity is an important aspect of vocal health, especially for people in vocally demanding occupations such as teaching. To analyze vocal loading, vocal loading tests (VLTs) or portable voice devices such as accelerometers have been used. However, it remains unclear how much a VLT in a clinical setup reflects the vocal effort of a real situation, in particular for teachers in a given classroom lesson. In this study of vocally healthy 101 student teachers, we analyzed different vocal doses for a 10-min VLT (80 dB at a distance of 30 cm) and a real 45-min teaching lesson. The phonation time, fundamental frequency, sound pressure level, and noise level were recorded using the VoxLog accelerometer/microphone system for both conditions. From these measurements the time dose, cycle dose, distance dose, energy dissipation dose, and radiated energy dose were calculated. The VLT was associated with a higher fundamental frequency, a higher sound pressure level, and higher relative phonation time compared to the real teaching lesson. Nevertheless, most vocal doses did not differ significantly between the conditions. A VLT of 10 min with >80 dB at 30 cm distance shows only small differences of vocal doses in comparison to a real teaching situation of 45 min. Thus, for clinical vocal assessment the vocal load of a VLT can be related to an approximately 45-min teaching situation. PMID:25012705

  17. The clarinet: how blowing pressure, lip force, lip position and reed "hardness" affect pitch, sound level, and spectrum.

    PubMed

    Almeida, Andre; George, David; Smith, John; Wolfe, Joe

    2013-09-01

    Using an automated clarinet playing system, the frequency f, sound level L, and spectral characteristics are measured as functions of blowing pressure P and the force F applied by the mechanical lip at different places on the reed. The playing regime on the (P,F) plane lies below an extinction line F(P) with a negative slope of a few square centimeters and above a pressure threshold with a more negative slope. Lower values of F and P can produce squeaks. Over much of the playing regime, lines of equal frequency have negative slope. This is qualitatively consistent with passive reed behavior: Increasing F or P gradually closes the reed, reducing its equivalent acoustic compliance, which increases the frequency of the peaks of the parallel impedance of bore and reed. High P and low F produce the highest sound levels and stronger higher harmonics. At low P, sound level can be increased at constant frequency by increasing P while simultaneously decreasing F. At high P, where lines of equal f and of equal L are nearly parallel, this compensation is less effective. Applying F further from the mouthpiece tip moves the playing regime to higher F and P, as does a stiffer reed. PMID:23967954

  18. Research on Earth's rotation and the effect of atmospheric pressure on vertical deformation and sea level variability

    NASA Technical Reports Server (NTRS)

    Wahr, John

    1993-01-01

    The work done under NASA grant NAG5-485 included modelling the deformation of the earth caused by variations in atmospheric pressure. The amount of deformation near coasts is sensitive to the nature of the oceanic response to the pressure. The PSMSL (Permanent Service for Mean Sea Level) data suggest the response is inverted barometer at periods greater than a couple months. Green's functions were constructed to describe the perturbation of the geoid caused by atmospheric and oceanic loading and by the accompanying load-induced deformation. It was found that perturbation of up to 2 cm are possible. Ice mass balance data was used for continental glaciers to look at the glacial contributions to time-dependent changes in polar motion, the lod, the earth's gravitational field, the position of the earth's center-of-mass, and global sea level. It was found that there can be lateral, non-hydrostatic structure inside the fluid core caused by gravitational forcing from the mantle, from the inner core, or from topography at the core/mantle or inner core/outer core boundaries. The nutational and tidal response of a non-hydrostatic earth with a solid inner core was modeled. Monthly, global tide gauge data from PSMSL was used to look at the 18.6-year ocean tide, the 14-month pole tide, the oceanic response to pressure, the linear trend and inter-annual variability in the earth's gravity field, the global sea level rise, and the effects of post glacial rebound. The effects of mantle anelasticity on nutations, earth tides, and tidal variation in the lod was modeled. Results of this model can be used with Crustal Dynamics observations to look at the anelastic dissipation and dispersion at tidal periods. The effects of surface topography on various components of crustal deformation was also modeled, and numerical models were developed of post glacial rebound.

  19. Research on Earth's rotation and the effect of atmospheric pressure on vertical deformation and sea level variability

    NASA Astrophysics Data System (ADS)

    Wahr, John

    1993-03-01

    The work done under NASA grant NAG5-485 included modelling the deformation of the earth caused by variations in atmospheric pressure. The amount of deformation near coasts is sensitive to the nature of the oceanic response to the pressure. The PSMSL (Permanent Service for Mean Sea Level) data suggest the response is inverted barometer at periods greater than a couple months. Green's functions were constructed to describe the perturbation of the geoid caused by atmospheric and oceanic loading and by the accompanying load-induced deformation. It was found that perturbation of up to 2 cm are possible. Ice mass balance data was used for continental glaciers to look at the glacial contributions to time-dependent changes in polar motion, the lod, the earth's gravitational field, the position of the earth's center-of-mass, and global sea level. It was found that there can be lateral, non-hydrostatic structure inside the fluid core caused by gravitational forcing from the mantle, from the inner core, or from topography at the core/mantle or inner core/outer core boundaries. The nutational and tidal response of a non-hydrostatic earth with a solid inner core was modeled. Monthly, global tide gauge data from PSMSL was used to look at the 18.6-year ocean tide, the 14-month pole tide, the oceanic response to pressure, the linear trend and inter-annual variability in the earth's gravity field, the global sea level rise, and the effects of post glacial rebound. The effects of mantle anelasticity on nutations, earth tides, and tidal variation in the lod was modeled. Results of this model can be used with Crustal Dynamics observations to look at the anelastic dissipation and dispersion at tidal periods. The effects of surface topography on various components of crustal deformation was also modeled, and numerical models were developed of post glacial rebound.

  20. Deep electronic levels in high-pressure Bridgman Cd{sub 1-x}Zn{sub x}Te

    SciTech Connect

    Szeles, C.; Shan, Y.Y.; Lynn, K.G.; Eissler, E.E.

    1995-12-01

    The behavior of deep electronic levels was studied as a function of Zn concentration in CdZnTe crystals grown by the high-pressure Bridgman technique using thermoelectric effect spectroscopy. A significant increase of the thermal ionization energies of hole traps was observed with the increasing Zn content of the ternary compound. The effect explains the stronger hole trapping and the resulting much shorter hole lifetime usually observed in CdZnTe as compared to CdTe. The behavior also suggests increased carrier recombination and explains the strong deterioration of electron collection in detectors fabricated from CdZnTe of high Zn concentration.

  1. Exposure to classroom sound pressure level among dance teachers in Porto Alegre (RS)

    PubMed Central

    Nehring, Cristiane; Bauer, Magda Aline; Teixeira, Adriane Ribeiro

    2013-01-01

    Summary Introduction: Dance teachers are exposed to high sound intensities. Aim: To verify the sound intensity of music used by dance teachers during classes. Method: This was a transversal and prospective study. Dance teachers were evaluated with a sociodemographic questionnaire, and sound intensity level measurements were taken at the beginning, middle, and end of dance classes. Results: The sample comprised 35 teachers (average age, 31.8 years). The duration of their career as dance teachers was 1–37 years; they worked daily for approximately 1–10 h. Among the classes followed, there were 15 (42.85%) classical ballet classes, 4 (11.42%) tap dancing lessons, 5 (14.28%) jazz dance classes, 2 (5.71) Arab dance lessons, 6 (17.14%) street dance classes, and 3 (8.57%) ballroom dancing lessons. The average values observed at the beginning, middle, and end of the classes were 80.91 dB (A), 83.22 dB (A), and 85.19 dB (A), respectively. The music played in the street dance classes exposed teachers to the highest sound intensity. Conclusion: The average level of sound intensity of the dance classes in this study was either below or equal to the limit considered harmful for hearing health. Analysis of different class types showed that the sound densities of street, ballroom, and tap dance classes were above the recommended limits. PMID:25991989

  2. Long-Term Continuous Positive Airway Pressure Therapy Normalizes High Exhaled Nitric Oxide Levels in Obstructive Sleep Apnea

    PubMed Central

    Chua, Ai-Ping; Aboussouan, Loutfi S.; Minai, Omar A.; Paschke, Kelly; Laskowski, Daniel; Dweik, Raed A.

    2013-01-01

    Study Objectives: Upper airway inflammation and oxidative stress have been implicated in the pathogenesis of obstructive sleep apnea (OSA) and may be linked to cardiovascular consequences. We prospectively examined fraction of exhaled nitric oxide (FENO), a surrogate marker of upper airway inflammation using a portable nitric oxide analyzer (NIOX MINO). Design: In consecutive adult nonsmokers with suspected OSA, FENO was measured immediately before and after polysomnographic studies, and within 1-3 months following continuous positive airway pressure (CPAP) therapy. Measurement and Results: FENO levels were increased in the 75 patients with OSA compared to the 29 controls, both before sleep (13.4 ± 6.5 ppb vs. 6.5 ± 3.5; p < 0.001) and after sleep (19.0 ± 7.7 ppb vs. 6.9 ± 3.7; p < 0.001). Furthermore, in patients with OSA, FENO levels were significantly higher post-sleep than pre-sleep (19.0 ± 7.7 ppb vs. 13.4 ± 6.5; p < 0.001), while there was no significant overnight change in patients without OSA. The rise in FENO correlated with the apnea-hypopnea index (r = 0.65, p < 0.001), nadir oxygen saturation (r = 0.54, p < 0.001), and arousal index (r = 0.52, p < 0.001). Thirty-seven of these patients underwent CPAP titration and treatment. Successful titration was associated with a lower overnight increase in FENO (7.2 ± 3.3 vs. 11.0 ± 4.3, p = 0.02). FENO levels declined after 1-3 months of CPAP therapy (11.7 ± 4.4 ppb, p < 0.001). Conclusions: FENO levels are elevated in OSA, correlate with severity, and decrease after positive pressure therapy. This study supports the role of upper airway inflammation in OSA pathogenesis and a possible role for FENO in monitoring CPAP therapy. Citation: Chua AP; Aboussouan LS; Minai OA; Paschke K; Laskowski D; Dweik RA. Long-term continuous positive airway pressure therapy normalizes high exhaled nitric oxide levels in obstructive sleep apnea. J Clin Sleep Med 2013;9(6):529-535. PMID:23772184

  3. Impact of HLA Selection Pressure on HIV Fitness at a Population Level in Mexico and Barbados

    PubMed Central

    Payne, Rebecca; Soto-Nava, Maribel; Avila-Rios, Santiago; Valenzuela-Ponce, Humberto; Adland, Emily; Leitman, Ellen; Brener, Jacqui; Muenchhoff, Maximilian; Branch, Songee; Landis, Clive; Reyes-Teran, Gustavo; Goulder, Philip

    2014-01-01

    ABSTRACT Previous studies have demonstrated that effective cytotoxic T lymphocyte (CTL) responses drive the selection of escape mutations that reduce viral replication capacity (VRC). Escape mutations, including those with reduced VRC, can be transmitted and accumulate in a population. Here we compared two antiretroviral therapy (ART)-naive HIV clade B-infected cohorts, in Mexico and Barbados, in which the most protective HLA alleles (HLA-B*27/57/58:01/81:01) are differentially expressed, at 8% and 34%, respectively. Viral loads were significantly higher in Mexico than in Barbados (median, 40,774 versus 14,200; P < 0.0001), and absolute CD4+ T-cell counts were somewhat lower (median, 380/mm3 versus 403/mm3; P = 0.007). We tested the hypothesis that the disparate frequencies of these protective HLA alleles would be associated with a higher VRC at the population level in Mexico. Analysis of VRC in subjects in each cohort, matched for CD4+ T-cell count, revealed that the VRC was indeed higher in the Mexican cohort (mean, 1.13 versus 1.03; P = 0.0025). Although CD4 counts were matched, viral loads remained significantly higher in the Mexican subjects (P = 0.04). This VRC difference was reflected by a significantly higher frequency in the Barbados cohort of HLA-B*27/57/58:01/81:01-associated Gag escape mutations previously shown to incur a fitness cost on the virus (P = 0.004), a difference between the two cohorts that remained statistically significant even in subjects not expressing these protective alleles (P = 0.01). These data suggest that viral set points and disease progression rates at the population level may be significantly influenced by the prevalence of protective HLA alleles such as HLA-B*27/57/58:01/81:01 and that CD4 count-based guidelines to initiate antiretroviral therapy may need to be modified accordingly, to optimize the effectiveness of treatment-for-prevention strategies and reduce HIV transmission rates to the absolute minimum. IMPORTANCE Immune

  4. Attenuation of peak sound pressure levels of shooting noise by hearing protective earmuffs.

    PubMed

    Lenzuni, Paolo; Sangiorgi, Tommaso; Cerini, Luigi

    2012-01-01

    Transmission losses (TL) to highly impulsive signals generated by three firearms have been measured for two ear muffs, using both a head and torso simulator and a miniature microphone located at the ear canal entrance (MIRE technique). Peak SPL TL have been found to be well approximated by 40 ms short-L eq TL. This has allowed the use of transmissibilities and correction factors for bone conduction and physiological masking appropriate for continuous noise, for the calculation of REAT-type peak insertion losses (IL). Results indicate that peak IL can be well predicted by estimates based on one-third octave band 40 ms short L eq and manufacturer-declared (nominal) IL measured for continuous noise according to test standards. Such predictions tend to be more accurate at the high end of the range, while they are less reliable when the attenuation is lower. A user-friendly simplified prediction algorithm has also been developed, which only requires nominal IL and one-third octave sound exposure level spectra. Separate predictions are possible for IL in direct and diffuse sound fields, albeit with higher uncertainties, due to the smaller number of experimental data comprising the two separate datasets on which such predictions are based. PMID:22718106

  5. Resolving the atmospheric pressure influence on watertable level fluctuations in the coastal aquifer south of Ravenna, Italy

    NASA Astrophysics Data System (ADS)

    Balugani, E.; Antonellini, M.

    2009-04-01

    Knowledge of water table fluctuations in coastal zones is important to obtain information on the aquifers hydraulic properties. In order to uniquely interpret this information, it is important to quantify the contribution of each process causing the fluctuations. We recorded two long-period time series of watertable level variations in two piezometers of the coastal phreatic aquifer at Cervia (south of Ravenna), Italy. The piezometers were located on a transect normal to the shoreline, one at 40 m and the other at 70 m from the coast. The dataset has been cleaned for input from rain events, pressure loading and tide-induced fluctuations. The eliminations of fluctuations with frequency 12-24 hours has been particular difficult, because no analytical solution can simulate the observed real fluctuation behaviour. The best solution among those tested has been the one from Li et al., 2000 (c) for spring-neap tides. Despite the fact that this solution predicts only groundwater waves generated by bichromatic signals, and that the boundary conditions require a steep beach slope (not always the case for this stretch of the adriatic sea), the results that we obtained are encouraging. As simplifying assumptions we used a beach slope set to the minimum acceptable value in the solution and no further interaction between the two bichromatic signals when added together. The Adriatic tide, in fact, is defined as "mixed" with dominant semidiurnal type, so that in order to model sea level variations properly we used four harmonic components as recommended from other authors (references). In enclosed or partially enclosed seas, seiches and tides could have similar frequencies, but they are caused by different processes. Seiches could, in fact, interfere with tide waves resulting in a change in amplitude and phase of sea level in response to wind and pressure. Seiches episodes have been extracted and filtered via power spectra and harmonic analysis in both dataset for sea level and

  6. MS2 virus inactivation by atmospheric-pressure cold plasma using different gas carriers and power levels.

    PubMed

    Wu, Yan; Liang, Yongdong; Wei, Kai; Li, Wei; Yao, Maosheng; Zhang, Jue; Grinshpun, Sergey A

    2015-02-01

    In this study, airborne MS2 bacteriophages were exposed for subsecond time intervals to atmospheric-pressure cold plasma (APCP) produced using different power levels (20, 24, and 28 W) and gas carriers (ambient air, Ar-O2 [2%, vol/vol], and He-O2 [2%, vol/vol]). In addition, waterborne MS2 viruses were directly subjected to the APCP treatment for up to 3 min. MS2 viruses with and without the APCP exposure were examined by scanning electron microscopy (SEM), reverse transcription-PCR (RT-PCR), and sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Viral inactivation was shown to exhibit linear relationships with the APCP generation power and exposure time (R(2) > 0.95 for all energy levels tested) up to 95% inactivation (1.3-log reduction) after a subsecond airborne exposure at 28 W; about the same inactivation level was achieved for waterborne viruses with an exposure time of less than 1 min. A larger amount of reactive oxygen species (ROS), such as atomic oxygen, in APCP was detected for a higher generation power with Ar-O2 and He-O2 gas carriers. SEM images, SDS-PAGE, and agarose gel analysis of exposed waterborne viruses showed various levels of damage to both surface proteins and their related RNA genes after the APCP exposure, thus leading to the loss of their viability and infectivity. PMID:25416775

  7. MS2 Virus Inactivation by Atmospheric-Pressure Cold Plasma Using Different Gas Carriers and Power Levels

    PubMed Central

    Wu, Yan; Liang, Yongdong; Wei, Kai; Li, Wei; Grinshpun, Sergey A.

    2014-01-01

    In this study, airborne MS2 bacteriophages were exposed for subsecond time intervals to atmospheric-pressure cold plasma (APCP) produced using different power levels (20, 24, and 28 W) and gas carriers (ambient air, Ar-O2 [2%, vol/vol], and He-O2 [2%, vol/vol]). In addition, waterborne MS2 viruses were directly subjected to the APCP treatment for up to 3 min. MS2 viruses with and without the APCP exposure were examined by scanning electron microscopy (SEM), reverse transcription-PCR (RT-PCR), and sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Viral inactivation was shown to exhibit linear relationships with the APCP generation power and exposure time (R2 > 0.95 for all energy levels tested) up to 95% inactivation (1.3-log reduction) after a subsecond airborne exposure at 28 W; about the same inactivation level was achieved for waterborne viruses with an exposure time of less than 1 min. A larger amount of reactive oxygen species (ROS), such as atomic oxygen, in APCP was detected for a higher generation power with Ar-O2 and He-O2 gas carriers. SEM images, SDS-PAGE, and agarose gel analysis of exposed waterborne viruses showed various levels of damage to both surface proteins and their related RNA genes after the APCP exposure, thus leading to the loss of their viability and infectivity. PMID:25416775

  8. Treating metabolic syndrome's metaflammation with low level light therapy: preliminary results

    NASA Astrophysics Data System (ADS)

    Yoshimura, Tania M.; Kato, Ilka T.; Deana, Alessandro M.; Ribeiro, Martha S.

    2014-02-01

    Metabolic syndrome comprises a constellation of morbidities such as insulin resistance, hyperinsulinemia, atherogenic dyslipidemia, dysglycemia and obesity (especially abdominal). Metabolic alterations are observed in major insulin target organs, increasing the risk of cardiovascular diseases, type-2 diabetes and therefore mortality. Tissue alterations are characterized by immune cells infiltrates (especially activated macrophages). Released inflammatory mediators such as TNF-α induce chronic inflammation in subjects with metabolic syndrome, since inflammatory pathways are activated in the neighboring cells. The intra-abdominal adipose tissue appears to be of particular importance in the onset of the inflammatory state, and strategies contributing to modulate the inflammatory process within this adipose tissue can mitigate the metabolic syndrome consequences. Considering the low level light therapy (LLLT) recognized benefits in inflammatory conditions, we hypothesized this therapeutic approach could promote positive effects in modulating the inflammatory state of metabolic syndrome. That being the scope of this study, male C57BL/6 mice were submitted to a high-fat/high-fructose diet among 8 weeks to induce metabolic syndrome. Animals were then irradiated on the abdominal region during 21 days using an 850 nm LED (6 sessions, 300 seconds per session, 60 mW output power, ~6 J/cm2 fluence, ~19 mW/cm2 fluence rate). Before and during treatment, blood was sampled either from the retroorbital plexus or from tail puncture for glucose, total cholesterol and triglycerides analysis. So far our results indicate no alterations on these metabolic parameters after LLLT. For further investigations, blood was collected for plasma inflammatory cytokine quantification and fresh ex vivo samples of liver and intra-abdominal adipose tissue were harvested for immunohistochemistry purposes.

  9. Fraction SX of maitake mushroom favorably influences blood glucose levels and blood pressure in streptozotocin-induced diabetic rats.

    PubMed

    Preuss, Harry G; Echard, Bobby; Fu, Jia; Perricone, Nicholas V; Bagchi, Debasis; Kaylor, Mark; Zhuang, Cun

    2012-10-01

    We assessed whether fraction SX derived from maitake mushroom could play a beneficial role in the treatment of a laboratory model of type-1 diabetes by decreasing circulating glucose levels and lowering blood pressure (BP). We injected 50 mg/kg body weight (BW) streptozotocin (STZ) intraperitoneally (i.p.) into 48 male Sprague-Dawley rats (SD) to produce a laboratory model of type-1 diabetes. SD were divided into four groups of 12 SD. A control group ate straight pulverized rat chow. To three treatment groups, we added into the pulverized rat chow: gliclazide (10 mg/kg), pioglitazone (10-30 mg/kg), or maitake SX (2.5 g/kg). In addition to measuring BW, circulating glucose level, and BP, the following procedures were also carried out: insulin challenge (insulin sensitivity), losartan challenge (renin-angiotensin system activity), Nw-nitro-L arginine-methyl ester hydrochloride (LNAME) challenge (nitric oxide [NO] system activity), and evaluation of serum angiotensin converting enzyme (ACE) activity. All treatments compared with control generally decreased circulating glucose levels, but only the maitake SX consistently enhanced measured insulin sensitivity. We found that maitake SX could significantly lower systolic blood pressure (SBP) in diabetic SD. In general, only SD receiving maitake SX, not the two drugs, showed decreased activity of the renin-angiotensin system and increased NO system activity compared with control under the conditions examined. Our results suggest that maitake SX may be useful for treating perturbations in glucose-insulin metabolism and elevated BP in type-1 diabetes. PMID:22873755

  10. Differences in Blood Pressure and Vascular Responses Associated with Ambient Fine Particulate Matter Exposures Measured at the Personal Versus Community Level

    EPA Science Inventory

    Background Higher ambient fine particulate matter (PM2.5) levels can be associated with increased blood pressure and vascular dysfunction. Objectives To determine the differential effects on blood pressure and vascular function of daily changes in community ambient-...

  11. Estimated pressure source and vertical deformation in Tatun volcano group, Taiwan, detected by precise leveling in June 2006-August 2007

    NASA Astrophysics Data System (ADS)

    Murase, M.; Ishikawa, K.; Lin, C.; Lin, J.; Pu, H.; Kimata, F.; Miyajima, R.; Nakamichi, H.; Suzuki, A.

    2007-12-01

    good enough to estimate the exact location of pressure source and its shape based on these data and we need constrain search area using other data for getting an appropriate result. One of the leveling results, conducted for a research of Jinshan fault at the period from 2004 to 2005 by Central Geological Survey in Tiwan, shows the subsidence around Len-Shuei-Keng. We assume the spherical source might exist around Len-Shuei-Keng located at the center of the swarm area. We estimate the location of pressure source on that condition by employing a genetic algorithm (GA). In order to give better constraint to our estimation and compare the pressure-source with the swarm in detail, we made a new leveling route over a distance of 10 km on August 2007. We will be able to discuss the detail relationship between earthquake swarm and deformation in the near future.

  12. Total antioxidant level is correlated with intra-ocular pressure in patients with primary angle closure glaucoma

    PubMed Central

    2014-01-01

    Background To evaluate total antioxidant status (TAS) in the plasma of primary angle closure glaucoma (PACG) patients and to compare it to that of the control group. Additionally, we aim to investigate the association of various PACG clinical indices with TAS level. Methods Plasma samples were obtained from 139 PACG patients and 149 glaucoma-free controls of matching age, sex, and ethnicity. TAS in all samples was determined by spectrophotometric and enzyme-linked immunosorbent assay methods. We studied the possible association of the TAS level with various clinical indices relevant to PACG. Results The mean (±SD) total antioxidant (TAS) value was almost similar in patients 1 (±0.22) compared to controls 0.97 (±0.43); p = 0.345. Among cases, mean TAS concentration showed a statistically significant lower pattern among subjects with glaucoma onset at the age of ≤ 50 years (p = 0.037) and female subjects (p = 0.014) as well as having a family history of glaucoma (p = 0.010). Interestingly, a statistically significant inverse correlation was detected between TAS concentration and intra ocular pressure (IOP), (R = -0.14, p = 0.037). Conclusions The inverse correlation of TAS level with IOP, highlights TAS potential role as a predictive-marker for PACG-severity. PMID:24646376

  13. Permissive hypotension does not reduce regional organ perfusion compared to normotensive resuscitation: animal study with fluorescent microspheres

    PubMed Central

    2012-01-01

    Introduction The objective of this study was to investigate regional organ perfusion acutely following uncontrolled hemorrhage in an animal model that simulates a penetrating vascular injury and accounts for prehospital times in urban trauma. We set forth to determine if hypotensive resuscitation (permissive hypotension) would result in equivalent organ perfusion compared to normotensive resuscitation. Methods Twenty four (n=24) male rats randomized to 4 groups: Sham, No Fluid (NF), Permissive Hypotension (PH) (60% of baseline mean arterial pressure - MAP), Normotensive Resuscitation (NBP). Uncontrolled hemorrhage caused by a standardised injury to the abdominal aorta; MAP was monitored continuously and lactated Ringer’s was infused. Fluorimeter readings of regional blood flow of the brain, heart, lung, kidney, liver, and bowel were obtained at baseline and 85 minutes after hemorrhage, as well as, cardiac output, lactic acid, and laboratory tests; intra-abdominal blood loss was assessed. Analysis of variance was used for comparison. Results Intra-abdominal blood loss was higher in NBP group, as well as, lower hematocrit and hemoglobin levels. No statistical differences in perfusion of any organ between PH and NBP groups. No statistical difference in cardiac output between PH and NBP groups, as well as, in lactic acid levels between PH and NBP. NF group had significantly higher lactic acidosis and had significantly lower organ perfusion. Conclusions Hypotensive resuscitation causes less intra-abdominal bleeding than normotensive resuscitation and concurrently maintains equivalent organ perfusion. No fluid resuscitation reduces intra-abdominal bleeding but also significantly reduces organ perfusion. PMID:23531188

  14. November Dipole Anomaly in Northern Extratropical Sea Level Pressure and its Linkage to the Preceding Wintertime Arctic Oscillation

    NASA Astrophysics Data System (ADS)

    Choi, Y. W.; Ahn, J. B.

    2015-12-01

    This paper examines the impact of the wintertime Arctic Oscillation (AO) on the following November circulation. The application of a set of statistical methods shows that a response of November sea level pressure (SLP) to the preceding wintertime AO operates on a hemispheric scale (Choi et al., 2015). At high and middle latitudes, this response is a well-pronounced seesaw in SLP between the Eastern and Western Hemispheres. Winters of the positive AO polarity tend to be followed by positive SLP anomalies spanning the whole Northern Eurasia and negative SLP anomalies extending from the Bering Sea through the Western North Atlantic. Opposite SLP anomalies prevail after winters of the negative AO polarity. The response of November SLP to the preceding wintertime AO closely resembles the first empirical orthogonal function of November SLP. That is, the polarity of the wintertime AO precedes the polarity of the leading mode of variability of November SLP over the Northern Hemisphere. The wintertime AO exerts a 9-month lag impact on November circulation due to the re-emergence of a sea surface temperature anomaly over the western North Atlantic. Acknowledgements This work was funded by the Korea Meteorological Administration Research and Development Program under grant KMIPA 2015-2081 and Rural Development Administration Cooperative Research Program for Agriculture Science and Technology Development under Grant Project No. PJ009353, Republic of Korea. Reference Choi, Y.-W., J.-B. Ahn, V. N. Kryjov, 2015. November seesaw in northern extratropical sea level pressure and its linkage to the preceding wintertime Arctic Oscillation, Int. J. Climatol., DOI: 10.1002/joc.4431

  15. Association between body fat composition and blood pressure level among secondary school adolescents in Dar es Salaam, Tanzania

    PubMed Central

    Mushengezi, Brighton; Chillo, Pilly

    2014-01-01

    Introduction Excess body fat and high blood pressure (BP) are important risk factors for increased cardiovascular morbidity and mortality, and both may have their roots of occurrence in childhood and adolescence. The present study aimed at determining the association between body fat composition and BP level among adolescents in Tanzania. Methods A cross-sectional study involving 5 randomly selected secondary schools within Dar es Salaam was conducted between June and November 2013. Structured questionnaires were used to collect information on demographic characteristics and other cardiovascular risk factors. BP, height, weight and waist circumference were measured following standard methods. Body fat was assessed by skinfold thickness and categorized as underfat, healthy, overfat or obese according to World Health Organization definitions. Hypertension was defined as BP ≥ 90th percentile for age, height and gender of the adolescent. Results The study included 582 adolescents (mean age 16.5±1.8 years, 52.1% boys). The proportion of adolescents with overfat or obesity was 22.2%. Systolic, diastolic and combined hypertension was present in 17.5%, 5.5%, and 4.0% respectively. In the total population mean body fat percent correlated positively with diastolic BP and mean arterial pressure (MAP) but not with systolic BP. In multivariate analysis body mass index (β=0.21, p=0.008) and waist circumference (β=0.12, p=0.049), but not body fat percentage (β=-0.09, p=0.399) independently predicted higher MAP. Conclusion Body mass index predicts BP level better than body fat composition and should be used as a measure of increased risk for hypertension among adolescents. PMID:25918567

  16. Blood pressure levels, left ventricular mass and function are correlated with left atrial volume in mild to moderate hypertensive patients.

    PubMed

    Milan, A; Caserta, M A; Dematteis, A; Naso, D; Pertusio, A; Magnino, C; Puglisi, E; Rabbia, F; Pandian, N G; Mulatero, P; Veglio, F

    2009-11-01

    Arterial hypertension is associated with an increased risk of atrial fibrillation (AF), and leads to a pronounced increase in morbidity and mortality. Left atrial volume (LAV) is an important prognostic marker in the older populations. The aim of our study was to identify the clinical and echocardiographic determinants of LAV in middle-aged (<70 years old) essential hypertensive patients.We evaluated cardiac structure and function in 458 patients, 394 treated and untreated mild to moderate essential hypertensives patients (mean+/-s.d. age 48.4+/-11.1 years) with no associated clinical condition and 64 normotensive control participants (age 45.7+/-12.8 years; P=0.12). A multivariate analysis was performed to calculate the relative weight of each of the variables considered able to predict LAV. The LAV index (LAVi) was significantly increased in the essential hypertensive group vs the control group and was significantly dependent on blood pressure levels (SBP and DBP, P<0.05 for both) and body mass index (BMI) (P<0.0001). Considering the left ventricular (LV) variables, the LV mass index (LVMI) (R(2)=0.19, P<0.001) and LAV were increased in essential hypertensive patients with left ventricular hypertrophy (LVH), and patients with enlarged LAV showed lower systolic and diastolic function and an increased LVMI. The LAVi is dependent on blood pressure levels and anthropometric variables (age and BMI). Further structural (LVMI) and functional (systolic and diastolic) variables are related to the LAVi; LVMI is the most important variable associated with LAV in mild to moderate essential hypertensive adult patients. These findings highlight the importance of left atrium evaluation in adult, relatively young, essential hypertensive patients. PMID:19262581

  17. Risk Stratification by Self-Measured Home Blood Pressure across Categories of Conventional Blood Pressure: A Participant-Level Meta-Analysis

    PubMed Central

    Asayama, Kei; Thijs, Lutgarde; Brguljan-Hitij, Jana; Niiranen, Teemu J.; Hozawa, Atsushi; Boggia, José; Aparicio, Lucas S.; Hara, Azusa; Johansson, Jouni K.; Ohkubo, Takayoshi; Tzourio, Christophe; Stergiou, George S.; Sandoya, Edgardo; Tsuji, Ichiro; Jula, Antti M.; Imai, Yutaka; Staessen, Jan A.

    2014-01-01

    Background The Global Burden of Diseases Study 2010 reported that hypertension is worldwide the leading risk factor for cardiovascular disease, causing 9.4 million deaths annually. We examined to what extent self-measurement of home blood pressure (HBP) refines risk stratification across increasing categories of conventional blood pressure (CBP). Methods and Findings This meta-analysis included 5,008 individuals randomly recruited from five populations (56.6% women; mean age, 57.1 y). All were not treated with antihypertensive drugs. In multivariable analyses, hazard ratios (HRs) associated with 10-mm Hg increases in systolic HBP were computed across CBP categories, using the following systolic/diastolic CBP thresholds (in mm Hg): optimal, <120/<80; normal, 120–129/80–84; high-normal, 130–139/85–89; mild hypertension, 140–159/90–99; and severe hypertension, ≥160/≥100. Over 8.3 y, 522 participants died, and 414, 225, and 194 had cardiovascular, cardiac, and cerebrovascular events, respectively. In participants with optimal or normal CBP, HRs for a composite cardiovascular end point associated with a 10-mm Hg higher systolic HBP were 1.28 (1.01–1.62) and 1.22 (1.00–1.49), respectively. At high-normal CBP and in mild hypertension, the HRs were 1.24 (1.03–1.49) and 1.20 (1.06–1.37), respectively, for all cardiovascular events and 1.33 (1.07–1.65) and 1.30 (1.09–1.56), respectively, for stroke. In severe hypertension, the HRs were not significant (p≥0.20). Among people with optimal, normal, and high-normal CBP, 67 (5.0%), 187 (18.4%), and 315 (30.3%), respectively, had masked hypertension (HBP≥130 mm Hg systolic or ≥85 mm Hg diastolic). Compared to true optimal CBP, masked hypertension was associated with a 2.3-fold (1.5–3.5) higher cardiovascular risk. A limitation was few data from low- and middle-income countries. Conclusions HBP substantially refines risk stratification at CBP levels assumed to carry no or only mildly increased

  18. Tigecycline Treatment Causes a Decrease in Fibrinogen Levels

    PubMed Central

    Zhang, Qian; Zhou, Suming

    2014-01-01

    The objective of this study was to assess the impact of tigecycline treatment on coagulation parameters, specifically fibrinogen, in patients with severe infections. We examined 20 cases of tigecycline-treated patients with severe infections, including hospital-acquired pneumonia, complicated intra-abdominal infections, complicated skin and soft tissue infections, and bloodstream infections. We monitored the relative markers of coagulation and renal and liver function before, during, and after treatment. Fibrinogen (FIB) levels decreased significantly after the use of tigecycline and normalized after the cessation of treatment. FIB levels significantly decreased in the patients treated with the recommended dose or a higher treatment dose. The FIB levels decreased more in the higher-treatment-dose group. There was no difference in the decrease in FIB levels or the FIB level recovery by age. Prothrombin time (PT), activated partial thromboplastin time (APTT), and thrombin time (TT) were prolonged after tigecycline use. The TT decreased after the cessation of treatment, and the PT and APTT also decreased but not to a significant level. There was no change in platelet, alanine aminotransferase (ALT), or creatinine (Cr) levels associated with treatment. The use of tigecycline was associated with decreased FIB levels, which returned to normal after the cessation of treatment. A high-dose treatment group showed greater decreases in FIB levels than did patients treated with the recommended dose. The decline in FIB was not related to patient age. The use of tigecycline was associated with prolonged PT, APTT, and TT. PMID:25547356

  19. Antiatherosclerotic effects of licorice extract supplementation on hypercholesterolemic patients: decreased CIMT, reduced plasma lipid levels, and decreased blood pressure

    PubMed Central

    Fogelman, Yacov; Gaitini, Diana; Carmeli, Eli

    2016-01-01

    Background Ethanolic extract of licorice root has been shown to reduce low-density lipoprotein (LDL) oxidation in atherosclerotic mice and in both hypercholesterolemic and normal lipidemic humans. Objective This study examined the effect of licorice-root extract on carotid intima-media thickness (CIMT) in individuals with hypercholesterolemia. Design Individuals with hypercholesterolemia (total cholesterol ≥6.18 mmol/L [240 mg/dL]) and without significant stenosis were randomly allocated to two groups: an experimental group that consumed 0.2 g/day of ethanolic extract of licorice root for 12 months, and a control group that received a placebo. Results Of 110 eligible participants, 94 (41–80 years old) completed the study. A significant CIMT decrease from 0.92±0.25 mm to 0.84±0.21 mm was observed in the experimental group compared with an increase from 0.85±0.17 mm to 0.88±0.19 mm in the control group. Mean plasma total cholesterol levels and LDL cholesterol decreased, at the range baseline to 1 year, from 284±32 mg/dl to 262±25 mg/dl and from 183±8.5 mg/dl to 174±9.1 mg/dl, respectively, for the experimental group (p<0.001) and from 291±35 to 289±31 mg/dl and from 177.6±10.7 to 179.3±9.6 (p=0.08), respectively, for the control group. Mean high-density lipoprotein (HDL) did not change significantly in either group. In the experimental group, systolic blood pressure decreased from 138±12 mmHg to 125±13 mmHg after 1 year (p=0.01) and increased from 136±15 mmHg to 137±13 mmHg in the control group. Diastolic blood pressure decreased from 92±9 mmHg to 84±10 mmHg (p=0.01) in the experimental group and increased from 89±11 mmHg to 90±8 mmHg in the control group. Conclusion Following 1 year of licorice consumption, mean CIMT, total cholesterol, LDL levels, and blood pressure were decreased. This suggests that licorice may attenuate the development of atherosclerosis and of related cardiovascular diseases. PMID:27113136

  20. Can Antidepressant Drug Impact on Blood Pressure Level in Patients with Psychiatric Disorder and Hypertension? A Randomized Trial

    PubMed Central

    Razavi Ratki, Seyed Kazem; Seyedhosseini, Seyedmostafa; Valizadeh, Alieh; Rastgoo, Tahere; Tavakkoli, Rozita; Golabchi, Allahyar; Ghashghaei, Fatemeh Esteki; Nemayandeh, Seyede Mahdieh; Boroomand, Amirreza; Shirinzade, Atefeh

    2016-01-01

    Background: High blood pressure (BP) has been known as a major risk factor for many chronic diseases. It should be noted, a psychiatric disorder which is common in the people living modern lifestyle may be one of the leading causes of hypertension, and many people are prescribed antidepressant each year. Hence, the purpose of this study was to evaluate the effect of selective serotonin reuptake inhibitors (SSRIs) and alprazolam which defined as antidepressant on the BP levels, and to compare the BP levels between the group of users and nonusers. Methods: This randomized clinical trial study was conducted at the Nohom Dey Hospital in the Torbat-e Heydarieh, Iran between December 2011 and March 2012. Participants comprised 101 psychiatric patients with hypertension that randomly separated into users and nonusers of antidepressant. The period of intervention lasted for 3 months. The mean of BP calculated by this formula (systolic BP [SBP] +2 diastolic BP [DBP])/3 which was the main outcome of the study. Results: Users of antidepressant drugs did not have any significant changes in BP levels, except in patients who received SSRIs alone, significant improvement was observed in DBP (P = 0.04) and mean of BP (P = 0.03). While, in nonusers of antidepressant, significant development was observed in DBP, and mean of BP. Comparing the users and nonusers did not show any significant differences in SBP, DBP, and Mean of BP; even, when outcomes were adjusted for risk factors and antihypertensive drugs. Conclusions: Three months treatment with SSRIs and alprazolam did not have any effect on lowering BP level in patients with the psychiatric disorder. PMID:26941927

  1. Beneficial Effects of Polyphenol-Rich Chokeberry Juice Consumption on Blood Pressure Level and Lipid Status in Hypertensive Subjects.

    PubMed

    Kardum, Nevena; Milovanović, Branislav; Šavikin, Katarina; Zdunić, Gordana; Mutavdžin, Slavica; Gligorijević, Tatjana; Spasić, Slavica

    2015-11-01

    Epidemiological studies have shown a positive association between intake of foods rich in antioxidants and lower incidence of cardiovascular disease development. Polyphenols are considered the most abundant and important dietary antioxidants. The aim of this study was to evaluate effects of polyphenol-rich chokeberry juice consumption on 24-h ambulatory monitored blood pressure (BP) level in subjects with no pharmacologically treated high normal BP or grade I hypertension. Twenty-three subjects (12 men and 11 women) aged 33-67 were enrolled and instructed to consume 200 mL of juice daily for 4 weeks. Participants were divided in two groups, based on prevalence of sympathetic or parasympathetic activity. Measurements of biochemical parameters and heart rate variability analysis were also applied. At the end of the intervention period, average 24-h and awake systolic and diastolic BP were significantly decreased (P<.05). This was more pronounced in the group with prevalence of sympathetic activity. Significant reduction in triglyceride level (P<.05) and a reducing effect on total and low-density lipoprotein cholesterol were also found. Obtained results indicate a positive impact of regular chokeberry juice consumption on BP and lipid status in pharmacologically untreated hypertensive subjects. PMID:25973889

  2. Changes in sea-level pressure over South Korea associated with high-speed solar wind events

    NASA Astrophysics Data System (ADS)

    Cho, Il-Hyun; Kwak, Young-Sil; Marubashi, Katsuhide; Kim, Yeon-Han; Park, Young-Deuk; Chang, Heon-Young

    2012-09-01

    We explore a possibility that the daily sea-level pressure (SLP) over South Korea responds to the high-speed solar wind event. This is of interest in two aspects: first, if there is a statistical association this can be another piece of evidence showing that various meteorological observables indeed respond to variations in the interplanetary environment. Second, this can be a very crucial observational constraint since most models proposed so far are expected to preferentially work in higher latitude regions than the low latitude region studied here. We have examined daily solar wind speed V, daily SLP difference ΔSLP, and daily log(BV2) using the superposed epoch analysis in which the key date is set such that the daily solar wind speed exceeds 800 km s-1. We find that the daily ΔSLP averaged out of 12 events reaches its peak at day +1 and gradually decreases back to its normal level. The amount of positive deviation of ΔSLP is +2.5 hPa. The duration of deviation is a few days. We also find that ΔSLP is well correlated with both the speed of solar wind and log(BV2). The obtained linear correlation coefficients and chance probabilities with one-day lag for two cases are r ≃ 0.81 with P > 99.9%, and r ≃ 0.84 with P > 99.9%, respectively. We conclude by briefly discussing future direction to pursue.

  3. Uterine Perforation with Intra-Abdominal Clostridium perfringens Gas Gangrene: A Rare and Fatal Infection

    PubMed Central

    Kashan, David; Muthu, Nagarajan; Davalos, Fidencio; Bernstein, Michael; Chendrasekhar, Akella

    2016-01-01

    Abstract Background: Clostridium perfringens gas gangrene is an extremely rare and fatal infection. Necrosis of the myometrium is rarely seen and has only been recorded in 18 cases to date. Of these 18 reported cases, only 5 have occurred in nonpregnant women. This article presents the 6th case of myometrium necrosis from C. perfringens. Case: A 72-year-old woman, gravida 2, para 2, presented with abdominal pain and vaginal bleeding. After examinations, laboratory testing, and several surgical interventions, she was found to have C. perfringens infection and advanced high-grade serous adenocarcinoma of the endometrium with >50% invasion into the myometrium. Results: Despite the surgical interventions and use of several antibiotics, this patient did not improve. She was weaned from treatment per her advance directive and died after weaning. Conclusions: Awareness of the many etiologies for peritonitis is of great importance when a fatal infection may be the cause of the condition. Correct diagnosis and proper treatment is essential for the survival of patients infected with C. perfringens. (J GYNECOL SURG 32:182) PMID:27274183

  4. [Paravertebral and intra-abdominal abscess due to oxygen-ozone therapy for lower back pain].

    PubMed

    Menéndez, P; García, A; Peláez, R

    2014-01-01

    Complications secondary to oxygen-ozone therapy are rare, but they have been described in medical literature. There are only two cases of infectious complications after oxygen-ozone therapy. Our aim is to describe a rare case of purulent complication that was secondary to oxygen-ozone therapy for the treatment of lower back pain. We report the clinical improvement with conservative treatment for a local complication after percutaneous oxygen-ozone treatment. According to the clinical improvement of our patient, conservative treatment should be considered before any aggressive surgery. PMID:24071048

  5. Stagnant loop syndrome in patients with continent ileostomy (intra-abdominal ileal reservoir).

    PubMed Central

    Schjonsby, H; Halvorsen, J F; Hofstad, T; Hovdenak, N

    1977-01-01

    Intestinal absorption and bacteriology of the ileal contents were compared in seven patients with continent ileostomy and seven patients with conventional ileostomy. The absorption of vitamin B12 was reduced in five patients with continent ileostomy and subnormal in two patients with conventional ileostomy. Steatorrhoea was present in four patients with continent and one patient with conventional ileostomy. Increased concentrations of total anaerobic bacteria and Bacteroides were found in the ileum of the patients with continent ileostomy. After an oral dose of (1-14C) glycocholic acid there was no difference in the faecal excretion of radioactivity, whereas the 14CO2-expiration was increased in two patients with continent ileostomy. In four patients with continent ileostomy and malabsorption of B12, there was evidence of a stagnant loopsyndrome as oral lincomycin treatment resulted in increased absorption of B12 decreased excretion of faecal fat, and decreased concentrations of Bacteroides in the ileum. PMID:590837

  6. Large Gastric Teratoma: A Rare Intra-abdominal Mass of Infancy

    PubMed Central

    Hasan, Roumina; Monappa, Vidya; Kumar, Sandeep; Kumar, Vijay

    2016-01-01

    Amongst the varied, diverse causes of intraabdominal masses in infancy and early childhood, gastric teratomas (GTs) account for a very small proportion. A worldwide literature search reveals only around one hundred cases of GT and also supports the fact that its preoperative diagnosis remains elusive. Here we report the case of a two-month-old male who presented to the pediatric surgery outpatient department of Kasturba Medical College and Hospital, Karnataka, India, with progressive distension of abdomen since birth. Clinically, a large firm, non-mobile and non-tender mass involving all four quadrants of the abdomen was seen. Ultrasound revealed a large solid-cystic mass with internal septations extending from the epigastrium up to the pelvis. Computed tomography revealed a large intraperitoneal fat containing solid-cystic mass lesion showing curvilinear and chunky areas of calcification, with the mass focally indenting the posterior gastric wall and showing focal polypoidal intragastric extension. Exploratory laparotomy revealed a large cystic tumor with a solid component, arising from lesser curvature of the stomach, showing focal intraluminal extension across the posterior gastric wall, and occupying the whole lesser sac and abdominal cavity. The tumor was excised in toto along with the body of the stomach. Histopathological examination showed mature tissue derived from all three germ cell layers and confirmed the diagnosis of mature gastric teratoma. The patient was disease free at one-year follow-up. PMID:27162596

  7. Large Gastric Teratoma: A Rare Intra-abdominal Mass of Infancy.

    PubMed

    Hasan, Roumina; Monappa, Vidya; Kumar, Sandeep; Kumar, Vijay

    2016-05-01

    Amongst the varied, diverse causes of intraabdominal masses in infancy and early childhood, gastric teratomas (GTs) account for a very small proportion. A worldwide literature search reveals only around one hundred cases of GT and also supports the fact that its preoperative diagnosis remains elusive. Here we report the case of a two-month-old male who presented to the pediatric surgery outpatient department of Kasturba Medical College and Hospital, Karnataka, India, with progressive distension of abdomen since birth. Clinically, a large firm, non-mobile and non-tender mass involving all four quadrants of the abdomen was seen. Ultrasound revealed a large solid-cystic mass with internal septations extending from the epigastrium up to the pelvis. Computed tomography revealed a large intraperitoneal fat containing solid-cystic mass lesion showing curvilinear and chunky areas of calcification, with the mass focally indenting the posterior gastric wall and showing focal polypoidal intragastric extension. Exploratory laparotomy revealed a large cystic tumor with a solid component, arising from lesser curvature of the stomach, showing focal intraluminal extension across the posterior gastric wall, and occupying the whole lesser sac and abdominal cavity. The tumor was excised in toto along with the body of the stomach. Histopathological examination showed mature tissue derived from all three germ cell layers and confirmed the diagnosis of mature gastric teratoma. The patient was disease free at one-year follow-up. PMID:27162596

  8. An adipose segmentation and quantification scheme for the intra abdominal region on minipigs

    NASA Astrophysics Data System (ADS)

    Engholm, Rasmus; Dubinskiy, Aleksandr; Larsen, Rasmus; Hanson, Lars G.; Christoffersen, Berit Østergaard

    2006-03-01

    This article describes a method for automatic segmentation of the abdomen into three anatomical regions: subcutaneous, retroperitoneal and visceral. For the last two regions the amount of adipose tissue (fat) is quantified. According to recent medical research, the distinction between retroperitoneal and visceral fat is important for studying metabolic syndrome, which is closely related to diabetes. However previous work has neglected to address this point, treating the two types of fat together. We use T1-weighted three-dimensional magnetic resonance data of the abdomen of obese minipigs. The pigs were manually dissected right after the scan, to produce the "ground truth" segmentation. We perform automatic segmentation on a representative slice, which on humans has been shown to correlate with the amount of adipose tissue in the abdomen. The process of automatic fat estimation consists of three steps. First, the subcutaneous fat is removed with a modified active contour approach. The energy formulation of the active contour exploits the homogeneous nature of the subcutaneous fat and the smoothness of the boundary. Subsequently the retroperitoneal fat located around the abdominal cavity is separated from the visceral fat. For this, we formulate a cost function on a contour, based on intensities, edges, distance to center and smoothness, so as to exploit the properties of the retroperitoneal fat. We then globally optimize this function using dynamic programming. Finally, the fat content of the retroperitoneal and visceral regions is quantified based on a fuzzy c-means clustering of the intensities within the segmented regions. The segmentation proved satisfactory by visual inspection, and closely correlated with the manual dissection data. The correlation was 0.89 for the retroperitoneal fat, and 0.74 for the visceral fat.

  9. Diagnosis of Intra-Abdominal Extralobar Pulmonary Sequestration by means of Ultrasound in a Neonate

    PubMed Central

    Pires, Claudio Rodrigues; Czapkowski, Adriano; Zanforlin Filho, Sebastião Marques

    2013-01-01

    Pulmonary sequestration is a congenital abnormality consisting of a mass of pulmonary tissue that presents an abnormal connection with the tracheobronchial tree, with a blood supply coming from an anomalous artery derived from the systemic circulation. Extralobar pulmonary sequestration is characterized by having pleural coverings that are independent of the normal lungs, with vascular supply usually coming from the aorta or from one of its branches. This diagnosis can be suspected prenatally if an abdominal mass, generally below the diaphragm, is seen. Here, we present a case of a neonate on the second day of life, with ultrasonography showing extralobar pulmonary sequestration located above the left adrenal gland that prenatally simulated a neuroblastoma. PMID:23762717

  10. Multiple intra-abdominal serosal myxosarcomas in two koalas (Phascolarctos cinereus).

    PubMed

    Astudillo, V González; Schaffer-White, A; Allavena, R; Palmieri, C

    2015-01-01

    Two adult koalas (Phascolarctos cinereus) were presented for necropsy examination without any clinical history. A diffuse, severe gelatinous effusion was found in the abdominal cavity, while numerous 1-3 mm diameter, round, well-demarcated, multifocal to coalescing, raised, firm nodules containing a clear gelatinous fluid were scattered on the surface of the parietal peritoneum, diaphragm, liver, gastrointestinal tract and mesentery. Microscopically, the nodular lesions consisted of spindle-shaped to stellate neoplastic cells, with scant eosinophilic cytoplasm and moderate anisocytosis and anisokaryosis. The neoplastic cells were admixed with and surrounded by abundant acellular pale eosinophilic material that was stained by Alcian blue and only weakly by the periodic acid-Schiff reaction. Serosal proliferations are described rarely in koalas and to the authors' knowledge this is the first reported case of serosal myxosarcoma. The significance and pathogenesis of this condition in the koala population is unknown. PMID:25728815

  11. Creation of a murine orthotopic hepatoma model with intra-abdominal metastasis

    PubMed Central

    Harris, Jamie; Kajdacsy-Balla, Andre; Chiu, Bill

    2016-01-01

    Aim: To create an orthotopic hepatoma model with local metastasis monitored with ultrasound could be created as a platform for testing new treatments. Background: Hepatoma accounts for 25% of liver tumors in children with poor overall survival. Intraabdominal metastasis are present in 35% of patients at time of diagnosis. We hypothesized that an orthotopic tumor model with local metastasis could be created as a platform for testing treatment modalities and could be monitored with ultrasound. Patients and methods: One million human hepatoma cells (Hep3B) were injected into the left lobe of the liver of immunocompromised mice. Tumor volume was monitored with high frequency-ultrasound until it reached 1,000mm3. At that time animals were sacrificed and examined for gross metastatic disease. Tumor sections were analyzed with hematoxylin and eosin (H&E) staining. Results: Tumor formed in 8/15 mice. The tumor was detected as small as 19.59mm3 on ultrasound. Of the forming tumors, tumor size was 145±177.93mm3 at 60 days post-injection, 665±650.39mm3 at 67 days, and reached >1000mm3 by 76.6±9.9 days. At necropsy, four mice (50%) had tumor only within the liver, four (50%) had additional tumors in omentum, pelvis and peritoneum. H&E showed tumor within the normal liver parenchyma, with multiple mitotic figures, small areas of necrosis, and hemorrhage within the tumor. Conclusion: We have successfully established an orthotopic hepatoma murine model, with a local metastatic rate of 50%. Non-invasive tumor monitoring is feasible via ultrasound. PMID:27458509

  12. 77 FR 59928 - Draft Guidance for Industry on Complicated Intra-Abdominal Infections: Developing Drugs for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-01

    ... clinical trial designs to support approval of drugs. DATES: Although you can comment on any guidance at any... endpoint and a non-inferiority trial design. The efficacy endpoint of clinical success represents the... of information referred to in the guidance for clinical trial sponsors ``Establishment and...

  13. Bilothorax as a rare sign of intra-abdominal bile leak in a patient without peritonitis.

    PubMed

    Jenkinson, M R J; Campbell, W; Taylor, M A

    2013-10-01

    We present the case of a 60-year-old patient who developed a right-sided bilothorax following para-aortic lymph node sampling. Bilothorax is a very rare condition, with most of the reported cases resulting from direct flow of bile from the biliary system to the pleural space through a fistula or other defect in the diaphragm. In this case, there was no obvious communication found between peritoneal and pleural spaces. Our patient proceeded to an exploratory laparotomy following this finding in the absence of peritonitis. Bilothorax should be considered in patients who develop a progressive pleural effusion following upper gastrointestinal surgery, particularly if it involves manipulation of the biliary system. PMID:24112483

  14. Laparoscopic resection of an intra-abdominal esophageal duplication cyst: a case report and literature review.

    PubMed

    Watanobe, Ikuo; Ito, Yuzuru; Akimoto, Eigo; Sekine, Yuuki; Haruyama, Yurie; Amemiya, Kota; Kawano, Fumihiro; Fujita, Shohei; Omori, Satoshi; Miyano, Shozo; Kosaka, Taijiro; Machida, Michio; Kitabatake, Toshiaki; Kojima, Kuniaki; Sakaguchi, Asumi; Ogura, Kanako; Matsumoto, Toshiharu

    2015-01-01

    Duplication of the alimentary tract is a rare congenital malformation that occurs most often in the abdominal region, whereas esophageal duplication cyst develops typically in the thoracic region but occasionally in the neck and abdominal regions. Esophageal duplication cyst is usually diagnosed in early childhood because of symptoms related to bleeding, infection, and displacement of tissue surrounding the lesion. We recently encountered a rare adult case of esophageal duplication cyst in the abdominal esophagus. A 50-year-old man underwent gastroscopy, endoscopic ultrasonography, computed tomography, and magnetic resonance imaging to investigate epigastric pain and dysphagia that started 3 months earlier. Imaging findings suggested esophageal duplication cyst, and the patient underwent laparoscopic resection followed by intraoperative esophagoscopy to reconstruct the esophagus safely and effectively. Histopathological examination of the resected specimen revealed two layers of smooth muscle in the cystic wall, confirming the diagnosis of esophageal duplication cyst. PMID:25883826

  15. The ubiquitous umbilicus. What it can reveal about intra-abdominal disease.

    PubMed

    Raymond, P L

    1990-02-01

    With ready access to noninvasive methods of assessing abdominal processes, physicians may forget the first step of physical examination: observation. Physical signs, often neglected or discarded (and felt to be of importance only in trivia quizzes), can quickly direct patient examination in a cost-effective way. In this article, Dr Raymond discusses various periumbilical signs and the conditions linked to them. PMID:2405369

  16. Intra-abdominal cavernous lymphangiomatosis in Siamese twins: a case report.

    PubMed

    Jain, Manjula; Aggarwal, Shilpi; Singh, Sarika

    2007-07-01

    Lymphangioma is a benign tumor like condition which is a developmental anomaly, involving any site but rarely involves retroperitoneum and abdomen (< 5%). Intraabdominal lymphangiomatosis is an even rarer entity that too occurring in a siamese twins. No such reports have been found in literature, although other congenital anomalies do coexist in Siamese twins and have been reported such as biliary tract and respiratory tract anomalies. PMID:17883139

  17. Estimation of the Atlantic sea-level response to atmospheric pressure using ERS-2 altimeter data and a global ocean model

    NASA Astrophysics Data System (ADS)

    Gomez-Enri, Jesus; Villares, Pilar; Bruno, Miguel; Benveniste, Jerome

    2002-01-01

    The ocean response to pressure variations is subtracted from altimeter records using the standard Inverse Barometer Correction (IBC), based on the hypothetical isostatic assumption. Previous analyses have demonstrated that this assumption has to be applied with care when the high frequency pressure variations are considered, as is the case of using the crossover track method. Using ERS-2 radar altimeter data, we study the response of the Atlantic Sea Level (ASL) to pressure forcings at different ranges of frequency, in order to determine the validity of the isostatic assumption. We have also determined this response when using the outputs of a Global Ocean Model (GOM) forced by pressure and wind fields. From the comparison between both results we have observed that data errors could be underestimating our estimations of the response of the ocean to pressure variations; this underestimation could represent more than 20 percent of the values obtained in equatorial and tropical zones, being insignificant out of the latitudinal band.

  18. Detection of the transitional layer between laminar and turbulent flow areas on a wing surface. [using an accelerometer to measure pressure levels during wind tunnel tests

    NASA Technical Reports Server (NTRS)

    Hood, W. R.

    1980-01-01

    A system is disclosed for detecting the laminar to turbulent boundary layer transition on a surface while simultaneously taking pressure measurements. The system uses an accelerometer for producing electrical signals proportional to the noise levels along the surface and a transducer for producing electrical signals proportional to pressure along the surface. The signals generated by the accelerometer and transducer are sent to a data reduction system for interpretation and storage.

  19. Erectile Dysfunction and Sexual Hormone Levels in Men With Obstructive Sleep Apnea: Efficacy of Continuous Positive Airway Pressure.

    PubMed

    Zhang, Xiao-Bin; Lin, Qi-Chang; Zeng, Hui-Qing; Jiang, Xing-Tang; Chen, Bo; Chen, Xiao

    2016-01-01

    In this study, the prevalence of erectile dysfunction (ED) and serum sexual hormone levels were evaluated in men with obstructive sleep apnea (OSA). In these patients, the efficacy of continuous positive airway pressure (CPAP) was determined. The 207 men (mean age 44.0 ± 11.1 years) enrolled in the study were stratified within four groups based on their apnea-hypopnea index score: simple snoring (n = 32), mild OSA (n = 29), moderate OSA (n = 38), and severe OSA (n = 108). The International Index of Erectile Dysfunction-5 (IIEF-5) score was obtained from each patient, and blood samples for the analysis of sexual hormones (prolactin, luteotropin, follicle-stimulating hormone, estradiol, progestin, and testosterone) were drawn in the morning after polysomnography. The IIEF-5 test and serum sexual hormone measurements were repeated after 3 months of CPAP treatment in 53 men with severe OSA. The prevalence of ED was 60.6 % in OSA patients overall and 72.2 % in those with severe OSA. Compared with the simple snoring group, patients with severe OSA had significantly lower testosterone levels (14.06 ± 5.62 vs. 17.02 ± 4.68, p = .018) and lower IIEF-5 scores (16.33 ± 6.50 vs. 24.09 ± 1.94, p = .001). The differences in the other sexual hormones between groups were not significant. After 3 months of CPAP treatment, there were no significant changes in sexual hormone levels, but the IIEF-5 score had improved significantly (18.21 ± 4.05 vs. 19.21 ± 3.86, p = .001). Severe OSA patients have low testosterone concentration and high ED prevalence. IIEF-5 scores increased significantly after CPAP treatment, but there was no effect on serum testosterone levels. PMID:26370402

  20. Bi-level positive airway pressure (BiPAP) ventilation in an infant with central hypoventilation syndrome.

    PubMed

    Villa, M P; Dotta, A; Castello, D; Piro, S; Pagani, J; Palamides, S; Ronchetti, R

    1997-07-01

    A 4-month-old baby girl, after a period of apparent good health, began to have aphonia, dyspnea, difficulties with swallowing, cyanosis, apnea, and hypopnea during sleep that resulted in admission to an intensive care unit for intubation and mechanical ventilation. At the age of 9 months she was admitted to our hospital with a possible diagnosis of central hypoventilation syndrome. A polysomnographic study showed apnea and hypopnea (apnea + hypopnea index = 47.1), hypercapnia (mean end-tidal PCO2 89 +/- 15.0 mmHg), and arterial desaturation (mean SaO2 91 +/- 1.7%; lowest SaO2 < 50%; 68% of total sleep time at SaO2 below 93%); the study also showed an absent ventilatory response to CO2, absent cardiac responses to apnea during sleep, and right ventricular hypertrophy. Nocturnal nasal bi-level positive airway pressure (BIPAP), applied initially at 6 cmH2O and gradually increased to 16 cmH2O, caused the sleep-related abnormal respiratory events to disappear. End-tidal PCO2 decreased to 39 mmHg, and SaO2 increased to 94%. After 6 months of nocturnal BiPAP ventricular right hypertrophy reversed and arrested growth and hypotonia normalized. The child has tolerated and has remained on BiPAP support up to her current age of 3 years and continues to use this form of ventilatory assistance without difficulties. PMID:9261857

  1. Interaural sound pressure level differences associated with sound-source locations in the frontal hemifield of the domestic cat.

    PubMed

    Martin, R L; Webster, W R

    1989-04-01

    Interaural sound pressure level differences (ILDs) associated with a range of sound-source azimuths and elevations in the frontal hemifields of four cats were measured for each of seven pure-tone stimuli ranging in frequency from 2-32 kHz. The overall pattern of ILD across location at each frequency was remarkably similar in all cats. At 2, 4 and 8 kHz the relationships of ILD to azimuth and elevation were generally monotonic with ILD increasing with increasing azimuth. At 12 kHz and above, however, non-monotonic relationships developed and circumscribed regions of particularly large, positive and negative ILDs were apparent. That ILDs associated with many sound-source locations on the near side of the head are negative in sign has not been widely noted in the previous literature. The data obtained in this study were compared with those from previous studies and the acoustical mechanisms likely to have contributed to production of the observed ILDs were considered. Some implications of the data for auditory localization in three-dimensional space were discussed. PMID:2708168

  2. Investigating the Influence of Anthropogenic Forcing on Observed Mean and Extreme Sea Level Pressure Trends over the Mediterranean Region

    DOE PAGESBeta

    Barkhordarian, Armineh

    2012-01-01

    We investigate whether the observed mean sea level pressure (SLP) trends over the Mediterranean region in the period from 1975 to 2004 are significantly consistent with what 17 models projected as response of SLP to anthropogenic forcing (greenhouse gases and sulphate aerosols, GS). Obtained results indicate that the observed trends in mean SLP cannot be explained by natural (internal) variability. Externally forced changes are detectable in all seasons, except spring. The large-scale component (spatial mean) of the GS signal is detectable in all the 17 models in winter and in 12 of the 17 models in summer. However, the small-scalemore » component (spatial anomalies about the spatial mean) of GS signal is only detectable in winter within 11 of the 17 models. We also show that GS signal has a detectable influence on observed decreasing (increasing) tendency in the frequencies of extremely low (high) SLP days in winter and that these changes cannot be explained by internal climate variability. While the detection of GS forcing is robust in winter and summer, there are striking inconsistencies in autumn, where analysis points to the presence of an external forcing, which is not GS forcing.« less

  3. On the efficacy of spatial sampling using manual scanning paths to determine the spatial average sound pressure level in rooms.

    PubMed

    Hopkins, Carl

    2011-05-01

    In architectural acoustics, noise control and environmental noise, there are often steady-state signals for which it is necessary to measure the spatial average, sound pressure level inside rooms. This requires using fixed microphone positions, mechanical scanning devices, or manual scanning. In comparison with mechanical scanning devices, the human body allows manual scanning to trace out complex geometrical paths in three-dimensional space. To determine the efficacy of manual scanning paths in terms of an equivalent number of uncorrelated samples, an analytical approach is solved numerically. The benchmark used to assess these paths is a minimum of five uncorrelated fixed microphone positions at frequencies above 200 Hz. For paths involving an operator walking across the room, potential problems exist with walking noise and non-uniform scanning speeds. Hence, paths are considered based on a fixed standing position or rotation of the body about a fixed point. In empty rooms, it is shown that a circle, helix, or cylindrical-type path satisfy the benchmark requirement with the latter two paths being highly efficient at generating large number of uncorrelated samples. In furnished rooms where there is limited space for the operator to move, an efficient path comprises three semicircles with 45°-60° separations. PMID:21568406

  4. Investigating the Influence of Anthropogenic Forcing on Observed Mean and Extreme Sea Level Pressure Trends over the Mediterranean Region

    PubMed Central

    Barkhordarian, Armineh

    2012-01-01

    We investigate whether the observed mean sea level pressure (SLP) trends over the Mediterranean region in the period from 1975 to 2004 are significantly consistent with what 17 models projected as response of SLP to anthropogenic forcing (greenhouse gases and sulphate aerosols, GS). Obtained results indicate that the observed trends in mean SLP cannot be explained by natural (internal) variability. Externally forced changes are detectable in all seasons, except spring. The large-scale component (spatial mean) of the GS signal is detectable in all the 17 models in winter and in 12 of the 17 models in summer. However, the small-scale component (spatial anomalies about the spatial mean) of GS signal is only detectable in winter within 11 of the 17 models. We also show that GS signal has a detectable influence on observed decreasing (increasing) tendency in the frequencies of extremely low (high) SLP days in winter and that these changes cannot be explained by internal climate variability. While the detection of GS forcing is robust in winter and summer, there are striking inconsistencies in autumn, where analysis points to the presence of an external forcing, which is not GS forcing. PMID:22654622

  5. Lower-body negative pressure restores leg bone microvascular flow to supine levels during head-down tilt.

    PubMed

    Siamwala, Jamila H; Lee, Paul C; Macias, Brandon R; Hargens, Alan R

    2015-07-15

    Skeletal unloading and cephalic fluid shifts in microgravity may alter the bone microvascular flow and may be associated with the 1-2% bone loss per month during spaceflight. The purpose of this study was to determine if lower-body negative pressure (LBNP) can prevent microgravity-induced alterations of tibial microvascular flow. Head-down tilt (HDT) simulates the cephalad fluid shift and microvascular flow responses that may occur in microgravity. We hypothesized that LBNP prevents HDT-induced increases in tibial microvascular flow. Tibial bone microvascular flow, oxygenation, and calf circumference were measured during 5 min sitting, 5 min supine, 5 min 15° HDT, and 10 min 15° HDT with 25 mmHg LBNP using photoplethysmography (PPG), near-infrared spectroscopy (NIRS), and strain-gauge plethysmography (SGP). Measurements were made simultaneously. Tibial microvascular flow increased by 36% with 5 min 15° HDT [2.2 ± 1.1 V; repeated-measures ANOVA (RMANOVA) P < 0.0001] from supine (1.4 ± 0.8 V). After 10 min of LBNP in the 15° HDT position, tibial microvascular flow returned to supine levels (1.1 ± 0.5 V; RMANOVA P < 0.001). Tibial oxygenation did not change significantly during sitting, supine, HDT, or HDT with LBNP. However, calf circumference decreased with 5 min 15° HDT (-0.7 ± 0.4 V; RMANOVA P < 0.0001) from supine (-0.5 ± 0.4 V). However, with LBNP calf circumference returned to supine levels (-0.4 ± 0.1 V; RMANOVA P = 0.002). These data establish that simulated microgravity increases tibial microvascular flow and LBNP prevents these increases. The results suggest that LBNP may provide a suitable countermeasure to normalize the bone microvascular flow during spaceflight. PMID:25930022

  6. The effects of 2 levels of the inspired oxygen fraction on blood gas variables in propofol-anesthetized dogs with high intracranial pressure

    PubMed Central

    Dias, Luis Gustavo Gosuen Gonçalves; Nunes, Newton; Lopes, Patrícia Cristina Ferro; de Almeida, Ricardo Miyasaka; Neto, Gláucia Bueno Pereira; de Souza, Ana Letícia Groszewicz; de Almeida Belmonte, Emílio

    2009-01-01

    The influence of 2 different levels of the inspired oxygen fraction (FiO2) on blood gas variables was evaluated in dogs with high intracranial pressure (ICP) during propofol anesthesia (induction followed by a continuous rate infusion [CRI] of 0.6 mg/kg/min) and intermittent positive pressure ventilation (IPPV). Eight adult mongrel dogs were anesthetized on 2 occasions, 21 d apart, and received oxygen at an FiO2 of 1.0 (G100) or 0.6 (G60) in a randomized crossover fashion. A fiberoptic catheter was implanted on the surface of the right cerebral cortex for assessment of the ICP. An increase in the ICP was induced by temporary ligation of the jugular vein 50 min after induction of anesthesia and immediately after baseline measurement of the ICP. Blood gas measurements were taken 20 min later and then at 15-min intervals for 1 h. Numerical data were submitted to Morrison’s multivariate statistical methods. The ICP, the cerebral perfusion pressure and the mean arterial pressure did not differ significantly between FiO2 levels or measurement times after jugular ligation. The only blood gas values that differed significantly (P < 0.05) were the arterial oxygen partial pressure, which was greater with G100 than with G60 throughout the procedure, and the venous haemoglobin saturation, that was greater with G100 than with G60 at M0. There were no significant differences between FiO2 levels or measurement times in the following blood gas variables: arterial carbon dioxide partial pressure, arterial hemoglobin saturation, base deficit, bicarbonate concentration, pH, venous oxygen partial pressure, venous carbon dioxide partial pressure and the arterial-to-end-tidal carbon dioxide difference. PMID:19436579

  7. Comparison of Regression Methods to Compute Atmospheric Pressure and Earth Tidal Coefficients in Water Level Associated with Wenchuan Earthquake of 12 May 2008

    NASA Astrophysics Data System (ADS)

    He, Anhua; Singh, Ramesh P.; Sun, Zhaohua; Ye, Qing; Zhao, Gang

    2016-05-01

    The earth tide, atmospheric pressure, precipitation and earthquake fluctuations, especially earthquake greatly impacts water well levels, thus anomalous co-seismic changes in ground water levels have been observed. In this paper, we have used four different models, simple linear regression (SLR), multiple linear regression (MLR), principal component analysis (PCA) and partial least squares (PLS) to compute the atmospheric pressure and earth tidal effects on water level. Furthermore, we have used the Akaike information criterion (AIC) to study the performance of various models. Based on the lowest AIC and sum of squares for error values, the best estimate of the effects of atmospheric pressure and earth tide on water level is found using the MLR model. However, MLR model does not provide multicollinearity between inputs, as a result the atmospheric pressure and earth tidal response coefficients fail to reflect the mechanisms associated with the groundwater level fluctuations. On the premise of solving serious multicollinearity of inputs, PLS model shows the minimum AIC value. The atmospheric pressure and earth tidal response coefficients show close response with the observation using PLS model. The atmospheric pressure and the earth tidal response coefficients are found to be sensitive to the stress-strain state using the observed data for the period 1 April-8 June 2008 of Chuan 03# well. The transient enhancement of porosity of rock mass around Chuan 03# well associated with the Wenchuan earthquake (Mw = 7.9 of 12 May 2008) that has taken its original pre-seismic level after 13 days indicates that the co-seismic sharp rise of water well could be induced by static stress change, rather than development of new fractures.

  8. Comparison of Regression Methods to Compute Atmospheric Pressure and Earth Tidal Coefficients in Water Level Associated with Wenchuan Earthquake of 12 May 2008

    NASA Astrophysics Data System (ADS)

    He, Anhua; Singh, Ramesh P.; Sun, Zhaohua; Ye, Qing; Zhao, Gang

    2016-07-01

    The earth tide, atmospheric pressure, precipitation and earthquake fluctuations, especially earthquake greatly impacts water well levels, thus anomalous co-seismic changes in ground water levels have been observed. In this paper, we have used four different models, simple linear regression (SLR), multiple linear regression (MLR), principal component analysis (PCA) and partial least squares (PLS) to compute the atmospheric pressure and earth tidal effects on water level. Furthermore, we have used the Akaike information criterion (AIC) to study the performance of various models. Based on the lowest AIC and sum of squares for error values, the best estimate of the effects of atmospheric pressure and earth tide on water level is found using the MLR model. However, MLR model does not provide multicollinearity between inputs, as a result the atmospheric pressure and earth tidal response coefficients fail to reflect the mechanisms associated with the groundwater level fluctuations. On the premise of solving serious multicollinearity of inputs, PLS model shows the minimum AIC value. The atmospheric pressure and earth tidal response coefficients show close response with the observation using PLS model. The atmospheric pressure and the earth tidal response coefficients are found to be sensitive to the stress-strain state using the observed data for the period 1 April-8 June 2008 of Chuan 03# well. The transient enhancement of porosity of rock mass around Chuan 03# well associated with the Wenchuan earthquake (Mw = 7.9 of 12 May 2008) that has taken its original pre-seismic level after 13 days indicates that the co-seismic sharp rise of water well could be induced by static stress change, rather than development of new fractures.

  9. School-based screening of plantar pressures during level walking with a backpack among overweight and obese schoolchildren.

    PubMed

    Pau, Massimiliano; Leban, Bruno; Corona, Federica; Gioi, Sara; Nussbaum, Maury A

    2016-05-01

    Among children, postural modifications due to backpack carriage have direct consequences on how forces are exchanged between body and ground and thus on plantar pressure distribution. However, it is unknown whether such alterations are influenced by the foot structure and functionality typical of obesity. In this study, we tested 65 overweight/obese primary schoolchildren using a pressure platform while walking with and without the backpack. Contact areas, arch index, peak and mean plantar pressures in the forefoot, midfoot and rearfoot were compared with those from an additional 65 age- and gender-matched group of normal-weight children. Backpack carriage modified pressure distribution similarly in both groups, with the exception of mean midfoot pressure, which increased significantly among normal-weight children but not in the overweight/obese group. Notably, the pressure values associated with mass excess and backpack carriage still raise some concerns regarding potential long-term adverse consequences on foot structure and functionality of overweight/obese children. Practitioner summary: Backpack carriage by overweight/obese schoolchildren altered plantar pressures similar to what was observed in their normal-weight peers. Yet, high pressures were found among the overweight/obese children. This raises concerns regarding potential long-term adverse consequences on foot structure and functionality, and supports establishing more specific limits for the carried load. PMID:26226045

  10. A computational analysis of the vibrational levels of molecular oxygen in low-pressure stationary and transient radio-frequency oxygen plasma

    NASA Astrophysics Data System (ADS)

    Kemaneci, Efe; Booth, Jean-Paul; Chabert, Pascal; van Dijk, Jan; Mussenbrock, Thomas; Brinkmann, Ralf Peter

    2016-04-01

    Vibrational levels of molecular oxygen, O2(v  <  42), are investigated in continuous and pulse-modulated low-pressure radio-frequency oxygen plasma with a global modelling approach. The model is benchmarked against a variety of pressure-, power- and time-resolved measurements of several inductive and asymmetric capacitive discharges available in the literature, and a good agreement is obtained. The sensitivity of the model with respect to the vibrational kinetics, the wall reactions and the spatial inhomogeneity of the charged particles are presented. The simulations without the vibrational levels are also shown for the sake of comparison.

  11. Physical activity levels and torso orientations of hospitalized patients at risk of developing a pressure injury: an observational study.

    PubMed

    Chaboyer, Wendy; Mills, Peter M; Roberts, Shelley; Latimer, Sharon

    2015-02-01

    Pressure injury guidelines recommend regular repositioning yet patients' mobility and repositioning patterns are unknown. An observational study using activity monitors was undertaken to describe the 24 h activity patterns of 84 hospitalized patients at risk of developing a pressure injury. The vast majority of participants' time was spent in the sedentary activity range (94% ± 3%) followed by the light range (5% ± 4 %). Patients changed their posture a median of 94 (interquartile range 48) time in the 24-h period (range 11-154), or ≈ 3.8 times per hour. Although a main focus for pressure injury prevention has been on repositioning, this study shows that patients with restricted mobility are actually moving quite often. Therefore, it might be appropriate to focus more attention on other pressure injury prevention strategies such as adequate nutrition, appropriate support surfaces and good skin care. PMID:24118408

  12. [The threshold levels of the stapedius reflex depending on the relationship between the gas pressure in the external auditory meatus and the middle ear].

    PubMed

    Petrov, S M; Azizov, G R; Gritsiuk, M I; Timenko, A N

    2014-01-01

    The objective of the present work was to detect and elucidate effects of a single factor (gas pressure) responsible for the threshold levels of stapedius reflex. It was shown that the threshold reflexes were recorded at 105 dB SPL when the gas pressure in the external auditory meatus decreased by 150-200 pPa against the atmospheric pressure and when it increased by 100-150 pPa. These effects can be accounted for by the reduced compliance of the tympanic membrane and different changes in the state of the auditory ossicles undergoing compression and tension. When entering the most comfortable stapedial reflex levels into the patient's tuning chart, an account should be taken of the maximum value of tympanic membrane compliance. PMID:25377672

  13. Single-Point but Not Tonic Cuff Pressure Pain Sensitivity Is Associated with Level of Physical Fitness – A Study of Non-Athletic Healthy Subjects

    PubMed Central

    Lemming, Dag; Börsbo, Björn; Sjörs, Anna; Lind, Eva-Britt; Arendt-Nielsen, Lars; Graven-Nielsen, Thomas; Gerdle, Björn

    2015-01-01

    Exercise is often used for pain rehabilitation but the link between physical activity level and pain sensitivity is still not fully understood. Pressure pain sensitivity to cuff algometry and conditioned pain modulation (CPM) were evaluated in highly active men (n=22), normally active men (n=26), highly active women (n=27) and normally active women (n=23) based on the Godin Leisure-Time Exercise Questionnaire. Cuff pressure pain sensitivity was assessed at the arm and lower leg. The subjects scored the pain intensity on an electronic Visual Analogue Scale (VAS) during ten minutes with 25 kPa constant cuff pressure and two minutes with zero pressure. The maximal VAS score and area under the VAS-curve were extracted. Pressure pain thresholds (PPT) were recorded by manual pressure algometry on the ipsilateral tibialis anterior muscle before, during and after the tonic arm stimulation. Tonic cuff stimulation of the arm and leg resulted in higher VAS peak scores in women compared with men (p<0.04). In all groups the PPTs were reduced during and after the cuff stimulation compared with baseline (p=0.001). PPT were higher in men compared with women (p=0.03) and higher in highly physical active compared with normal active (p=0.048). Besides the well-known gender difference in pressure pain sensitivity this study demonstrates that a high physical fitness degree in non-athletic subjects is associated with increased pressure pain thresholds but does not affect cuff pressure pain sensitivity in healthy people. PMID:25933412

  14. COMT Val158Met polymorphism is associated with blood pressure and lipid levels in general families of Bama longevous area in China

    PubMed Central

    Ge, Lin; Wu, Hua-Yu; Pan, Shang-Ling; Huang, Ling; Sun, Peng; Liang, Qing-Hua; Pang, Guo-Fang; Lv, Ze-Ping; Hu, Cai-You; Liu, Cheng-Wu; Zhou, Xiao-Ling; Huang, Ling-Jin; Yin, Rui-Xing; Peng, Jun-Hua

    2015-01-01

    To see the possible relationship between COMT Val158Met polymorphism and blood pressure (BP) and serum lipid levels and its putative role in human longevity, we genotyped COMT Val158Met (rs4680) by PCR-RFLP for members from Bama long-lived families (BLF, n = 1538), Bama non-long-lived families (BNLF, n = 600), Pingguo (a county outside Bama region) long-lived families (PLF, n = 538) and Pingguo non-long-lived families (PNLF, n = 403) after anthropometric measures were collected and serum lipid levels were detected. The distribution of genotypes and alleles among four family groups was significantly different (all P < 0.01), with GA/AA genotype and minor allele A presenting more frequently in Bama population than Pingguo Population (P < 0.01). The systolic blood pressure (SBP), pulse pressure (PP), total cholesterol (TC), triglyceride (TG) and low density lipoprotein-cholesterol (LDL-C) levels of GG genotype carriers were dramatically higher than non-GG carriers in BNLF (P < 0.05); the SBP and PP levels of GG carriers were lower (P < 0.05) while TC, LDL-C level were higher (P < 0.01) than that of non-GG carriers in PLF; no difference in blood pressure and lipids were observed between genotypes in BLF and PNLF (P > 0.05). Correlation analyses revealed that COMT Val158Met was mainly correlated negatively with SBP, diastolic blood pressure (DBP) and LDL-C in BNLF and negatively with TC level in BLF, BNLF and PLF. These data suggest that COMT Val158Met polymorphism may have more impact on the modulation of BP and lipid profiles in the average families than in the long-lived families in Bama region. The association between this SNP and other phenotypes (e.g. cognition) and its roles in the longevity in Bama area thus warrant further investigation. PMID:26823844

  15. Acute effects of traditional Thai massage on cortisol levels, arterial blood pressure and stress perception in academic stress condition: A single blind randomised controlled trial.

    PubMed

    Bennett, Surussawadi; Bennett, Michael John; Chatchawan, Uraiwon; Jenjaiwit, Patcharaporn; Pantumethakul, Rungthip; Kunhasura, Soontorn; Eungpinichpong, Wichai

    2016-04-01

    Traditional Thai massage (TTM) has been applied widely to promote relaxation. However, there is little evidence to support its efficacy on academic stress. A randomised controlled trial was performed to examine the acute effects of TTM on cortisol level, blood pressure, heart rate and stress perception in academic stress. This prospective trial included 36 physiotherapy students with a self perceived stress score of between 3 and 5. They were randomly allocated into the TTM (18 people) group or the control group (18 people). Saliva cortisol level, blood pressure, heart rate and stress perception rating were measured before and after the intervention. Both groups showed a significant reduction in cortisol level and heart rate when compared with baseline (p < 0.001). There were no significant differences in cortisol level between the two groups. The results suggest the need for further study into other possible physiological effects on stress of TTM. PMID:27210845

  16. Hydrological response to earthquakes in the Haibara well, central Japan - I. Groundwater level changes revealed using state space decomposition of atmospheric pressure, rainfall and tidal responses

    USGS Publications Warehouse

    Matsumoto, N.; Kitagawa, G.; Roeloffs, E.A.

    2003-01-01

    For the groundwater level observed at the Haibara well, Shizuoka Prefecture, central Japan, time series analysis using state-space modelling is applied to extract hydrological anomalies related to earthquakes. This method can decompose observed groundwater level time series into five components: atmospheric pressure, tidal, and precipitation responses, observation noise, and residual water level. The decomposed responses to atmospheric pressure and precipitation are independently determined and are consistent with the expected response to surface loading. In the groundwater level at the Haibara well, 28 coseismic changes can be discerned during the period from 1981 April to 1997 December. There is a threshold in the relationship between earthquake magnitude and the well-hypocentre distance, above which earthquakes cause coseismic changes in the residual water level. All of the coseismic water level changes at the Haibara well are decreases, although 33 per cent of the estimated coseismic volumetric strain steps are contraction, which would be expected to cause water level increases. The coseismic changes in groundwater level are more closely proportional to the estimated ground motion than to coseismic volumetric strain steps, suggesting that ground motion due to earthquakes is the major cause of the coseismic water level drops and that the contribution from static strain is rather small. Possible pre- or inter-earthquake water level changes have occurred at the Haibara well and may have been caused by local aseismic crustal deformation.

  17. Pulse wave velocity as marker of preclinical arterial disease: reference levels in a uruguayan population considering wave detection algorithms, path lengths, aging, and blood pressure.

    PubMed

    Farro, Ignacio; Bia, Daniel; Zócalo, Yanina; Torrado, Juan; Farro, Federico; Florio, Lucía; Olascoaga, Alicia; Alallón, Walter; Lluberas, Ricardo; Armentano, Ricardo L

    2012-01-01

    Carotid-femoral pulse wave velocity (PWV) has emerged as the gold standard for non-invasive evaluation of aortic stiffness; absence of standardized methodologies of study and lack of normal and reference values have limited a wider clinical implementation. This work was carried out in a Uruguayan (South American) population in order to characterize normal, reference, and threshold levels of PWV considering normal age-related changes in PWV and the prevailing blood pressure level during the study. A conservative approach was used, and we excluded symptomatic subjects; subjects with history of cardiovascular (CV) disease, diabetes mellitus or renal failure; subjects with traditional CV risk factors (other than age and gender); asymptomatic subjects with atherosclerotic plaques in carotid arteries; patients taking anti-hypertensives or lipid-lowering medications. The included subjects (n = 429) were categorized according to the age decade and the blood pressure levels (at study time). All subjects represented the "reference population"; the group of subjects with optimal/normal blood pressures levels at study time represented the "normal population." Results. Normal and reference PWV levels were obtained. Differences in PWV levels and aging-associated changes were obtained. The obtained data could be used to define vascular aging and abnormal or disease-related arterial changes. PMID:22666551

  18. Pulse Wave Velocity as Marker of Preclinical Arterial Disease: Reference Levels in a Uruguayan Population Considering Wave Detection Algorithms, Path Lengths, Aging, and Blood Pressure

    PubMed Central

    Farro, Ignacio; Bia, Daniel; Zócalo, Yanina; Torrado, Juan; Farro, Federico; Florio, Lucía; Olascoaga, Alicia; Alallón, Walter; Lluberas, Ricardo; Armentano, Ricardo L.

    2012-01-01

    Carotid-femoral pulse wave velocity (PWV) has emerged as the gold standard for non-invasive evaluation of aortic stiffness; absence of standardized methodologies of study and lack of normal and reference values have limited a wider clinical implementation. This work was carried out in a Uruguayan (South American) population in order to characterize normal, reference, and threshold levels of PWV considering normal age-related changes in PWV and the prevailing blood pressure level during the study. A conservative approach was used, and we excluded symptomatic subjects; subjects with history of cardiovascular (CV) disease, diabetes mellitus or renal failure; subjects with traditional CV risk factors (other than age and gender); asymptomatic subjects with atherosclerotic plaques in carotid arteries; patients taking anti-hypertensives or lipid-lowering medications. The included subjects (n = 429) were categorized according to the age decade and the blood pressure levels (at study time). All subjects represented the “reference population”; the group of subjects with optimal/normal blood pressures levels at study time represented the “normal population.” Results. Normal and reference PWV levels were obtained. Differences in PWV levels and aging-associated changes were obtained. The obtained data could be used to define vascular aging and abnormal or disease-related arterial changes. PMID:22666551

  19. The effect of bi-level positive airway pressure on postoperative pulmonary function following gastric surgery for obesity.

    PubMed

    Ebeo, C T; Benotti, P N; Byrd, R P; Elmaghraby, Z; Lui, J

    2002-09-01

    The severely obese patient has varying degrees of intrinsic reduction of expiratory flow rates and lung volumes. Thus, the severely obese patient is predisposed to postoperative atelectasis, ineffective clearing of respiratory secretions, and other pulmonary complications. This study evaluated the effect of bi-level positive airway pressure (BiPAP) on pulmonary function in obese patients following open gastric bypass surgery Patients with a body mass index (BMI) of at least 40 kg/m2 who were undergoing elective gastric bypass were eligible to be randomized to receive either BiPAP during the first 24 h postoperatively or conventional postoperative care. Patients with significant cardiovascular and pulmonary diseases were excluded from the study. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1.0), peak expiratory flow rate (PEFR), and percent hemoglobin oxygen saturation (SpO2) were measured preoperatively, and on postoperative days 1, 2, and 3. Twenty-seven patients were entered in the study 14 received BiPAP and 13 received conventional postoperative care. There was no significant difference preoperatively between the study and control groups in regards to age, BMI, FVC, FEV1.0, PEFR or SpO2. Postoperatively expiratory flow was decreased in both groups. However, the FVC and FEV1.0 were significantly higher on each of the three consecutive postoperative days in the patients who received BiPAP therapy. The SpO2 was significantly decreased in the control group over the same time period. Prophylactic BiPAP during the first 12-24 h postoperatively resulted in significantly higher measures of pulmonary function in severely obese patients who had undergone elective gastric bypass surgery. These improved measures of pulmonary function, however, did not translate into fewer hospital days or a lower complication rate in our study population of otherwise healthy obese patients. Further study is necessary to determine if BiPAP therapy in the first 24

  20. Abdominal Circulatory Interactions.

    PubMed

    Dagar, Gaurav; Taneja, Amit; Nanchal, Rahul S

    2016-04-01

    The abdominal compartment is separated from the thoracic compartment by the diaphragm. Under normal circumstances, a large portion of the venous return crosses the splanchnic and nonsplanchnic abdominal regions before entering the thorax and the right side of the heart. Mechanical ventilation may affect abdominal venous return independent of its interactions at the thoracic level. Changes in pressure in the intra-abdominal compartment may have important implications for organ function within the thorax, particularly if there is a sustained rise in intra-abdominal pressure. It is important to understand the consequences of abdominal pressure changes on respiratory and circulatory physiology. This article elucidates important abdominal-respiratory-circulatory interactions and their clinical effects. PMID:27016167

  1. Spectroscopic properties and location of the Tb(3+) and Eu(3+) energy levels in Y2O2S under high hydrostatic pressure.

    PubMed

    Behrendt, M; Mahlik, S; Szczodrowski, K; Kukliński, B; Grinberg, M

    2016-08-10

    In this contribution, an extensive spectroscopic study of Y2O2S doped with Eu(3+) and Tb(3+) is presented. Steady-state luminescence and luminescence excitation spectra as well as the time-resolved spectra and luminescence kinetics were obtained at high hydrostatic pressures up to 240 kbar. It was found that pressure quenches the luminescence from the (5)D3 excited state of Tb(3+) and recovers additional luminescence related to transitions from the (5)D3 state of Eu(3+). These effects are related to the pressure-induced increases in the energies of the ground electronic manifold 4f(n) of Eu(3+) and Tb(3+) ions with respect to the band edges. Analysis of the emission and excitation spectra allowed the estimation of the energies of the ground states of all lanthanide (Ln) ions (Ln(3+) and Ln(2+)) with respect to the valence and conduction bands edges of the Y2O2S host. The bandgap energy and difference between energies of the ground states of Ln(2+) and Ln(3+) have been calculated as functions of pressure. The experimental high-pressure spectroscopy results allow the calculation of the absolute values (calculated with respect to the vacuum level) of the energies and pressure-induced shifts of the conduction and valence band edges and the ground states of Ln(3+) and Ln(2+) ions in Y2O2S. PMID:27453544

  2. Blood pressure and levels of Fe, Ca, Mg, Zn, Cu, Na and K in the hair of young Bantu men from Tanzania.

    PubMed

    Rębacz-Maron, Ewa; Baranowska-Bosiacka, Irena; Gutowska, Izabela; Chlubek, Dariusz

    2013-03-01

    Mineral imbalance in the body may significantly contribute to the development and course of hypertension. In this paper, blood pressure figures have been linked to the levels of Fe, Ca, Mg, Zn, Cu, Na and K in hair. The research sample was composed of young men (n = 91) aged 13-21, from the town of Mafinga, Iringa District, Tanzania. The data collected included their age, tribal background and weekly diet. Based on body mass index, the participants were categorised into pre-defined subgroups. To examine how the minerals in question affect blood pressure, correlation analysis and multiple ridge regression analysis were performed. Analysis of ridge regression findings for the researched group (n = 91) shows that the minerals under scrutiny account for systolic blood pressure variation in 13 % and in 15 % for diastolic blood pressure variation. After including two additional variables-calendar age and body mass index-in regression analysis, the ultimate coefficient of determination (R (2)) changes for systolic blood pressure and remains the same for diastolic blood pressure (R (2) = 0.194 and R (2) = 0.156, respectively). Nutritional analysis shows that the students included in the study received insufficient calories per day (1,500-2,200 kcal). The group of students with abnormal blood pressure were not aware of their poor health. Research findings may result from progressive environmental changes and poor nutrition in terms of food quantity and quality, which had an impact on the subjects' blood pressure. Hair analysis used to determine mineral content in the body may be an auxiliary tool in identifying the links between factors leading to the development of hypertension. PMID:23279941

  3. Evaluation of the psychophysical detection threshold level for vibrotactile and pressure stimulation of prosthetic limbs using bone anchorage or soft tissue support.

    PubMed

    Jacobs, R; Brånemark, R; Olmarker, K; Rydevik, B; Van Steenberghe, D; Brånemark, P I

    2000-08-01

    In the present study the psychophysical detection threshold levels mechanical stimulation of 32 prosthetic limbs were determined. Prosthetic limbs were anchored to the bone by means of an implant (n=17) or supported by a socket enclosing the amputation stump (n=15). Detection threshold levels were assessed for pressure and vibratory stimulation of the prosthesis and the limb at the contralateral side (control). Following vibratory stimulation, thresholds were increased on an average 20% for socket prostheses. but approached those of the control for bone-anchored prostheses. For pressure stimulation, thresholds were increased up to 60% for socket prostheses and 40% for bone-anchored prostheses compared to the control. While bone-anchored prostheses yielded significantly lower threshold levels than socket prostheses, there was no significant difference between both treatments regarding pressure stimulation. Results were applicable to both upper and lower limb amputees. It could be concluded that detection thresholds for pressure and especially vibratory stimulation of prosthetic limbs were generally higher than for control limbs. The outcome was related to the prosthetic limb design with bone-anchored prostheses yielding better perception than socket prostheses. PMID:11061200

  4. Pressure dependence of the configurational bistability and deep electronic levels of the MFe center in InP

    NASA Astrophysics Data System (ADS)

    Samara, G. A.; Barnes, C. E.

    2006-04-01

    The influence of hydrostatic pressure on the structural bistability and electronic properties of the processing-induced MFe center in Fe-doped n -type InP was investigated. Earlier work has shown that, when occupied by electrons, the center can be reversibly placed in either of two configurations, termed A and B , by the proper choice of electric biasing conditions and temperature. Pressure strongly modifies the energetics and kinetics of the various electronic transitions and of the transformations associated with the center. The activation volumes (ΔV*) for these processes were determined. In the absence of barriers to electron capture, or for small barriers, ΔV* can be interpreted as the breathing mode relaxation associated with electron emission or capture. At pressures ⩾8kbar , the center exists only in the A configuration regardless of bias conditions, because at these pressures the energetics and kinetics of the various processes have changed so much as to always favor the A configuration. It is also shown that, whereas the A⇄B transformations are charge state controlled at 1bar , this is not the case at high pressure where the transformations can be brought about without electron emission or hole capture. Earlier tentative atomic models for the center are discussed, and it is shown that some features of one of the models including the signs of the breathing mode relaxations associated with the various electron emissions are consistent with the experimental results, but issues remain. The results are also found to be generally consistent with first-principles calculations on defects in InP, but it is emphasized that whereas these calculations are for simple defects, the defects associated with the MFe center are more complex.

  5. Dietary phytosterols and phytostanols decrease cholesterol levels but increase blood pressure in WKY inbred rats in the absence of salt-loading

    PubMed Central

    2010-01-01

    Background There are safety concerns regarding widespread consumption of phytosterol and phytostanol supplemented food products. The aim of this study was to determine, in the absence of excess dietary salt, the individual effects of excess accumulation of dietary phytosterols and phytostanols on blood pressure in Wistar Kyoto (WKY) inbred rats that have a mutation in the Abcg5 gene and thus over absorb phytosterols and phytostanols. Methods Thirty 35-day old male WKY inbred rats (10/group) were fed a control diet or a diet containing phytosterols or phytostanols (2.0 g/kg diet) for 5 weeks. The sterol composition of the diets, plasma and tissues were analysed by gas chromatography. Blood pressure was measured by the tail cuff method. mRNA levels of several renal blood pressure regulatory genes were measured by real-time quantitative PCR. Results Compared to the control diet, the phytosterol diet resulted in 3- to 4-fold increases in the levels of phytosterols in plasma, red blood cells, liver, aorta and kidney of WKY inbred rats (P < 0.05). The phytostanol diet dramatically increased (> 9-fold) the levels of phytostanols in plasma, red blood cells, liver, aorta and kidney of these rats (P < 0.05). The phytosterol diet decreased cholesterol levels by 40%, 31%, and 19% in liver, aorta and kidney, respectively (P < 0.05). The phytostanol diet decreased cholesterol levels by 15%, 16%, 20% and 14% in plasma, liver, aorta and kidney, respectively (P < 0.05). The phytostanol diet also decreased phytosterol levels by 29% to 54% in plasma and tissues (P < 0.05). Both the phytosterol and phytostanol diets produced significant decreases in the ratios of cholesterol to phytosterols and phytostanols in plasma, red blood cells, liver, aorta and kidney. Rats that consumed the phytosterol or phytostanol diets displayed significant increases in systolic and diastolic blood pressure compared to rats that consumed the control diet (P < 0.05). The phytosterol diet increased renal

  6. High-angle reverse faulting in northern New Brunswick, Canada, and its implications for fluid pressure levels

    NASA Astrophysics Data System (ADS)

    Sibson, Richard H.

    The 1982 Miramichi earthquake sequence in northern New Brunswick included four shocks in the magnitude range, 5.7 > m, > 5.0, and extensive aftershock activity. Rupturing occurred within granitic terrain on a pair of NNE—SSW-striking, opposite-facing, high-angle reverse faults which converge at the mainshock focal depth of ≈7 km. It seems probable that the earthquake sequence involved the reactivation under horizontal compression of an existing set of steep normal faults, perhaps derived from Mesozoic rifting of the Atlantic continental margin. The symmetry of the V-shaped profile of faults in WNW—ESE section suggests that the maximum principal compressive stress (σ 1) during reactivation was subhorizontal and the least principal stress (σ 3) was subvertical, so that the reactivation angle between σ 1 and the faults corresponded to the 50-65° dip of the faults. Stress analysis of the conditions for frictional reactivation of existing cohesionless faults shows that pore-fluid pressures approaching or exceeding lithostatic values are required for reshear at such high reactivation angles, with the implication that the earthquake sequence was triggered by locally elevated fluid pressure. While the source and composition of the inferred high pressure fluids are uncertain, a mixed H 2O—CO 2 fluid of mantle origin seems most likely.

  7. Overall fluctuating pressure levels on prospective space shuttle launch configurations at Mach numbers from 0.8 to 2.2

    NASA Technical Reports Server (NTRS)

    Dods, J. B., Jr.; Hanly, R. D.; Efting, J. H.

    1973-01-01

    Overall fluctuating pressure levels of seven space shuttle launch configurations are presented. The model was a 4-percent-scale space shuttle vehicle, tested in both a 11- by 11-foot transonic wind tunnel and a 9- by 7-foot supersonic wind tunnel. Mach numbers varied from 0.8 to 2.2, and the angle of attack range was from -8 deg to 8 deg at angles of sideslip of -5 deg, and 5 deg. The model configurations included both series-burn and parallel-burn configurations, two canopy configurations, two positions of the orbiter nose relative to the HO tank nose and two HO tank nose-cone angles (15 deg and 20 deg). The fluctuating pressure levels are presented in three forms.

  8. Nighttime Systolic Blood-Pressure Load Is Correlated with Target-Organ Damage Independent of Ambulatory Blood-Pressure Level in Patients with Non-Diabetic Chronic Kidney Disease

    PubMed Central

    Deng, Wenjie; Gong, Wenyu; Liu, Xun; Ye, Zengchun; Peng, Hui; Lou, Tanqi

    2015-01-01

    Background The impacts of blood pressure (BP) load on target-organ damage in patients with chronic kidney disease (CKD) are largely unclear. We examined whether BP load is correlated with target-organ damage (TOD) in Chinese CKD patients independent of BP level. Methods We recruited 1219 CKD patients admitted to our hospital division in this cross-sectional study. The TOD were measured by estimated glomerular filtration rate (eGFR), proteinuria, left ventricular mass index (LVMI) and carotid intima-media thickness (cIMT) in this study. Univariate and multivariate linear analyses were used to evaluate the relationship between systolic blood pressure (SBP) load, diastolic blood pressure (DBP) load and these renal, cardiovascular parameters. Results In multivariable-adjusted models, BP load and ambulatory BP levels both independently correlated with LVMI, eGFR and proteinuria in all groups of CKD patients (p<0.05), 24-h SBP correlated with cIMT only in non-diabetic CKD patients without hypertension (p<0.05), while nighttime SBP load was associated with cIMT only in non-diabetic CKD patients (p<0.05). Furthermore, nighttime SBP load additionally increased coefficient of determination (R2) and correlated with LVMI, proteinuria in non-diabetic CKD patients without hypertension (R2 = 0.034, P<0.001 and R2 = 0.012, P = 0.006 respectively) and LVMI, cIMT, eGFR in non-diabetic CKD patients with hypertension (R2>0.008, P<0.05) in multivariable-adjusted model which already including the 24-h BP. BP load did not refine this correlation based on the 24-h BP level in diabetic CKD patients. Conclusion Night-time SBP load was correlated with TOD in patients with non-diabetic chronic kidney disease independent of BP level. PMID:26186336

  9. Porcine liver decellularization under oscillating pressure conditions: a technical refinement to improve the homogeneity of the decellularization process.

    PubMed

    Struecker, Benjamin; Hillebrandt, Karl Herbert; Voitl, Robert; Butter, Antje; Schmuck, Rosa B; Reutzel-Selke, Anja; Geisel, Dominik; Joehrens, Korinna; Pickerodt, Philipp A; Raschzok, Nathanael; Puhl, Gero; Neuhaus, Peter; Pratschke, Johann; Sauer, Igor M

    2015-03-01

    Decellularization and recellularization of parenchymal organs may facilitate the generation of autologous functional liver organoids by repopulation of decellularized porcine liver matrices with induced liver cells. We present an accelerated (7 h overall perfusion time) and effective protocol for human-scale liver decellularization by pressure-controlled perfusion with 1% Triton X-100 and 1% sodium dodecyl sulfate via the hepatic artery (120 mmHg) and portal vein (60 mmHg). In addition, we analyzed the effect of oscillating pressure conditions on pig liver decellularization (n=19). The proprietary perfusion device used to generate these pressure conditions mimics intra-abdominal conditions during respiration to optimize microperfusion within livers and thus optimize the homogeneity of the decellularization process. The efficiency of perfusion decellularization was analyzed by macroscopic observation, histological staining (hematoxylin and eosin [H&E], Sirius red, and alcian blue), immunohistochemical staining (collagen IV, laminin, and fibronectin), and biochemical assessment (DNA, collagen, and glycosaminoglycans) of decellularized liver matrices. The integrity of the extracellular matrix (ECM) postdecellularization was visualized by corrosion casting and three-dimensional computed tomography scanning. We found that livers perfused under oscillating pressure conditions (P(+)) showed a more homogenous course of decellularization and contained less DNA compared with livers perfused without oscillating pressure conditions (P(-)). Microscopically, livers from the (P(-)) group showed remnant cell clusters, while no cells were found in livers from the (P(+)) group. The grade of disruption of the ECM was higher in livers from the (P(-)) group, although the perfusion rates and pressure did not significantly differ. Immunohistochemical staining revealed that important matrix components were still present after decellularization. Corrosion casting showed an intact

  10. [Research on Adaptive Balance Reaction for Gait Slippery Instability Events on Level Walk Based on Plantar Pressure and Gait Parameter Analysis].

    PubMed

    Li, Yang; Zhang, Junxia; Si, Ying

    2015-12-01

    Nowadays, for gait instability phenomenon, many researches have been carried out at home and abroad. However, the relationship between plantar pressure and gait parameters in the process of balance adjustment is still unclear. This study describes the human body adaptive balance reaction during slip events on slippery level walk by plantar pressure and gait analysis. Ten healthy male subjects walked on a level path wearing shoes with two contrastive contaminants (dry, oil). The study collected and analyzed the change rule of spatiotemporal parameters, plantar pressure parameters, vertical ground reaction force (VGRF), etc. The results showed that the human body adaptive balance reaction during slip events on slippery level walk mainly included lighter touch at the heel strikes, tighter grip at the toe offs, a lower velocity, a shorter stride length and longer support time. These changes are used to maintain or recover body balance. These results would be able to explore new ideas and provide reference value for slip injury prevention, walking rehabilitation training design, research and development of walking assistive equipments, etc. PMID:27079090

  11. High blood pressure medicines

    MedlinePlus

    Hypertension - medicines ... blood vessel diseases. You may need to take medicines to lower your blood pressure if lifestyle changes ... blood pressure to the target level. WHEN ARE MEDICINES FOR HIGH BLOOD PRESSURE USED Most of the ...

  12. Comparison of the effects of two levels of negative pressure in open endotracheal tube suction on the physiological indices among patients in intensive care units

    PubMed Central

    Yousefi, Hojatollah; Vahdatnejad, Jahanbakhsh; Yazdannik, Ahmad Reza

    2014-01-01

    Background: Most of the patients admitted in the intensive care units (ICUs) require an endotracheal tube and mechanical ventilation. In order to clear and maintain patency of the airways, endotracheal suctioning is required. Therefore, the least detrimental way of endotracheal tube suctioning which can diminish the complications should be selected. The present study aimed to compare the effect of two levels of negative pressure (100 mmHg and 200 mmHg) in open endotracheal tube suction on the physiological indices among patients in the ICUs. Materials and Methods: In this single-blind clinical t