Science.gov

Sample records for air bleed device

  1. Evaluation of the Ram-Jet device, a PCV air bleed. Technical report

    SciTech Connect

    Barth, E.A.

    1980-01-01

    The Environmental Protection Agency receives information about many systems which appear to offer potential for emission reduction or fuel economy improvement compared to conventional engines and vehicles. This report discusses EPA's evaluation of the Ram-Jet, a retrofit device marketed by Ed Almquist. It is designed to bleed in extra air to the engine by allowing ambient air to bypass the carburetor under high engine load conditions. The manufacturer claims the device reduces emission pollutants and improves fuel economy.

  2. Engine bleed air reduction in DC-10

    NASA Technical Reports Server (NTRS)

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

    1980-01-01

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

  3. 21 CFR 864.6100 - Bleeding time device.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Manual Hematology Devices § 864.6100 Bleeding time device. (a) Identification. A bleeding time device is a device, usually employing two spring-loaded blades... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Bleeding time device. 864.6100 Section...

  4. 21 CFR 864.6100 - Bleeding time device.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Manual Hematology Devices § 864.6100 Bleeding time device. (a) Identification. A bleeding time device is a device, usually employing two spring-loaded blades... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Bleeding time device. 864.6100 Section...

  5. 14 CFR 23.1109 - Turbocharger bleed air system.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Turbocharger bleed air system. 23.1109... Induction System § 23.1109 Turbocharger bleed air system. The following applies to turbocharged bleed air systems used for cabin pressurization: (a) The cabin air system may not be subject to...

  6. 14 CFR 23.1109 - Turbocharger bleed air system.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Turbocharger bleed air system. 23.1109... Induction System § 23.1109 Turbocharger bleed air system. The following applies to turbocharged bleed air systems used for cabin pressurization: (a) The cabin air system may not be subject to...

  7. 14 CFR 23.1109 - Turbocharger bleed air system.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Turbocharger bleed air system. 23.1109... Induction System § 23.1109 Turbocharger bleed air system. The following applies to turbocharged bleed air systems used for cabin pressurization: (a) The cabin air system may not be subject to...

  8. 14 CFR 23.1109 - Turbocharger bleed air system.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Turbocharger bleed air system. 23.1109... Induction System § 23.1109 Turbocharger bleed air system. The following applies to turbocharged bleed air systems used for cabin pressurization: (a) The cabin air system may not be subject to...

  9. 14 CFR 23.1109 - Turbocharger bleed air system.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Induction System § 23.1109 Turbocharger bleed air system. The following applies to turbocharged bleed air systems used for cabin pressurization: (a) The cabin air system may not be subject to hazardous... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Turbocharger bleed air system....

  10. 14 CFR 23.1111 - Turbine engine bleed air system.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Turbine engine bleed air system. 23.1111 Section 23.1111 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... Induction System § 23.1111 Turbine engine bleed air system. For turbine engine bleed air systems,...

  11. 14 CFR 23.1111 - Turbine engine bleed air system.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Turbine engine bleed air system. 23.1111 Section 23.1111 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... Induction System § 23.1111 Turbine engine bleed air system. For turbine engine bleed air systems,...

  12. 14 CFR 23.1111 - Turbine engine bleed air system.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Turbine engine bleed air system. 23.1111 Section 23.1111 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... Induction System § 23.1111 Turbine engine bleed air system. For turbine engine bleed air systems,...

  13. 14 CFR 23.1111 - Turbine engine bleed air system.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Turbine engine bleed air system. 23.1111 Section 23.1111 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... Induction System § 23.1111 Turbine engine bleed air system. For turbine engine bleed air systems,...

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

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Turbine engine bleed air system. 23.1111 Section 23.1111 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION... Induction System § 23.1111 Turbine engine bleed air system. For turbine engine bleed air systems,...

  15. Reduced bleed air extraction for DC-10 cabin air conditioning

    NASA Technical Reports Server (NTRS)

    Newman, W. H.; Viele, M. R.; Hrach, F. J.

    1980-01-01

    It is noted that a significant fuel savings can be achieved by reducing bleed air used for cabin air conditioning. Air in the cabin can be recirculated to maintain comfortable ventilation rates but the quality of the air tends to decrease due to entrainment of smoke and odors. Attention is given to a development system designed and fabricated under the NASA Engine Component Improvement Program to define the recirculation limit for the DC-10. It is shown that with the system, a wide range of bleed air reductions and recirculation rates is possible. A goal of 0.8% fuel savings has been achieved which results from a 50% reduction in bleed extraction from the engine.

  16. 21 CFR 864.6100 - Bleeding time device.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Bleeding time device. 864.6100 Section 864.6100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Manual Hematology Devices § 864.6100 Bleeding time...

  17. 21 CFR 864.6100 - Bleeding time device.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Bleeding time device. 864.6100 Section 864.6100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Manual Hematology Devices § 864.6100 Bleeding time...

  18. 21 CFR 864.6100 - Bleeding time device.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Bleeding time device. 864.6100 Section 864.6100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Manual Hematology Devices § 864.6100 Bleeding time...

  19. 14 CFR 33.66 - Bleed air system.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Bleed air system. 33.66 Section 33.66 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Design and Construction; Turbine Aircraft Engines § 33.66 Bleed air system....

  20. 14 CFR 33.66 - Bleed air system.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false Bleed air system. 33.66 Section 33.66 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Design and Construction; Turbine Aircraft Engines § 33.66 Bleed air system....

  1. 14 CFR 33.66 - Bleed air system.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Bleed air system. 33.66 Section 33.66 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Design and Construction; Turbine Aircraft Engines § 33.66 Bleed air system....

  2. 14 CFR 33.66 - Bleed air system.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  3. 14 CFR 33.66 - Bleed air system.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Bleed air system. 33.66 Section 33.66 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Design and Construction; Turbine Aircraft Engines § 33.66 Bleed air system....

  4. Air filtering device

    SciTech Connect

    Backus, A.L.

    1992-07-28

    This patent describes a room air cleaning device. It comprises: a box housing having an air inlet and an air outlet provided therein; a vertical baffle coupled to the box housing opposite the air outlet and spaced form the box housing such that an air egress outlet is formed between the vertical baffle and the box housing; air cleansing means substantially disposed within the box housing and cleansing air passing into the inlet and out of the air egress outlet; a fan disposed within the box housing, the fan providing air movement through the air inlet and the air egress outlet; wherein air exits the room air cleaning device through the air egress outlet as a vertical plane of moving air; and wherein formation of the vertical plane of moving air contributes to the formation of a low pressure area drawing impure air toward the air inlet.

  5. Bleeding

    MedlinePlus

    ... emergency help. Calm and reassure the person. The sight of blood can be very frightening. If the ... is best for external bleeding, except for an eye injury. Maintain pressure until the bleeding stops. When ...

  6. Air bag restraint device

    DOEpatents

    Marts, D.J.; Richardson, J.G.

    1995-10-17

    A rear-seat air bag restraint device is disclosed that prevents an individual, or individuals, from continuing violent actions while being transported in a patrol vehicle`s rear seat without requiring immediate physical contact by the law enforcement officer. The air bag is activated by a control switch in the front seat and inflates to independently restrict the amount of physical activity occurring in the rear seat of the vehicle while allowing the officer to safely stop the vehicle. The air bag can also provide the officer additional time to get backup personnel to aid him if the situation warrants it. The bag is inflated and maintains a constant pressure by an air pump. 8 figs.

  7. Air bag restraint device

    DOEpatents

    Marts, Donna J.; Richardson, John G.

    1995-01-01

    A rear-seat air bag restraint device is disclosed that prevents an individual, or individuals, from continuing violent actions while being transported in a patrol vehicle's rear seat without requiring immediate physical contact by the law enforcement officer. The air bag is activated by a control switch in the front seat and inflates to independently restrict the amount of physical activity occurring in the rear seat of the vehicle while allowing the officer to safely stop the vehicle. The air bag can also provide the officer additional time to get backup personnel to aid him if the situation warrants it. The bag is inflated and maintains a constant pressure by an air pump.

  8. Compressor discharge bleed air circuit in gas turbine plants and related method

    DOEpatents

    Anand, Ashok Kumar; Berrahou, Philip Fadhel; Jandrisevits, Michael

    2003-04-08

    A gas turbine system that includes a compressor, a turbine component and a load, wherein fuel and compressor discharge bleed air are supplied to a combustor and gaseous products of combustion are introduced into the turbine component and subsequently exhausted to atmosphere. A compressor discharge bleed air circuit removes bleed air from the compressor and supplies one portion of the bleed air to the combustor and another portion of the compressor discharge bleed air to an exhaust stack of the turbine component in a single cycle system, or to a heat recovery steam generator in a combined cycle system. In both systems, the bleed air diverted from the combustor may be expanded in an air expander to reduce pressure upstream of the exhaust stack or heat recovery steam generator.

  9. Compressor discharge bleed air circuit in gas turbine plants and related method

    DOEpatents

    Anand, Ashok Kumar; Berrahou, Philip Fadhel; Jandrisevits, Michael

    2002-01-01

    A gas turbine system that includes a compressor, a turbine component and a load, wherein fuel and compressor discharge bleed air are supplied to a combustor and gaseous products of combustion are introduced into the turbine component and subsequently exhausted to atmosphere. A compressor discharge bleed air circuit removes bleed air from the compressor and supplies one portion of the bleed air to the combustor and another portion of the compressor discharge bleed air to an exhaust stack of the turbine component in a single cycle system, or to a heat recovery steam generator in a combined cycle system. In both systems, the bleed air diverted from the combustor may be expanded in an air expander to reduce pressure upstream of the exhaust stack or heat recovery steam generator.

  10. Air monitoring device

    NASA Technical Reports Server (NTRS)

    Tissandier, Michael D. (Inventor)

    2012-01-01

    An air monitoring device (100) includes an outer casing (101) configured to receive an airflow (102) comprising particulate; a bore (103) located inside the outer casing (101); and a collection probe (104) located inside the outer casing (101), the collection probe (104) being configured such that there is a gap (105) between an exit of the bore (103) and an entrance of the collection probe (104), such that particulate in the airflow (102) having a diameter larger than a threshold flows through an interior of the collection probe (104).

  11. Acoustic hemostasis device for automated treatment of bleeding in limbs

    NASA Astrophysics Data System (ADS)

    Sekins, K. Michael; Zeng, Xiaozheng; Barnes, Stephen; Hopple, Jerry; Kook, John; Moreau-Gobard, Romain; Hsu, Stephen; Ahiekpor-Dravi, Alexis; Lee, Chi-Yin; Ramachandran, Suresh; Maleke, Caroline; Eaton, John; Wong, Keith; Keneman, Scott

    2012-10-01

    A research prototype automated image-guided acoustic hemostasis system for treatment of deep bleeding was developed and tested in limb phantoms. The system incorporated a flexible, conformal acoustic applicator cuff. Electronically steered and focused therapeutic arrays (Tx) populated the cuff to enable dosing from multiple Tx's simultaneously. Similarly, multiple imaging arrays (Ix) were deployed on the cuff to enable 3D compounded images for targeting and treatment monitoring. To affect a lightweight cuff, highly integrated Tx electrical circuitry was implemented, fabric and lightweight structural materials were used, and components were minimized. Novel cuff and Ix and Tx mechanical registration approaches were used to insure targeting accuracy. Two-step automation was implemented: 1) targeting (3D image volume acquisition and stitching, Power and Pulsed Wave Doppler automated bleeder detection, identification of bone, followed by closed-loop iterative Tx beam targeting), and 2) automated dosing (auto-selection of arrays and Tx dosing parameters, power initiation and then monitoring by acoustic thermometry for power shut-off). In final testing the device automatically detected 65% of all bleeders (with various bleeder flow rates). Accurate targeting was achieved in HIFU phantoms with end-dose (30 sec) temperature rise reaching the desired 33-58°C. Automated closed-loop targeting and treatment was demonstrated in separate phantoms.

  12. Respiratory and Laryngeal Responses to an Oral Air Pressure Bleed during Speech

    ERIC Educational Resources Information Center

    Huber, Jessica E.; Stathopoulos, Elaine T.

    2003-01-01

    Researchers have hypothesized that the respiratory and laryngeal speech subsystems would respond to an air pressure bleed, but these responses have not been empirically studied. The present study examined the nature of the responses of the respiratory and laryngeal subsystems to an air pressure bleed in order to provide information relevant to the…

  13. Fuel-air control device

    SciTech Connect

    Norman, J.

    1981-12-15

    The invention concerns a device for controlling the vehicles fuel-air mixture by regulating the air in the ventilation passage leading to the engine air intake from the crankcase. In a vehicle provided with a PCV valve, the device is located in the ventilation passage leading from the crankcase to the engine air intake and the device is downstream of the PCV valve. The device admits outside air to the ventilation passage to lean the gas mixture when the engine creates a vacuum less than 8 psi in the ventilation passage.

  14. Gastrointestinal bleeding in a patient with a continuous-flow biventricular assist device

    PubMed Central

    Mirasol, Raymond V; Tholany, Jason J; Reddy, Hasini; Fyfe-Kirschner, Billie S; Cheng, Christina L; Moubarak, Issam F; Nosher, John L

    2016-01-01

    The association between continuous-flow left ventricular assist devices (CF-LVADs) and gastrointestinal (GI) bleeding from angiodysplasia is well recognized. However, the association between continuous-flow biventricular assist devices (CF-BIVADs) and bleeding angiodysplasia is less understood. We report a case of GI bleeding from a patient with a CF-BIVAD. The location of GI bleeding was identified by nuclear red blood cell bleeding scan. The vascular malformation leading to the bleed was identified and localized on angiography and then by pathology. The intensity of bleeding, reflected by number of units of packed red blood cells needed for normalization of hemoglobin, as well as the time to onset of bleeding after transplantation, are similar to that seen in the literature for CF-LVADs and pulsatile BIVADs. While angiography only detected a dilated late draining vein, pathology demonstrated the presence of both arterial and venous dilation in the submucosa, vascular abnormalities characteristic of a late arteriovenous malformation. PMID:27158430

  15. Gastrointestinal bleeding in a patient with a continuous-flow biventricular assist device.

    PubMed

    Mirasol, Raymond V; Tholany, Jason J; Reddy, Hasini; Fyfe-Kirschner, Billie S; Cheng, Christina L; Moubarak, Issam F; Nosher, John L

    2016-04-28

    The association between continuous-flow left ventricular assist devices (CF-LVADs) and gastrointestinal (GI) bleeding from angiodysplasia is well recognized. However, the association between continuous-flow biventricular assist devices (CF-BIVADs) and bleeding angiodysplasia is less understood. We report a case of GI bleeding from a patient with a CF-BIVAD. The location of GI bleeding was identified by nuclear red blood cell bleeding scan. The vascular malformation leading to the bleed was identified and localized on angiography and then by pathology. The intensity of bleeding, reflected by number of units of packed red blood cells needed for normalization of hemoglobin, as well as the time to onset of bleeding after transplantation, are similar to that seen in the literature for CF-LVADs and pulsatile BIVADs. While angiography only detected a dilated late draining vein, pathology demonstrated the presence of both arterial and venous dilation in the submucosa, vascular abnormalities characteristic of a late arteriovenous malformation. PMID:27158430

  16. Comparison of a novel bedside portable endoscopy device with nasogastric aspiration for identifying upper gastrointestinal bleeding

    PubMed Central

    Choi, Jong Hwan; Choi, Jae Hyuk; Lee, Yoo Jin; Lee, Hyung Ki; Choi, Wang Yong; Kim, Eun Soo; Park, Kyung Sik; Cho, Kwang Bum; Jang, Byoung Kuk; Chung, Woo Jin; Hwang, Jae Seok

    2014-01-01

    AIM: To compare outcomes using the novel portable endoscopy with that of nasogastric (NG) aspiration in patients with gastrointestinal bleeding. METHODS: Patients who underwent NG aspiration for the evaluation of upper gastrointestinal (UGI) bleeding were eligible for the study. After NG aspiration, we performed the portable endoscopy to identify bleeding evidence in the UGI tract. Then, all patients underwent conventional esophagogastroduodenoscopy as the gold-standard test. The sensitivity, specificity, and accuracy of the portable endoscopy for confirming UGI bleeding were compared with those of NG aspiration. RESULTS: In total, 129 patients who had GI bleeding signs or symptoms were included in the study (age 64.46 ± 13.79, 91 males). The UGI tract (esophagus, stomach, and duodenum) was the most common site of bleeding (81, 62.8%) and the cause of bleeding was not identified in 12 patients (9.3%). Specificity for identifying UGI bleeding was higher with the portable endoscopy than NG aspiration (85.4% vs 68.8%, P = 0.008) while accuracy was comparable. The accuracy of the portable endoscopy was significantly higher than that of NG in the subgroup analysis of patients with esophageal bleeding (88.2% vs 75%, P = 0.004). Food material could be detected more readily by the portable endoscopy than NG tube aspiration (20.9% vs 9.3%, P = 0.014). No serious adverse effect was observed during the portable endoscopy. CONCLUSION: The portable endoscopy was not superior to NG aspiration for confirming UGI bleeding site. However, this novel portable endoscopy device might provide a benefit over NG aspiration in patients with esophageal bleeding. PMID:25009396

  17. Octreotide for the Management of Gastrointestinal Bleeding in a Patient with a HeartWare Left Ventricular Assist Device

    PubMed Central

    Dang, Geetanjali; Grayburn, Ryan; Lamb, Geoffrey; Umpierrez De Reguero, Adrian; Gaglianello, Nunzio

    2014-01-01

    HeartWare is a third generation left ventricular assist device (LVAD), widely used for the management of advanced heart failure patients. These devices are frequently associated with a significant risk of gastrointestinal (GI) bleeding. The data for the management of patients with LVAD presenting with GI bleeding is limited. We describe a 56-year-old lady, recipient of a HeartWare device, who experienced recurrent GI bleeding and was successfully managed with subcutaneous (SC) formulations of octreotide. PMID:25587457

  18. Inertial impaction air sampling device

    DOEpatents

    Dewhurst, K.H.

    1990-05-22

    An inertial impactor is designed which is to be used in an air sampling device for collection of respirable size particles in ambient air. The device may include a graphite furnace as the impaction substrate in a small-size, portable, direct analysis structure that gives immediate results and is totally self-contained allowing for remote and/or personal sampling. The graphite furnace collects suspended particles transported through the housing by means of the air flow system, and these particles may be analyzed for elements, quantitatively and qualitatively, by atomic absorption spectrophotometry. 3 figs.

  19. A novel device for intraoperative cauterization of bleeding points in endoscopic sinus surgery.

    PubMed

    Pagella, Fabio; Pusateri, Alessandro; Berardi, Anna; Zaccari, Dario; Avato, Irene; Matti, Elina

    2016-08-01

    Hemostasis is a critical point in endoscopic sinus and skull base surgery. A variety of techniques are presently available for reducing intraoperative bleeding; however, several limitations of the classical instruments should be stated. For example, reaching bleeding points in an anatomically angled site with straightforward bipolar devices could be quite difficult. With the aim of solving this problem, we developed a simple system using a standard curved suction tube, a rubber catheter and a monopolar system. This device provides an integrated suction function and is able to reach all paranasal and skull base areas, making it extremely useful in gaining precise access to the site of bleeding while providing excellent endoscopic vision. The described monopolar suction tube has proven to be a valid instrument for intraoperative hemostasis in endoscopic procedures; moreover, it does not add any further cost, making it applicable in particular healthcare settings, such as those in developing countries. PMID:27216302

  20. Circulatory support devices: fundamental aspects and clinical management of bleeding and thrombosis.

    PubMed

    Susen, S; Rauch, A; Van Belle, E; Vincentelli, A; Lenting, P J

    2015-10-01

    Circulatory support devices are increasingly being used to overcome cardiac or respiratory failure. Long-term devices are used either as a 'bridge to transplant' to support patients who are unable to wait any longer for a heart transplant, or, more recently, as 'destination therapy' for older patients suffering from end-stage heart failure and who have contraindications to heart transplantation. Short-term support devices for high-risk percutaneous coronary intervention, or as a 'bridge for decision' for patients suffering from refractory cardiogenic shock, have also been developed. The clinical benefit of such assist devices has been demonstrated in several important studies, but, unfortunately, thrombotic and bleeding complications are two major clinical issues in patients requiring these devices. Overcoming these issues is of major importance to allow the safe and broad use of these devices, and to consider them as true alternatives to heart transplantation. The present review focuses on thrombotic and bleeding complications, and describes how the risk of thrombosis and bleeding may vary according to the clinical indication, but also according to the type of device. We describe the current knowledge of the mechanisms underlying the occurrence of these complications, provide some guidance for choosing the most appropriate anticoagulation regimen to prevent their occurrence for each type of device and indication, and provide some recommendations for the management of patients when the complication occurs. PMID:26302994

  1. Performance characteristics and clinical evaluation of an in vitro bleeding time device--Thrombostat 4000.

    PubMed

    Alshameeri, R S; Mammen, E F

    1995-08-01

    The performance characteristics of an in vitro bleeding time device--Thrombostat 4000 were evaluated and compared with the Simplate bleeding time in healthy individuals and patients with disorders of primary hemostasis. Reference ranges were established using 30 normal volunteers. Although there were variations between different filter batches, reproducibility was good within a single batch. There were no differences between the two channels of the instrument and between male and female subjects. Hematocrit correlated negatively with the initial flow (IF) and IF correlated positively with closure time (T) and bleeding volume (V). Aspirin could be detected only when the traditional addition of ADP was replaced with CaCl2. Both, closure time (T) or bleeding volume (V) were more sensitive than Simplate bleeding time and T was more sensitive than V in detecting patients with disorders of primary hemostasis. We conclude that the Thrombostat 4000 is a reproducible, reliable, sensitive and easy to use instrument. It is superior to the traditional in vivo bleeding times for investigations of disorders of primary hemostasis (screening, diagnosis, monitoring, etc.). PMID:8533123

  2. Gastrointestinal angiodysplasia is associated with significant gastrointestinal bleeding in patients with continuous left ventricular assist devices

    PubMed Central

    Cochrane, Justin; Jackson, Christian; Schlepp, Greg; Strong, Richard

    2016-01-01

    Background and study aims: Patients with a continuous-flow left ventricular assist device (LVAD) have a 65 % incidence of bleeding events within the first year. The majority of gastrointestinal bleeding (GIB) is from gastrointestinal angiodyplasia (GIAD). The primary aim of the study was to determine whether GIAD was associated with a higher rate of significant bleeding, an increased number of bleeding events per year, and a higher rate of transfusion compared to non-GIAD sources. Patients and methods: This retrospective cohort study included 118 individuals who received a LVAD at a tertiary medical center from 2006 through 2014. Patients were subdivided into GIB and non-GIB for comparison of patient demographics, comorbid conditions, and laboratory data. GIB was further divided into sources of GIB, GIAD, obscure, or non-GIAD to establish severity of bleeding, rate of re-bleeding, and transfusion rate. Results: GIAD is associated with an increased number of bleeding events compared to non-GIAD sources of GIB (2.07 vs 1.23, P = 0.01) and a higher number of bleeding events per year (0.806 vs. 0.455 P = 0.001). GIAD compared to non-GIAD sources of GIB was associated with an increased incidence of major bleeding (100 % vs 60 %, P = 0.006) and increased rates of transfusion (8.8 vs 2.95 units, P = 0.0004). Cox Regression analysis between non-GIB and GIAD demonstrated increased risk with age (P = 0.001), history of chronic kidney disease (P = 0.005), and length of stay after LVAD implantation of more than 45 days (P = 0.04). History of hypertension (P = 0.045), diabetes mellitus (P = 0.016), and male gender was associated with decreased risk (P = 0.04). Conclusion: Patients with a continuous-flow LVAD who develop a GIB secondary to GIAD have a higher rate of major bleeding, multiple bleeding events, and require more transfusions to achieve stabilization compared to patients who do not have GIAD. PMID

  3. Effects of bleed air extraction on thrust levels on the F404-GE-400 turbofan engine

    NASA Technical Reports Server (NTRS)

    Yuhas, Andrew J.; Ray, Ronald J.

    1992-01-01

    A ground test was performed to determine the effects of compressor bleed flow extraction on the performance of F404-GE-400 afterburning turbofan engines. The two engines were installed in the F/A-18 High Alpha Research Vehicle at the NASA Dryden Flight Research Facility. A specialized bleed ducting system was installed onto the aircraft to control and measure engine bleed airflow while the aircraft was tied down to a thrust measuring stand. The test was conducted on each engine and at various power settings. The bleed air extraction levels analyzed included flow rates above the manufacturer's maximum specification limit. The measured relationship between thrust and bleed flow extraction was shown to be essentially linear at all power settings with an increase in bleed flow causing a corresponding decrease in thrust. A comparison with the F404-GE-400 steady-state engine simulation showed the estimation to be within +/- 1 percent of measured thrust losses for large increases in bleed flow rate.

  4. Inertial impaction air sampling device

    DOEpatents

    Dewhurst, K.H.

    1987-12-10

    An inertial impactor to be used in an air sampling device for collection of respirable size particles in ambient air which may include a graphite furnace as the impaction substrate in a small-size, portable, direct analysis structure that gives immediate results and is totally self-contained allowing for remote and/or personal sampling. The graphite furnace collects suspended particles transported through the housing by means of the air flow system, and these particles may be analyzed for elements, quantitatively and qualitatively, by atomic absorption spectrophotometry. 3 figs.

  5. Inertial impaction air sampling device

    DOEpatents

    Dewhurst, Katharine H.

    1990-01-01

    An inertial impactor to be used in an air sampling device for collection of respirable size particles in ambient air which may include a graphite furnace as the impaction substrate in a small-size, portable, direct analysis structure that gives immediate results and is totally self-contained allowing for remote and/or personal sampling. The graphite furnace collects suspended particles transported through the housing by means of the air flow system, and these particles may be analyzed for elements, quantitatively and qualitatively, by atomic absorption spectrophotometry.

  6. Comparing the Effect of Mefenamic Acid and Vitex Agnus on Intrauterine Device Induced Bleeding

    PubMed Central

    Yavarikia, Parisa; Shahnazi, Mahnaz; Hadavand Mirzaie, Samira; Javadzadeh, Yousef; Lutfi, Razieh

    2013-01-01

    Introduction: Increased bleeding is the most common cause of intrauterine device (IUD) removal. The use of alternative therapies to treat bleeding has increased due to the complications of medications. But most alternative therapies are not accepted by women. Therefore, conducting studies to find the right treatment with fewer complications and being acceptable is necessary. This study aimed to compare the effect of mefenamic acid and vitex agnus castus on IUD induced bleeding. Methods: This was a double blinded randomized controlled clinical trial. It was conducted on 84 women with random allocation in to two groups of 42 treated with mefenamic acid and vitex agnus capsules taking three times a day during menstruation for four months. Data were collected by demographic questionnaire and Higham 5 stage chart (1 month before the treatment and 4 months during the treatment)., Paired t-test, independent t-test, chi-square test, analysis of variance (ANOVA) with repeated measurements, and SPSS software were used to determine the results. Results: Mefenamic acid and vitex agnus significantly decreased bleeding. This decrease in month 4 was 52% in the mefenamic acid group and 47.6% in the vitex agnus group. The mean bleeding score changes was statistically significant between the two groups in the first three months and before the intervention. In the mefenamic acid group, the decreased bleeding was significantly more than the vitex agnus group. However, during the 4th month, the mean change was not statistically significant. Conclusion: Mefenamic acid and vitex agnus were both effective on IUD induced bleeding; however, mefenamic acid was more effective. PMID:25276733

  7. Video capsule endoscopy in left ventricular assist device recipients with obscure gastrointestinal bleeding

    PubMed Central

    Amornsawadwattana, Surachai; Nassif, Michael; Raymer, David; LaRue, Shane; Chen, Chien-Huan

    2016-01-01

    AIM: To assess whether video capsule endoscopy (VCE) affects the outcomes of left ventricular assist devices (LVADs) recipients with gastrointestinal bleeding. METHODS: This is a retrospective study of LVAD recipients with obscure gastrointestinal bleeding (OGIB) who underwent VCE at a tertiary medical center between 2005 and 2013. All patients were admitted and monitored with telemetry and all VCE and subsequent endoscopic procedures were performed as inpatients. A VCE study was considered positive only when P2 lesions were found and was regarded as negative if P1 or P0 were identified. All patients were followed until heart transplant, death, or the end of the study. RESULTS: Between 2005 and 2013, 30 patients with LVAD underwent VCE. Completion rate of VCE was 93.3% and there was no capsule retention. No interference of VCE recording or the function of LVAD was found. VCE was positive in 40% of patients (n = 12). The most common finding was active small intestinal bleeding (50%) and small intestinal angiodysplasia (33.3%). There was no difference in the rate of recurrent bleeding between patients with positive and negative VCE study (50.0% vs 55.6%, P = 1.00) during an average of 11.6 ± 9.6 mo follow up. Among patients with positive VCE, the recurrent bleeding rate did not differ whether subsequent endoscopy was performed (50% vs 50%, P = 1.00). CONCLUSION: VCE can be safely performed in LVAD recipients with a diagnostic yield of 40%. VCE does not affect recurrent bleeding in LVAD patients regardless of findings. PMID:27182165

  8. Air Pressure Responses to Sudden Vocal Tract Pressure Bleeds during Production of Stop Consonants: New Evidence of Aeromechanical Regulation.

    ERIC Educational Resources Information Center

    Zajac, David J.; Weissler, Mark C.

    2004-01-01

    Two studies were conducted to evaluate short-latency vocal tract air pressure responses to sudden pressure bleeds during production of voiceless bilabial stop consonants. It was hypothesized that the occurrence of respiratory reflexes would be indicated by distinct patterns of responses as a function of bleed magnitude. In Study 1, 19 adults…

  9. Bleeding esophageal varices

    MedlinePlus

    ... air. This produces pressure against the bleeding veins (balloon tamponade). Once the bleeding is stopped, varices can be treated with medicines and medical procedures to prevent future bleeding including: Drugs called ...

  10. Bleeding esophageal varices

    MedlinePlus

    ... air. This produces pressure against the bleeding veins (balloon tamponade). Once the bleeding is stopped, other varices can be treated with medicines and medical procedures to prevent future bleeding, including: Drugs called ...

  11. Postmenopausal Bleeding due to a Cu-7 Intrauterine Device Retained for Thirty Years

    PubMed Central

    Gimpelson, Richard J.

    2012-01-01

    Background: A retained intrauterine device is a rare, but easily correctable, cause of postmenopausal bleeding (PMB). Case: A 64-year-old woman presented to her gynecologist with PMB. Sonographic evaluation of the endometrium revealed the presence of a Cu-7 IUD retained for at least 30 years. Hysteroscopically assisted retrieval of the IUD resulted in complete resolution of symptoms. Conclusion: A retained IUD should be considered in the differential diagnosis for PMB. In addition, the authors recommend pelvic sonography as the first-line diagnostic modality for PMB to aid the diagnosis of retained IUD as well as other pathology. PMID:23477190

  12. Characterization of the frequency and nature of bleed air contamination events in commercial aircraft.

    PubMed

    Shehadi, M; Jones, B; Hosni, M

    2016-06-01

    Contamination of the bleed air used to pressurize and ventilate aircraft cabins is of concern due to the potential health and safety hazards for passengers and crew. Databases from the Federal Aviation Administration, NASA, and other sources were examined in detail to determine the frequency of bleed air contamination incidents. The frequency was examined on an aircraft model basis with the intent of identifying aircraft make and models with elevated frequencies of contamination events. The reported results herein may help investigators to focus future studies of bleed air contamination incidents on smaller number of aircrafts. Incident frequency was normalized by the number of aircraft, number of flights, and flight hours for each model to account for the large variations in the number of aircraft of different models. The focus of the study was on aircraft models that are currently in service and are used by major airlines in the United States. Incidents examined in this study include those related to smoke, oil odors, fumes, and any symptom that might be related to exposure to such contamination, reported by crew members, between 2007 and 2012, for US-based carriers for domestic flights and all international flights that either originated or terminated in the US. In addition to the reported frequency of incidents for different aircraft models, the analysis attempted to identify propulsion engines and auxiliary power units associated with aircrafts that had higher frequencies of incidents. While substantial variations were found in frequency of incidents, it was found that the contamination events were widely distributed across nearly all common models of aircraft. PMID:25864418

  13. Experimental Heat Transfer and Bulk Air Temperature Measurements for a Multipass Internal Cooling Model with Ribs and Bleed

    NASA Technical Reports Server (NTRS)

    Thurman, Douglas; Poinsatte, Philip

    2001-01-01

    An experimental study was made to obtain heat transfer and air temperature data for a simple three-leg serpentine test section that simulates a turbine blade internal cooling passage with trip strips and bleed holes. The objectives were to investigate the interaction of ribs and various bleed conditions on internal cooling and to gain a better understanding of bulk air temperature in an internal passage. Steady-state heat transfer measurements were obtained using a transient technique with thermochromic liquid crystals. Trip strips were attached to one wall of the test section and were located either between or near the bleed holes. The bleed holes, used for film cooling, were metered to simulate the effect of external pressure on the turbine blade. Heat transfer enhancement was found to be greater for ribs near bleed holes compared to ribs between holes, and both configurations were affected slightly by bleed rates upstream. Air temperature measurements were taken at discrete locations along one leg of the model. Average bulk air temperatures were found to remain fairly constant along one leg of the model.

  14. Experimental Heat Transfer and Bulk Air Temperature Measurements for a Multipass Internal Cooling Model with Ribs and Bleed

    NASA Technical Reports Server (NTRS)

    Thurman, Douglas; Poinsatte, Philip

    2000-01-01

    An experimental study was made to obtain heat transfer and air temperature data for a simple 3-leg serpentine test section that simulates a turbine blade internal cooling passage with trip strips and bleed holes. The objectives were to investigate the interaction of ribs and various bleed conditions on internal cooling and to gain a better understanding of bulk air temperature in an internal passage. Steady state heat transfer measurements were obtained using a transient technique with thermochromic liquid crystals. Trip strips were attached to one wall of the test section and were located either between or near the bleed holes. The bleed holes, used for film cooling, were metered to simulate the effect of external pressure on the turbine blade. Heat transfer enhancement was found to be greater for ribs near bleed holes compared to ribs between holes, and both configurations were affected slightly by bleed rates upstream. Air temperature measurements were taken at discreet locations along one leg of the model. Average bulk air temperatures were found to remain fairly constant along one leg of the model.

  15. Personal cooling air filtering device

    DOEpatents

    Klett, James [Knoxville, TN; Conway, Bret [Denver, NC

    2002-08-13

    A temperature modification system for modifying the temperature of fluids includes at least one thermally conductive carbon foam element, the carbon foam element having at least one flow channel for the passage of fluids. At least one temperature modification device is provided, the temperature modification device thermally connected to the carbon foam element and adapted to modify the temperature of the carbon foam to modify the temperature of fluids flowing through the flow channels. Thermoelectric and/or thermoionic elements can preferably be used as the temperature modification device. A method for the reversible temperature modification of fluids includes the steps of providing a temperature modification system including at least one thermally conductive carbon foam element having flow channels and at least one temperature modification device, and flowing a fluid through the flow channels.

  16. The Mechanism of Stall Margin Improvement in a Centrifugal Compressor with the Air Bleeding Circumferential Grooves Casing Treatment

    NASA Astrophysics Data System (ADS)

    Gao, P.; Chu, W. L.; Wu, Y. H.

    The air bleeding circumferential grooves casing treatment has the potential to extent the operating range of centrifugal compressor with no loss in efficiency. A time accurate 3-dimentional numerical simulation was performed in a low speed centrifugal compressor with the air bleeding circumferential grooves casing treatment. The numerical results agreed well with experimental test data for the global performance. Detailed analyses of the flow visualization at the tip of blades have exposed the different tip flow topologies between the cases with casing treatment and with untreated smooth wall, and the reasons how the second flow vortex is retrained. The mechanism of stall margin improvement is gained finally.

  17. Microwave Regenerable Air Purification Device

    NASA Technical Reports Server (NTRS)

    Atwater, James E.; Holtsnider, John T.; Wheeler, Richard R., Jr.

    1996-01-01

    The feasibility of using microwave power to thermally regenerate sorbents loaded with water vapor, CO2, and organic contaminants has been rigorously demonstrated. Sorbents challenged with air containing 0.5% CO2, 300 ppm acetone, 50 ppm trichloroethylene, and saturated with water vapor have been regenerated, singly and in combination. Microwave transmission, reflection, and phase shift has also been determined for a variety of sorbents over the frequency range between 1.3-2.7 GHz. This innovative technology offers the potential for significant energy savings in comparison to current resistive heating methods because energy is absorbed directly by the material to be heated. Conductive, convective and radiative losses are minimized. Extremely rapid heating is also possible, i.e., 1400 C in less than 60 seconds. Microwave powered thermal desorption is directly applicable to the needs of Advance Life Support in general, and of EVA in particular. Additionally, the applicability of two specific commercial applications arising from this technology have been demonstrated: the recovery for re-use of acetone (and similar solvents) from industrial waste streams using a carbon based molecular sieve; and the separation and destruction of trichloroethylene using ZSM-5 synthetic zeolite catalyst, a predominant halocarbon environmental contaminant. Based upon these results, Phase II development is strongly recommended.

  18. Risk Factors and Outcomes of Gastrointestinal Bleeding in Left Ventricular Assist Device Recipients.

    PubMed

    Joy, Parijat Saurav; Kumar, Gagan; Guddati, Achuta Kumar; Bhama, Jay Kumar; Cadaret, Linda Marie

    2016-01-15

    Increasing use of left ventricular assist devices (LVADs) has been accompanied by rising incidence of gastrointestinal bleeding (GIB). Objectives of this study were to determine the yearly incidence of GIB in LVAD recipients, compare outcomes of continuous-flow (CF) and pulsatile-flow LVAD eras, and investigate for risk factors. The Healthcare Cost and Utilization Project-Nationwide Inpatient Sample database from 2005 to 2010 was analyzed. Primary outcome of interest was incidence of GIB in LVAD recipients. Multivariate logistic regression model was used to examine independent associations of GIB with risk factors and outcomes. An estimated 8,879 LVAD index admissions and 8,722 readmissions in LVAD recipients over 6 years were analyzed. The yearly incidence of GIB after LVAD implantation increased from 5% in 2005 to 10% in 2010. On multivariate regression analysis, the odds of GIB was 3.24 times greater (95% confidence interval 1.53 to 6.89) in the era of CF LVADs than in the era of pulsatile-flow LVADs. Compared to their younger counterparts, in LVAD recipients aged >65 years, the adjusted odds of GIB was 20.5 times greater (95% confidence interval 2.24 to 188). GIB did not significantly increase the inhospital mortality but increased the inpatient length of stay. In conclusion, the incidence of GIB in LVAD recipients has increased since the use of CF LVADs has increased, leading to greater inpatient lengths of stay and hospital charges. Older recipients of CF LVADs appear to be at a greater risk of GIB. PMID:26651456

  19. Utility of double-balloon enteroscopy in patients with left ventricular assist devices and obscure overt gastrointestinal bleeding.

    PubMed

    Edwards, Adam L; Mönkemüller, Klaus; Pamboukian, Salpy V; George, James F; Wilcox, C M; Peter, Shajan

    2014-11-01

    Obscure overt gastrointestinal bleeding (OGIB) is a challenge in patients with left ventricular assist devices (LVADs). We evaluated the utility and safety of double-balloon enteroscopy (DBE) in patients with LVADs in an observational consecutive-patient cohort from a single tertiary referral center. Ten patients with LVADs underwent thirteen DBEs for obscure OGIB. The first OGIB event necessitating DBE occurred after a mean of 512 ± 363 days of LVAD support. All patients underwent DBE, eleven anterograde and two retrograde, with a mean insertion depth 176 ± 85 cm. Diagnostic yield was 69 % with the primary bleeding lesion most frequently found in the mid-bowel. The most common lesions were arteriovenous malformations. Therapeutic yield with argon plasma coagulation (APC), epinephrine injection, and/or hemoclip placement was 89 %. There were no procedure-related complications. DBE in patients with LVADs has good diagnostic yield and high therapeutic yield for obscure OGIB and is safe and well tolerated. PMID:25290096

  20. Bleeding time

    MedlinePlus

    Bleeding time is a medical test that measures how fast small blood vessels in the skin stop bleeding. ... until the bleeding stops. The provider records the time it takes for the cuts to stop bleeding.

  1. Air-moving device noise: An overview

    NASA Astrophysics Data System (ADS)

    Maling, George C., Jr.

    This paper presents a review of published information on the noise emission of small blowers and fans. The design is given for a noise meter for air-movement devices. The summary of research on noise sources and noise reduction includes information on axial-flow fans and centrifugal blowers. Sound reduction methods discussed include the introduction of obstructions and dampening plates and grilles. References are given for information on environmetal effects of fan noise. Design criteria and scaling laws are presented for minimal noise production. The paper identifies issues where further research is needed.

  2. 49 CFR 179.220-17 - Gauging devices, top loading and unloading devices, venting and air inlet devices.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 3 2014-10-01 2014-10-01 false Gauging devices, top loading and unloading devices, venting and air inlet devices. 179.220-17 Section 179.220-17 Transportation Other Regulations Relating to... and 115AW) § 179.220-17 Gauging devices, top loading and unloading devices, venting and air...

  3. 49 CFR 179.220-17 - Gauging devices, top loading and unloading devices, venting and air inlet devices.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Gauging devices, top loading and unloading devices, venting and air inlet devices. 179.220-17 Section 179.220-17 Transportation Other Regulations Relating to... and 115AW) § 179.220-17 Gauging devices, top loading and unloading devices, venting and air...

  4. 49 CFR 179.220-17 - Gauging devices, top loading and unloading devices, venting and air inlet devices.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Gauging devices, top loading and unloading devices, venting and air inlet devices. 179.220-17 Section 179.220-17 Transportation Other Regulations Relating to... and 115AW) § 179.220-17 Gauging devices, top loading and unloading devices, venting and air...

  5. 49 CFR 179.220-17 - Gauging devices, top loading and unloading devices, venting and air inlet devices.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Gauging devices, top loading and unloading devices, venting and air inlet devices. 179.220-17 Section 179.220-17 Transportation Other Regulations Relating to... and 115AW) § 179.220-17 Gauging devices, top loading and unloading devices, venting and air...

  6. Analytical and Experimental Investigation of the Effects of Compressor Interstage Air Bleed on Performance Characteristics of a 13-stage Axial-flow Compressor

    NASA Technical Reports Server (NTRS)

    Lucas, James G; Geye, Richard P; Calvert, Howard F

    1957-01-01

    Air was bled over the fifth-and tenth-stage rotor-blade rows through ports designed to pass 11 and 9 percent of the inlet flow, respectively, at 80 percent speed. Along the rated operating line the maximum speed at which rotating stall was encountered was lowered by either of these bleeds, and the stall patterns below these speeds were altered so that no dangerous resonant rotor-blade bending vibrations were excited. The combination of the two bleeds completely eliminated rotating stall to at least 50 percent speed. The compressor-discharge weight flow was decreased only at intermediate speeds, and the overall pressure ratio was affected only at intermediate speeds, and the overall pressure ratio was affected only by the combination bleed at intermediate speeds. Fifth-stage bleed increased compressor efficiency at low speeds, and tenth-stage bleed decreased efficiency at intermediate speeds.

  7. Nonlinear control of rotating stall and surge with axisymmetric bleed and air injection on axial flow compressors

    NASA Astrophysics Data System (ADS)

    Yeung, Chung-Hei (Simon)

    The study of compressor instabilities in gas turbine engines has received much attention in recent years. In particular, rotating stall and surge are major causes of problems ranging from component stress and lifespan reduction to engine explosion. In this thesis, modeling and control of rotating stall and surge using bleed valve and air injection is studied and validated on a low speed, single stage, axial compressor at Caltech. Bleed valve control of stall is achieved only when the compressor characteristic is actuated, due to the fast growth rate of the stall cell compared to the rate limit of the valve. Furthermore, experimental results show that the actuator rate requirement for stall control is reduced by a factor of fourteen via compressor characteristic actuation. Analytical expressions based on low order models (2--3 states) and a high fidelity simulation (37 states) tool are developed to estimate the minimum rate requirement of a bleed valve for control of stall. A comparison of the tools to experiments show a good qualitative agreement, with increasing quantitative accuracy as the complexity of the underlying model increases. Air injection control of stall and surge is also investigated. Simultaneous control of stall and surge is achieved using axisymmetric air injection. Three cases with different injector back pressure are studied. Surge control via binary air injection is achieved in all three cases. Simultaneous stall and surge control is achieved for two of the cases, but is not achieved for the lowest authority case. This is consistent with previous results for control of stall with axisymmetric air injection without a plenum attached. Non-axisymmetric air injection control of stall and surge is also studied. Three existing control algorithms found in literature are modeled and analyzed. A three-state model is obtained for each algorithm. For two cases, conditions for linear stability and bifurcation criticality on control of rotating stall are

  8. Is the copper T 380A device associated with an increased risk of removal due to bleeding and/or pain? An analysis.

    PubMed

    Chi, I C; Farr, G; Thompson, K; Acosta, M; Alvarado, G; Rivera, R; Bandaragoda, J; Delgado Betancourt, J

    1990-08-01

    Previous studies have consistently shown that the family of the Copper T 380 devices is more effective in preventing accidental pregnancies than the inert, as well as most other, if not all, copper devices. However, a number of these studies also reported a higher removal rate due to bleeding and/or pain for the TCu 380A than for other devices. The programmatical importance of these findings prompted us to analyze the international multi-center randomized clinical trial datasets to examine this question on the new TCu 380A (ParaGard) recently marketed in the U.S. Our results, while confirming the inherent superior efficacy of the TCu 380A, did not reveal a significantly higher removal rate because of bleeding and/or pain among TCu 380A users than among users of the comparative devices, which included the Lippes Loop D, the TCu 200, the TCu 220 and the Multiload Cu 250 devices. PMID:2085967

  9. 49 CFR 179.220-17 - Gauging devices, top loading and unloading devices, venting and air inlet devices.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Gauging devices, top loading and unloading devices, venting and air inlet devices. 179.220-17 Section 179.220-17 Transportation Other Regulations Relating to... DOT-111AW and 115AW) § 179.220-17 Gauging devices, top loading and unloading devices, venting and...

  10. 77 FR 41930 - Bleed Air Cleaning and Monitoring Equipment and Technology

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-17

    ... Privacy Act Statement can be found in the Federal Register published on April 11, 2000 (65 FR 19477-19478... industry developers, manufacturers, and the public related to effective air cleaning technology and...

  11. 49 CFR 179.200-16 - Gauging devices, top loading and unloading devices, venting and air inlet devices.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 3 2013-10-01 2013-10-01 false Gauging devices, top loading and unloading devices... and 115AW) § 179.200-16 Gauging devices, top loading and unloading devices, venting and air inlet...). In no case shall the wall thickness be less than that specified in § 179.201-1. (f) When top...

  12. 49 CFR 179.200-16 - Gauging devices, top loading and unloading devices, venting and air inlet devices.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 3 2012-10-01 2012-10-01 false Gauging devices, top loading and unloading devices... and 115AW) § 179.200-16 Gauging devices, top loading and unloading devices, venting and air inlet...). In no case shall the wall thickness be less than that specified in § 179.201-1. (f) When top...

  13. 49 CFR 179.200-16 - Gauging devices, top loading and unloading devices, venting and air inlet devices.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 3 2014-10-01 2014-10-01 false Gauging devices, top loading and unloading devices... and 115AW) § 179.200-16 Gauging devices, top loading and unloading devices, venting and air inlet...). In no case shall the wall thickness be less than that specified in § 179.201-1. (f) When top...

  14. 49 CFR 179.200-16 - Gauging devices, top loading and unloading devices, venting and air inlet devices.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 3 2011-10-01 2011-10-01 false Gauging devices, top loading and unloading devices... and 115AW) § 179.200-16 Gauging devices, top loading and unloading devices, venting and air inlet...). In no case shall the wall thickness be less than that specified in § 179.201-1. (f) When top...

  15. 49 CFR 179.200-16 - Gauging devices, top loading and unloading devices, venting and air inlet devices.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Gauging devices, top loading and unloading devices... DOT-111AW and 115AW) § 179.200-16 Gauging devices, top loading and unloading devices, venting and air...). In no case shall the wall thickness be less than that specified in § 179.201-1. (f) When top...

  16. Gastrointestinal bleeding

    MedlinePlus

    ... on a lab test such as the fecal occult blood test. Other signs of GI bleeding include: ... ray Volvulus - x-ray GI bleeding - series Fecal occult blood test References Jensen DM. GI hemorrhage and ...

  17. Bleeding gums

    MedlinePlus

    ... form of gum and jawbone disease known as periodontitis . Other causes of bleeding gums include: Any bleeding ... been diagnosed with a vitamin deficiency, take vitamin supplements. Avoid aspirin unless your health care provider has ...

  18. What is an effective portable air cleaning device? A review.

    PubMed

    Shaughnessy, R J; Sextro, R G

    2006-04-01

    The use of portable air cleaning devices in residential settings has been steadily growing over the last 10 years. Three out of every 10 households now contain a portable air cleaning device. This increased use of air cleaners is accompanied by, if not influenced by, a fundamental belief by consumers that the air cleaners are providing an improved indoor air environment. However, there is a wide variation in the performance of air cleaners that is dependent on the specific air cleaner design and various indoor factors. The most widely used method in the United States to assess the performance of new air cleaners is the procedure described in the American National Standards Institute (ANSI)/Association of Home Appliance Manufacturers (AHAM) AC-1-2002. This method describes both the test conditions and the testing protocol. The protocol yields a performance metric that is based on the measured decay rate of contaminant concentrations with the air cleaner operating compared with the measured decay rate with the air cleaner turned off. The resulting metric, the clean air delivery rate (CADR), permits both an intercomparison of performance among various air cleaners and a comparison of air cleaner operation to other contaminant removal processes. In this article, we comment on the testing process, discuss its applicability to various contaminants, and evaluate the resulting performance metrics for effective air cleaning. PMID:16531290

  19. A Conductivity Device for Measuring Sulfur Dioxide in the Air

    ERIC Educational Resources Information Center

    Craig, James C.

    1972-01-01

    Described is a general electroconductivity device enabling students to determine sulfur dioxide concentration in a particular location, hopefully leading to a deeper understanding of the problem of air pollution. (DF)

  20. [Hygienic relevance of devices for indoor air treatment].

    PubMed

    Wegner, J

    1982-01-01

    Shortcomings regarding design, construction, operation (including emissions), maintenance/repair and control of buildings with rooms for the accommodation of persons may be the reason to install air conditioning devices. According to manufacturers' data, such devices may be applied for various purposes, e.g. the creation of a defined air temperature or humidity, an increase of the supply of outdoor air, the cleaning and deodorization of indoor air or the alteration of the so-called electric climate of a room. The hygienic health evaluation of the different types of air conditioning devices should establish whether --there are aspects of health necessitating alterations of the microclimate of a room; --such alterations could be brought about in a more economic way by purely constructional or individual measures; --the function of individual apparatuses could be accomplished in a better way by replacing them by a larger device serving several rooms; --the operation of such devices may produce adverse health effects such as nuisance by noise, formation of undesirable gases (ozone), danger owing to non-adherence to electric safety rules; --there will be no damage to rooms and furniture, e.g. by water droplets. A look at a number of commercially available devices shows that they are generally dispensable. There are, however, special rare cases where the use of such devices may result in an improvement of the quality of indoor environments. PMID:7184170

  1. Fuel-air munition and device

    DOEpatents

    Carlson, Gary A.

    1976-01-01

    An aerially delivered fuel-air munition consisting of an impermeable tank filled with a pressurized liquid fuel and joined at its two opposite ends with a nose section and a tail assembly respectively to complete an aerodynamic shape. On impact the tank is explosively ruptured to permit dispersal of the fuel in the form of a fuel-air cloud which is detonated after a preselected time delay by means of high explosive initiators ejected from the tail assembly. The primary component in the fuel is methylacetylene, propadiene, or mixtures thereof to which is added a small mole fraction of a relatively high vapor pressure liquid diluent or a dissolved gas diluent having a low solubility in the primary component.

  2. A simple novel device for air sampling by electrokinetic capture

    DOE PAGESBeta

    Gordon, Julian; Gandhi, Prasanthi; Shekhawat, Gajendra; Frazier, Angel; Hampton-Marcell, Jarrad; Gilbert, Jack A.

    2015-12-27

    A variety of different sampling devices are currently available to acquire air samples for the study of the microbiome of the air. All have a degree of technical complexity that limits deployment. Here, we evaluate the use of a novel device, which has no technical complexity and is easily deployable. An air-cleaning device powered by electrokinetic propulsion has been adapted to provide a universal method for collecting samples of the aerobiome. Plasma-induced charge in aerosol particles causes propulsion to and capture on a counter-electrode. The flow of ions creates net bulk airflow, with no moving parts. A device and electrodemore » assembly have been re-designed from air-cleaning technology to provide an average air flow of 120 lpm. This compares favorably with current air sampling devices based on physical air pumping. Capture efficiency was determined by comparison with a 0.4 μm polycarbonate reference filter, using fluorescent latex particles in a controlled environment chamber. Performance was compared with the same reference filter method in field studies in three different environments. For 23 common fungal species by quantitative polymerase chain reaction (qPCR), there was 100 % sensitivity and apparent specificity of 87%, with the reference filter taken as “gold standard.” Further, bacterial analysis of 16S RNA by amplicon sequencing showed equivalent community structure captured by the electrokinetic device and the reference filter. Unlike other current air sampling methods, capture of particles is determined by charge and so is not controlled by particle mass. We analyzed particle sizes captured from air, without regard to specific analyte by atomic force microscopy: particles at least as low as 100 nM could be captured from ambient air. This work introduces a very simple plug-and-play device that can sample air at a high-volume flow rate with no moving parts and collect particles down to the sub-micron range. In conclusion, the performance of

  3. A simple novel device for air sampling by electrokinetic capture

    SciTech Connect

    Gordon, Julian; Gandhi, Prasanthi; Shekhawat, Gajendra; Frazier, Angel; Hampton-Marcell, Jarrad; Gilbert, Jack A.

    2015-12-27

    A variety of different sampling devices are currently available to acquire air samples for the study of the microbiome of the air. All have a degree of technical complexity that limits deployment. Here, we evaluate the use of a novel device, which has no technical complexity and is easily deployable. An air-cleaning device powered by electrokinetic propulsion has been adapted to provide a universal method for collecting samples of the aerobiome. Plasma-induced charge in aerosol particles causes propulsion to and capture on a counter-electrode. The flow of ions creates net bulk airflow, with no moving parts. A device and electrode assembly have been re-designed from air-cleaning technology to provide an average air flow of 120 lpm. This compares favorably with current air sampling devices based on physical air pumping. Capture efficiency was determined by comparison with a 0.4 μm polycarbonate reference filter, using fluorescent latex particles in a controlled environment chamber. Performance was compared with the same reference filter method in field studies in three different environments. For 23 common fungal species by quantitative polymerase chain reaction (qPCR), there was 100 % sensitivity and apparent specificity of 87%, with the reference filter taken as “gold standard.” Further, bacterial analysis of 16S RNA by amplicon sequencing showed equivalent community structure captured by the electrokinetic device and the reference filter. Unlike other current air sampling methods, capture of particles is determined by charge and so is not controlled by particle mass. We analyzed particle sizes captured from air, without regard to specific analyte by atomic force microscopy: particles at least as low as 100 nM could be captured from ambient air. This work introduces a very simple plug-and-play device that can sample air at a high-volume flow rate with no moving parts and collect particles down to the sub-micron range. In conclusion, the performance of the

  4. Gastrointestinal Bleeding

    MedlinePlus

    ... stool Dark blood mixed with stool Signs of bleeding in the lower digestive tract include Black or tarry stool Dark blood mixed with stool Stool mixed or coated with bright red blood GI bleeding is not a disease, but a symptom of ...

  5. [Gastrointestinal bleeding].

    PubMed

    Lanas, Ángel

    2015-09-01

    In the Digestive Disease Week in 2015 there have been some new contributions in the field of gastrointestinal bleeding that deserve to be highlighted. Treatment of celecoxib with a proton pump inhibitor is safer than treatment with nonselective NSAID and a proton pump inhibitor in high risk gastrointestinal and cardiovascular patients who mostly also take acetylsalicylic acid. Several studies confirm the need to restart the antiplatelet or anticoagulant therapy at an early stage after a gastrointestinal hemorrhage. The need for urgent endoscopy before 6-12 h after the onset of upper gastrointestinal bleeding episode may be beneficial in patients with hemodynamic instability and high risk for comorbidity. It is confirmed that in Western but not in Japanese populations, gastrointestinal bleeding episodes admitted to hospital during weekend days are associated with a worse prognosis associated with delays in the clinical management of the events. The strategy of a restrictive policy on blood transfusions during an upper GI bleeding event has been challenged. Several studies have shown the benefit of identifying the bleeding vessel in non varicose underlying gastric lesions by Doppler ultrasound which allows direct endoscopic therapy in the patient with upper GI bleeding. Finally, it has been reported that lower gastrointestinal bleeding diverticula band ligation or hemoclipping are both safe and have the same long-term outcomes. PMID:26520197

  6. Incidence and Risk Factor Analysis for Gastrointestinal Bleeding and Pump Thrombosis in Left Ventricular Assist Device Recipients.

    PubMed

    Lopilato, Alex C; Doligalski, Christina Teeter; Caldeira, Christiano

    2015-11-01

    Left ventricular assist devices (LVADs) are associated with hemostatic complications. We describe the incidence and risk factors for gastrointestinal bleeding (GIB) and pump thrombosis (PT) to optimize patient selection/management. An IRB-approved retrospective review of first LVAD implants between October 1, 2011 and September 30, 2013 at a single center was conducted. Endpoints included epidemiological and risk factor analyses for GIB and PT. Descriptive statistics, chi-squared, and t-tests were used. Sixty-four patients received continuous-flow LVADs. The 12-month incidence of GIB and PT was 23.4% and 12.5%. Time to first GIB was 72.6 days (9-160). The 1-, 3-, and 6-month rate of PT was 1.6%, 6.25%, and 12.5%, respectively. All PT required pump exchange. Females (50% vs. 16%, P = 0.026) and patients without antiplatelet therapy (12.5% vs. 50%, P = 0.046) were at increased risk of PT. No pre-implant comorbidities were associated with PT. Infection was not identified as a risk factor in our cohort (25% vs. 51.8%, P = 0.156). Mean INR preceding event was not different from nonevent patients (2.1 vs. 2.24, P = 0.24). Regarding biomarkers preceding event, elevated plasma free hemoglobin (pfHg) did not reach significance (75% vs. 58%, P = 0.383) while lactate dehydrogenase was elevated significantly (744 vs. 298, P < 0.001). Receiver operating characteristic (ROC) analysis demonstrated that an LDH of >500 was highly sensitive and specific for PT. No pre-implant factors were associated with GIB. Post-implant risk factors for GIB included infection (80% vs. 38.8%, P = 0.005) and infrequent elevations in pfHg (13.3% vs. 63.3%, P < 0.001). Increased pump speed as a GIB risk factor was confirmed (HeartMate II 9560 rpm vs. 9490 rpm, P < 0.001; HeartWare 2949 rpm vs. 2710 rpm, P < 0.001). Anticoagulation/antiplatelet therapy did not affect GIB: mean INR preceding event was not different from nonevent patients (2.21 vs. 2.27, P

  7. Bleeding Disorders

    MedlinePlus

    ... cause bleeding, such as endometriosis (EN-doh-MEE-tree-OH-suhss) Large bruises from a minor bump ... 8573 National Hemophilia Foundation Phone: 800-424-2634 World Federation of Hemophilia Phone: 514-875-7944 Return ...

  8. Bleeding time

    MedlinePlus

    A blood pressure cuff is inflated around your upper arm. While the cuff is on your arm, the health care provider makes two ... a tiny amount of bleeding. The blood pressure cuff is immediately deflated. Blotting paper is touched to ...

  9. Bleeding gums

    MedlinePlus

    ... line. This will lead to a condition called gingivitis , or inflamed gums. Plaque that is not removed ... Livingstone; 2009:chap 60. Read More Bleeding disorders Gingivitis Periodontitis Update Date 2/25/2014 Updated by: ...

  10. APPLICATION OF SEMIPERMEABLE MEMBRANE DEVICES TO INDOOR AIR SAMPLING

    EPA Science Inventory

    Semipermeable membrane devices (SPMDs) are a relatively new passive sampling technique for nonpolar organic compounds that have been extensively used for surface water sampling. A small body of literature indicates that SPMDs are also useful for air sampling. Because SPMDs ha...

  11. Portable microwave air plasma device for wound healing

    NASA Astrophysics Data System (ADS)

    Kang, S. K.; Kim, H. Y.; Yun, G. S.; Lee, J. K.

    2015-06-01

    A portable microwave air plasma has been developed for safe and effective wound healing. The device is operated by a fixed microwave power and two different air gas flows (main and cooling air flow). It was found that the speeds of the two air flows determine the stability of the plasma jet and gas temperature and thereby regulate the concentrations of the individual reactive species. Two different regimes, i.e. the NO abundant (0.1 slm main air flow) and ozone abundant regimes (4 slm main air flow), were identified as suitable for wound healing without thermal damage and toxicity. These regimes show similar plasma characteristics (e.g. less than 40 °C at the treatment point, less than 4 ppm of NO2) except for different NO and ozone amounts. Both regimes show more than twice as fast wound healing speed compared with the untreated case without any histological damages. Faster healing speed with intrinsic ozone safety make the NO abundant regime the best operation regime for wound healing. Finally, the stability of the developed device was demonstrated by a one-hour continuous operation test with a 24 V battery.

  12. Thermoelectric Air/Soil Energy-Harvesting Device

    NASA Technical Reports Server (NTRS)

    Snyder, Jeffrey; Fleurial, Jean-Pierre; Lawrence, Eric

    2005-01-01

    A proposed thermoelectric device would exploit natural temperature differences between air and soil to harvest small amounts of electric energy. Because the air/soil temperature difference fluctuates between nighttime and daytime, it is almost never zero, and so there is almost always some energy available for harvesting. Unlike photovoltaic cells, the proposed device could operate in the absence of sunlight. Unlike a Stirling engine, which could be designed to extract energy from the air/soil temperature difference, the proposed device would contain no moving parts. The main attractive feature of the proposed device would be high reliability. In a typical application, this device would be used for low-power charging of a battery that would, in turn, supply high power at brief, infrequent intervals for operating an instrumentation package containing sensors and communication circuits. The device (see figure) would include a heat exchanger buried in soil and connected to a heat pipe extending up to a short distance above the ground surface. A thermoelectric microgenerator (TEMG) would be mounted on top of the heat pipe. The TEMG could be of an advanced type, now under development, that could maintain high (relative to prior thermoelectric generators) power densities at small temperature differentials. A heat exchanger exposed to the air would be mounted on top of the TEMG. It would not matter whether the air was warmer than the soil or the soil warmer than the air: as long as there was a nonzero temperature difference, heat would flow through the device and electricity would be generated. A study of factors that could affect the design and operation of the device has been performed. These factors include the thermal conductances of the soil, the components of the device, the contacts between the components of the device, and the interfaces between the heat exchangers and their environments. The study included experiments that were performed on a model of the device

  13. Device for improved air and fuel distribution to a combustor

    DOEpatents

    Laster, Walter R.; Schilp, Reinhard

    2016-05-31

    A flow conditioning device (30, 50, 70, 100, 150) for a can annular gas turbine engine, including a plurality of flow elements (32, 34, 52, 54, 72, 74, 102) disposed in a compressed air flow path (42, 60, 80, 114, 122) leading to a combustor (12), configured such that relative adjustment of at least one flow directing element (32, 52, 72, 110) with respect to an adjacent flow directing element (34, 54, 74, 112, 120) during operation of the gas turbine engine is effective to adjust a level of choking of the compressed air flow path (42, 60, 80, 114, 122).

  14. Transmission of sound from air terminal devices through ceiling systems

    SciTech Connect

    Warnock, A.C.C.

    1998-10-01

    Sound from HVAC ducts or devices in ceiling plenums passes through the ceiling system to the room below and can cause annoyance to the occupants of the rooms. ARI Standard 885 provides a method to calculate the level of the sound in the room using the sound power of the device and some attenuation factors for the ceiling. The goal of ASHRAE research project RP-755 was to evaluate and extend the information given in ARI 885. This paper describes the attenuation factors found for six types of ceiling tiles and four air-terminal units. Attenuations at low frequencies were found to correlate with the area of the lower face of the device emitting sound. Sound fields in the room below were essentially uniform; no significant attenuation with distance was found.

  15. Optimization of HPM device parameters for maximum air transmission

    SciTech Connect

    Roussel-Dupre, R.; Tunnell, T.

    1993-02-01

    The propagation of high-power microwave (HPM) pulses through the atmosphere is a subject that has received renewed attention in the last decade. For sufficiently high-power pulses it is possible for air breakdown to be initiated by the front end of the pulse and for ohmic dissipation of the tail end to proceed as the tail propagates through the newly created plasma. Generally, this nonlinear process termed tail erosion is modeled with time-dependent fluid or kinetic codes that require a fine mesh of range and time points. The computational time to run these codes, however, precludes their use in determining theoptimum pulse characteristics and propagation paths for transmission of a desired fluence. In this paper a new frequency scaling law that greatly reduces computational requirements and at the same time incorporates the nonlinear effects inherent to HPM propagation is discussed. Results of a comparison between predictions of air breakdown thresholds made using the frequency scaling law and experimental data taken at various frequencies are presented. The scaling law is implemented in an existing HPM propagation code and has been used recently to develop a new predictive capability that calculates the optimum energy, power, and antenna requirements necessary to transmit a desired fluence. These capabilities provide both the accuracy and rapid computational turnaround necessary for system studies that assess the effects of HPM propagation for particular HPM devices and that attempt to open device parameters for maximum air transmission. Samples of both forward propagation, predictive calculations and inverse, optimization calculations are presented.

  16. Optimization of HPM device parameters for maximum air transmission

    SciTech Connect

    Roussel-Dupre, R. ); Tunnell, T. )

    1993-01-01

    The propagation of high-power microwave (HPM) pulses through the atmosphere is a subject that has received renewed attention in the last decade. For sufficiently high-power pulses it is possible for air breakdown to be initiated by the front end of the pulse and for ohmic dissipation of the tail end to proceed as the tail propagates through the newly created plasma. Generally, this nonlinear process termed tail erosion is modeled with time-dependent fluid or kinetic codes that require a fine mesh of range and time points. The computational time to run these codes, however, precludes their use in determining theoptimum pulse characteristics and propagation paths for transmission of a desired fluence. In this paper a new frequency scaling law that greatly reduces computational requirements and at the same time incorporates the nonlinear effects inherent to HPM propagation is discussed. Results of a comparison between predictions of air breakdown thresholds made using the frequency scaling law and experimental data taken at various frequencies are presented. The scaling law is implemented in an existing HPM propagation code and has been used recently to develop a new predictive capability that calculates the optimum energy, power, and antenna requirements necessary to transmit a desired fluence. These capabilities provide both the accuracy and rapid computational turnaround necessary for system studies that assess the effects of HPM propagation for particular HPM devices and that attempt to open device parameters for maximum air transmission. Samples of both forward propagation, predictive calculations and inverse, optimization calculations are presented.

  17. Bleeding during cancer treatment

    MedlinePlus

    ... by helping your blood clot. Chemotherapy , radiation , and bone marrow transplants can destroy some of your platelets. If you ... Names Cancer treatment - bleeding; Chemotherapy - bleeding; Radiation - bleeding; Bone marrow transplant - bleeding; Thrombocytopenia - cancer treatment References Doroshow JH. Approach ...

  18. 30 CFR 70.205 - Approved sampling devices; operation; air flowrate.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Approved sampling devices; operation; air... § 70.205 Approved sampling devices; operation; air flowrate. (a) Sampling devices approved in... Secretary of Health and Human Services for the particular device. (b) Except as provided in paragraph (d)...

  19. 30 CFR 70.205 - Approved sampling devices; operation; air flowrate.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Approved sampling devices; operation; air... § 70.205 Approved sampling devices; operation; air flowrate. (a) Sampling devices approved in... Secretary of Health and Human Services for the particular device. (b) Except as provided in paragraph (d)...

  20. 30 CFR 70.205 - Approved sampling devices; operation; air flowrate.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Approved sampling devices; operation; air... § 70.205 Approved sampling devices; operation; air flowrate. (a) Sampling devices approved in... Secretary of Health and Human Services for the particular device. (b) Except as provided in paragraph (d)...

  1. 30 CFR 70.205 - Approved sampling devices; operation; air flowrate.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Approved sampling devices; operation; air... § 70.205 Approved sampling devices; operation; air flowrate. (a) Sampling devices approved in... Secretary of Health and Human Services for the particular device. (b) Except as provided in paragraph (d)...

  2. 30 CFR 70.205 - Approved sampling devices; operation; air flowrate.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Approved sampling devices; operation; air... § 70.205 Approved sampling devices; operation; air flowrate. (a) Sampling devices approved in... Secretary of Health and Human Services for the particular device. (b) Except as provided in paragraph (d)...

  3. Efficiencies of free-air gas fumigation devices

    SciTech Connect

    Lipfert, F.W.; Hendrey, G.R.; Lewin, K.F.; Nagy, J.

    1992-03-01

    One of the key uncertainties relative to future increases in atmospheric CO{sub 2} is the extent to which growth in future emissions will be accommodated by increased uptake by terrestrial vegetation, the so-called ``fertilization`` effect. Research on this issue is currently pursued by many research groups around the world, using various experimental protocols and devices. These range from leaf cuvettes to various types of enclosures and glass-houses to various types of open-field gas enrichment or fumigation systems. As research priorities move from crops to forests and natural ecosystems, these experimental devices tend to become large and enrichment gas (i.e., CO{sub 2}) requirements and costs become a major factor in experimental design. This paper considers the relative efficiencies of gas usage for different types of systems currently in use. One of these is the Free Air CO{sub 2} Enrichment System (FACE) designed and developed at Brookhaven National Laboratory (BNL). In this paper, we develop some nondimensional groups of parameters for the purpose of characterizing performance, i.e., enrichment gas usage. These nondimensional groups are then used as figures of merit and basically allow the required flow rates of CO{sub 2} to be predicted based on the geometry of the device, wind speed, and the incremental gas concentration desired. The parameters chosen to comprise a useful nondimensional group must not only have the correct dimensions, they must also represent an appropriate physical relationship.

  4. Efficiencies of free-air gas fumigation devices

    SciTech Connect

    Lipfert, F.W.; Hendrey, G.R.; Lewin, K.F.; Nagy, J.

    1992-03-01

    One of the key uncertainties relative to future increases in atmospheric CO{sub 2} is the extent to which growth in future emissions will be accommodated by increased uptake by terrestrial vegetation, the so-called fertilization'' effect. Research on this issue is currently pursued by many research groups around the world, using various experimental protocols and devices. These range from leaf cuvettes to various types of enclosures and glass-houses to various types of open-field gas enrichment or fumigation systems. As research priorities move from crops to forests and natural ecosystems, these experimental devices tend to become large and enrichment gas (i.e., CO{sub 2}) requirements and costs become a major factor in experimental design. This paper considers the relative efficiencies of gas usage for different types of systems currently in use. One of these is the Free Air CO{sub 2} Enrichment System (FACE) designed and developed at Brookhaven National Laboratory (BNL). In this paper, we develop some nondimensional groups of parameters for the purpose of characterizing performance, i.e., enrichment gas usage. These nondimensional groups are then used as figures of merit and basically allow the required flow rates of CO{sub 2} to be predicted based on the geometry of the device, wind speed, and the incremental gas concentration desired. The parameters chosen to comprise a useful nondimensional group must not only have the correct dimensions, they must also represent an appropriate physical relationship.

  5. Development of acquired von Willebrand syndrome during short-term micro axial pump support: implications for bleeding in a patient bridged to a long-term continuous-flow left ventricular assist device.

    PubMed

    Davis, Mary E; Haglund, Nicholas A; Tricarico, Nicole M; Keebler, Mary E; Maltais, Simon

    2014-01-01

    Percutaneous continuous-flow (CF) micro axial blood pumps, like the Impella 5.0, are commonly used for short-term (ST) mechanical circulatory support in patients with acute decompensated heart failure. The Impella device often serves as a bridge to implantation of a long-term (LT) CF left ventricular assist device (CF-LVAD), such as the centrifugal-flow HeartWare (HVAD). All patients supported with axial CF-LVADs develop acquired von Willebrand syndrome (AVWS) as a result of mechanical shear stress. Increased shear stress leads to excessive proteolysis of von Willebrand factor and loss of high molecular weight multimers, thus contributing to platelet dysfunction and increased gastrointestinal bleeding. Bleeding events associated with AVWS have been reported in patients supported with LT CF-LVADs; however, the relation between early perioperative bleeding complications and AVWS remains poorly characterized in ST CF-LVADs. We sought to describe the relation between the development of AVWS and excessive intraoperative bleeding in a patient who was sequentially bridged with an ST micro axial device to a LT centrifugal CF-LVAD. This case highlights the importance of monitoring these hemostatic changes when bridging to LT CF-LVADs. PMID:24614358

  6. Design of an air ejector for boundary-layer bleed of an acoustically treated turbofan engine inlet during ground testing

    NASA Technical Reports Server (NTRS)

    Stakolich, E. G.

    1978-01-01

    An air ejector was designed and built to remove the boundary-layer air from the inlet a turbofan engine during an acoustic ground test program. This report describes; (1) how the ejector was sized; (2) how the ejector performed; and (3) the performance of a scale model ejector built and tested to verify the design. With proper acoustic insulation, the ejector was effective in reducing boundary layer thickness in the inlet of the turbofan engine while obtaining the desired acoustic test conditions.

  7. Failsafe device for air/fuel ratio feedback control system

    SciTech Connect

    Otsuka, K.; Hasegawa, S.; Narasaka, S.

    1983-11-15

    A fail safe device is disclosed, comprising means for detecting a failure in an air/fuel ratio feedback control system and generating a fault signal when such failure is detected, and means responsive to the fault signal to drive an actuator for driving an air/fuel ratio control valve and also responsive to a reference position signal supplied thereto during the above driving, which is generated when the actuator passes its reference position, to stop the actuator at the reference position. The actuator driving/stopping means may comprise means for repeatedly driving the actuator over a predetermined operating range inclusive of the reference position a plurality of times when it is not supplied with the reference position signal upon the actuator passing the reference position, and means for driving the actuator from its extreme operating position to a predetermined position and holding the same there when it is not supplied with the reference position signal even after a predetermined number of times of the above repeated driving of the actuator.

  8. 40 CFR 60.2141 - By what date must I conduct the initial air pollution control device inspection?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... air pollution control device inspection? 60.2141 Section 60.2141 Protection of Environment... initial air pollution control device inspection? (a) The initial air pollution control device inspection... startup. (b) Within 10 operating days following an air pollution control device inspection, all...

  9. 40 CFR 60.2141 - By what date must I conduct the initial air pollution control device inspection?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... air pollution control device inspection? 60.2141 Section 60.2141 Protection of Environment... initial air pollution control device inspection? (a) The initial air pollution control device inspection... startup. (b) Within 10 operating days following an air pollution control device inspection, all...

  10. Abnormal Uterine Bleeding

    MedlinePlus

    ... Abnormal uterine bleeding is any bleeding from the uterus (through your vagina) other than your normal monthly ... or fibroids (small and large growths) in the uterus can also cause bleeding. Rarely, a thyroid problem, ...

  11. Bleeders, bleeding rates, and bleeding score.

    PubMed

    Tosetto, A; Castaman, G; Rodeghiero, F

    2013-06-01

    Bleeding symptoms are frequently reported even in otherwise healthy subjects, and differentiating a normal subject from a patient with a mild bleeding disorder (MBD) can be extremely challenging. The concept of bleeding rate, that is, the number of bleeding episodes occurring within a definite time, could be used as the unifying framework reconciling the bleeding risk observed in congenital and acquired coagulopathies into a single picture. For instance, primary prevention trials have shown that the incidence of non-major bleeding symptoms in normal subjects is around five per 100 person-years, and this figure is in accordance with the number of hemorrhagic symptoms reported by normal controls in observational studies on hemorrhagic disorders. The incidence of non-major bleeding in patients with MBDs (e.g. in patients with type 1 VWD carrying the C1130F mutation) is also strikingly similar with that of patients taking antiplatelet drugs, and the incidence in moderately severe bleeding disorders (e.g. type 2 VWD) parallels that of patients taking vitamin K antagonists. The severity of a bleeding disorder may therefore be explained by a bleeding rate model, which also explains several common clinical observations. Appreciation of the bleeding rate of congenital and acquired conditions and of its environmental/genetic modifiers into a single framework will possibly allow the development of better prediction tools in the coming years and represents a major scientific effort to be pursued. PMID:23809118

  12. EPA evaluation of the 'Pass Master Vehicle Air Conditioner Cut-Off' Device. Technical report

    SciTech Connect

    Penninga, T.J.

    1980-08-01

    The conclusions of the EPA evaluation of the 'Pass Master Vehicle Air Conditioner Compressor Cut-Off Device' under the provisions of Section 511 of the Motor Vehicle Information and Cost Savings Act are announced. The Pass Master device disengages the air conditioning compressor during hard vehicle acceleration modes. The reduced engine loading will result in some fuel savings.

  13. 30 CFR 71.205 - Approved sampling devices; operation; air flowrate.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Approved sampling devices; operation; air... OF UNDERGROUND COAL MINES Sampling Procedures § 71.205 Approved sampling devices; operation; air... flowrate as prescribed by the Secretary and the Secretary of Health and Human Services for the...

  14. 30 CFR 90.205 - Approved sampling devices; operation; air flowrate.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Approved sampling devices; operation; air... DEVELOPMENT OF PNEUMOCONIOSIS Sampling Procedures § 90.205 Approved sampling devices; operation; air flowrate... flowrate as prescribed by the Secretary and the Secretary of Health and Human Services for the...

  15. 30 CFR 90.205 - Approved sampling devices; operation; air flowrate.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Approved sampling devices; operation; air... DEVELOPMENT OF PNEUMOCONIOSIS Sampling Procedures § 90.205 Approved sampling devices; operation; air flowrate... flowrate as prescribed by the Secretary and the Secretary of Health and Human Services for the...

  16. 30 CFR 71.205 - Approved sampling devices; operation; air flowrate.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Approved sampling devices; operation; air... OF UNDERGROUND COAL MINES Sampling Procedures § 71.205 Approved sampling devices; operation; air... flowrate as prescribed by the Secretary and the Secretary of Health and Human Services for the...

  17. 30 CFR 90.205 - Approved sampling devices; operation; air flowrate.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Approved sampling devices; operation; air... DEVELOPMENT OF PNEUMOCONIOSIS Sampling Procedures § 90.205 Approved sampling devices; operation; air flowrate... flowrate as prescribed by the Secretary and the Secretary of Health and Human Services for the...

  18. 30 CFR 71.205 - Approved sampling devices; operation; air flowrate.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Approved sampling devices; operation; air... OF UNDERGROUND COAL MINES Sampling Procedures § 71.205 Approved sampling devices; operation; air... flowrate as prescribed by the Secretary and the Secretary of Health and Human Services for the...

  19. 30 CFR 71.205 - Approved sampling devices; operation; air flowrate.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Approved sampling devices; operation; air... OF UNDERGROUND COAL MINES Sampling Procedures § 71.205 Approved sampling devices; operation; air... flowrate as prescribed by the Secretary and the Secretary of Health and Human Services for the...

  20. 30 CFR 71.205 - Approved sampling devices; operation; air flowrate.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Approved sampling devices; operation; air... OF UNDERGROUND COAL MINES Sampling Procedures § 71.205 Approved sampling devices; operation; air... flowrate as prescribed by the Secretary and the Secretary of Health and Human Services for the...

  1. 30 CFR 90.205 - Approved sampling devices; operation; air flowrate.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Approved sampling devices; operation; air... DEVELOPMENT OF PNEUMOCONIOSIS Sampling Procedures § 90.205 Approved sampling devices; operation; air flowrate... flowrate as prescribed by the Secretary and the Secretary of Health and Human Services for the...

  2. The effects of compressor seventh-stage bleed air extraction on performance of the F100-PW-220 afterburning turbofan engine

    NASA Technical Reports Server (NTRS)

    Evans, Alison B.

    1991-01-01

    A study was conducted to determine the effects of seventh-stage compressor bleed on the performance of the F100 afterburning turbofan engine. The effects of bleed on thrust, specific fuel consumption, fan turbine inlet temperature, bleed total pressure, and bleed total temperature were obtained from the engine manufacturer's status deck computer simulation. These effects were determined for power settings of intermediate, partial afterburning, and maximum afterburning for Mach numbers between 0.6 and 2.2 and for altitudes of 30,000, 40,000, and 50,000 ft. It was found that thrust loss and specific fuel consumption increase were approximately linear functions of bleed flow and, based on a percent-thrust change basis, were approximately independent of power setting.

  3. Contribution of a portable air plasma torch to rapid blood coagulation as a method of preventing bleeding

    NASA Astrophysics Data System (ADS)

    Kuo, S. P.; Tarasenko, O.; Chang, J.; Popovic, S.; Chen, C. Y.; Fan, H. W.; Scott, A.; Lahiani, M.; Alusta, P.; Drake, J. D.; Nikolic, M.

    2009-11-01

    The effectiveness and mechanism of a low temperature air plasma torch in clotting blood are explored. Both blood droplets and smeared blood samples were used in the tests. The treated droplet samples reveal how blood clotting depends on the distance at which the torch operated, and for how long the droplets have been exposed to the torch. Microscopy and cell count of smeared blood samples shed light on dependencies of erythrocyte and platelet counts on torch distance and exposure time. With an increase of torch distance, the platelet count of treated blood samples increases but is less than that of the control. The flux of reactive atomic oxygen (RAO) and the degree of blood clotting decreased. With an increase of exposure time, platelet count of treated samples decreased, while the degree of clot increased. The correlation among these dependencies and published data support a blood clotting mechanism that RAO as well as other likely reactive oxygen species generated by the plasma torch activate erythrocyte-platelets interactions and induces blood coagulation.

  4. 40 CFR 60.2151 - By what date must I conduct the annual air pollution control device inspection?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... air pollution control device inspection? 60.2151 Section 60.2151 Protection of Environment... annual air pollution control device inspection? On an annual basis (no more than 12 months following the previous annual air pollution control device inspection), you must complete the air pollution...

  5. 40 CFR 60.2151 - By what date must I conduct the annual air pollution control device inspection?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... air pollution control device inspection? 60.2151 Section 60.2151 Protection of Environment... annual air pollution control device inspection? On an annual basis (no more than 12 months following the previous annual air pollution control device inspection), you must complete the air pollution...

  6. Rapid on-site air sampling with a needle extraction device for evaluating the indoor air environment in school facilities.

    PubMed

    Inoue, Mitsuru; Mizuguchi, Ayako; Ueta, Ikuo; Takahashi, Kazuya; Saito, Yoshihiro

    2013-01-01

    A rapid on-site air sampling technique was developed with a miniaturized needle-type sample preparation device for a systematic evaluation of the indoor air environments in school facilities. With the in-needle extraction device packed with a polymer particle of divinylbenzene and activated carbon particles, various types of volatile organic compounds (VOCs) were successfully extracted. For evaluating the indoor air qualities in school facilities, air samples in renovated rooms using organic solvent as a thinner of the paint were analyzed along with measurements of several VOCs in indoor air samples taken in newly built primary schools mainly using low-VOCs materials. After periodical renovation/maintenance, the time-variation profile of typical VOCs found in the school facilities has also been monitored. From the results, it could be observed that the VOCs in most of the rooms in these primary schools were at a quite low level; however, a relatively higher concentration of VOCs was found in some specially designed rooms, such as music rooms. In addition, some non-regulated compounds, including benzyl alcohol and branched alkanes, were detected in these primary schools. The results showed a good applicability of the needle device to indoor air analysis in schools, suggesting a wide range of future employment of the needle device, especially for indoor air analysis in other types of facilities and rooms including hospitals and hotels. PMID:23665624

  7. Bleed Hole Flow Phenomena Studied

    NASA Technical Reports Server (NTRS)

    1997-01-01

    Boundary-layer bleed is an invaluable tool for controlling the airflow in supersonic aircraft engine inlets. Incoming air is decelerated to subsonic speeds prior to entering the compressor via a series of oblique shocks. The low momentum flow in the boundary layer interacts with these shocks, growing in thickness and, under some conditions, leading to flow separation. To remedy this, bleed holes are strategically located to remove mass from the boundary layer, reducing its thickness and helping to maintain uniform flow to the compressor. The bleed requirements for any inlet design are unique and must be validated by extensive wind tunnel testing to optimize performance and efficiency. To accelerate this process and reduce cost, researchers at the NASA Lewis Research Center initiated an experimental program to study the flow phenomena associated with bleed holes. Knowledge of these flow properties will be incorporated into computational fluid dynamics (CFD) models that will aid engine inlet designers in optimizing bleed configurations before any hardware is fabricated. This ongoing investigation is currently examining two hole geometries, 90 and 20 (both with 5-mm diameters), and various flow features.

  8. Vaginal bleeding between periods

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/003156.htm Vaginal bleeding between periods To use the sharing features ... this page, please enable JavaScript. This article discusses vaginal bleeding that occurs between a woman's monthly menstrual ...

  9. 40 CFR 60.2141 - By what date must I conduct the initial air pollution control device inspection?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... air pollution control device inspection? 60.2141 Section 60.2141 Protection of Environment... Compliance Requirements § 60.2141 By what date must I conduct the initial air pollution control device inspection? (a) The initial air pollution control device inspection must be conducted within 60 days...

  10. 40 CFR 60.2706 - By what date must I conduct the initial air pollution control device inspection?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... air pollution control device inspection? 60.2706 Section 60.2706 Protection of Environment... Requirements § 60.2706 By what date must I conduct the initial air pollution control device inspection? (a) The initial air pollution control device inspection must be conducted within 60 days after installation of...

  11. 40 CFR 62.14441 - When must I inspect my HMIWI equipment and air pollution control devices?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... and air pollution control devices? 62.14441 Section 62.14441 Protection of Environment ENVIRONMENTAL... my HMIWI equipment and air pollution control devices? (a) You must inspect your large, medium, small... inspect the air pollution control devices on your large, medium, small or small rural HMIWI by May...

  12. 40 CFR 60.2706 - By what date must I conduct the initial air pollution control device inspection?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... air pollution control device inspection? 60.2706 Section 60.2706 Protection of Environment... pollution control device inspection? (a) The initial air pollution control device inspection must be... meeting the amended emission limitations. (b) Within 10 operating days following an air pollution...

  13. 40 CFR 60.2141 - By what date must I conduct the initial air pollution control device inspection?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... air pollution control device inspection? 60.2141 Section 60.2141 Protection of Environment... Compliance Requirements § 60.2141 By what date must I conduct the initial air pollution control device inspection? (a) The initial air pollution control device inspection must be conducted within 60 days...

  14. 40 CFR 60.2706 - By what date must I conduct the initial air pollution control device inspection?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... air pollution control device inspection? 60.2706 Section 60.2706 Protection of Environment... pollution control device inspection? (a) The initial air pollution control device inspection must be... meeting the amended emission limitations. (b) Within 10 operating days following an air pollution...

  15. 40 CFR 60.2706 - By what date must I conduct the initial air pollution control device inspection?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... air pollution control device inspection? 60.2706 Section 60.2706 Protection of Environment... pollution control device inspection? (a) The initial air pollution control device inspection must be... meeting the amended emission limitations. (b) Within 10 operating days following an air pollution...

  16. Face-Saving Devices: Seat Belts and Air Bags

    MedlinePlus

    ... treatment at a trauma center after a motor vehicle collision. More than 56,000 (nearly 11 percent) ... t use or have safety devices in their vehicles. Of those who suffered facial fractures, almost three ...

  17. A SURVEY OF INDOOR AIR CONTAMINATES USING SEMIPERMEABLE MEMBRANE DEVICES

    EPA Science Inventory

    Semipermeable membrane devices (SPMDs) were deployed in indoor areas in approximately 50 residences along the border between Arizona and Mexico to measure airborne contaminants. The results of the primary analyses and gas chromatographic/mass spectrometric confirmation for org...

  18. Medical devices; ear, nose, and throat devices; classification of the transcutaneous air conduction hearing aid system. Final rule.

    PubMed

    2002-11-01

    The Food and Drug Administration (FDA) is classifying the transcutaneous air conduction hearing aid system (TACHAS) into class II (special controls). Elsewhere in this issue of the Federal Register, FDA is announcing the availability of a guidance document that will serve as the special control for the device. The agency is taking this action in response to a petition submitted under the Federal Food, Drug, and Cosmetic Act (the act) as amended by the Medical Device Amendments of 1976 (the amendments), the Safe Medical Devices Act of 1990, and the Food and Drug Administration Modernization Act of 1997 (FDAMA). The agency is classifying this device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device. PMID:12422884

  19. NEW APPLICATION OF PASSIVE SAMPLING DEVICES FOR ASSESSMENT OF RESPIRATORY EXPOSURE TO PESTICIDES IN INDOOR AIR

    EPA Science Inventory

    The United States Environmental Protection Agency (EPA) has long maintained an interest in potential applications of passive sampling devices (PSDs) for estimating the concentrations of various pollutants in air. Typically PSDs were designed for the workplace monitoring of vola...

  20. Hollow Fiber Membrane Dehumidification Device for Air Conditioning System.

    PubMed

    Zhao, Baiwang; Peng, Na; Liang, Canzeng; Yong, Wai Fen; Chung, Tai-Shung

    2015-01-01

    In order to provide a comfortable living and working environment indoors in tropical countries, the outdoor air often needs to be cooled and dehumidified before it enters the rooms. Membrane separation is an emerging technology for air dehumidification and it is based on the solution diffusion mechanism. Water molecules are preferentially permeating through the membranes due to its smaller kinetic diameter and higher condensability than the other gases. Compared to other dehumidification technologies such as direct cooling or desiccation, there is no phase transition involved in membrane dehumidification, neither the contact between the fresh air stream and the desiccants. Hence, membrane dehumidification would not only require less energy consumption but also avoid cross-contamination problems. A pilot scale air dehumidification system is built in this study which comprises nine pieces of one-inch PAN/PDMS hollow fiber membrane modules. A 150 h long-term test shows that the membrane modules has good water vapor transport properties by using a low vacuum force of only 0.78 bar absolute pressure at the lumen side. The water vapor concentration of the feed humid air decreases dramatically from a range of 18-22 g/m³ to a range of 13.5-18.3 g/m³. Most importantly, the total energy saving is up to 26.2% compared with the conventional air conditioning process. PMID:26580660

  1. Hollow Fiber Membrane Dehumidification Device for Air Conditioning System

    PubMed Central

    Zhao, Baiwang; Peng, Na; Liang, Canzeng; Yong, Wai Fen; Chung, Tai-Shung

    2015-01-01

    In order to provide a comfortable living and working environment indoors in tropical countries, the outdoor air often needs to be cooled and dehumidified before it enters the rooms. Membrane separation is an emerging technology for air dehumidification and it is based on the solution diffusion mechanism. Water molecules are preferentially permeating through the membranes due to its smaller kinetic diameter and higher condensability than the other gases. Compared to other dehumidification technologies such as direct cooling or desiccation, there is no phase transition involved in membrane dehumidification, neither the contact between the fresh air stream and the desiccants. Hence, membrane dehumidification would not only require less energy consumption but also avoid cross-contamination problems. A pilot scale air dehumidification system is built in this study which comprises nine pieces of one-inch PAN/PDMS hollow fiber membrane modules. A 150 h long-term test shows that the membrane modules has good water vapor transport properties by using a low vacuum force of only 0.78 bar absolute pressure at the lumen side. The water vapor concentration of the feed humid air decreases dramatically from a range of 18–22 g/m3 to a range of 13.5–18.3 g/m3. Most importantly, the total energy saving is up to 26.2% compared with the conventional air conditioning process. PMID:26580660

  2. 40 CFR 60.2716 - By what date must I conduct the annual air pollution control device inspection?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... air pollution control device inspection? 60.2716 Section 60.2716 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY... annual air pollution control device inspection), you must complete the air pollution control...

  3. 40 CFR 60.2716 - By what date must I conduct the annual air pollution control device inspection?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... air pollution control device inspection? 60.2716 Section 60.2716 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY... annual air pollution control device inspection), you must complete the air pollution control...

  4. 40 CFR 60.2716 - By what date must I conduct the annual air pollution control device inspection?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... air pollution control device inspection? 60.2716 Section 60.2716 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) STANDARDS OF PERFORMANCE FOR NEW STATIONARY... annual air pollution control device inspection), you must complete the air pollution control...

  5. Development of an ultrasonic airflow measurement device for ducted air.

    PubMed

    Raine, Andrew B; Aslam, Nauman; Underwood, Christopher P; Danaher, Sean

    2015-01-01

    In this study, an in-duct ultrasonic airflow measurement device has been designed, developed and tested. The airflow measurement results for a small range of airflow velocities and temperatures show that the accuracy was better than 3.5% root mean square (RMS) when it was tested within a round or square duct compared to the in-line Venturi tube airflow meter used for reference. This proof of concept device has provided evidence that with further development it could be a low-cost alternative to pressure differential devices such as the orifice plate airflow meter for monitoring energy efficiency performance and reliability of ventilation systems. The design uses a number of techniques and design choices to provide solutions to lower the implementation cost of the device compared to traditional airflow meters. The design choices that were found to work well are the single sided transducer arrangement for a "V" shaped reflective path and the use of square wave transmitter pulses ending with the necessary 180° phase changed pulse train to suppress transducer ringing. The device is also designed so that it does not have to rely on high-speed analogue to digital converters (ADC) and intensive digital signal processing, so could be implemented using voltage comparators and low-cost microcontrollers. PMID:25954952

  6. Development of an Ultrasonic Airflow Measurement Device for Ducted Air

    PubMed Central

    Raine, Andrew B.; Aslam, Nauman; Underwood, Christopher P.; Danaher, Sean

    2015-01-01

    In this study, an in-duct ultrasonic airflow measurement device has been designed, developed and tested. The airflow measurement results for a small range of airflow velocities and temperatures show that the accuracy was better than 3.5% root mean square (RMS) when it was tested within a round or square duct compared to the in-line Venturi tube airflow meter used for reference. This proof of concept device has provided evidence that with further development it could be a low-cost alternative to pressure differential devices such as the orifice plate airflow meter for monitoring energy efficiency performance and reliability of ventilation systems. The design uses a number of techniques and design choices to provide solutions to lower the implementation cost of the device compared to traditional airflow meters. The design choices that were found to work well are the single sided transducer arrangement for a “V” shaped reflective path and the use of square wave transmitter pulses ending with the necessary 180° phase changed pulse train to suppress transducer ringing. The device is also designed so that it does not have to rely on high-speed analogue to digital converters (ADC) and intensive digital signal processing, so could be implemented using voltage comparators and low-cost microcontrollers. PMID:25954952

  7. Trial of a negative ion generator device in remediating problems related to indoor air quality

    SciTech Connect

    Daniell, W.; Camp, J.; Horstman, S. )

    1991-06-01

    It has been suggested that supplementation of indoor air with negative ions can improve air quality. This study examined the effects of a negative ion-generator device on air contaminants and symptom reporting in two office buildings. Separate sets of functional and nonfunctional negative ion generators were monitored using a double blind, crossover design involving two 5-week exposure periods. There were no detectable direct or residual effects of negative ion generator use on air ion levels, airborn particulates, carbon dioxide levels, or symptom reporting. Symptom reporting declined at both sites initially and appeared to be consistent with placebo effect. Job dissatisfaction was an apparent contributor to symptom reporting, with a magnitude comparable to presumed effects of air quality. Further testing of such devices is needed before they should be considered for office air quality problems.

  8. The fate of mercury collected from air pollution control devices

    EPA Science Inventory

    The mercury that enters a coal-fired power plant, originates from the coal that is burned, and leaves through the output streams that include stack emissions and air pollution control (APC) residues (either in solid or liquid form). This article describes recent fmdings on the fa...

  9. Training augmentation device for the Air Force satellite Control Network

    NASA Technical Reports Server (NTRS)

    Shoates, Keith B.

    1993-01-01

    From the 1960's and into the early 1980's satellite operations and control were conducted by Air Force Systems Command (AFSC), now Air Force Materiel Command (AFMC), out of the Satellite Control Facility at Onizuka AFB, CA. AFSC was responsible for acquiring satellite command and control systems and conducting routine satellite operations. The daily operations, consisting of satellite health and status contacts and station keeping activities, were performed for AFSC by a Mission Control Team (MCT) staffed by civilian contractors who were responsible for providing their own technically 'qualified' personnel as satellite operators. An MCT consists of five positions: mission planner, ground controller, planner analyst, orbit analyst, and ranger controller. Most of the training consisted of On-the-Job-Training (OJT) with junior personnel apprenticed to senior personnel until they could demonstrate job proficiency. With most of the satellite operators having 15 to 25 years of experience, there was minimal risk to the mission. In the mid 1980's Air Force Space Command (AFSPACOM) assumed operational responsibility for a newly established control node at Falcon AFB (FAFB) in CO. The satellites and ground system program offices (SPO's) are organized under AFSC's Space and Missiles Systems Center (SMC) to function as a systems engineering and acquisition agency for AFSPACECOM. The collection of the satellite control nodes, ground tracking stations, computer processing equipment, and connecting communications links is referred to as the Air Force Satellite Control Network (AFSCN).

  10. CONTROL OF AIR EMISSIONS FROM HAZARDOUS WASTE COMBUSTION SOURCES: FIELD EVALUATIONS OF PILOT-SCALE AIR POLLUTION CONTROL DEVICES

    EPA Science Inventory

    Pilot scale air pollution control devices supplied by Hydro-Sonic Systems, ETS, Inc., and Vulcan Engineering Company were installed at the ENSCO, Inc. Incinerator in El Dorado, Arkansas, in the spring of 1984. Each of these units treated an uncontrolled slipstream of the incinera...

  11. The Use of Vascular Closure Devices and Impact on Major Bleeding and Net Adverse Clinical Events (NACE) in Balloon Aortic Valvuloplasty: A Sub-Analysis of the BRAVO study

    PubMed Central

    O’Neill, Brian; Singh, Vikas; Kini, Annapoorna; Mehran, Roxana; Jacobs, Evan; Knopf, David; Alfonso, Carlos E.; Martinez, Claudia A.; Martinezclark, Pedro; O’Neill, William; Heldman, Alan W.; Yu, Jennifer; Baber, Usman; Kovacic, Jason; Dangas, George; Sharma, Samin; Sartori, Samantha; Cohen, Mauricio G.

    2013-01-01

    Objective To determine the impact of suture-mediated vascular closure devices on net adverse clinical events (NACE) after balloon aortic valvuloplasty (BAV). Background Ischemic and bleeding complications are common following transfemoral BAV however; previous studies have been single center and limited by varying definitions of major bleeding. Methods The Effect of Bivalirudin on Aortic Valve Intervention Outcomes (BRAVO) study was a retrospective observational study conducted at two high-volume academic centers over a 6-year period designed to compare the effect of bivalirudin versus unfractionated heparin. This is a sub-analysis of 428 consecutive patients who underwent BAV (with 10-13 French sheaths) to compare the effect of hemostasis with vascular closure devices versus manual compression utilizing standardized definitions. NACE was defined as the composite of major bleeding and major adverse clinical events (MACE). All events were adjudicated by an independent clinical events committee who were blinded to antithrombin use. Results Pre-closure was performed in 269 (62.8%) of patients. While bivalirudin was used more frequently in those with pre-closure (60.6% vs. 37.7%, p<0.001), a history of prior BAV (11.1% vs. 3.6%, p=0.04) and peripheral vascular disease (30.7% vs. 19.7%, p=0.01) was more common in those not undergoing pre-closure (n=159, 37%). Other clinical and demographic features were well balanced between groups. Vascular closure was associated with a significant reduction in NACE (24.5% vs 10.0% p<0.001). Results remained significant after adjusting for baseline differences and bivalirudin use (OR 0.38, 95% CI: 0.21 - 0.68; p=0.001). Conclusions Our study suggests that suture-mediated vascular closure is associated with a substantial reduction in NACE after transfemoral BAV. Large randomized clinical trials should be conducted to confirm our results. PMID:23436434

  12. [Acute gastrointestinal bleeding].

    PubMed

    Baumbach, Robert; Faiss, Siegbert; Cordruwisch, Wolfgang; Schrader, Carsten

    2016-04-01

    Acute gastrointestinal bleeding is a common major emergency (Internal medical or gastroenterological or medical), approximately 85 % of which occur in the upper GI tract. It is estimated that about a half of upper GI bleeds are caused by peptic ulcers. Upper GI bleeds are associated with more severe bleeding and poorer outcomes when compared to middle or lower GI bleeds. Prognostic determinants include bleeding intensity, patient age, comorbid conditions and the concomitant use of anticoagulants. A focused medical history can offer insight into the bleeding intensity, location and potential cause (along with early risk stratification). Initial measures should focus on rapid assessment and resuscitation of unstable patients. The oesophagogastroduodenoscopy (OGD) is the gold standard method for localizing the source of bleeding and for interventional therapy. Bleeding as a result of peptic ulcers is treated endoscopically with mechanical and / or thermal techniques in combination with proton pump inhibitor (PPI) therapy. When variceal bleeding is suspected, pre-interventional use of vasopressin analogues and antibiotic therapies are recommended. Endoscopically, the first line treatment of esophageal varices is endoscopic ligature therapy, whereas that for gastric varices is the use of Histoacryl injection sclerotherapy. When persistent and continued massive hemorrhage occurs in a patient with known or suspected aortic disease the possibility of an aorto-enteric fistula must be considered. PMID:27078246

  13. Gas turbine engine with recirculating bleed

    NASA Technical Reports Server (NTRS)

    Adamson, A. P. (Inventor)

    1978-01-01

    Carbon monoxide and unburned hydrocarbon emissions in a gas turbine engine are reduced by bleeding hot air from the engine cycle and introducing it back into the engine upstream of the bleed location and upstream of the combustor inlet. As this hot inlet air is recycled, the combustor inlet temperature rises rapidly at a constant engine thrust level. In most combustors, this will reduce carbon monoxide and unburned hydrocarbon emissions significantly. The preferred locations for hot air extraction are at the compressor discharge or from within the turbine, whereas the preferred reentry location is at the compressor inlet.

  14. Fate of mercury collected from air pollution control devices

    SciTech Connect

    Constance L. Senior; Susan Thorneloe; Bernine Khan; David Goss

    2009-07-15

    Mercury that enters a coal-fired power plant originates from the coal that is burned and leaves through the output streams, which include stack emissions and air pollution control (APC) residues (either in solid or liquid form). This article describes recent findings on the fate and environmental stability of mercury in coal combustion residues (CCRs) such as fly ash and solid products from flue gas desulfurization (FGD) scrubbers when either disposed or reused in agricultural, commercial, or engineering applications. 19 refs., 4 figs., 5 tabs.

  15. Severe gastrointestinal bleeding.

    PubMed

    Isaacs, K L

    1994-02-01

    Severe gastrointestinal bleeding is a common cause of admission of the elderly to intensive care units. Differentiation between upper and lower gastrointestinal bleeding is made on the basis of history, physical examination, and diagnostic tests. Therapy is based in part on the severity of the bleeding episode and on the cause of the hemorrhage. Therapeutic intervention may involve medical therapy, endoscopic therapy, angiographic therapy, and surgery. Patient outcome is often related to other underlying disease states. PMID:8168017

  16. A portable air jet actuator device for mechanical system identification

    NASA Astrophysics Data System (ADS)

    Belden, Jesse; Staats, Wayne L.; Mazumdar, Anirban; Hunter, Ian W.

    2011-03-01

    System identification of limb mechanics can help diagnose ailments and can aid in the optimization of robotic limb control parameters and designs. An interesting fluid phenomenon—the Coandă effect—is utilized in a portable actuator to provide a stochastic binary force disturbance to a limb system. The design of the actuator is approached with the goal of creating a portable device which could be deployed on human or robotic limbs for in situ mechanical system identification. The viability of the device is demonstrated by identifying the parameters of an underdamped elastic beam system with fixed inertia and stiffness and variable damping. The nonparametric compliance impulse response yielded from the system identification is modeled as a second-order system and the resultant parameters are found to be in excellent agreement with those found using more traditional system identification techniques. The current design could be further miniaturized and developed as a portable, wireless, unrestrained mechanical system identification instrument for less intrusive and more widespread use.

  17. A portable air jet actuator device for mechanical system identification.

    PubMed

    Belden, Jesse; Staats, Wayne L; Mazumdar, Anirban; Hunter, Ian W

    2011-03-01

    System identification of limb mechanics can help diagnose ailments and can aid in the optimization of robotic limb control parameters and designs. An interesting fluid phenomenon--the Coandă effect--is utilized in a portable actuator to provide a stochastic binary force disturbance to a limb system. The design of the actuator is approached with the goal of creating a portable device which could be deployed on human or robotic limbs for in situ mechanical system identification. The viability of the device is demonstrated by identifying the parameters of an underdamped elastic beam system with fixed inertia and stiffness and variable damping. The nonparametric compliance impulse response yielded from the system identification is modeled as a second-order system and the resultant parameters are found to be in excellent agreement with those found using more traditional system identification techniques. The current design could be further miniaturized and developed as a portable, wireless, unrestrained mechanical system identification instrument for less intrusive and more widespread use. PMID:21456788

  18. Bleeding and cupping.

    PubMed Central

    Turk, J. L.; Allen, E.

    1983-01-01

    Bleeding and cupping have been used in medicine since ancient times in the treatment of fevers and local inflammatory disorders. Local bleeding, by 'wet cupping', was effected by a scarificator or by leeches. John Hunter recommended venesection in moderation but preferred leeches for local bleeding. Bleeding as an accepted therapeutic practice went out of vogue in the middle of the nineteenth century as a result of the introduction of modern scientific methods. Dry cupping and the use of leeches, as counter irritants, persisted until the middle of this century. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 PMID:6338802

  19. 40 CFR 60.5215 - By what date must I conduct annual air pollution control device inspections and make any...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... air pollution control device inspections and make any necessary repairs? (a) You must conduct an annual inspection of each air pollution control device used to comply with the emission limits, according to § 60.5220(c), no later than 12 months following the previous annual air pollution control...

  20. 40 CFR 60.5215 - By what date must I conduct annual air pollution control device inspections and make any...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... air pollution control device inspections and make any necessary repairs? (a) You must conduct an annual inspection of each air pollution control device used to comply with the emission limits, according to § 60.5220(c), no later than 12 months following the previous annual air pollution control...

  1. 40 CFR 60.2151 - By what date must I conduct the annual air pollution control device inspection?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... air pollution control device inspection? 60.2151 Section 60.2151 Protection of Environment... Compliance Requirements § 60.2151 By what date must I conduct the annual air pollution control device inspection? On an annual basis (no more than 12 months following the previous annual air pollution...

  2. 40 CFR 60.2151 - By what date must I conduct the annual air pollution control device inspection?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... air pollution control device inspection? 60.2151 Section 60.2151 Protection of Environment... Compliance Requirements § 60.2151 By what date must I conduct the annual air pollution control device inspection? On an annual basis (no more than 12 months following the previous annual air pollution...

  3. 40 CFR 424.10 - Applicability; description of the open electric furnaces with wet air pollution control devices...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... electric furnaces with wet air pollution control devices subcategory. 424.10 Section 424.10 Protection of... MANUFACTURING POINT SOURCE CATEGORY Open Electric Furnaces With Wet Air Pollution Control Devices Subcategory § 424.10 Applicability; description of the open electric furnaces with wet air pollution control...

  4. 40 CFR 60.4895 - By what date must I conduct annual air pollution control device inspections and make any...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Compliance Requirements § 60.4895 By what date must I conduct annual air pollution control device inspections and make any necessary repairs? (a) You must conduct an annual inspection of each air pollution... following the previous annual air pollution control device inspection. (b) Within 10 operating...

  5. 40 CFR 60.4895 - By what date must I conduct annual air pollution control device inspections and make any...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Compliance Requirements § 60.4895 By what date must I conduct annual air pollution control device inspections and make any necessary repairs? (a) You must conduct an annual inspection of each air pollution... following the previous annual air pollution control device inspection. (b) Within 10 operating...

  6. 40 CFR 60.2716 - By what date must I conduct the annual air pollution control device inspection?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... air pollution control device inspection? 60.2716 Section 60.2716 Protection of Environment... Requirements § 60.2716 By what date must I conduct the annual air pollution control device inspection? On an annual basis (no more than 12 months following the previous annual air pollution control...

  7. 40 CFR 60.5215 - By what date must I conduct annual air pollution control device inspections and make any...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... air pollution control device inspections and make any necessary repairs? (a) You must conduct an annual inspection of each air pollution control device used to comply with the emission limits, according to § 60.5220(c), no later than 12 months following the previous annual air pollution control...

  8. 40 CFR 60.5215 - By what date must I conduct annual air pollution control device inspections and make any...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... air pollution control device inspections and make any necessary repairs? (a) You must conduct an annual inspection of each air pollution control device used to comply with the emission limits, according to § 60.5220(c), no later than 12 months following the previous annual air pollution control...

  9. 40 CFR 424.10 - Applicability; description of the open electric furnaces with wet air pollution control devices...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... electric furnaces with wet air pollution control devices subcategory. 424.10 Section 424.10 Protection of... MANUFACTURING POINT SOURCE CATEGORY Open Electric Furnaces With Wet Air Pollution Control Devices Subcategory § 424.10 Applicability; description of the open electric furnaces with wet air pollution control...

  10. 40 CFR 424.10 - Applicability; description of the open electric furnaces with wet air pollution control devices...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... electric furnaces with wet air pollution control devices subcategory. 424.10 Section 424.10 Protection of... MANUFACTURING POINT SOURCE CATEGORY Open Electric Furnaces With Wet Air Pollution Control Devices Subcategory § 424.10 Applicability; description of the open electric furnaces with wet air pollution control...

  11. 40 CFR 60.4895 - By what date must I conduct annual air pollution control device inspections and make any...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Compliance Requirements § 60.4895 By what date must I conduct annual air pollution control device inspections and make any necessary repairs? (a) You must conduct an annual inspection of each air pollution... following the previous annual air pollution control device inspection. (b) Within 10 operating...

  12. 40 CFR 60.4895 - By what date must I conduct annual air pollution control device inspections and make any...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Compliance Requirements § 60.4895 By what date must I conduct annual air pollution control device inspections and make any necessary repairs? (a) You must conduct an annual inspection of each air pollution... following the previous annual air pollution control device inspection. (b) Within 10 operating...

  13. 40 CFR 424.10 - Applicability; description of the open electric furnaces with wet air pollution control devices...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... electric furnaces with wet air pollution control devices subcategory. 424.10 Section 424.10 Protection of... MANUFACTURING POINT SOURCE CATEGORY Open Electric Furnaces With Wet Air Pollution Control Devices Subcategory § 424.10 Applicability; description of the open electric furnaces with wet air pollution control...

  14. A novel membrane device for the removal of water vapor and water droplets from air

    NASA Technical Reports Server (NTRS)

    Ray, Rod; Newbold, David D.; Mccray, Scott B.; Friesen, Dwayne T.; Kliss, Mark

    1992-01-01

    One of the key challenges facing NASA engineers is the development of systems for separating liquids and gases in microgravity environments. In this paper, a novel membrane-based phase separator is described. This device, known as a water recovery heat exchanger (WRHEX), overcomes the inherent deficiencies of current phase-separation technology. Specifically, the WRHEX cools and removes water vapor or water droplets from feed-air streams without the use of a vacuum or centrifugal force. As is shown in this paper, only a low-power air blower and a small stream of recirculated cool water is required for WRHEX operation. This paper presents the results of tests using this novel membrane device over a wide range of operating conditions. The data show that the WRHEX produces a dry air stream containing no entrained or liquid water - even when the feed air contains water droplets or mist. An analysis of the operation of the WRHEX is presented.

  15. Impact of Air Filter Material on Metal Oxide Semiconductor (MOS) Device Characteristics in HF Vapor Environment

    NASA Astrophysics Data System (ADS)

    Hsiao, Chih-Wen; Lou, Jen-Chung; Yeh, Ching-Fa; Hsieh, Chih-Ming; Lin, Shiuan-Jeng; Kusumi, Toshio

    2004-05-01

    Airborne molecular contamination (AMC) is becoming increasingly important as devices are scaled down to the nanometer generation. Optimum ultra low penetration air (ULPA) filter technology can eliminate AMC. In a cleanroom, however, the acid vapor generated from the cleaning process may degrade the ULPA filter, releasing AMC to the air and the surface of wafers, degrading the electrical characteristics of devices. This work proposes the new PTFE ULPA filter, which is resistant to acid vapor corrosion, to solve this problem. Experimental results demonstrate that the PTFE ULPA filter can effectively eliminate the AMC and provide a very clean cleanroom environment.

  16. [The pewter bleeding bowls].

    PubMed

    Renner, Claude

    2004-01-01

    In the late seventeenth century, then along the eighteen and nineteenth centuries the amount of the bloodlettings was measured by means of three pewter bleeding bowls that held three ounces of blood, about 300 millilitres. In the middle of the nineteenth century new and large bleeding bowls with metric graduations were manufactured only by the Parisian potters. PMID:15359483

  17. Gastrointestinal Bleeding in Athletes.

    ERIC Educational Resources Information Center

    Eichner, Edward R.

    1989-01-01

    Describes the scope and importance of gastrointestinal bleeding in runners and other athletes, discussing causes, sites, and implications of exercise-related bleeding. Practical tips to mitigate the problem, potentially more troublesome in women because of lower iron stores, are presented (e.g., gradual conditioning and avoidance of prerace…

  18. An automated system for the acoustical and aerodynamic characterization of small air moving devices

    NASA Astrophysics Data System (ADS)

    Schmitt, Jeff G.; Nelson, David A.; Phillips, John

    2005-09-01

    A plenum fixture for use in the measurement of acoustic emissions of air moving devices used to cool electronic equipment under the actual aerodynamic conditions of operation has been standardized in ISO 10302 and ANSI S12.11. This fixture has proven to be a valuable tool for use in the characterization of these devices. However, as many in industry have discovered, the construction of the plenum to the standardized specifications can quite complex, and the use of the plenum to fully characterize air moving devices can be quite laborious and tedious. Under contract to the NASA Glenn Research Center, which has a significant interest in the acoustic emissions of the air moving devices it uses to cool racks and payloads that are installed on the International Space Station, the authors have developed a fully automated fan test plenum that operates under software control. This plenum has been developed to facilitate rapid acoustic characterization of fans and other air moving devices, both independently and when operating into real world inlet conditions, obstructions and aerodynamic loads. The plenum slider has been calibrated to allow full development of fan curve data in parallel with acoustic emission data.

  19. Do forced air patient-warming devices disrupt unidirectional downward airflow?

    PubMed

    Legg, A J; Cannon, T; Hamer, A J

    2012-02-01

    Patient warming significantly decreases the risk of surgical site infection. Recently there have been concerns that forced air warming may interfere with unidirectional airflow, potentially posing an increased risk of infection. Our null hypothesis was that forced air and radiant warming devices do not increase the temperature and the number of particles over the surgical site when compared with no warming device. A forced air warming device was compared with a radiant warming device and no warming device as a control. The temperature and number of particles were measured over the surgical site. The theatre was prepared as for a routine lower-limb arthroplasty operation, and the same volunteer was used throughout the study. Forced air warming resulted in a significant mean increase in the temperature (1.1°C vs 0.4°C, p < 0.0001) and number of particles (1038.2 vs 274.8, p = 0.0087) over the surgical site when compared with radiant warming, which raises concern as bacteria are known to require particles for transport. PMID:22323696

  20. Novel Air Stimulation MR-Device for Intraoral Quantitative Sensory Cold Testing

    PubMed Central

    Brönnimann, Ben; Meier, Michael L.; Hou, Mei-Yin; Parkinson, Charles; Ettlin, Dominik A.

    2016-01-01

    The advent of neuroimaging in dental research provides exciting opportunities for relating excitation of trigeminal neurons to human somatosensory perceptions. Cold air sensitivity is one of the most frequent causes of dental discomfort or pain. Up to date, devices capable of delivering controlled cold air in an MR-environment are unavailable for quantitative sensory testing. This study therefore aimed at constructing and evaluating a novel MR-compatible, computer-controlled cold air stimulation apparatus (CASA) that produces graded air puffs. CASA consisted of a multi-injector air jet delivery system (AJS), a cold exchanger, a cooling agent, and a stimulus application construction. Its feasibility was tested by performing an fMRI stimulation experiment on a single subject experiencing dentine cold sensitivity. The novel device delivered repetitive, stable air stimuli ranging from room temperature (24.5°C ± 2°C) to −35°C, at flow rates between 5 and 17 liters per minute (l/min). These cold air puffs evoked perceptions similar to natural stimuli. Single-subject fMRI-analysis yielded brain activations typically associated with acute pain processing including thalamus, insular and cingulate cortices, somatosensory, cerebellar, and frontal brain regions. Thus, the novel CASA allowed for controlled, repetitive quantitative sensory testing by using air stimuli at graded temperatures (room temperature down to −35°C) while simultaneously recording brain responses. No MR-compatible stimulation device currently exists that is capable of providing non-contact natural-like stimuli at a wide temperature range to tissues in spatially restricted areas such as the mouth. The physical characteristics of this novel device thus holds promise for advancing the field of trigeminal and spinal somatosensory research, namely with respect to comparing therapeutic interventions for dentine hypersensitivity. PMID:27445771

  1. Novel Air Stimulation MR-Device for Intraoral Quantitative Sensory Cold Testing.

    PubMed

    Brönnimann, Ben; Meier, Michael L; Hou, Mei-Yin; Parkinson, Charles; Ettlin, Dominik A

    2016-01-01

    The advent of neuroimaging in dental research provides exciting opportunities for relating excitation of trigeminal neurons to human somatosensory perceptions. Cold air sensitivity is one of the most frequent causes of dental discomfort or pain. Up to date, devices capable of delivering controlled cold air in an MR-environment are unavailable for quantitative sensory testing. This study therefore aimed at constructing and evaluating a novel MR-compatible, computer-controlled cold air stimulation apparatus (CASA) that produces graded air puffs. CASA consisted of a multi-injector air jet delivery system (AJS), a cold exchanger, a cooling agent, and a stimulus application construction. Its feasibility was tested by performing an fMRI stimulation experiment on a single subject experiencing dentine cold sensitivity. The novel device delivered repetitive, stable air stimuli ranging from room temperature (24.5°C ± 2°C) to -35°C, at flow rates between 5 and 17 liters per minute (l/min). These cold air puffs evoked perceptions similar to natural stimuli. Single-subject fMRI-analysis yielded brain activations typically associated with acute pain processing including thalamus, insular and cingulate cortices, somatosensory, cerebellar, and frontal brain regions. Thus, the novel CASA allowed for controlled, repetitive quantitative sensory testing by using air stimuli at graded temperatures (room temperature down to -35°C) while simultaneously recording brain responses. No MR-compatible stimulation device currently exists that is capable of providing non-contact natural-like stimuli at a wide temperature range to tissues in spatially restricted areas such as the mouth. The physical characteristics of this novel device thus holds promise for advancing the field of trigeminal and spinal somatosensory research, namely with respect to comparing therapeutic interventions for dentine hypersensitivity. PMID:27445771

  2. Surgical bleeding in microgravity

    NASA Technical Reports Server (NTRS)

    Campbell, M. R.; Billica, R. D.; Johnston, S. L. 3rd

    1993-01-01

    A surgical procedure performed during space flight would occur in a unique microgravity environment. Several experiments performed during weightlessness in parabolic flight were reviewed to ascertain the behavior of surgical bleeding in microgravity. Simulations of bleeding using dyed fluid and citrated bovine blood, as well as actual arterial and venous bleeding in rabbits, were examined. The high surface tension property of blood promotes the formation of large fluid domes, which have a tendency to adhere to the wound. The use of sponges and suction will be adequate to prevent cabin atmosphere contamination with all bleeding, with the exception of temporary arterial droplet streams. The control of the bleeding with standard surgical techniques should not be difficult.

  3. Air-Q intubating laryngeal airway: A study of the second generation supraglottic airway device

    PubMed Central

    Attarde, Viren Bhaskar; Kotekar, Nalini; Shetty, Sarika M

    2016-01-01

    Background and Aims: Air-Q intubating laryngeal mask airway (ILA) is used as a supraglottic airway device and as a conduit for endotracheal intubation. This study aims to assess the efficacy of the Air-Q ILA regarding ease of insertion, adequacy of ventilation, rate of successful intubation, haemodynamic response and airway morbidity. Methods: Sixty patients presenting for elective surgery at our Medical College Hospital were selected. Following adequate premedication, baseline vital parameters, pulse rate and blood pressure were recorded. Air-Q size 3.5 for patients 50-70 kg and size 4.5 for 70-100 kg was selected. After achieving adequate intubating conditions, Air-Q ILA was introduced. Confirming adequate ventilation, appropriate sized endotracheal tube was advanced through the Air-Q blindly to intubate the trachea. Placement of the endotracheal tube in trachea was confirmed. Results: Air-Q ILA was successfully inserted in 88.3% of patients in first attempt and 11.7% patients in second attempt. Ventilation was adequate in 100% of patients. Intubation was successful in 76.7% of patients with Air-Q ILA. 23.3% of patients were intubated by direct laryngoscopy following failure with two attempts using Air-Q ILA. Post-intubation the change in heart rate was statistically significant (P < 0.0001). 10% of patients were noted to have a sore throat and 5% of patients had mild airway trauma. Conclusion: Air-Q ILA is a reliable device as a supraglottic airway ensuring adequate ventilation as well as a conduit for endotracheal intubation. It benefits the patient by avoiding the stress of direct laryngoscopy and is also superior alternative device for use in a difficult airway. PMID:27212722

  4. Upper GI Bleeding in Children

    MedlinePlus

    Upper GI Bleeding in Children What is upper GI Bleeding? Irritation and ulcers of the lining of the esophagus, stomach or duodenum can result in upper GI bleeding. When this occurs the child may vomit ...

  5. Obscure digestive bleeding.

    PubMed

    Van Gossum, A

    2001-02-01

    Obscure digestive bleeding is defined as recurrent bleeding for which no definite source has been identified by routine endoscopic or barium studies. Mucosal vascular abnormality or 'angioectasia' is the most common course of obscure bleeding, especially in elderly patients. Small bowel tumours are more frequent in patients younger than 50 years. However, missed or underestimated upper and lower gastrointestinal lesions at the initial endoscopic investigation may be the source of a so-called obscure intestinal bleeding. The various radiological procedures, including enteroclysis, visceral angiography and CT scan as well as radioisotope bleeding scans have limitations in the case of obscure gastrointestinal bleeding. Recent developments in magnetic resonance imaging are promising. The different methods of enteroscopy have a similar diagnostic yield, reaching approximately 40-65%. Endoscopic cauterization of small bowel angioectasias seems to be efficacious but randomized trials are needed. Efficacy of hormonal therapy is very controversial. The extent of diagnostic and therapeutic strategies must be based on a number of factors including the patient's parameters, bleeding characteristics and also the result of previous work-up. PMID:11355906

  6. 30 CFR 90.205 - Approved sampling devices; operation; air flowrate.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Approved sampling devices; operation; air flowrate. 90.205 Section 90.205 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY HEALTH STANDARDS-COAL MINERS WHO HAVE EVIDENCE OF THE DEVELOPMENT OF PNEUMOCONIOSIS Sampling Procedures §...

  7. Critical Evaluation of Air-Liquid Interface Exposure Devices for In Vitro Assessment of Atmospheric Pollutants

    EPA Science Inventory

    Exposure of cells to atmospheric pollutants at the air-liquid interface (ALI) is a more realistic approach than exposures of attached cells submerged in liquid medium. However, there is still limited understanding of the ideal ALI device design features that permit reproducible a...

  8. Vaginal or uterine bleeding - overview

    MedlinePlus

    ... of the vaginal bleeding, including: Dysfunctional uterine bleeding Endometriosis Uterine fibroids Ectopic pregnancy Polycystic ovary syndrome Treatment may include hormonal medicines, pain relievers, and possibly ...

  9. Dysfunctional Uterine Bleeding

    PubMed Central

    Casper, Robert F.

    1983-01-01

    Dysfunctional uterine bleeding is most commonly associated with chronic anovulation. Early diagnosis of anovulation is important; the induction of regular withdrawal periods using a progestin such as Provera prevents the development of endometrial hyperplasia with the subsequent inevitable occurrence of a heavy, frightening vaginal bleed. The etiology of dysfunctional uterine bleeding occurring during ovulatory cycles is unknown and all medical therapies at present are necessarily experimental. Hysterectomy is probably the treatment of choice for women who have finished their childbearing career and in whom persisting menorrhagia during ovulatory cycles results in anemia. PMID:21283453

  10. Regenerable device for scrubbing breathable air of CO2 and moisture without special heat exchanger equipment

    NASA Technical Reports Server (NTRS)

    Tepper, E. H. (Inventor)

    1977-01-01

    The device concerns the circulation of cabin air through canisters which absorb and adsorb carbon dioxide, together with excess moisture, and return the scrubbed air to the cabin for recirculation. A coating on an inert substrate in granular form absorbs and adsorbs the impurities at standard temperatures and pressures, but desorbs such impurities at low pressures (vacuum) and standard temperatures. This fact is exploited by making the device in a stack of cells consisting of layers or cells which are isolated from one another flow-wise and are connected to separate manifolds and valving systems into two separate subsets. A first subset may be connected for the flow breathable air therethrough until the polyethyleneimine of its cells is saturated with CO2 and H2O. During the same period the second subset of cells is manifolded to a vacuum source.

  11. Effect of an ozone-generating air-purifying device on reducing concentrations of formaldehyde in air

    SciTech Connect

    Esswein, E.J.; Boeniger, M.F.

    1994-02-01

    Formaldehyde, an air contaminant found in many indoor air investigations, poses distinct occupational exposure hazards in certain job categories (e.g., mortuary science) but is also of concern when found or suspected in office buildings and homes. A variety of air-purifying devices (APDs) are currently available or marketed for application to reduce or remove concentrations of a variety of indoor air pollutants through the use of ozone as a chemical oxidant. An investigation was conducted to determine if concentrations of formaldehyde similar to those found in industrial hygiene evaluations of funeral homes could be reduced with the use of an ozone-generating APD. An ozone-generating APD was placed in an exposure chamber and formaldehyde-containing embalming solution was allowed to evaporate naturally, creating peak and mean chamber concentrations of 2.5 and 1.3 ppm, respectively. Continuous-reading instruments were used to sample for formaldehyde and ozone. Active sampling methods were also used to sample simultaneously for formaldehyde and a possible reactant product, formic acid. Triplicate measurements were made in each of three evaluations: formaldehyde alone, ozone alone, and formaldehyde and ozone combined. Concentrations of formaldehyde were virtually identical with and without 0.5 ppm ozone. No reduction in formaldehyde concentration was found during a 90-minute evaluation using ozone at this concentration with peak and average concentrations of approximately 2.5 and 1.3 ppm formaldehyde, respectively. The results of this investigation suggest that the use of ozone is ineffective in reducing concentrations of formaldehyde. Because ozone has demonstrated health hazards, and is a regulated air contaminant in both the occupational and ambient environment, the use of ozone as an air purification agent in indoor air does not seem warranted. 25 refs., 5 figs., 4 tabs.

  12. Vaginal bleeding in pregnancy

    MedlinePlus

    ... 9 , bleeding may be a sign of: The placenta separating from the inner wall of the uterus ... the baby is born ( abruptio placentae ) Miscarriage The placenta is covering all or part of the opening ...

  13. Understanding Minor Rectal Bleeding

    MedlinePlus

    ... fever or significant rectal bleeding. Laser or infrared coagulation and sclerotherapy (injection of medicine directly into the ... or if symptoms persist despite rubber band ligation, coagulation or sclerotherapy. What are anal fissures? Tears that ...

  14. GI bleeding - slideshow

    MedlinePlus

    ... this page: //medlineplus.gov/ency/presentations/100162.htm GI bleeding - series—Normal anatomy To use the sharing ... colon, and finally, the rectum and anus. The GI tract is a long, hollow, muscular tube through ...

  15. GI bleeding - series (image)

    MedlinePlus

    ... colon, and finally, the rectum and anus. The GI tract is a long, hollow, muscular tube through ... Bleeding from the GI tract is a common medical problem. Patients usually notice either dark red blood or bright red blood in their ...

  16. Approach to bleeding patient

    PubMed Central

    Gopinath, Ramachandran; Sreekanth, Y.; Yadav, Monu

    2014-01-01

    Managing a bleeding patient is very challenging for the perioperative physician. Bleeding in a patient would be due to inherited or acquired disorders of haemostasis. Identifying the patients at risk of bleeding and utilising prophylactic treatment protocols has good outcomes. Along with clinical signs, trends in monitoring coagulation parameters and analysing blood picture are necessary. Management of patients in the postoperative period and in intensive care unit should be focused on normalization of coagulation profile as early as possible with available blood and its products. Available recombinant factors should be given priority as per the approved indications. Exploring the surgical site should be considered for persistent bleeding because haemodynamic compromise, excessive transfusion of fluids, blood and its products and more inotropic support may have a negative impact on the patient outcome. PMID:25535422

  17. Bleeding during cancer treatment

    MedlinePlus

    ... barefoot. Use only an electric razor. Use knives, scissors, and other tools carefully. Do not blow your ... bowel movements. To further prevent bleeding: Avoid heavy lifting or playing contact sports. Do not drink alcohol. ...

  18. Abnormal Uterine Bleeding FAQ

    MedlinePlus

    ... as cancer of the uterus, cervix, or vagina • Polycystic ovary syndrome How is abnormal bleeding diagnosed? Your health care ... before the fetus can survive outside the uterus. Polycystic Ovary Syndrome: A condition characterized by two of the following ...

  19. 75 FR 63198 - In the Matter of Certain Connecting Devices (“Quick Clamps”) for Use With Modular Compressed Air...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-14

    ... devices for modular compressed air conditioning units and the FRL units they connect by reason of... COMMISSION In the Matter of Certain Connecting Devices (``Quick Clamps'') for Use With Modular Compressed Air Conditioning Units, Including Filters, Regulators, and Lubricators (``Frl's'') That Are Part of...

  20. Factors that influence the tribocharging of pulverulent materials in compressed-air devices

    NASA Astrophysics Data System (ADS)

    Das, S.; Medles, K.; Mihalcioiu, A.; Beleca, R.; Dragan, C.; Dascalescu, L.

    2008-12-01

    Tribocharging of pulverulent materials in compressed-air devices is a typical multi-factorial process. This paper aims at demonstrating the interest of using the design of experiments methodology in association with virtual instrumentation for quantifying the effects of various process varaibles and of their interactions, as a prerequisite for the development of new tribocharging devices for industrial applications. The study is focused on the tribocharging of PVC powders in compressed-air devices similar to those employed in electrostatic painting. A classical 2 full-factorial design (3 factors at two levels) was employed for conducting the experiments. The response function was the charge/mass ratio of the material collected in a modified Faraday cage, at the exit of the tribocharging device. The charge/mass ratio was found to increase with the injection pressure and the vortex pressure in the tribocharging device, and to decrease with the increasing of the feed rate. In the present study an in-house design of experiments software was employed for statistical analysis of experimental data and validation of the experimental model.

  1. Wearable air supply for pneumatic artificial hearts and ventricular assist devices.

    PubMed

    Sipin, A J; Fabrey, W J; Smith, S H; Doussourd, J D; Olsen, D B

    1992-08-01

    An experimental wearable air supply for pneumatic artificial hearts and ventricular assist devices has been built and tested. The unit eliminates the need for tethering to a large, stationery driver. The miniaturized air supply is designed for ambulatory patients with implanted pulsatile pneumatic total artificial hearts (TAH) or pneumatic left-ventricular assist devices (LVAD), to permit mobility in clinical and home settings. The device has major short-term utility as a supply for pneumatic TAH or VAD bridges in patients awaiting heart transplants. The system design for the wearable driver includes a novel, fast rotary compressor, driven by a brushless direct current (DC) motor to supply air to the ventricle through an electromagnetically actuated directional valve, all controlled by a microcomputer. Stroke volume from 0 to 200 cc; pulse rate from 60 to 160 bpm, and duty cycle from 33% to 50% are selected on a keyboard, and the selected or measured parameters can be shown on a liquid crystal display. For control of delivery from a single ventricular assist device, stroke volume is controlled by variation of compressor speed. In the wearable air supply for a TAH, a single compressor drives both ventricles alternately through a double-acting directional valve. Air volume delivered to the left ventricle is adjusted by variation of compressor speed, and air volume to the right ventricle by variation of ejection time. The effect on blood flow rate of the lower impedance to the right ventricle is compensated by provision of a two-stage compressor, in which a single stage drives the right ventricle, and both stages connected in parallel drive the left ventricle. The overall dimensions of the prototype air supply for driving either a TAH or LVAD are 4.5 by 7.8 by 4.5 inches, including an emergency battery with a duration of 15 to 30 min depending on load. The weight is presently 5.5 lb, but this will be reduced in a production design and for a dedicated LVAD air supply

  2. Emergent Bleeding in Patients Receiving Direct Oral Anticoagulants.

    PubMed

    Summers, Richard L; Sterling, Sarah A

    2016-01-01

    Direct oral anticoagulants (DOACs) offer clinical advantages over warfarin, such as minimal medication and food interactions and fixed dosing without the need for routine monitoring of coagulation status. As with all anticoagulants, bleeding, either spontaneous or provoked, is the most common complication. The long-term use of these drugs is increasing, and there is a crucial need for emergency medicine service professionals to understand the optimal management of associated bleeding. This review aims to describe the indications and pharmacokinetics of available DOACs; to discuss the risk of bleeding; to provide a treatment algorithm to manage DOAC-associated emergency bleeding; and to discuss future directions in bleeding management, including the role of specific reversal agents, such as the recently approved idarucizumab for reversal of the direct thrombin inhibitor dabigatran. Because air medical personnel are increasingly likely to encounter patients receiving DOACs, it is important that they have an understanding of how to manage patients with emergent bleeding. PMID:27255877

  3. Wireless capsule endoscopy: perspectives beyond gastrointestinal bleeding.

    PubMed

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

    2014-11-14

    Wireless capsule endoscopy (CE) is a technology developed for the endoscopic exploration of the small bowel. The first capsule model was approved by the Food and Drug Administration in 2001, and its first and essential indication was occult gastrointestinal (GI) bleeding. Over subsequent years, this technology has been refined to provide superior resolution, increased battery life, and capabilities to view different parts of the GI tract. Indeed, cases for which CE proved useful have increased significantly over the last few years, with new indications for the small bowel and technical improvements that have expanded its use to other parts of the GI tract, including the esophagus and colon. The main challenges in the development of CE are new devices with the ability to provide therapy, air inflation for a better vision of the small bowel, biopsy sampling systems attached to the capsule and the possibility to guide and move the capsule with an external motion control. In this article we review the current and new indications of CE, and the evolving technological changes shaping this technology, which has a promising potential in the coming future of gastroenterology. PMID:25400450

  4. Acute upper gastrointestinal bleeding.

    PubMed

    Kurien, Matthew; Lobo, Alan J

    2015-10-01

    Acute upper gastrointestinal bleeding (AUGIB) is a frequently encountered medical emergency with an incidence of 84-160/100000 and associated with mortality of approximately 10%. Guidelines from the National Institute for Care and Care Excellence outline key features in the management of AUGIB. Patients require prompt resuscitation and risk assessment using validated tools. Upper gastrointestinal endoscopy provides accurate diagnosis, aids in estimating prognosis and allows therapeutic intervention. Endoscopy should be undertaken immediately after resuscitation in unstable patients and within 24 hours in all other patients. Interventional radiology may be required for bleeding unresponsive to endoscopic intervention. Drug therapy depends on the cause of bleeding. Intravenous proton pump inhibitors should be used in patients with high-risk ulcers. Terlipressin and broad-spectrum antibiotics should be used following variceal haemorrhage. Hospitals admitting patients with AUGIB need to provide well organised services and ensure access to relevant services for all patients, and particularly to out of hours endoscopy. PMID:26430191

  5. Far-field dispersal modeling for fuel-air-explosive devices

    SciTech Connect

    Glass, M.W.

    1990-05-01

    A computer model for simulating the explosive dispersal of a fuel agent in the far-field regime is described and is applied to a wide variety of initial conditions to judge their effect upon the resulting fuel/air cloud. This work was directed toward modeling the dispersal process associated with Fuel-Air-Explosives devices. The far-field dispersal regime is taken to be that time after the initial burster charge detonation in which the shock forces no longer dominate the flow field and initial canister and fuel mass breakup has occurred. The model was applied to a low vapor pressure fuel, a high vapor pressure fuel and a solid fuel. A strong dependence of the final cloud characteristics upon the initial droplet size distribution was demonstrated. The predicted fuel-air clouds were highly non-uniform in concentration. 18 refs., 86 figs., 4 tabs.

  6. Complications of coronary intervention: device embolisation, no-reflow, air embolism

    PubMed Central

    Dash, Debabrata

    2013-01-01

    The introduction of drug-eluting stents, better equipment, stronger antiplatelet drugs, and higher levels of operator experience has led to markedly improved patency rates for complex percutaneous coronary interventions (PCIs). The evolving techniques of contemporary PCI have been unable to completely eliminate complications. However, rigorous preventive measures pre-empt the appearance of complications. During traversal of severely diseased coronary arteries and manipulating equipment, particularly devices with detachable components, the opportunity for loss or embolisation of material in the coronary circulation presents itself. Device embolisation is associated with periprocedural myocardial infarction and emergent referral to surgery, particularly if the device is not retrieved. The coronary no-reflow phenomenon is a feared complication of PCI. It is associated with a worse prognosis and has been shown to be an independent predictor of death, myocardial infarction and impaired left ventricular function. Air embolism can be prevented by flushing of catheters during equipment exchanges. PMID:27326077

  7. First trimester bleeding evaluation.

    PubMed

    Dogra, Vikram; Paspulati, Raj Mohan; Bhatt, Shweta

    2005-06-01

    First trimester bleeding is a common presentation in the emergency room. Ultrasound evaluation of patients with first trimester bleeding is the mainstay of the examination. The important causes of first trimester bleeding include spontaneous abortion, ectopic pregnancy, and gestational trophoblastic disease; 50% to 70% of spontaneous abortions are due to genetic abnormalities. In normal pregnancy, the serum beta hCG doubles or increases by at least 66% in 48 hours. The intrauterine GS should be visualized by TVUS with beta hCG levels between 1000 to 2000 mIU/mL IRP. Visualization of the yolk sac within the gestational sac is definitive evidence of intrauterine pregnancy. Embryonic cardiac activity can be identified with CRL of >5 mm. A GS with a mean sac diameter (MSD) of 8 mm or more without a yolk sac and a GS with an MSD of 16 mm or more without an embryo, are important predictors of a nonviable gestation. A GS with a mean sac diameter of 16 mm or more (TVUS) without an embryo is a sonographic sign of anembryonic gestation. A difference of <5 mm between the mean sac diameter and the CRL carries an 80% risk of spontaneous abortion. Approximately 20% of women with first trimester bleeding have a subchorionic hematoma. The presence of an extra ovarian adnexal mass is the most common sonographic finding in ectopic pregnancy. Other findings include the tubal ring sign and hemorrhage. About 26% of ectopic pregnancies have normal pelvic sonograms on TVUS. Complete hydatidiform mole presents with a complex intrauterine mass with multiple anechoic areas of varying sizes (Snowstorm appearance). Twenty-five percent to 65% of molar pregnancies have associated theca-leutin cysts. Arteriovenous malformation of the uterus is a rare but life-threatening cause of vaginal bleeding in the first trimester. The sonographic findings in a patient with first trimester bleeding should be correlated with serum beta hCG levels to arrive at an appropriate clinical diagnosis. PMID:15905817

  8. [Gastrointestinal bleeding in cardiological patients].

    PubMed

    Braun, G; Messmann, H

    2013-11-01

    Oral anticoagulation and antiplatelet therapy are risk factors for gastrointestinal (GI) bleeding. GI bleeding-especially lower GI bleeding-seems to be associated with a poorer outcome. With the introduction of dabigatrane and rivaroxaban, difficulties in the management of bleeding complications arose. Thus, the goal of the authors was to establish a standard operating procedure (SOP) for the treatment of severe GI bleeding associated with rivaroxaban, dabigatrane, and antiplatelet therapy. Bleeding complications during phenprocoumon treatment should be treated with prothrombin complex concentrates and vitamin K1. Dabigatrane elimination is highly dependent to the renal function. The measurement of drug concentrations of dabigatrane and rivaroxaban is useful to indicate an increased risk of bleeding complications. Severe bleeding associated with dabigatrane or rivaroxaban therapy should trigger prothrombin complex therapy, whereby in cases with severe bleeding associated with antiplatelet therapy platelet transfusion should be initiated. Low-dose aspirin should be continued after 24 h. PMID:24150711

  9. Nonvariceal Upper Gastrointestinal Bleeding.

    PubMed

    Rahman, Syed Irfan-Ur; Saeian, Kia

    2016-04-01

    In the intensive care unit, vigilance is needed to manage nonvariceal upper gastrointestinal bleeding. A focused history and physical examination must be completed to identify inciting factors and the need for hemodynamic stabilization. Although not universally used, risk stratification tools such as the Blatchford and Rockall scores can facilitate triage and management. Urgent evaluation for nonvariceal upper gastrointestinal bleeds requires prompt respiratory assessment, and identification of hemodynamic instability with fluid resuscitation and blood transfusions if necessary. Future studies are needed to evaluate the indication, safety, and efficacy of emerging endoscopic techniques. PMID:27016164

  10. Bleeding Avoidance Strategies: Consensus and Controversy

    PubMed Central

    Dauerman, Harold L.; Rao, Sunil V.; Resnic, Frederic S.; Applegate, Robert J.

    2011-01-01

    Bleeding complications after coronary intervention are associated with prolonged hospitalization, increased hospital costs, patient dissatisfaction, morbidity and one year mortality. Bleeding Avoidance Strategies represent a term incorporating multiple modalities that aim to reduce bleeding and vascular complications after cardiovascular catheterization. Recent improvements in the rates of bleeding complications after invasive cardiovascular procedures suggests that the clinical community has successfully embraced specific strategies and improved patient care in this area. There remains controversy regarding the efficacy, safety and/or practicality of 3 key bleeding avoidance strategies for cardiac catheterization and coronary intervention: procedural (radial artery approach, safezone arteriotomy), pharmacologic (multiple agents) and technological (vascular closure devices) approaches to improved access. In this article, we address areas of consensus with respect to selected modalities in order to define the role of each strategy in current practice. Furthermore, we focus on areas of controversy for selected modalities in order to define key areas warranting cautious clinical approaches and the need for future randomized clinical trials in this area. PMID:21700085

  11. The fabrication of polyfluorene and polycarbazole-based photovoltaic devices using an air-stable process route

    SciTech Connect

    Bovill, E.; Lidzey, D. G.; Yi, H.; Iraqi, A.

    2014-12-01

    We report a comparative study based on the fabrication of polymer:fullerene photovoltaic (PV) devices incorporating carbazole, fluorene, and a PTB based co-polymer. We have explored the efficiency and performance of such devices when the active polymer:fullerene layer is deposited by spin-casting either under nitrogen or ambient conditions. We show that PV devices based on carbazole and fluorene based materials have very similar power conversion efficiencies when processed under both air and nitrogen, with other photobleaching measurements suggesting that such materials have comparatively enhanced photostability. Devices based on the PTB co-polymer, however, have reduced efficiency when processed in air.

  12. Vaginal bleeding in pregnancy

    MedlinePlus

    ... rest of your pregnancy or until the bleeding stops. The bed rest may be complete. Or, you may be able to get up to go to the bathroom, walk around the house, or do light chores. Medication is not needed in most cases. ...

  13. Novel device (AirWave) to assess endotracheal tube migration: A pilot study☆,☆☆

    PubMed Central

    Nacheli, Gustavo Cumbo; Sharma, Manish; Wang, Xiaofeng; Gupta, Amit; Guzman, Jorge A.; Tonelli, Adriano R.

    2013-01-01

    Introduction Little is known about endotracheal tube (ETT) migration during routine care among critically ill patients. AirWave is a novel device that uses sonar waves to measure ETT migration and obstructions in real time. The aim of the present study is to assess the accuracy of the AirWave to evaluate ETT migration. In addition, we determined the degree of variation in ETT position and tested whether more pronounced migration occurs in specific clinical scenarios. Methods After institutional review board approval, we included mechanically ventilated patients from February 2012 to May 2012. A chest radiography (CXR) was obtained at baseline and 24 hours when clinically indicated. The ETT distance at the lips was recorded at baseline and every 4 hours. The AirWave system continuously recorded ETT position changes from baseline, and luminal obstructions. Results A total of 42 patients (age: 61 [SD ± 13] years, men: 52%) were recruited. A total of 19 patients had measurements of ETT migration at 24 hours by the 3 methodologies used in this study. The mean (SD) of the ETT migration at 24 hours was +0.04 (1.2), −0.42 (0.7) and +0.34 (1.81) cm when measured by portable CXR, ETT distance at the teeth and AirWave device, respectively. Bland-Altman analysis of tube migration at 24 hours comparing the AirWave with CXR readings showed a bias of 0.1 cm with 95% limit of agreement of −3.8 and +4.3 cm. Comparison of tube migration at 24 hours determined by AirWave with ETT distance at the lips revealed a bias of −0.4 with 95% limit of agreement −3.7 to +3 cm, similar to the values observed between CXR and ETT distance at the lips (bias of −0.3 cm, 95% limit of agreement of −3.4 to +2.8 cm). Factors associated with ETT migration at 24 hours were ETT size and initial measurement from ETT tip to carina by portable CXR. AirWave detected in eight patients some degree of ETT obstruction (30% ± 9.6%) that resolved with prompt ETT catheter suction. Conclusions The Air

  14. 40 CFR 60.5195 - By what date must I conduct the initial air pollution control device inspection and make any...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... air pollution control device inspection and make any necessary repairs? 60.5195 Section 60.5195... air pollution control device inspection and make any necessary repairs? (a) You must conduct an air... approved state plan, Federal plan, or delegation, as applicable. For air pollution control...

  15. 40 CFR 60.5195 - By what date must I conduct the initial air pollution control device inspection and make any...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... air pollution control device inspection and make any necessary repairs? 60.5195 Section 60.5195... air pollution control device inspection and make any necessary repairs? (a) You must conduct an air... approved state plan, Federal plan, or delegation, as applicable. For air pollution control...

  16. 40 CFR 60.5195 - By what date must I conduct the initial air pollution control device inspection and make any...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... air pollution control device inspection and make any necessary repairs? 60.5195 Section 60.5195... air pollution control device inspection and make any necessary repairs? (a) You must conduct an air... approved state plan, Federal plan, or delegation, as applicable. For air pollution control...

  17. 40 CFR 60.5195 - By what date must I conduct the initial air pollution control device inspection and make any...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... air pollution control device inspection and make any necessary repairs? 60.5195 Section 60.5195... air pollution control device inspection and make any necessary repairs? (a) You must conduct an air... approved state plan, Federal plan, or delegation, as applicable. For air pollution control...

  18. Bleeding and Clotting Disorders Glossary

    MedlinePlus

    ... excessive or lengthy bleeding. breakthrough bleedbleeding between infusions of factor product. Campaign for Our Future —NHF ... in a vein for patients who need regular infusions. chromosome —structures in the cell’s nucleus that contain ...

  19. Air-activated chemical warming devices: effects of oxygen and pressure.

    PubMed

    Raleigh, G; Rivard, R; Fabus, S

    2005-01-01

    Air-activated chemical warming devices use an exothermic chemical reaction of rapidly oxidizing iron to generate heat for therapeutic purposes. Placing these products in a hyperbaric oxygen environment greatly increases the supply of oxidant and thus increases the rate of reaction and maximum temperature. Testing for auto-ignition and maximum temperatures attained by ThermaCare Heat Wraps, Playtex Heat Therapy, and Heat Factory disposable warm packs under ambient conditions and under conditions similar to those encountered during hyperbaric oxygen treatments in monoplace and multiplace hyperbaric chambers (3 atm abs and > 95% oxygen) revealed a maximum temperature of 269 degrees F (132 degrees C) with no spontaneous ignition. The risk of thermal burn injury to adjacent skin may be increased significantly if these devices are used under conditions of hyperbaric oxygen. PMID:16509287

  20. A microfluidic device to apply shear stresses to polarizing ciliated airway epithelium using air flow

    PubMed Central

    Trieu, Dennis; Waddell, Thomas K.; McGuigan, Alison P.

    2014-01-01

    Organization of airway epithelium determines ciliary beat direction and coordination for proper mucociliary clearance. Fluidic shear stresses have the potential to influence ciliary organization. Here, an in vitro fluidic flow system was developed for inducing long-term airflow shear stresses on airway epithelium with a view to influencing epithelial organization. Our system consists of a fluidic device for cell culture, integrated into a humidified airflow circuit. The fluidic device has a modular design and is made from a combination of polystyrene and adhesive components incorporated into a 6-well filter membrane insert. We demonstrate the system operates within physiologically relevant shear and pressure ranges and estimate the shear stress exerted on the epithelial cell layer as a result of air flow using a computational model. For both the bronchial epithelial cell line BEAS2B and primary human tracheal airway epithelial cells, we demonstrate that cells remain viable within the device when exposed to airflow for 24 h and that normal differentiation and cilia formation occurs. Furthermore, we demonstrate the utility of our device for exploring the impact of exposing cells to airflow: our tool enables quantification of cytoskeletal organization, and is compatible with in situ bead assays to assess the orientation of cilia beating. PMID:25553181

  1. 76 FR 13661 - In the Matter of Certain Connecting Devices (“Quick Clamps”) for Use With Modular Compressed Air...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-14

    ... air conditioning units and the FRL units they connect by reason of infringement of certain claims of... COMMISSION In the Matter of Certain Connecting Devices (``Quick Clamps'') for Use With Modular Compressed Air Conditioning Units, Including Filters, Regulators, and Lubricators (``FRL's'') That Are Part of...

  2. EVALUATION OF PILOT-SCALE AIR POLLUTION CONTROL DEVICES ON A REFUSE AND COAL-FIRED BOILER

    EPA Science Inventory

    The project report describes the operation of pilot-scale air pollution control devices to gather data on air pollution efficiency versus several different operating parameters on various waste-as-fuel combustio processes. It also includes a test of a full scale fabric filter use...

  3. 40 CFR 62.14441 - When must I inspect my HMIWI equipment and air pollution control devices?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 9 2013-07-01 2013-07-01 false When must I inspect my HMIWI equipment and air pollution control devices? 62.14441 Section 62.14441 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) APPROVAL AND PROMULGATION OF STATE PLANS FOR DESIGNATED FACILITIES AND POLLUTANTS Federal...

  4. Lower gastrointestinal bleeding.

    PubMed

    Silber, G

    1990-09-01

    The differential diagnosis of lower gastrointestinal bleeding in children can be reduced markedly simply by taking into account the age of the child. The clinical condition of the patient can further help narrow the diagnostic possibilities. Newborns and infants who are clinically unstable are more likely to have diseases such as necrotizing enterocolitis, volvulus, Hirschprung disease, intussusception, or Meckel diverticulum. A baby who appears healthy should be examined for swallowed blood, allergic colitis, anal fissures, or lymphonodular hyperplasia. An older child of healthy appearance with bleeding is likely to have a juvenile polyp or infectious colitis, but a child who appears sick may have hemolytic uremic syndrome, Henoch-Schoenlein purpura, or inflammatory bowel disease. This information, along with that gleaned from the physical examination, can lead the pediatrician to determine the need for specific tests, such as abdominal radiographs, stool cultures, and an endoscopic evaluation. We have come a long way in our ability to diagnose the causes of lower gastrointestinal bleeding. With the availability of newer radiographic and nuclear medicine modalities and the ability to visualize the colon endoscopically, the need for exploratory laparotomy for diagnosis is rarer. While surgery may still be the therapy of choice, new diagnostic modalities give the surgeon much more preoperative information. PMID:2235771

  5. Enzyme incorporated microfluidic device for in-situ glucose detection in water-in-air microdroplets.

    PubMed

    Piao, Yunxian; Han, Dong Ju; Azad, Mohammad Reza; Park, Minsu; Seo, Tae Seok

    2015-03-15

    Droplet generating microfluidic systems can provide miniaturized bioanalytical tools by using the homogenous and high-throughput droplets as nanoreactors. In this study, we demonstrated a sensitive and in-situ glucose monitoring system using water-in-air droplets in an enzyme incorporated microfluidic device. A thin film structure of a glucose oxidase (GOx) enzyme immobilized hydrogel was constructed in the middle of the microfluidic channel, and nanoliter scaled water-in-air droplets which contain a glucose sample, horseradish peroxidase (HRP), and an Amplex Red substrate were generated by flow focusing of water phase with air. Once the droplets passed through the enzyme trapped hydrogel, the droplets temporarily halted and a GOx mediated catalytic reaction with glucose proceeded, resulting in producing fluorescent resorufin products in the droplets. With optimized conditions such as the thickness of a hydrogel film and the size and flowing rate of droplets, fluorescence intensities of the released droplets linearly increased in proportional to the glucose concentration up to 3mM, and the limit of detection was calculated as 6.64µM. A spiked glucose in a real urine sample was also successfully analyzed, and the functionality of the proposed enzyme immobilized microfluidic chip was maintained for at least two weeks without loss of enzymatic activity and detection sensitivity. Thus, our methodology suggests a novel droplet based glucose sensing chip which can monitor glucose in a real-time and high-throughput manner. PMID:25461161

  6. Passive cathodic water/air management device for micro-direct methanol fuel cells

    NASA Astrophysics Data System (ADS)

    Peng, Hsien-Chih; Chen, Po-Hon; Chen, Hung-Wen; Chieng, Ching-Chang; Yeh, Tsung-Kuang; Pan, Chin; Tseng, Fan-Gang

    A high efficient passive water/air management device (WAMD) is proposed and successfully demonstrated in this paper. The apparatus consists of cornered micro-channels and air-breathing windows with hydrophobicity arrangement to regulate liquids and gases to flow on their predetermined pathways. A high performance water/air separation with water removal rate of about 5.1 μl s -1 cm -2 is demonstrated. The performance of the proposed WAMD is sufficient to manage a cathode-generated water flux of 0.26 μl s -1 cm -2 in the micro-direct methanol fuel cells (μDMFCs) which are operated at 100 mW cm -2 or 400 mA cm -2. Furthermore, the condensed vapors can also be collected and recirculated with the existing micro-channels which act as a passive water recycling system for μDMFCs. The durability testing shows that the fuel cells equipped with WAMD exhibit improved stability and higher current density.

  7. Air core poloidal magnetic field system for a toroidal plasma producing device

    DOEpatents

    Marcus, Frederick B.

    1978-01-01

    A poloidal magnetics system for a plasma producing device of toroidal configuration is provided that reduces both the total volt-seconds requirement and the magnitude of the field change at the toroidal field coils. The system utilizes an air core transformer wound between the toroidal field (TF) coils and the major axis outside the TF coils. Electric current in the primary windings of this transformer is distributed and the magnetic flux returned by air core windings wrapped outside the toroidal field coils. A shield winding that is closely coupled to the plasma carries a current equal and opposite to the plasma current. This winding provides the shielding function and in addition serves in a fashion similar to a driven conducting shell to provide the equilibrium vertical field for the plasma. The shield winding is in series with a power supply and a decoupling coil located outside the TF coil at the primary winding locations. The present invention requires much less energy than the usual air core transformer and is capable of substantially shielding the toroidal field coils from poloidal field flux.

  8. 40 CFR 60.4875 - By what date must I conduct the initial air pollution control device inspection and make any...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... air pollution control device inspection and make any necessary repairs? 60.4875 Section 60.4875... Initial Compliance Requirements § 60.4875 By what date must I conduct the initial air pollution control device inspection and make any necessary repairs? (a) You must conduct an air pollution control...

  9. 40 CFR 60.4875 - By what date must I conduct the initial air pollution control device inspection and make any...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... air pollution control device inspection and make any necessary repairs? 60.4875 Section 60.4875... Initial Compliance Requirements § 60.4875 By what date must I conduct the initial air pollution control device inspection and make any necessary repairs? (a) You must conduct an air pollution control...

  10. 40 CFR 60.4875 - By what date must I conduct the initial air pollution control device inspection and make any...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... air pollution control device inspection and make any necessary repairs? 60.4875 Section 60.4875... Initial Compliance Requirements § 60.4875 By what date must I conduct the initial air pollution control device inspection and make any necessary repairs? (a) You must conduct an air pollution control...

  11. 40 CFR 60.4875 - By what date must I conduct the initial air pollution control device inspection and make any...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... air pollution control device inspection and make any necessary repairs? 60.4875 Section 60.4875... Initial Compliance Requirements § 60.4875 By what date must I conduct the initial air pollution control device inspection and make any necessary repairs? (a) You must conduct an air pollution control...

  12. Abnormal uterine bleeding.

    PubMed

    Whitaker, Lucy; Critchley, Hilary O D

    2016-07-01

    Abnormal uterine bleeding (AUB) is a common and debilitating condition with high direct and indirect costs. AUB frequently co-exists with fibroids, but the relationship between the two remains incompletely understood and in many women the identification of fibroids may be incidental to a menstrual bleeding complaint. A structured approach for establishing the cause using the Fédération International de Gynécologie et d'Obstétrique (FIGO) PALM-COEIN (Polyp, Adenomyosis, Leiomyoma, Malignancy (and hyperplasia), Coagulopathy, Ovulatory disorders, Endometrial, Iatrogenic and Not otherwise classified) classification system will facilitate accurate diagnosis and inform treatment options. Office hysteroscopy and increasing sophisticated imaging will assist provision of robust evidence for the underlying cause. Increased availability of medical options has expanded the choice for women and many will no longer need to recourse to potentially complicated surgery. Treatment must remain individualised and encompass the impact of pressure symptoms, desire for retention of fertility and contraceptive needs, as well as address the management of AUB in order to achieve improved quality of life. PMID:26803558

  13. Dysfunctional uterine bleeding (DUB).

    PubMed

    Bulletti, C; Flamigni, C; Prefetto, R A; Polli, V; Giacomucci, E

    1994-09-30

    Cyclic or irregular uterine bleeding is common in perimenarchal and perimenopausal women with or without endometrial hyperplasia. The disturbance often requires surgical treatment because of its negative effects on both blood loss and abnormal endometrial growth including the development of endometrial cancer. The endometrium is often overstimulated during the perimenopausal period when estrogen/progesterone production is unbalanced. A therapeutical approach with gonadotropin-releasing hormone agonist (GnRHa) was proposed in a depot formulation (Zoladex) that induces a sustained and reversible ovarian suppression. To avoid the risk of osteoporosis and to obtain adequate endometrial proliferation and differentiation during ovarian suppression, transdermal 17-beta-estradiol and oral progestin were administered. Results of 20 cases versus 20 controls showed a reduction of metrorrhagia, a normalization of hemoglobin plasma concentration, and an adequate proliferation and secretory differentiation of the endometrium of patients with abnormal endometrial growth. Abnormal uterine bleeding is mainly due to uterine fibrosis and an inadequate estrogen and/or progesterone production or to a disordered estrogen transport from blood into the endometrium. In premenopausal women, endometrial hyperplasia may be part of a continuum that is ultimately manifested in the histological and biological pattern of endometrial carcinoma. The regression of endometrial hyperplasia obtained by using the therapeutic regimen mentioned above represents a preventive measure for endometrial cancer. Finally the normalization of blood loss offers a good medical alternative to surgery for patients with DUB. PMID:7978956

  14. Rapid PCR amplification using a microfluidic device with integrated microwave heating and air impingement cooling.

    PubMed

    Shaw, Kirsty J; Docker, Peter T; Yelland, John V; Dyer, Charlotte E; Greenman, John; Greenway, Gillian M; Haswell, Stephen J

    2010-07-01

    A microwave heating system is described for performing polymerase chain reaction (PCR) in a microfluidic device. The heating system, in combination with air impingement cooling, provided rapid thermal cycling with heating and cooling rates of up to 65 degrees C s(-1) and minimal over- or under-shoot (+/-0.1 degrees C) when reaching target temperatures. In addition, once the required temperature was reached it could be maintained with an accuracy of +/-0.1 degrees C. To demonstrate the functionality of the system, PCR was successfully performed for the amplification of the Amelogenin locus using heating rates and quantities an order of magnitude faster and smaller than current commercial instruments. PMID:20414500

  15. Laboratory issues in bleeding disorders.

    PubMed

    Lillicrap, D; Nair, S C; Srivastava, A; Rodeghiero, F; Pabinger, I; Federici, A B

    2006-07-01

    The clinical history of the patient and of his/her relatives is the most important tool for making correct diagnosis of inherited or acquired bleeding disorders. Several attempts have been made by clinicians to evaluate the sensitivity and specificity of bleeding symptoms. Specific and detailed questionnaires have been designed to quantify the bleeding tendency of patients with von Willebrand's disease (VWD) and a bleeding score has been calculated. VWD is considered the most frequent inherited bleeding disorder according to population studies: however, due to the complexity of its diagnosis, the number of patients with correct diagnosis of VWD in many developing countries is relatively low and most cases remain still under- or misdiagnosed. Once bleeding history is carefully evaluated by means of a bleeding score, the laboratory workout should be organized to find out the specific defect of haemostasis responsible for bleeding. Since factors involved in haemostasis are many, the correct approach must include first level screening tests with the aim to identify the abnormal phase of haemostasis involved: then, second level tests should be focused on the specific factors within the abnormal step of haemostasis. Among many other acquired bleeding disorders related to clinical conditions or to the use of drugs, the acquired inhibitors of haemostasis are rare but should be immediately characterized by appropriate laboratory tests because they can be often life-threatening for the patients. PMID:16683999

  16. Air-over-ground calculations of the neutron, prompt, and secondary-gamma free-in-air tissue kerma from the Hiroshima and Nagasaki devices

    SciTech Connect

    Pace, J.V. III; Knight, J.R.; Bartine, D.E.

    1982-01-01

    This paper reports preliminary results of the two-dimensional discrete-ordinate, calculations for the air-over-ground transport of radiation from the Hiroshima and Nagasaki weapon devices. It was found that the gamma-ray kerma dominated the total kerma for both environments.

  17. Changes in cervical muscle activity according to the traction force of an air-inflatable neck traction device.

    PubMed

    Kang, Jong Ho; Park, Tae-Sung

    2015-09-01

    [Purpose] The purpose of this study was to analyze cervical muscle activity at different traction forces of an air-inflatable neck traction device. [Subjects] Eighteen males participated in this study. [Methods] The subjects put on an air-inflatable neck traction device and the traction forces administered were 40, 80, and 120 mmHg. The electromyography (EMG) signals of the splenius capitis, and upper trapezius were measured to assess the muscle activity. [Results] The muscle activity of the splenius capitis was significantly higher at 80, and 120 mmHg compared to 40 mmHg. The muscle activity of the upper trapezius did not show significant differences among the traction forces. [Conclusion] Our research result showed that the air-inflatable home neck traction device did not meet the condition of muscle relaxation. PMID:26504278

  18. Changes in cervical muscle activity according to the traction force of an air-inflatable neck traction device

    PubMed Central

    Kang, Jong Ho; Park, Tae-Sung

    2015-01-01

    [Purpose] The purpose of this study was to analyze cervical muscle activity at different traction forces of an air-inflatable neck traction device. [Subjects] Eighteen males participated in this study. [Methods] The subjects put on an air-inflatable neck traction device and the traction forces administered were 40, 80, and 120 mmHg. The electromyography (EMG) signals of the splenius capitis, and upper trapezius were measured to assess the muscle activity. [Results] The muscle activity of the splenius capitis was significantly higher at 80, and 120 mmHg compared to 40 mmHg. The muscle activity of the upper trapezius did not show significant differences among the traction forces. [Conclusion] Our research result showed that the air-inflatable home neck traction device did not meet the condition of muscle relaxation. PMID:26504278

  19. One-dimensional Numerical Model of Transient Discharges in Air of a Spatial Plasma Ignition Device

    NASA Astrophysics Data System (ADS)

    Saceleanu, Florin N.

    This thesis examines the modes of discharge of a plasma ignition device. Oscilloscope data of the discharge voltage and current are analyzed for various pressures in air at ambient temperature. It is determined that the discharge operates in 2 modes: a glow discharge and a postulated streamer discharge. Subsequently, a 1-dimensional fluid simulation of plasma using the finite volume method (FVM) is developed to gain insight into the particle kinetics. Transient results of the simulation agree with theories of electric discharges; however, quasi-steady state results were not reached due to high diffusion time of ions in air. Next, an ordinary differential equation (ODE) is derived to understand the discharge transition. Simulated results were used to estimate the voltage waveform, which describes the ODE's forcing function; additional simulated results were used to estimate the discharge current and the ODE's non-linearity. It is found that the ODE's non-linearity increases exponentially for capacitive discharges. It is postulated that the non-linearity defines the mode transition observed experimentally. The research is motivated by Spatial Plasma Discharge Ignition (SPDI), an innovative ignition system postulated to increase combustion efficiency in automobile engines for up to 9%. The research thus far can only hypothesize SPDI's benefits on combustion, based on the literature review and the modes of discharge.

  20. A Portable, Air-Jet-Actuator-Based Device for System Identification

    NASA Astrophysics Data System (ADS)

    Staats, Wayne; Belden, Jesse; Mazumdar, Anirban; Hunter, Ian

    2010-11-01

    System identification (ID) of human and robotic limbs could help in diagnosis of ailments and aid in optimization of control parameters and future redesigns. We present a self-contained actuator, which uses the Coanda effect to rapidly switch the direction of a high speed air jet to create a binary stochastic force input to a limb for system ID. The design of the actuator is approached with the goal of creating a portable device, which could deployed on robot or human limbs for in situ identification. The viability of the device is demonstrated by performing stochastic system ID on an underdamped elastic beam system with fixed inertia and stiffness, and variable damping. The non-parametric impulse response yielded from the stochastic system ID is modeled as a second order system, and the resultant parameters are found to be in excellent agreement with those found using more traditional system ID techniques. The current design could be further miniaturized and developed as a portable, wireless, on-site multi-axis system identification system for less intrusive and more widespread use.

  1. Evaluation of mercury speciation and removal through air pollution control devices of a 190 MW boiler.

    PubMed

    Wu, Chengli; Cao, Yan; Dong, Zhongbing; Cheng, Chinmin; Li, Hanxu; Pan, Weiping

    2010-01-01

    Air pollution control devices (APCDs) are installed at coal-fired power plants for air pollutant regulation. Selective catalytic reduction (SCR) and wet flue gas desulfurization (FGD) systems have the co-benefits of air pollutant and mercury removal. Configuration and operational conditions of APCDs and mercury speciation affect mercury removal efficiently at coal-fired utilities. The Ontario Hydro Method (OHM) recommended by the U.S. Environmental Protection Agency (EPA) was used to determine mercury speciation simultaneously at five sampling locations through SCR-ESP-FGD at a 190 MW unit. Chlorine in coal had been suggested as a factor affecting the mercury speciation in flue gas; and low-chlorine coal was purported to produce less oxidized mercury (Hg2+) and more elemental mercury (Hg0) at the SCR inlet compared to higher chlorine coal. SCR could oxidize elemental mercury into oxidized mercury when SCR was in service, and oxidation efficiency reached 71.0%. Therefore, oxidized mercury removal efficiency was enhanced through a wet FGD system. In the non-ozone season, about 89.5%-96.8% of oxidized mercury was controlled, but only 54.9%-68.8% of the total mercury was captured through wet FGD. Oxidized mercury removal efficiency was 95.9%-98.0%, and there was a big difference in the total mercury removal efficiencies from 78.0% to 90.2% in the ozone season. Mercury mass balance was evaluated to validate reliability of OHM testing data, and the ratio of mercury input in the coal to mercury output at the stack was from 0.84 to 1.08. PMID:20397418

  2. Air

    MedlinePlus

    ... do to protect yourself from dirty air . Indoor air pollution and outdoor air pollution Air can be polluted indoors and it can ... this chart to see what things cause indoor air pollution and what things cause outdoor air pollution! Indoor ...

  3. 76 FR 34845 - Medical Devices; Ear, Nose, and Throat Devices; Classification of the Wireless Air-Conduction...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-15

    ... first FEDERAL REGISTER issue of each #0;week. #0; #0; #0; #0;#0;Federal Register / Vol. 76, No. 115... the Wireless Air-Conduction Hearing Aid AGENCY: Food and Drug Administration, HHS. ACTION: Final rule. SUMMARY: The Food and Drug Administration (FDA) is classifying the wireless air-conduction hearing...

  4. Novel atmospheric pressure plasma device releasing atomic hydrogen: reduction of microbial-contaminants and OH radicals in the air

    NASA Astrophysics Data System (ADS)

    Nojima, Hideo; Park, Rae-Eun; Kwon, Jun-Hyoun; Suh, Inseon; Jeon, Junsang; Ha, Eunju; On, Hyeon-Ki; Kim, Hye-Ryung; Choi, Kyoung Hui; Lee, Kwang-Hee; Seong, Baik-Lin; Jung, Hoon; Kang, Shin Jung; Namba, Shinichi; Takiyama, Ken

    2007-01-01

    A novel atmospheric pressure plasma device releasing atomic hydrogen has been developed. This device has specific properties such as (1) deactivation of airborne microbial-contaminants, (2) neutralization of indoor OH radicals and (3) being harmless to the human body. It consists of a ceramic plate as a positive ion generation electrode and a needle-shaped electrode as an electron emission electrode. Release of atomic hydrogen from the device has been investigated by the spectroscopic method. Optical emission of atomic hydrogen probably due to recombination of positive ions, H+(H2O)n, generated from the ceramic plate electrode and electrons emitted from the needle-shaped electrode have been clearly observed in the He gas (including water vapour) environment. The efficacy of the device to reduce airborne concentrations of influenza virus, bacteria, mould fungi and allergens has been evaluated. 99.6% of airborne influenza virus has been deactivated with the operation of the device compared with the control test in a 1 m3 chamber after 60 min. The neutralization of the OH radical has been investigated by spectroscopic and biological methods. A remarkable reduction of the OH radical in the air by operation of the device has been observed by laser-induced fluorescence spectroscopy. The cell protection effects of the device against OH radicals in the air have been observed. Furthermore, the side effects have been checked by animal experiments. The harmlessness of the device has been confirmed.

  5. Management of Acute Variceal Bleeding

    PubMed Central

    2014-01-01

    Acute variceal bleeding could be a fatal complication in patients with liver cirrhosis. In patients with decompensated liver cirrhosis accompanied by ascites or hepatic encephalopathy, acute variceal bleeding is associated with a high mortality rate. Therefore, timely endoscopic hemostasis and prevention of relapse of bleeding are most important. The treatment goals for acute variceal bleeding are to correct hypovolemia; achieve rapid hemostasis; and prevent early rebleeding, complications related to bleeding, and deterioration of liver function. If variceal bleeding is suspected, treatment with vasopressors and antibiotics should be initiated immediately on arrival to the hospital. Furthermore, to obtain hemodynamic stability, the hemoglobin level should be maintained at >8 g/dL, systolic blood pressure >90 to 100 mm Hg, heart rate <100/min, and the central venous pressure from 1 to 5 mm Hg. When the patient becomes hemodynamically stable, hemostasis should be achieved by performing endoscopy as soon as possible. For esophageal variceal bleeding, endoscopic variceal ligation is usually performed, and for gastric variceal bleeding, endoscopic variceal obturation is performed primarily. If it is considered difficult to achieve hemostasis through endoscopy, salvage therapy may be carried out while keeping the patient hemodynamically stable. PMID:25133116

  6. Liquefied Bleed for Stability and Efficiency of High Speed Inlets

    NASA Technical Reports Server (NTRS)

    Saunders, J. David; Davis, David; Barsi, Stephen J.; Deans, Matthew C.; Weir, Lois J.; Sanders, Bobby W.

    2014-01-01

    A mission analysis code was developed to perform a trade study on the effectiveness of liquefying bleed for the inlet of the first stage of a TSTO vehicle. By liquefying bleed, the vehicle weight (TOGW) could be reduced by 7 to 23%. Numerous simplifying assumptions were made and lessons were learned. Increased accuracy in future analyses can be achieved by: Including a higher fidelity model to capture the effect of rescaling (variable vehicle TOGW). Refining specific thrust and impulse models ( T m a and Isp) to preserve fuel-to-air ratio. Implementing LH2 for T m a and Isp. Correlating baseline design to other mission analyses and correcting vehicle design elements. Implementing angle-of-attack effects on inlet characteristics. Refining aerodynamic performance (to improve L/D ratio at higher Mach numbers). Examining the benefit with partial cooling or densification of the bleed air stream. Incorporating higher fidelity weight estimates for the liquefied bleed system (heat exchange and liquid storage versus bleed duct weights) could be added when more fully developed. Adding trim drag or 6-degree-of-freedom trajectory analysis for higher fidelity. Investigating vehicle optimization for each of the bleed configurations.

  7. Design and development of a biomimetic device for micro air vehicles

    NASA Astrophysics Data System (ADS)

    Bohorquez, Felipe; Pines, Darryll J.

    2002-07-01

    This paper presents the design and development of a pitching and plunging (flapping) mechanism for small-scale flight. In order to harness the unsteady lift mechanisms, used by most insects, a biologically inspired flapping/pitching device in conjunction with a rotary wing concept was developed and built. This mechanism attempts to replicate some of the aerodynamic phenomena that enhance the performance of small fliers, replacing the periodic translational motion with a unidirectional circular motion while actively flapping and pitching the rotor blades. In order to find the appropriate combination of phase, amplitude, frequency and rotational speed that leads to enhancement in lift, the device requires uncoupled independent pitch and flap actuation systems to permit the complete mapping of the parameter space. In the device under consideration the phase shift between the flapping and the pitching oscillations can be adjusted from 0 to 360 degrees over a wide range of rotational speeds. Maximum flapping and pitching amplitudes of +/- 23 degree(s) and +/- 20 degree(s) respectively can be attained. Linear displacements of two coaxial shafts are translated into the flapping and pitching motion of the rotor blades. The mechanism was designed to minimize the actuation stroke so that smart materials and conventional actuators such as motors and cams could be used. Kinematic analysis as well as experimental tests were performed. Using a customized test stand thrust and torque produced by the rotor were measured at different angles of attack, in steady-state and under periodical pitching actuation. The results showed that hover efficiency was considerably increased for a range of thrust coefficients. The device was developed based on the University of Maryland's rotary wing Micro Air vehicle (MAV) the MICOR (MIcro COaxial Rotorcraft), an electrically driven 100 g coaxial helicopter. It is anticipated that active flapping and/or pitching could be implemented in the

  8. Air Cleaning Devices for HVAC Supply Systems in Schools. Technical Bulletin.

    ERIC Educational Resources Information Center

    Wheeler, Arthur E.

    Guidelines for maintaining indoor air quality in schools with HVAC air cleaning systems are provided in this document. Information is offered on the importance of air cleaning, sources of air contaminants and indoor pollutants, types of air cleaners and particulate filters used in central HVAC systems, vapor and gas removal, and performance…

  9. Anode reactive bleed and injector shift control strategy

    DOEpatents

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

    2012-01-03

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

  10. Detection of airborne bacteria in a duck production facility with two different personal air sampling devices for an exposure assessment.

    PubMed

    Martin, Elena; Dziurowitz, Nico; Jäckel, Udo; Schäfer, Jenny

    2015-01-01

    Prevalent airborne microorganisms are not well characterized in industrial animal production buildings with respect to their quantity or quality. To investigate the work-related microbial exposure, personal bioaerosol sampling during the whole working day is recommended. Therefore, bioaerosol sampling in a duck hatchery and a duck house with two personal air sampling devices, a filter-based PGP and a NIOSH particle size separator, was performed. Subsequent, quantitative and qualitative analyses were carried out with" culture independent methods. Total cell concentrations (TCC) determined via fluorescence microscopy showed no difference between the two devices. In average, 8 × 10(6) cells/m(3) were determined in the air of the duck hatchery and 5 × 10(7) cells/m(3) in the air of the duck house. A Generated Restriction Fragment Length Polymorphism (RFLP) pattern revealed deviant bacterial compositions comparing samples collected with both devices. Clone library analyses based on 16S rRNA gene sequence analysis from the hatchery's air showed 65% similarity between the two sampling devices. Detailed 16S rRNA gene sequence analyses showed the occurrence of bacterial species like Acinetobacter baumannii, Enterococcus faecalis, Escherichia sp., and Shigella sp.; and a group of Staphylococcus delphini, S. intermedius, and S. pseudintermedius that provided the evidence of potential exposure to risk group 2 bacteria at the hatchery workplace. Size fractionated sampling with the developed by the Institute for Occupational Safety and Health of the German Social Accident Insurance (IFA) device revealed that pathogenic bacteria would deposit in the inhalable, the thorax, and possibly alveolar dust fraction according to EN481. TCC analysis showed the deposition of bacterial cells in the third stage (< 1μm) at the NIOSH device which implies that bacteria can reach deep into the lungs and contaminate the alveolus after inhalation. Nevertheless, both personal sampling devices

  11. Abnormal Uterine Bleeding (Beyond the Basics)

    MedlinePlus

    ... Approach to abnormal uterine bleeding in nonpregnant reproductive-age women Differential diagnosis of genital tract bleeding in women Postmenopausal uterine bleeding The following organizations also provide reliable health information. ● National Library of Medicine ( www.nlm.nih.gov/ ...

  12. 40 CFR 424.10 - Applicability; description of the open electric furnaces with wet air pollution control devices...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 30 2013-07-01 2012-07-01 true Applicability; description of the open electric furnaces with wet air pollution control devices subcategory. 424.10 Section 424.10 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS FERROALLOY MANUFACTURING POINT SOURCE CATEGORY...

  13. Air Filter Devices Including Nonwoven Meshes of Electrospun Recombinant Spider Silk Proteins

    PubMed Central

    Lang, Gregor; Jokisch, Stephan; Scheibel, Thomas

    2013-01-01

    Based on the natural sequence of Araneus diadematus Fibroin 4 (ADF4), the recombinant spider silk protein eADF4(C16) has been engineered. This highly repetitive protein has a molecular weight of 48kDa and is soluble in different solvents (hexafluoroisopropanol (HFIP), formic acid and aqueous buffers). eADF4(C16) provides a high potential for various technical applications when processed into morphologies such as films, capsules, particles, hydrogels, coatings, fibers and nonwoven meshes. Due to their chemical stability and controlled morphology, the latter can be used to improve filter materials. In this protocol, we present a procedure to enhance the efficiency of different air filter devices, by deposition of nonwoven meshes of electrospun recombinant spider silk proteins. Electrospinning of eADF4(C16) dissolved in HFIP results in smooth fibers. Variation of the protein concentration (5-25% w/v) results in different fiber diameters (80-1,100 nm) and thus pore sizes of the nonwoven mesh. Post-treatment of eADF4(C16) electrospun from HFIP is necessary since the protein displays a predominantly α-helical secondary structure in freshly spun fibers, and therefore the fibers are water soluble. Subsequent treatment with ethanol vapor induces formation of water resistant, stable β-sheet structures, preserving the morphology of the silk fibers and meshes. Secondary structure analysis was performed using Fourier transform infrared spectroscopy (FTIR) and subsequent Fourier self-deconvolution (FSD). The primary goal was to improve the filter efficiency of existing filter substrates by adding silk nonwoven layers on top. To evaluate the influence of electrospinning duration and thus nonwoven layer thickness on the filter efficiency, we performed air permeability tests in combination with particle deposition measurements. The experiments were carried out according to standard protocols. PMID:23685883

  14. Effect of particle size, air flow and inhaler device on the aerosolisation of disodium cromoglycate powders.

    PubMed

    Chew, N Y; Bagster, D F; Chan, H K

    2000-09-25

    Recently, the dispersion of mannitol powders has demonstrated the importance of particle size, air flow and inhaler device (Chew and Chan, 1999). The aim of the present study is to extend our investigation to a different compound, disodium cromoglycate (DSCG) powders. Solid state characteristics of the powders were assessed by particle sizing, scanning electron microscopy, X-ray powder diffraction, moisture content, particle density determination and freeze fracture. The aerosol behaviour of the powders was studied by dispersion using Rotahaler(R) and Dinkihaler(R), connected to a four-stage liquid impinger operating at 30-120 l/min. Three amorphous powders with a mass median diameter (MMD) of 2.3, 3.7, 5.2 microm and a similar polydispersity were prepared. The particles were nearly spherical with a particle density of 1.6 g/cm(3) and moisture content of 6.6 wt.%. Using Rotahaler(R), the maximum fine particle fraction (FPF(max)) for all three powders was only 15 wt.%, attained at the highest flow of 120 l/min. Using Dinkihaler(R), the FPF(max) was two to four times higher, being 36 and 29 wt.% for the 2.3 and 3.7 microm powder, respectively, at 60 l/min; and 18 wt.% for the 5.2 microm powder at 120 l/min. Hence, the study shows that the FPF in the DSCG powder aerosols was determined by the interaction of the particle size, air flow and inhaler design. The attribution of the amorphous nature and the different physico-chemical properties of the powder may explain the incomplete and low dispersibility of DSCG. PMID:11058812

  15. Inflammation and endometrial bleeding.

    PubMed

    Berbic, M; Ng, C H M; Fraser, I S

    2014-12-01

    the amount of viable cellular material transiting the Fallopian tubes. All of these processes are influenced or controlled by regulatory T cells. Many of these leukocytes also have the potential to release regulatory molecules which stimulate endometrial repair mechanisms. Increasing recent evidence also implicates disturbances of immune cells and their cytokine mediators in contributing to symptoms of abnormal uterine bleeding and pelvic pain. These recent findings all point towards the importance of the 'inflammatory process' in both normal and abnormal endometrial bleeding. PMID:25247830

  16. Primary prophylaxis of variceal bleeding.

    PubMed

    Ilyas, Jawad A; Kanwal, Fasiha

    2014-12-01

    Gastroesophageal varices are present in almost half of patients with cirrhosis at the time of initial diagnosis. Variceal bleeding occurs in 25% to 35% of patients with cirrhosis. Effective and timely care can prevent variceal bleeding (primary prophylaxis). For example, clinical studies demonstrate that both beta-blockers and endoscopic variceal ligation are effective in preventing a first episode of variceal bleeding. The major challenge is to screen patients in a timely manner and institute a form of therapy that has the highest chance of success in terms of patient compliance and effectiveness. PMID:25440925

  17. Vaginal or uterine bleeding - overview

    MedlinePlus

    Vaginal bleeding normally occurs during a woman's menstrual cycle, when she gets her period. Every woman's period is different. Most women have cycles between 24 and 34 days apart. It usually lasts ...

  18. [Gastrointestinal bleeding in intensive care].

    PubMed

    Vartic, M; Chilie, A; Beuran, M

    2006-01-01

    Gastrointestinal bleeding (GIB) is a frequent finding in intensive care unit (ICU) and has considerable morbidity particularly for the elderly. The most common etiology for upper digestive bleeding is the stress ulcer and for the lower bleeding the diverticular disease of the colon. The predictive risk factors for GIB are age, organ failure, mechanical ventilation and length of stay in ICU. Even though a 4.5 times increase in mortality is seen in these patients it cannot be directly correlated to the bleeding. Routine use of H2 inhibitors is effective only in high risk patients, opposing enteral nutrition which is valuable in all patients. Prophylactic measures resulted in a 50% decrease in incidence of GIB in ICU and also of the mortality. Most of the patients are now treated non-operatively. PMID:17059147

  19. MedlinePlus: Gastrointestinal Bleeding

    MedlinePlus

    ... looks like coffee grounds Black or tarry stool Dark blood mixed with stool Signs of bleeding in ... lower digestive tract include Black or tarry stool Dark blood mixed with stool Stool mixed or coated ...

  20. [The use of individual protective devices for decreasing the microbial contamination of the inhaled air].

    PubMed

    Sedov, A V; Akin'shin, A V; Tregub, T I

    1995-01-01

    The work was aimed to justify application of gas masks and respirators with autonomous air source fo lower bacterial contamination of inhaled air. The studies also covered possible catch of bacteria by cotton and filters FPP-15-1.5, those composed of antimicrobial materials, containing furagin or copper ions. As the studies proved, for lower bacterial contaminations of inhaled air one can apply autonomous air source apparatus with filters made of Petrianov tissue, antimicrobial tissue (containing furagin or copper ions), as they reduce fungal content of the air. Such filters are self-disinfecting, but do not influence total contamination of the air. PMID:7663856

  1. An analysis of using semi-permeable membrane devices to assess persistent organic pollutants in ambient air of Alaska

    NASA Astrophysics Data System (ADS)

    Wu, Ted Hsin-Yeh

    A region of concern for persistent organic pollutants (POPS) contamination is the Arctic, because of POPs' ability to migrate long distances through the atmosphere toward cold regions, condense out of the atmosphere in those region, deposit in sensitive arctic ecosystems and bioaccumulate in Arctic species. Thus, monitoring of POP concentrations in the Arctic is necessary. However, traditional active air monitoring techniques for POPs may not be feasible in the Arctic, because of logistics and cost. While these issues may be overcome using passive air sampling devices, questions arise about the interpretation of the contaminant concentrations detected using the passive air samplers. In this dissertation semi-permeable membrane devices (SPMDs) containing triolein were characterized and evaluated for use in sampling the ambient air of Alaska for three classes of POPS (organochlorines [OCs], polychlorinated biphenyls [PCBs] and polyaromatic hydrocarbons [PAHs]). In addition, a SPMD-based sampling campaign for POPS was conducted simultaneously at five sites in Alaska during a one-year period. The POP concentrations obtained from the SPMDs were examined to determine the spatial and seasonal variability at the locations. POP concentrations detected in SPMDs were influenced by exposure to sunlight, concentrations of particulate-bound contaminants and changes in temperature. PAH concentrations in a SPMD mounted in a sunlight-blocking deployment unit were higher than in a SPMD exposed to sunlight (P = 0.007). PCB concentrations in SPMD exposed to filtered and non-filtered air were significantly different (P < 0.0001). Derived PAH air concentrations measured using SPMD were within a factor of approximately 7 of those obtained from an air sampler in Barrow, Alaska. The field study showed three distinct groups of samples. Barrow was separated from the sub-Arctic samples and a Homer sample (September-December) was distinct from the sub-Arctic samples. The separations suggest

  2. Bleeding varices: 1. Emergency management.

    PubMed Central

    Hanna, S S; Warren, W D; Galambos, J T; Millikan, W J

    1981-01-01

    The aim of the emergency management of bleeding varices is to stop the hemorrhage nonoperatively if possible, avoiding emergency shunt surgery, an operation that has a higher mortality than elective shunt surgery. Patients with an upper gastrointestinal hemorrhage should undergo endoscopy immediately to verify the diagnosis of bleeding varices. They can then be categorized according to whether they stop bleeding spontaneously (group 1), continue to bleed slowly (group 2) or continue to bleed rapidly (group 3). Group 1 patients are discussed in the second part of this two-part series. Group 2 patients are initially treated with vasopressin given intravenously; those who fail to respond should undergo emergency angiography and receive vasopressin intra-arterially. If this fails, patients at low surgical risk should undergo urgent shunt surgery; those at high risk do better with endoscopic sclerotherapy. Group 3 patients are also given an intravenous infusion of vasopressin. Patients at low surgical risk who continue to bleed then receive tamponade with a Sengstaken--Blakemore tube. If this fails, they undergo emergency creation of an H-shaped mesocaval shunt. Patients at high surgical risk who fail to respond to vasopressin given intravenously are next treated intra-arterially. If this fails they are given either endoscopic or transhepatic sclerotherapy. PMID:7006779

  3. Statistical estimate of mercury removal efficiencies for air pollution control devices of municipal solid waste incinerators.

    PubMed

    Takahashi, Fumitake; Kida, Akiko; Shimaoka, Takayuki

    2010-10-15

    Although representative removal efficiencies of gaseous mercury for air pollution control devices (APCDs) are important to prepare more reliable atmospheric emission inventories of mercury, they have been still uncertain because they depend sensitively on many factors like the type of APCDs, gas temperature, and mercury speciation. In this study, representative removal efficiencies of gaseous mercury for several types of APCDs of municipal solid waste incineration (MSWI) were offered using a statistical method. 534 data of mercury removal efficiencies for APCDs used in MSWI were collected. APCDs were categorized as fixed-bed absorber (FA), wet scrubber (WS), electrostatic precipitator (ESP), and fabric filter (FF), and their hybrid systems. Data series of all APCD types had Gaussian log-normality. The average removal efficiency with a 95% confidence interval for each APCD was estimated. The FA, WS, and FF with carbon and/or dry sorbent injection systems had 75% to 82% average removal efficiencies. On the other hand, the ESP with/without dry sorbent injection had lower removal efficiencies of up to 22%. The type of dry sorbent injection in the FF system, dry or semi-dry, did not make more than 1% difference to the removal efficiency. The injection of activated carbon and carbon-containing fly ash in the FF system made less than 3% difference. Estimation errors of removal efficiency were especially high for the ESP. The national average of removal efficiency of APCDs in Japanese MSWI plants was estimated on the basis of incineration capacity. Owing to the replacement of old APCDs for dioxin control, the national average removal efficiency increased from 34.5% in 1991 to 92.5% in 2003. This resulted in an additional reduction of about 0.86Mg emission in 2003. Further study using the methodology in this study to other important emission sources like coal-fired power plants will contribute to better emission inventories. PMID:20713298

  4. Modeled effectiveness of ventilation with contaminant control devices on indoor air quality in a swine farrowing facility.

    PubMed

    Anthony, T Renée; Altmaier, Ralph; Park, Jae Hong; Peters, Thomas M

    2014-01-01

    Because adverse health effects experienced by swine farm workers in concentrated animal feeding operations (CAFOs) have been associated with exposure to dust and gases, efforts to reduce exposures are warranted, particularly in winter seasons when exposures increase due to decreased ventilation. Simulation of air quality and operating costs for ventilating swine CAFO, including treating and recirculating air through a farrowing room, was performed using mass and energy balance equations over a 90-day winter season. System operation required controlling heater operation to achieve room temperatures optimal to ensure animal health (20 to 22.5 °C). Five air pollution control devices, four room ventilation rates, and five recirculation patterns were examined. Inhalable dust concentrations were easily reduced using standard industrial air pollution control devices, including a cyclone, filtration, and electrostatic precipitator. Operating ventilation systems at 0.94 m3 s(-1) (2000 cfm) with 75 to 100% recirculation of treated air from cyclone, electrostatic precipitator, and shaker dust filtration system achieves adequate particle control with operating costs under $1.00 per pig produced ($0.22 to 0.54), although carbon dioxide (CO2) concentrations approach 2000 ppm using in-room ventilated gas fired heaters. In no simulation were CO2 concentrations below industry recommended concentrations (1540 ppm), but alternative heating devices could reduce CO2 to acceptable concentrations. While this investigation does not represent all production swine farrowing barns, which differ in characteristics including room dimensions and swine occupancy, the simulation model and ventilation optimization methods can be applied to other production sites. This work shows that ventilation may be a cost-effective control option in the swine industry to reduce exposures. PMID:24433305

  5. Modeled Effectiveness of Ventilation with Contaminant Control Devices on Indoor Air Quality in a Swine Farrowing Facility

    PubMed Central

    Anthony, T. Renée; Altmaier, Ralph; Park, Jae Hong; Peters, Thomas M.

    2016-01-01

    Because adverse health effects experienced by swine farm workers in concentrated animal feeding operations (CAFOs) have been associated with exposure to dust and gases, efforts to reduce exposures are warranted, particularly in winter seasons when exposures increase due to decreased ventilation. Simulation of air quality and operating costs for ventilating swine CAFO, including treating and recirculating air through a farrowing room, was performed using mass and energy balance equations over a 90-day winter season. System operation required controlling heater operation to achieve room temperatures optimal to ensure animal health (20 to 22.5°C). Five air pollution control devices, four room ventilation rates, and five recirculation patterns were examined. Inhalable dust concentrations were easily reduced using standard industrial air pollution control devices, including a cyclone, filtration, and electrostatic precipitator. Operating ventilation systems at 0.94 m3 s−1 (2000 cfm) with 75 to 100% recirculation of treated air from cyclone, electrostatic precipitator, and shaker dust filtration system achieves adequate particle control with operating costs under $1.00 per pig produced ($0.22 to 0.54), although carbon dioxide (CO2) concentrations approach 2000 ppm using in-room ventilated gas fired heaters. In no simulation were CO2 concentrations below industry recommended concentrations (1540 ppm), but alternative heating devices could reduce CO2 to acceptable concentrations. While this investigation does not represent all production swine farrowing barns, which differ in characteristics including room dimensions and swine occupancy, the simulation model and ventilation optimization methods can be applied to other production sites. This work shows that ventilation may be a cost-effective control option in the swine industry to reduce exposures. PMID:24433305

  6. Surgical management of presacral bleeding

    PubMed Central

    Ausobsky, JR; Vowden, P

    2014-01-01

    Introduction Presacral venous bleeding is an uncommon but potentially life threatening complication of rectal surgery. During the posterior rectal dissection, it is recommended to proceed into the plane between the fascia propria of the rectum and the presacral fascia. Incorrect mobilisation of the rectum outside the Waldeyer’s fascia can tear out the lower presacral venous plexus or the sacral basivertebral veins, causing what may prove to be uncontrollable bleeding. Methods A systematic search of the MEDLINE® and Embase™ databases was performed to obtain primary data published in the period between 1 January 1960 and 31 July 2013. Each article describing variables such as incidence of presacral venous bleeding, surgical approach, number of cases treated and success rate was included in the analysis. Results A number of creative solutions have been described that attempt to provide good tamponade of the presacral haemorrhage, eliminating the need for second operation. However, few cases are reported in the literature. Conclusions As conventional haemostatic measures often fail to control this type of haemorrhage, several alternative methods to control bleeding definitively have been described. We propose a practical comprehensive classification of the available techniques for the management of presacral bleeding. PMID:24780015

  7. A Community-Based Approach to Developing a Mobile Device for Measuring Ambient Air Exposure, Location, and Respiratory Health

    DOE PAGESBeta

    Rohlman, Diana; Syron, Laura; Hobbie, Kevin; Anderson, Kim A.; Scaffidi, Christopher; Sudakin, Daniel; Peterson, Elena S.; Waters, Katrina M.; Haynes, Erin; Arkin, Lisa; et al

    2015-08-15

    In west Eugene (Oregon), community research indicates residents are disproportionately exposed to industrial air pollution and exhibit increased asthma incidence. In Carroll County (Ohio), recent increases in unconventional natural gas drilling sparked air quality concerns. These community concerns led to the development of a prototype mobile device to measure personal chemical exposure, location, and respiratory function. Working directly with the environmental justice (EJ) communities, the prototype was developed to (1) meet the needs of the community and; (2) evaluate the use in EJ communities. The prototype was evaluated in 3 community focus groups (n=25) to obtain feedback on the prototypemore » and feasibility study design to evaluate the efficacy of the device to address community concerns. Focus groups were recorded and qualitatively analyzed with discrete feedback tabulated for further refinement. The prototype was improved by community feedback resulting in 8 alterations/additions to software and instructional materials. Overall, focus group participants were supportive of the device and believed it would be a useful environmental health tool. The use of focus groups ensured that community members were engaged in the research design and development of a novel environmental health tool. We found that community-based research strategies resulted in a refined device as well as relevant research questions, specific to the EJ community needs and concerns.« less

  8. A Community-Based Approach to Developing a Mobile Device for Measuring Ambient Air Exposure, Location, and Respiratory Health

    SciTech Connect

    Rohlman, Diana; Syron, Laura; Hobbie, Kevin; Anderson, Kim A.; Scaffidi, Christopher; Sudakin, Daniel; Peterson, Elena S.; Waters, Katrina M.; Haynes, Erin; Arkin, Lisa; Feezel, Paul; Kincl, Laurel

    2015-08-15

    In west Eugene (Oregon), community research indicates residents are disproportionately exposed to industrial air pollution and exhibit increased asthma incidence. In Carroll County (Ohio), recent increases in unconventional natural gas drilling sparked air quality concerns. These community concerns led to the development of a prototype mobile device to measure personal chemical exposure, location, and respiratory function. Working directly with the environmental justice (EJ) communities, the prototype was developed to (1) meet the needs of the community and; (2) evaluate the use in EJ communities. The prototype was evaluated in 3 community focus groups (n=25) to obtain feedback on the prototype and feasibility study design to evaluate the efficacy of the device to address community concerns. Focus groups were recorded and qualitatively analyzed with discrete feedback tabulated for further refinement. The prototype was improved by community feedback resulting in 8 alterations/additions to software and instructional materials. Overall, focus group participants were supportive of the device and believed it would be a useful environmental health tool. The use of focus groups ensured that community members were engaged in the research design and development of a novel environmental health tool. We found that community-based research strategies resulted in a refined device as well as relevant research questions, specific to the EJ community needs and concerns.

  9. The Impact of Refrigerant Charge, Air Flow and Expansion Devices on the Measured Performance of an Air-Source Heat Pump Part I

    SciTech Connect

    Shen, Bo

    2011-01-01

    This paper describes extensive tests performed on a 3-ton R-22 split heat pump in heating mode. The tests contain 150 steady-state performance tests, 18 cyclic tests and 18 defrost tests. During the testing work, the refrigerant charge level was varied from 70 % to 130% relative to the nominal value; the outdoor temperature was altered by three levels at 17 F (-8.3 C), 35 F (1.7 C) and 47 F (8.3 C); indoor air flow rates ranged from 60% to 150% of the rated air flow rate; and the expansion device was switched from a fixed-orifice to a thermal expansion value. Detailed performance data from the extensive steady state cyclic and defrost testing performed were presented and compared.

  10. Field-based evaluation of semipermeable membrane devices (SPMDs) as passive air samplers of polyaromatic hydrocarbons (PAHs)

    NASA Astrophysics Data System (ADS)

    Bartkow, Michael E.; Huckins, James N.; Müller, Jochen F.

    2004-11-01

    Semipermeable membrane devices (SPMDs) have been used as passive air samplers of semivolatile organic compounds in a range of studies. However, due to a lack of calibration data for polyaromatic hydrocarbons (PAHs), SPMD data have not been used to estimate air concentrations of target PAHs. In this study, SPMDs were deployed for 32 days at two sites in a major metropolitan area in Australia. High-volume active sampling systems (HiVol) were co-deployed at both sites. Using the HiVol air concentration data from one site, SPMD sampling rates were measured for 12 US EPA Priority Pollutant PAHs and then these values were used to determine air concentrations at the second site from SPMD concentrations. Air concentrations were also measured at the second site with co-deployed HiVols to validate the SPMD results. PAHs mostly associated with the vapour phase (Fluorene to Pyrene) dominated both the HiVol and passive air samples. Reproducibility between replicate passive samplers was satisfactory (CV<20%) for the majority of compounds. Sampling rates ranged between 0.6 and 6.1 m3 d-1. SPMD-based air concentrations were calculated at the second site for each compound using these sampling rates and the differences between SPMD-derived air concentrations and those measured using a HiVol were, on average, within a factor of 1.5. The dominant processes for the uptake of PAHs by SPMDs were also assessed. Using the SPMD method described herein, estimates of particulate sorbed airborne PAHs with five rings or greater were within 1.8-fold of HiVol measured values.

  11. Field-based evaluation of semipermeable membrane devices (SPMDs) as passive air samplers of polyaromatic hydrocarbons (PAHs)

    USGS Publications Warehouse

    Bartkow, M.E.; Huckins, J.N.; Muller, J.F.

    2004-01-01

    Semipermeable membrane devices (SPMDs) have been used as passive air samplers of semivolatile organic compounds in a range of studies. However, due to a lack of calibration data for polyaromatic hydrocarbons (PAHs), SPMD data have not been used to estimate air concentrations of target PAHs. In this study, SPMDs were deployed for 32 days at two sites in a major metropolitan area in Australia. High-volume active sampling systems (HiVol) were co-deployed at both sites. Using the HiVol air concentration data from one site, SPMD sampling rates were measured for 12 US EPA Priority Pollutant PAHs and then these values were used to determine air concentrations at the second site from SPMD concentrations. Air concentrations were also measured at the second site with co-deployed HiVols to validate the SPMD results. PAHs mostly associated with the vapour phase (Fluorene to Pyrene) dominated both the HiVol and passive air samples. Reproducibility between replicate passive samplers was satisfactory (CV<20%) for the majority of compounds. Sampling rates ranged between 0.6 and 6.1 m3 d-1. SPMD-based air concentrations were calculated at the second site for each compound using these sampling rates and the differences between SPMD-derived air concentrations and those measured using a HiVol were, on average, within a factor of 1.5. The dominant processes for the uptake of PAHs by SPMDs were also assessed. Using the SPMD method described herein, estimates of particulate sorbed airborne PAHs with five rings or greater were within 1.8-fold of HiVol measured values. ?? 2004 Elsevier Ltd. All rights reserved.

  12. [Direct oral anticoagulant associated bleeding].

    PubMed

    Godier, A; Martin, A-C; Rosencher, N; Susen, S

    2016-07-01

    Direct oral anticoagulants (DOAC) are recommended for stroke prevention in atrial fibrillation and for the treatment of venous thromboembolism. However, they are associated with hemorrhagic complications. Management of DOAC-induced bleeding remains challenging. Activated or non-activated prothrombin concentrates are proposed, although their efficacy to reverse DOAC is uncertain. Therapeutic options also include antidotes: idarucizumab, antidote for dabigatran, has been approved for use whereas andexanet alpha, antidote for anti-Xa agents, and aripazine, antidote for all DOAC, are under development. Other options include hemodialysis for the treatment of dabigatran-associated bleeding and administration of oral charcoal if recent DOAC ingestion. DOAC plasma concentration measurement is necessary to guide DOAC reversal. We propose an update on DOAC-associated bleeding, integrating the availability of dabigatran antidote and the critical place of DOAC concentration measurements. PMID:27297642

  13. A solvent replenishment solution for managing evaporation of biochemical reactions in air-matrix digital microfluidics devices

    SciTech Connect

    Jebrail, Mais J.; Renzi, Ronald F.; Sinha, Anupama; Van De Vreugde, Jim; Gondhalekar, Carmen; Ambriz, Cesar; Meagher, Robert J.; Branda, Steven S.

    2014-10-01

    Digital microfluidics (DMF) is a powerful technique for sample preparation and analysis for a broad range of biological and chemical applications. In many cases, it is desirable to carry out DMF on an open surface, such that the matrix surrounding the droplets is ambient air. However, the utility of the air-matrix DMF format has been severely limited by problems with droplet evaporation, especially when the droplet-based biochemical reactions require high temperatures for long periods of time. We present a simple solution for managing evaporation in air-matrix DMF: just-in-time replenishment of the reaction volume using droplets of solvent. We demonstrate that this solution enables DMF-mediated execution of several different biochemical reactions (RNA fragmentation, first-strand cDNA synthesis, and PCR) over a range of temperatures (4–95 °C) and incubation times (up to 1 h or more) without use of oil, humidifying chambers, or off-chip heating modules. Reaction volumes and temperatures were maintained roughly constant over the course of each experiment, such that the reaction kinetics and products generated by the air-matrix DMF device were comparable to those of conventional benchscale reactions. As a result, this simple yet effective solution for evaporation management is an important advance in developing air-matrix DMF for a wide variety of new, high-impact applications, particularly in the biomedical sciences.

  14. A solvent replenishment solution for managing evaporation of biochemical reactions in air-matrix digital microfluidics devices

    DOE PAGESBeta

    Jebrail, Mais J.; Renzi, Ronald F.; Sinha, Anupama; Van De Vreugde, Jim; Gondhalekar, Carmen; Ambriz, Cesar; Meagher, Robert J.; Branda, Steven S.

    2014-10-01

    Digital microfluidics (DMF) is a powerful technique for sample preparation and analysis for a broad range of biological and chemical applications. In many cases, it is desirable to carry out DMF on an open surface, such that the matrix surrounding the droplets is ambient air. However, the utility of the air-matrix DMF format has been severely limited by problems with droplet evaporation, especially when the droplet-based biochemical reactions require high temperatures for long periods of time. We present a simple solution for managing evaporation in air-matrix DMF: just-in-time replenishment of the reaction volume using droplets of solvent. We demonstrate thatmore » this solution enables DMF-mediated execution of several different biochemical reactions (RNA fragmentation, first-strand cDNA synthesis, and PCR) over a range of temperatures (4–95 °C) and incubation times (up to 1 h or more) without use of oil, humidifying chambers, or off-chip heating modules. Reaction volumes and temperatures were maintained roughly constant over the course of each experiment, such that the reaction kinetics and products generated by the air-matrix DMF device were comparable to those of conventional benchscale reactions. As a result, this simple yet effective solution for evaporation management is an important advance in developing air-matrix DMF for a wide variety of new, high-impact applications, particularly in the biomedical sciences.« less

  15. PLATELET GLYCOPROTEIN Ibα (GPIbα) ECTODOMAIN SHEDDING AND NON-SURGICAL BLEEDING IN HEART FAILURE PATIENTS SUPPORTED BY CONTINUOUS FLOW LEFT VENTRICULAR ASSIST DEVICES (CF-LVADs)

    PubMed Central

    Hu, Jingping; Mondal, Nandan K; Sorensen, Erik N; Cai, Ling; Fang, Hong-Bin; Griffith, Bartley P; Wu, Zhongjun J

    2013-01-01

    BACKGROUND Non-surgical bleeding (NSB) is a major complication among heart failure (HF) patients supported by CF-LVADs. Understanding the hemostatic defects contributing to NSB after CF-LVAD implantation is crucial for prevention of this adverse event. The aim of this study was to examine the link between platelet GPIbα ectodomain shedding and NSB in CF-LVAD recipients and to identify a potential biomarker of NSB. METHODS Serial blood samples were collected from thirty five HF patients supported with CF-LVADs. Platelet function was evaluated by Platelet Function Analyzer 100® and thromboelastography (TEG). Platelet GPIbα shedding, von Villebrand factor (vWF) antigen and vWF collagen binding capacity were determined using enzyme-linked immunosorbent assays (ELISAs). The structural analysis of vWF was performed by gel electrophoresis. These platelet functional measures with vWF parameters of the patients who experienced NSB between 4 to 32 days after CF-LVAD implantation (bleeder) were analyzed against those without NSB (non-bleeder). Blood samples from seven healthy individuals were collected to obtain the healthy reference values for the laboratory assays. RESULTS Elevated GPIbα shedding was found to be a preexisting condition in all HF patients prior to CF-LVAD implantation. Post-operative level of GPIbα shedding increased and remained elevated in the bleeder group while a consistent decrease was found in the non-bleeder group. A receiver operating characteristic (ROC) analysis indicated that the level of GPIbα shedding has a predictive power of NSB in patients supported with CF-LVADs. CONCLUSION Platelet GPIbα ectodomain shedding which attenuates platelet reactivity is associated with NSB. Plasma GPIbα level may potentially be used to refine bleeding risk stratification in CF-LVAD patients. PMID:24055626

  16. Thrombosis in rare bleeding disorders.

    PubMed

    Ruiz-Sáez, Arlette

    2012-04-01

    Inherited deficiencies of blood coagulation factors are usually associated with lifelong bleeding tendency. In addition to Haemophilias A and B and von Willebrand disease, congenital deficiencies of such factors as fibrinogen, prothrombin (FII)), FV, FVII, FX, FXI, FXIII, and combined deficiencies occur and can lead to a diversity of clinical conditions. Paradoxically, for some of these disorders associated with significant bleeding tendency there are reports of thrombotic events, both arterial and venous. Thrombosis in hemophilia patients has a multifactorial pathogenesis and the main conditions associated with this complication are the use of long-term central venous catheters, intensive replacement therapy usually in the setting of surgical procedures, the use of bypassing agents or the coexistence of acquired or inherited prothrombotic risk factors. Regarding other rare bleeding disorders, thrombotic phenomena has been described particularly in patients with afibrinogenemia, FXI and FVII deficiency and the events can occur even in young patients, in the presence of concomitant risk factors or spontaneously. Replacement therapy must be individualized and should take into account past history of haemostatic challenges, family history of bleeding and thrombosis, just like the level of factor. For mild deficiencies when patients are asymptomatic the use of antithrombotic prophylaxis must be considered with or without concomitant use of replacement therapy. In patients with history of thrombosis it may be helpful to perform a thrombophilia screening to exclude coexisting prothrombotic defects and for all patients it is recommended to control known cardiovascular disease risk factors. PMID:22507808

  17. Gastrointestinal Bleeding Secondary to Calciphylaxis.

    PubMed

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

    2015-01-01

    BACKGROUND Calciphylaxis is associated with a high mortality that approaches 80%. The diagnosis is usually made when obvious skin lesions (painful violaceous mottling of the skin) are present. However, visceral involvement is rare. We present a case of calciphylaxis leading to lower gastrointestinal (GI) bleeding and rectal ulceration of the GI mucosa. CASE REPORT A 66-year-old woman with past medical history of diabetes mellitus, hypertension, end-stage renal disease (ESRD), recently diagnosed ovarian cancer, and on hemodialysis (HD) presented with painful black necrotic eschar on both legs. The radiograph of the legs demonstrated extensive calcification of the lower extremity arteries. The hospital course was complicated with lower GI bleeding. A CT scan of the abdomen revealed severe circumferential calcification of the abdominal aorta, celiac artery, and superior and inferior mesenteric arteries and their branches. Colonoscopy revealed severe rectal necrosis. She was deemed to be a poor surgical candidate due to comorbidities and presence of extensive vascular calcifications. Recurrent episodes of profuse GI bleeding were managed conservatively with blood transfusion as needed. Following her diagnosis of calciphylaxis, supplementation with vitamin D and calcium containing phosphate binders was stopped. She was started on daily hemodialysis with low calcium dialysate bath as well as intravenous sodium thiosulphate. The clinical condition of the patient deteriorated. The patient died secondary to multiorgan failure. CONCLUSIONS Calciphylaxis leading to intestinal ischemia/perforation should be considered in the differential diagnosis in ESRD on HD presenting with abdominal pain or GI bleeding. PMID:26572938

  18. CACD (Complex Air Cleaning Devices) of the GTE (Gas turbine electrostation)-110: Problems and solutions

    NASA Astrophysics Data System (ADS)

    Budakov, I. V.; Neuimin, V. M.

    2015-12-01

    The paper considers CACD of the compressor of the GTE-110 gas turbine. The CACD efficiency has been tested under different conditions of the GTE-325 of the Ivanovo combined cycle plant (CCP) JSC INTER RAO-Electrogeneration Exploitation. It sets out the requirements for the dust collector, de-icing system, and air intake tract CACD. De-icing and air preparation methods are shown.

  19. Spontaneous Bleeding Associated with Ginkgo biloba

    PubMed Central

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

    2005-01-01

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

  20. Swallowable fluorometric capsule for wireless triage of gastrointestinal bleeding.

    PubMed

    Nemiroski, A; Ryou, M; Thompson, C C; Westervelt, R M

    2015-12-01

    Real-time detection of gastrointestinal bleeding remains a major challenge because there does not yet exist a minimally invasive technology that can both i) monitor for blood from an active hemorrhage and ii) uniquely distinguish it from blood left over from an inactive hemorrhage. Such a device would be an important tool for clinical triage. One promising solution, which we have proposed previously, is to inject a fluorescent dye into the blood stream and to use it as a distinctive marker of active bleeding by monitoring leakage into the gastrointestinal tract with a wireless fluorometer. This paper reports, for the first time to our knowledge, the development of a swallowable, wireless capsule with a built-in fluorometer capable of detecting fluorescein in blood, and intended for monitoring gastrointestinal bleeding in the stomach. The embedded, compact fluorometer uses pinholes to define a microliter sensing volume and to eliminate bulky optical components. The proof-of-concept capsule integrates optics, low-noise analog sensing electronics, a microcontroller, battery, and low power Zigbee radio, all into a cylindrical package measuring 11 mm × 27 mm and weighing 10 g. Bench-top experiments demonstrate wireless fluorometry with a limit-of-detection of 20 nM aqueous fluorescein. This device represents a major step towards a technology that would enable simple, rapid detection of active gastrointestinal bleeding, a capability that would save precious time and resources and, ultimately, reduce complications in patients. PMID:26490455

  1. A study of hear sink performance in air and soil for use in a thermoelectric energy harvesting device

    NASA Technical Reports Server (NTRS)

    Snyder, J.; Lawrence, E. E.

    2002-01-01

    A suggested application of a thermoelectric generator is to exploit the natural temperature difference between the air and the soil to generate small amounts of electrical energy. Since the conversion efficiency of even the best thermoelectric generators available is very low, the performance of the heat sinks providing the heat flow is critical. By providing a constant heat input to various heat sinks, field tests of their thermal conductances in soil and in air were performed. Aprototype device without a thermoelectric generator was constructed, buried, and monitored to experimentally measure the heat flow achievable in such a system. Theoretical considerations for design and selection of improved heat sinks are also presented. In particular, the method of shape factoranalysis is used to give rough estimates and upper bounds for the thermal conductance of a passive heat sink buried in soil.

  2. Performances of Different Global Positioning System Devices for Time-Location Tracking in Air Pollution Epidemiological Studies

    PubMed Central

    Wu, Jun; Jiang, Chengsheng; Liu, Zhen; Houston, Douglas; Jaimes, Guillermo; McConnell, Rob

    2010-01-01

    Background: People’s time-location patterns are important in air pollution exposure assessment because pollution levels may vary considerably by location. A growing number of studies are using global positioning systems (GPS) to track people’s time-location patterns. Many portable GPS units that archive location are commercially available at a cost that makes their use feasible for epidemiological studies. Methods: We evaluated the performance of five portable GPS data loggers and two GPS cell phones by examining positional accuracy in typical locations (indoor, outdoor, in-vehicle) and factors that influence satellite reception (building material, building type), acquisition time (cold and warm start), battery life, and adequacy of memory for data storage. We examined stationary locations (eg, indoor, outdoor) and mobile environments (eg, walking, traveling by vehicle or bus) and compared GPS locations to highly-resolved US Geological Survey (USGS) and Digital Orthophoto Quarter Quadrangle (DOQQ) maps. Results: The battery life of our tested instruments ranged from <9 hours to 48 hours. The acquisition of location time after startup ranged from a few seconds to >20 minutes and varied significantly by building structure type and by cold or warm start. No GPS device was found to have consistently superior performance with regard to spatial accuracy and signal loss. At fixed outdoor locations, 65%–95% of GPS points fell within 20-m of the corresponding DOQQ locations for all the devices. At fixed indoor locations, 50%–80% of GPS points fell within 20-m of the corresponding DOQQ locations for all the devices except one. Most of the GPS devices performed well during commuting on a freeway, with >80% of points within 10-m of the DOQQ route, but the performance was significantly impacted by surrounding structures on surface streets in highly urbanized areas. Conclusions: All the tested GPS devices had limitations, but we identified several devices which showed

  3. Theory and experiment on resonant frequencies of liquid-air interfaces trapped in microfluidic devices

    NASA Astrophysics Data System (ADS)

    Chindam, Chandraprakash; Nama, Nitesh; Ian Lapsley, Michael; Costanzo, Francesco; Jun Huang, Tony

    2013-11-01

    Bubble-based microfluidic devices have been proven to be useful for many biological and chemical studies. These bubble-based microdevices are particularly useful when operated at the trapped bubbles' resonance frequencies. In this work, we present an analytical expression that can be used to predict the resonant frequency of a bubble trapped over an arbitrary shape. Also, the effect of viscosity on the dispersion characteristics of trapped bubbles is determined. A good agreement between experimental data and theoretical results is observed for resonant frequency of bubbles trapped over different-sized rectangular-shaped structures, indicating that our expression can be valuable in determining optimized operational parameters for many bubble-based microfluidic devices. Furthermore, we provide a close estimate for the harmonics and a method to determine the dispersion characteristics of a bubble trapped over circular shapes. Finally, we present a new method to predict fluid properties in microfluidic devices and complement the explanation of acoustic microstreaming.

  4. Predictors of re-bleeding after endoscopic hemostasis for delayed post-endoscopic sphincterotomy bleeding

    PubMed Central

    Lee, Mu-Hsien; Tsou, Yung-Kuan; Lin, Cheng-Hui; Lee, Ching-Song; Liu, Nai-Jen; Sung, Kai-Feng; Cheng, Hao-Tsai

    2016-01-01

    AIM: To predict the re-bleeding after endoscopic hemostasis for delayed post-endoscopic sphincterotomy (ES) bleeding. METHODS: Over a 15-year period, data from 161 patients with delayed post-ES bleeding were retrospectively collected from a single medical center. To identify risk factors for re-bleeding after initial successful endoscopic hemostasis, parameters before, during and after the procedure of endoscopic retrograde cholangiopancreatography were analyzed. These included age, gender, blood biochemistry, co-morbidities, endoscopic diagnosis, presence of peri-ampullary diverticulum, occurrence of immediate post-ES bleeding, use of needle knife precut sphincterotomy, severity of delayed bleeding, endoscopic features on delayed bleeding, and type of endoscopic therapy. RESULTS: A total of 35 patients (21.7%) had re-bleeding after initial successful endoscopic hemostasis for delayed post-ES bleeding. Univariate analysis revealed that malignant biliary stricture, serum bilirubin level of greater than 10 mg/dL, initial bleeding severity, and bleeding diathesis were significant predictors of re-bleeding. By multivariate analysis, serum bilirubin level of greater than 10 mg/dL and initial bleeding severity remained significant predictors. Re-bleeding was controlled by endoscopic therapy in a single (n = 23) or multiple (range, 2-7; n = 6) sessions in 29 of the 35 patients (82.9%). Four patients required transarterial embolization and one went for surgery. These five patients had severe bleeding when delayed post-ES bleeding occurred. One patient with decompensated liver cirrhosis died from re-bleeding. CONCLUSION: Re-bleeding occurs in approximately one-fifth of patients after initial successful endoscopic hemostasis for delayed post-ES bleeding. Severity of initial bleeding and serum bilirubin level of greater than 10 mg/dL are predictors of re-bleeding. PMID:27003996

  5. En Route Air Traffic Control Input Devices for the Next Generation

    NASA Technical Reports Server (NTRS)

    Mainini, Matthew J.

    2010-01-01

    The purpose of this study was to investigate the usefulness of different input device configurations when trial planning new routes for aircraft in an advanced simulation of the en route workstation. The task of trial planning is one of the futuristic tools that is performed by the graphical manipulation of an aircraft's trajectory to reroute the aircraft without voice communication. In this study with two input devices, the FAA's current trackball and a basic optical computer mouse were evaluated with "pick" button in a click-and-hold state and a click-and-release state while the participant dragged the trial plan line. The trial plan was used for three different conflict types: Aircraft Conflicts, Weather Conflicts, and Aircraft + Weather Conflicts. Speed and accuracy were the primary dependent variables. Results indicate that the mouse conditions were significantly faster than the trackball conditions overall with no significant loss of accuracy. Several performance ratings and preference ratings were analyzed from post-run and post-simulation questionnaires. The release conditions were significantly more useful and likable than the hold conditions. The results suggest that the mouse in the release button state was the fastest and most well liked device configuration for trial planning in the en route workstation. Keywords-input devices, en route, controller, workstation, mouse, trackball, NextGen

  6. Gastrointestinal Bleeding Secondary to Calciphylaxis

    PubMed Central

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

    2015-01-01

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

  7. Research on Supersonic Inlet Bleed

    NASA Technical Reports Server (NTRS)

    Davis, David O.; Vyas, Manan A.; Slater, John W.

    2012-01-01

    Phase I data results of the Fundamental Inlet Bleed Experiments project at NASA Glenn Research Center (GRC) are presented which include flow coefficient results for two single-hole boundary-layer bleed configurations. The bleed configurations tested are round holes at inclination angles of 90deg and 20deg both having length-to-diameter ratios of 2.0. Results were obtained at freestream Mach numbers of 1.33, 1.62, 1.98, 2.46, and 2.92 and unit Reynolds numbers of 0.984, 1.89, and 2.46 10(exp 7)/m. Approach boundary-layer data are presented for each flow condition and the flow coefficient results are compared to existing multi-hole data obtained under similar conditions. For the 90deg hole, the single and multi-hole distributions agree fairly well with the exception that under supercritical operation, the multi-hole data chokes at higher flow coefficient levels. This behavior is also observed for the 20deg hole but to a lesser extent. The 20deg hole also shows a markedly different characteristic at subcritical operation. Also presented are preliminary results of a Computational Fluid Dynamics (CFD) analysis of both configurations at the Mach 1.33 and a unit Reynolds number of 2.46 10(exp 7)/m. Comparison of the results shows the agreement to be very good.

  8. Genomic approaches to bleeding disorders.

    PubMed

    Peyvandi, F; Hayward, C P M

    2016-07-01

    The genes encoding the coagulation factors were characterized over two decades ago. Since then, significant progress has been made in the genetic diagnosis of the two commonest severe inherited bleeding disorders, haemophilia A and B. Experience with the genetic of inherited rare bleeding disorders and platelet disorders is less well advanced. Rare bleeding disorders are usually inherited as autosomal recessive disorders, while it is now clear that a number of the more common platelet function disorders are inherited as autosomal dominant traits. In both cases, DNA sequencing has been useful since most of these disorders are due to mutations located at the coding regions or splice sites of genes encoding the abnormal protein. However, in 5-10% of patients affected with severe clotting factor deficiencies, no genetic defect can be identified and until recently, the genetic characterization of inherited platelet disorders had been confined to the more prevalent conditions such as Glanzmann disease and Bernard-Soulier syndrome. In patients with no gene mutations identified, so far, the role of next-generation sequencing as well as of other new genomic technologies will very likely have increasing importance. However, such methods require extensive bioinformatics analysis that, in turn will require critical revision of our current diagnostic infrastructure. PMID:27405675

  9. Improved Wetting of Mixed Ionic/Electronic Conductors Used in Electrochemical Devices with Ternary Reactive Air Braze Filler Metals

    SciTech Connect

    Hardy, John S; Kim, Jin Yong Y; Thomsen, Ed C; Weil, K Scott

    2007-01-19

    This paper reports on the wetting behavior, reactivity, and long-term electrical conductance of a series of ternary filler metals being considered for brazing lanthanum strontium cobalt ferrite (LSCF) based oxygen separation membranes. Mixed ionic/electronic conducting perovskite oxides such as LSCF and various doped barium cerates are currently being considered for use in high-temperature electrochemical devices such as oxygen and hydrogen concentrators and solid oxide fuel cells. However to take full advantage of the unique properties of these materials, reliable joining techniques need to be developed. Furthermore, if the proposed joining technique were to yield a hermetic ceramic-to-metal junction that was also electrically conductive, it would additionally benefit the device by allowing current to be drawn from or carried to the electrochemically active mixed conducting oxide component without requiring an separate current collector. A newly developed brazing technique known as air brazing is one such method of joining. In its present form, air brazing uses a silver-copper oxide based filler metal that can be melted directly in air to form a compliant joint that is electrically conductive. Recently, it has been shown that the addition of titania can enhance the wetting behavior of Ag-CuO filler metals on alumina. Here the effect of this wetting agent on the surface wettability, long-term electrical resistance at 750°C, and reactivity with La0.6Sr0.4Co0.2Fe0.8O3- (LSCF-6428 or LSCF) substrates is discussed.

  10. Early-phase strength gains during traditional resistance training compared with an upper-body air-resistance training device.

    PubMed

    McGinley, Cian; Jensen, Randall L; Byrne, Ciarán A; Shafat, Amir

    2007-05-01

    The purpose of this study was to examine the early-phase adaptations of traditional dynamic constant external resistance (DCER) training vs. a portable upper-body training device (Fortex). The Fortex is a concentric training device based on air resistance. Contractions using this device are slow (1.5-3 s) and have a limited range of motion. The exercises potentially allow maximal muscle action during each contraction. Healthy, sedentary men (n = 30) were assigned to begin either 8 weeks of weight training (W, n = 12) or 8 weeks of Fortex training (F, n = 9), and were compared with a control group (C, n = 9). Exercises were chosen for the W group that would train similar muscle groups and contain a similar volume of repetitions as the F group. However, movement patterns and force curves were not identical. Increases in the upper-arm cross-sectional area were not detected in any of the groups. Both training groups showed strength gains in the various strength tests that were distinct from each other. Our results indicate that both Fortex and DCER training proved effective in eliciting strength gains in sedentary men over an 8-week training period. There are, however, limitations with the Fortex in terms of progression needs and training asymmetry that indicate it should be used as a complement to other training. PMID:17530937

  11. An experimental wind-tunnel investigation of a ram-air-spoiler roll-control device on a forward-control missile at supersonic speeds

    NASA Technical Reports Server (NTRS)

    Blair, A. B., Jr.

    1978-01-01

    A parametric experimental wind-tunnel investigation was made at supersonic Mach numbers to provide design data on a ram-air-spoiler roll-control device that is to be used on forward-control cruciform missile configurations. The results indicate that the ram-air-spoiler tail fin is an effective roll-control device and that roll control is generally constant with vehicle attitude and Mach number unless direct canard and/or forebody shock impingement occurs. The addition of the ram-air-spoiler tail fins resulted in only small changes in aerodynamic-center location. For the ram-air-spoiler configuration tested, there are large axial force coefficient effects associated with the increased fin thickness and ram-air momentum loss.

  12. A Source-Term Based Boundary Layer Bleed/Effusion Model for Passive Shock Control

    NASA Technical Reports Server (NTRS)

    Baurle, Robert A.; Norris, Andrew T.

    2011-01-01

    A modeling framework for boundary layer effusion has been developed based on the use of source (or sink) terms instead of the usual practice of specifying bleed directly as a boundary condition. This framework allows the surface boundary condition (i.e. isothermal wall, adiabatic wall, slip wall, etc.) to remain unaltered in the presence of bleed. This approach also lends itself to easily permit the addition of empirical models for second order effects that are not easily accounted for by simply defining effective transpiration values. Two effusion models formulated for supersonic flows have been implemented into this framework; the Doerffer/Bohning law and the Slater formulation. These models were applied to unit problems that contain key aspects of the flow physics applicable to bleed systems designed for hypersonic air-breathing propulsion systems. The ability of each model to predict bulk bleed properties was assessed, as well as the response of the boundary layer as it passes through and downstream of a porous bleed system. The model assessment was performed with and without the presence of shock waves. Three-dimensional CFD simulations that included the geometric details of the porous plate bleed systems were also carried out to supplement the experimental data, and provide additional insights into the bleed flow physics. Overall, both bleed formulations fared well for the tests performed in this study. However, the sample of test problems considered in this effort was not large enough to permit a comprehensive validation of the models.

  13. Bleeding

    MedlinePlus

    ... NY: McGraw-Hill; 2004:chap 251. Lammers RL. Principles of wound management. In: Roberts JR, Hedges JR, eds. Roberts: Clinical ... 2009:chap 39. Simon BC, Hern HG. Wound management principles. In: Marx JA, Hockberger RS, Walls RM, et ...

  14. Effect of diffuser bleed on performance of an annular swirl can combustor

    NASA Technical Reports Server (NTRS)

    Juhasz, A. J.

    1974-01-01

    A full-scale annular swirl can combustor equipped with diffuser bleed capability was tested at low fuel-air ratio, burning natural gas fuel. Test results show that, by drawing off a small amount of air on the inner or outer diffuser wall, the radial profile of combustor exit temperature could be changed from a strongly tip biased, to a strongly hub biased shape. Furthermore, combustor total pressure loss could be reduced by about one third by using a total bleed rate equal to 6 percent of diffuser inlet flow. At simulated engine idle conditions combustion efficiency was increased from 64 percent to nearly 100 percent by using 3 percent outer wall bleed. Combustor blowout performance was also improved significantly by using this diffuser bleed scheme.

  15. Risk factors for bleeding after endoscopic submucosal dissection of colorectal neoplasms

    PubMed Central

    Suzuki, Sho; Chino, Akiko; Kishihara, Teruhito; Uragami, Naoyuki; Tamegai, Yoshiro; Suganuma, Takanori; Fujisaki, Junko; Matsuura, Masaaki; Itoi, Takao; Gotoda, Takuji; Igarashi, Masahiro; Moriyasu, Fuminori

    2014-01-01

    AIM: To investigate the risk factors for delayed bleeding following endoscopic submucosal dissection (ESD) treatment for colorectal neoplasms. METHODS: We retrospectively reviewed the medical records of 317 consecutive patients with 325 lesions who underwent ESD for superficial colorectal neoplasms at our hospital from January 2009 to June 2013. Delayed post-ESD bleeding was defined as bleeding that resulted in overt hematochezia 6 h to 30 d after ESD and the observation of bleeding spots as confirmed by repeat colonoscopy or a required blood transfusion. We analyzed the relationship between risk factors for delayed bleeding following ESD and the following factors using univariate and multivariate analyses: age, gender, presence of comorbidities, use of antithrombotic drugs, use of intravenous heparin, resected specimen size, lesion size, lesion location, lesion morphology, lesion histology, the device used, procedure time, and the presence of significant bleeding during ESD. RESULTS: Delayed post-ESD bleeding was found in 14 lesions from 14 patients (4.3% of all specimens, 4.4% patients). Patients with episodes of delayed post-ESD bleeding had a mean hemoglobin decrease of 2.35 g/dL. All episodes were treated successfully using endoscopic hemostatic clips. Emergency surgery was not required in any of the cases. Blood transfusion was needed in 1 patient (0.3%). Univariate analysis revealed that lesions located in the cecum (P = 0.012) and the presence of significant bleeding during ESD (P = 0.024) were significantly associated with delayed post-ESD bleeding. The risk of delayed bleeding was higher for larger lesion sizes, but this trend was not statistically significant. Multivariate analysis revealed that lesions located in the cecum (OR = 7.26, 95%CI: 1.99-26.55, P = 0.003) and the presence of significant bleeding during ESD (OR = 16.41, 95%CI: 2.60-103.68, P = 0.003) were independent risk factors for delayed post-ESD bleeding. CONCLUSION: Location in the cecum

  16. EPA (Environmental Protection Agency) evaluation of the Cyclone-Z device under Section 511 of the Motor Vehicle Information and Cost Savings Act. Technical report

    SciTech Connect

    Syria, S.L.

    1983-01-01

    This document announces the conclusions of the EPA evaluation of the Cyclone-Z device under the provisions of Section 511 of the Motor Vehicle Information and Cost Savings Act. The evaluation of the Cyclone-Z device was conducted upon receiving an application from the marketer. The device is claimed to improve fuel economy and driveability and to reduce exhaust emissions. EPA fully considered all of the information submitted by the applicant. The evaluation of the Cyclone-Z device was based on that information, EPA's engineering judgement, and its experience with other air bleed devices.

  17. Massive Bleeding and Massive Transfusion

    PubMed Central

    Meißner, Andreas; Schlenke, Peter

    2012-01-01

    Massive bleeding in trauma patients is a serious challenge for all clinicians, and an interdisciplinary diagnostic and therapeutic approach is warranted within a limited time frame. Massive transfusion usually is defined as the transfusion of more than 10 units of packed red blood cells (RBCs) within 24 h or a corresponding blood loss of more than 1- to 1.5-fold of the body's entire blood volume. Especially male trauma patients experience this life-threatening condition within their productive years of life. An important parameter for clinical outcome is to succeed in stopping the bleeding preferentially within the first 12 h of hospital admission. Additional coagulopathy in the initial phase is induced by trauma itself and aggravated by consumption and dilution of clotting factors. Although different aspects have to be taken into consideration when viewing at bleedings induced by trauma compared to those caused by major surgery, the basic strategy is similar. Here, we will focus on trauma-induced massive hemorrhage. Currently there are no definite, worldwide accepted algorithms for blood transfusion and strategies for optimal coagulation management. There is increasing evidence that a higher ratio of plasma and RBCs (e.g. 1:1) endorsed by platelet transfusion might result in a superior survival of patients at risk for trauma-induced coagulopathy. Several strategies have been evolved in the military environment, although not all strategies should be transferred unproven to civilian practice, e.g. the transfusion of whole blood. Several agents have been proposed to support the restoration of coagulation. Some have been used for years without any doubt on their benefit-to-risk profile, whereas great enthusiasm of other products has been discouraged by inefficacy in terms of blood transfusion requirements and mortality or significant severe side effects. This review surveys current literature on fluid resuscitation, blood transfusion, and hemostatic agents currently

  18. Diagnosis of heavy menstrual bleeding.

    PubMed

    Herman, Malou C; Mol, Ben W; Bongers, Marlies Y

    2016-01-01

    Heavy menstrual bleeding (HMB) is an important health problem. This paper gives an overview of the diagnosis of HMB. For each woman, a thorough history should be taken as one should ascertain whether there are underlying factors that could cause complaints of HMB. Objectively knowing whether or not the blood loss is excessive could also be very beneficial. The pictorial blood assessment chart score can help with diagnosis. Physical examination starts with standard gynecological examination. Imaging tests are widely used in the work-up for women with HMB. The first step in imaging tests should be the transvaginal ultrasound. Other diagnostic tests should only be performed when indicated. PMID:26696006

  19. Ram-air sample collection device for a chemical warfare agent sensor

    DOEpatents

    Megerle, Clifford A.; Adkins, Douglas R.; Frye-Mason, Gregory C.

    2002-01-01

    In a surface acoustic wave sensor mounted within a body, the sensor having a surface acoustic wave array detector and a micro-fabricated sample preconcentrator exposed on a surface of the body, an apparatus for collecting air for the sensor, comprising a housing operatively arranged to mount atop the body, the housing including a multi-stage channel having an inlet and an outlet, the channel having a first stage having a first height and width proximate the inlet, a second stage having a second lower height and width proximate the micro-fabricated sample preconcentrator, a third stage having a still lower third height and width proximate the surface acoustic wave array detector, and a fourth stage having a fourth height and width proximate the outlet, where the fourth height and width are substantially the same as the first height and width.

  20. Evaluation of Refrigerating and Air Conditioning Devices in Energy Cascade Systems under the Restriction of Carbon Dioxide Emissions

    NASA Astrophysics Data System (ADS)

    Shimazaki, Yoichi; Akisawa, Atsushi; Kashiwagi, Takao

    It is necessary to introduce energy cascade systems into the industrial sector in Japan to reduce carbon dioxide emissions. The aim of this study is to evaluate the refrigerating and air conditioning devices in cases of introducing both energy cascade systems and thermal recycling systems in industries located around urban areas. The authors have developed an energy cascade model based on linear programming so as to minimize the total system costs with carbon taxes. Five cases are investigated. Limitation of carbon dioxide emissions results in the enhancement of heat cascading, where high temperature heat is supplied for process heating while low temperature one is shifted to refrigeration. It was found that increasing the amount of garbage combustor waste heat can reduce electric power for the turbo refrigerator by promoting waste heat driven ammonia absorption refrigerator.

  1. AN UNUSUAL CAUSE OF UPPER GASTROINTESTINAL BLEEDING.

    PubMed

    Ali, Kishwar; Zarin, Muhammad; Latif, Humera

    2015-01-01

    Gastrointestinal haemorrhage (GI) is a serious condition that presents both diagnostic as well as therapeutic challenges. Resuscitation of the patient is the first and most important step in its management followed by measures to localize and treat the exact source and site of bleeding. These modalities are upper and lower GI endoscopies, radionuclide imaging and angiography. Surgery is the last resort to handle the situation, if the patient does not respond to resuscitative measures and the various interventional procedures fail to locate and stop the bleeding. We present a case of upper GI bleeding which presented with massive per rectal bleeding and the patient was not responding to resuscitation with multiple blood transfusions. Ultimately an exploratory laparotomy was done which revealed an extra-intestinal source of bleeding into the lumen of duodenum, presenting as upper GI bleeding. PMID:26721047

  2. Sandostatin therapy of acute oesophageal variceal bleeding.

    PubMed

    McKee, R F

    1993-01-01

    This communication deals with the emergency control of variceal bleeding rather than the prevention of rebleeding. The current main options of oesophageal tamponade, emergency sclerotherapy and drug therapy are discussed, with particular reference to the use of somatostatin. Sandostatin (Sandoz, Basel), a synthetic long-acting somatostatin analogue, was found to reduce transhepatic venous gradient by 30% with no effect on systemic haemodynamics in a study of 16 stable cirrhotic patients. In a trial comparing intravenous infusion of Sandostatin (SMS) to oesophageal tamponade (OT) in active variceal bleeding, 18 of 20 bleeds in the SMS group and 19 of 20 bleeds in the OT group were controlled at 4 h. Ten in the SMS group and 14 in the OT group had no further bleeding during the 48-hour study period. Thus SMS may be useful in the temporary control of active variceal bleeding. PMID:8359565

  3. Modeling Improvements for Air Source Heat Pumps using Different Expansion Devices at Varied Charge Levels Part II

    SciTech Connect

    Shen, Bo

    2011-01-01

    This paper describes steady-state performance simulations performed on a 3-ton R-22 split heat pump in heating mode. In total, 150 steady-state points were simulated, which covers refrigerant charge levels from 70 % to 130% relative to the nominal value, the outdoor temperatures at 17 F (-8.3 C), 35 F (1.7 C) and 47 F (8.3 C), indoor air flow rates from 60% to 150% of the rated air flow rate, and two types of expansion devices (fixed orifice and thermostatic expansion valve). A charge tuning method, which is to calibrate the charge inventory model based on measurements at two operation conditions, was applied and shown to improve the system simulation accuracy significantly in an extensive range of charge levels. In addition, we discuss the effects of suction line accumulator in modeling a heat pump system using either a fixed orifice or thermal expansion valve. Last, we identify the issue of refrigerant mass flow mal-distribution at low charge levels and propose an improved modeling approach.

  4. Development of an algorithm to regulate pump output for a closed air-loop type pneumatic biventricular assist device.

    PubMed

    Nam, Kyoung Won; Lee, Jung Joo; Hwang, Chang Mo; Choi, Jaesoon; Choi, Hyuk; Choi, Seong Wook; Sun, Kyung

    2009-12-01

    The closed air space-type of extracorporeal pneumatic ventricular assist device (VAD) developed by the Korea Artificial Organ Center utilizes a bellows-transforming mechanism to generate the air pressure required to pump blood. This operating mechanism can reduce the size and weight of the driving unit; however, the output of the blood pump can be affected by the pressure loading conditions of the blood sac. Therefore, to guarantee a proper pump output level, regardless of the pressure loading conditions that vary over time, automatic pump output regulation of the blood pump is required. We describe herein a pump output regulation algorithm that was developed to maintain pump output around a reference level against various afterload pressures, and verified the pump performance in vitro. Based on actual operating conditions in animal experiments, the pumping rate was limited to 40-84 beats per minute, and the afterload pressure was limited to 80-150 mm Hg. The tested reference pump output was 4.0 L/min. During experiments, the pump output was successfully and automatically regulated within the preset area regardless of the varying afterload conditions. The results of this preliminary experiment can be used as the basis for an automatic control algorithm that can enhance the stability and reliability of the applied VAD. PMID:19604228

  5. [Diagnosis and therapy of bleeding in ENT].

    PubMed

    Schulz, T; Eßer, D

    2013-12-01

    Bleeding in the oral cavity, nose or ear are common events in the daily routine of ENT specialists. Apart from trivial cases that often get outpatient treatment, there are numerous cases of serious bleeding that require stationary treatment and if necessary, an operative or interventional therapy. In the following section the most frequent types of bleeding, their diagnosis and therapy will be explained. PMID:24285208

  6. Portable device for use in starting air-start-units for aircraft and having cable lead testing capability

    NASA Technical Reports Server (NTRS)

    Rosier, W. R.; Volk, G. G. (Inventor)

    1980-01-01

    A portable device for starting aircraft engines and the like is disclosed. The device includes a lead testing and motor starting circuit characterized by: (1) a direct current voltage source, (2) a pair of terminal plugs connected with the circuit (each being characterized by a first, second, and third terminal) (3) a pair of manually operable switches for connecting the first terminal of each plug of the pair to the positive side of the voltage source, (4) a circuit lead connecting to the second terminal of each plug the negative side of said source, (5) a pair of electrical cables adapted to connect said first and second terminals of each plug to an air-start unit, and means for connecting each cable of the pair of cables between the first terminal of one plug and the third terminal of the other plug of the pair, and (6) a second pair of manually operable switches for selectivity connecting the third terminal of each plug of the pair to the negative side of the voltage source.

  7. Immediate Unprepped Hydroflush Colonoscopy for Severe Lower GI Bleeding: A Feasibility Study

    PubMed Central

    Repaka, Aparna; Atkinson, Matthew R.; Faulx, Ashley L.; Isenberg, Gerard A.; Cooper, Gregory S.; Chak, Amitabh; Wong, Richard C. K.

    2014-01-01

    Background Urgent colonoscopy is not always the preferred initial intervention in severe lower GI bleeding due to the need for a large volume of oral bowel preparation, the time required for administering the preparation, and concern regarding adequate visualization. Objective To evaluate feasibility, safety, and outcomes of immediate unprepped hydroflush colonoscopy for severe lower gastrointestinal bleeding. Design Prospective feasibility study of immediate colonoscopy after tap-water enema without oral bowel preparation, aided by water jet pumps and mechanical suction devices in patients admitted to the intensive care unit with a primary diagnosis of severe lower gastrointestinal bleeding Setting Tertiary referral center Main outcome measurements Primary outcome measurement was the percentage of colonoscopies where the preparation permitted satisfactory evaluation of the entire length of the colon suspected to contain the source of bleeding. Secondary outcome measurements were visualization of a definite source of bleeding, length of hospital and ICU stays, re-bleeding rates, and transfusion requirements. Results Thirteen procedures were performed in 12 patients. Complete colonoscopy to the cecum was performed in 9/13 patients (69.2 %). However, endoscopic visualization was felt to be adequate to definitively or presumptively identify the source of bleeding in all procedures, with no colonoscopy repeated due to inadequate preparation. A definite source of bleeding was identified in 5/13 procedures (38.5%). Median length of ICU stay was 1.5 days and hospital stay was 4.3 days. Recurrent bleeding during the same hospitalization, requiring repeat endoscopy, surgery or angiotherapy was seen in 3/12 patients (25%). Limitations Uncontrolled feasibility study of selected patients. Conclusion Immediate unprepped hydroflush colonoscopy in patients with severe lower GI bleeding is feasible with the hydroflush technique. PMID:22658390

  8. Small bowel bleeding: a comprehensive review

    PubMed Central

    Gunjan, Deepak; Sharma, Vishal; Bhasin, Deepak K

    2014-01-01

    The small intestine is an uncommon site of gastro-intestinal (GI) bleeding; however it is the commonest cause of obscure GI bleeding. It may require multiple blood transfusions, diagnostic procedures and repeated hospitalizations. Angiodysplasia is the commonest cause of obscure GI bleeding, particularly in the elderly. Inflammatory lesions and tumours are the usual causes of small intestinal bleeding in younger patients. Capsule endoscopy and deep enteroscopy have improved our ability to investigate small bowel bleeds. Deep enteroscopy has also an added advantage of therapeutic potential. Computed tomography is helpful in identifying extra-intestinal lesions. In cases of difficult diagnosis, surgery and intra-operative enteroscopy can help with diagnosis and management. The treatment is dependent upon the aetiology of the bleed. An overt bleed requires aggressive resuscitation and immediate localisation of the lesion for institution of appropriate therapy. Small bowel bleeding can be managed by conservative, radiological, pharmacological, endoscopic and surgical methods, depending upon indications, expertise and availability. Some patients, especially those with multiple vascular lesions, can re-bleed even after appropriate treatment and pose difficult challenge to the treating physician. PMID:24874805

  9. Serendipity in scintigraphic gastrointestinal bleeding studies

    SciTech Connect

    Goergen, T.G.

    1983-09-01

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

  10. [New therapeutical options for heavy gastrointestinal bleeding].

    PubMed

    Braun, Georg; Messmann, Helmut

    2015-06-01

    The number of patients taking new oral anticoagulants is rising, so is the number of serious bleeding events. In severe bleeding, the decision to start a procoagulant therapy is difficult to take. With Idarucizumab and Andexanet Alfa, specific antidotes have been developed against both, direct thrombin inhibitors as well as direct Factor Xa inhibitors. In the endoscopic treatment of severe gastrointestinal bleeding, alternative treatment options are available with Hemospray™, Endoclot™ and new hemostasis clips. Especially in the recurrent ulcer bleeding, the newly developed clips can achieve hemostasis and prevent an operational procedure. PMID:26069913

  11. Cyclical rectal bleeding in colorectal endometriosis.

    PubMed

    Levitt, M D; Hodby, K J; van Merwyk, A J; Glancy, R J

    1989-12-01

    Three case reports of cyclical rectal bleeding in endometriosis affecting rectum and sigmoid colon emphasize the close relationship between such cyclical bleeding and intestinal endometriosis. The cause of bleeding, however, is still unclear. The predilection of endometriotic deposits for the outer layers of the bowel wall suggests that mucosal involvement is not a prerequisite for rectal bleeding. The frequent absence of identifiable intramural haemorrhage casts doubt on the premise that intestinal endometriotic deposits 'menstruate'. The cause may simply be a transient tear in normal mucosa due to swelling of an underlying endometriotic deposit at the time of menstruation. PMID:2597100

  12. The effects of powered air supply to the respiratory protective device on respiration parameters during rest and exercise.

    PubMed

    Arad, M; Heruti, R; Shaham, E; Atsmon, J; Epstein, Y

    1992-12-01

    The common chemical warfare protective masks impose an excessive respiratory load on the wearer due to elevated breathing resistance and increased dead space. For patients with severe respiratory disease, the excessive respiratory effort may be intolerable. Besides, the substantial negative pressure created within the mask during inspiration may result in an inward leakage in individuals having difficulties with proper facial fitting of the mask. The purpose of the current investigation was to evaluate the effects of a blower, actively driving air, through the mask's filter, at a flow (mean +/- SD) of 42 +/- 2 L/min, on respiratory parameters during rest and moderate exercise. Ten healthy subjects of either sex participated in two experimental sessions, wearing the mask with and without the blower. Each session included 6 min of sitting at rest and 6 min of walking on a treadmill (3.2 mph, and 10 percent grade). In nine of the subjects, the active air supply produced a positive inspiratory pressure at rest (5 +/- 4 vs -24 +/- 9 mm H2O peak inspiratory pressure with and without the blower, respectively, p < 0.0001). Inspiratory carbon dioxide concentration (FICO2) at rest was diminished (0.4 +/- 0.4 vs 1.3 +/- 0.7 percent with and without the blower, respectively; p < 0.01) while FIO2 increased from 19.5 +/- 0.7 percent to 20.6 +/- 0.4 percent with the device (p < 0.01). These changes were associated with a significant decrease in respiratory rate (15 +/- 2 vs 18 +/- 3 per minute, p < 0.01). During exercise the blower barely decreased the negative inspiratory pressures, had no effect on other respiratory parameters measured, but significantly shortened the inspiratory/cycle-length time ratio (0.46 +/- 0.03 vs 0.53 +/- 0.03, p < 0.005). The effects of active air supply were not different between male and female subjects. We conclude that the blower is expected to be a useful accessory to respiratory protective devices for patients with pulmonary disease. PMID:1446491

  13. Nondiscrimination on the basis of disability in air travel; compensation for damage to wheelchairs and other assistive devices. Office of the Secretary, DOT. Final rule.

    PubMed

    1999-08-01

    The Department is amending its rules implementing the Air Carrier Access Act of 1986 (ACAA) to lift an existing cap on the amount of compensation airlines have to pay to passengers for loss or damage of their wheelchairs and other assistive devices. The rule is intended to provide additional relief to passengers who use expensive assistive devices that are lost, destroyed or damaged in the course of airline travel. PMID:11010720

  14. Obstetric management of adolescents with bleeding disorders.

    PubMed

    James, Andra H

    2010-12-01

    Adolescents with bleeding disorders who become pregnant must contend with the dual challenges of their bleeding disorder and their pregnancy. Adolescents are more likely to terminate a pregnancy than adult women, and when they do carry a pregnancy, they are more likely to deliver prematurely. Otherwise, they are at risk for the same complications that adult women with bleeding disorders experience, particularly bleeding complications postpartum. Since one half to two thirds of adolescent pregnancies are unplanned, issues related to reproduction should be addressed during routine visits with the pediatrician, hematologist or gynecologist. Girls who are at risk of being carriers for hemophilia A and B, severe von Willebrand disease, and other severe bleeding disorders should have their bleeding disorder status determined before they become pregnant. During pregnancy, a plan should be established to ensure that both mother and fetus deliver safely. Young women at risk for severe bleeding or at risk of having a severely affected infant should be referred for prenatal care and delivery to a center where, in addition to specialists in high-risk obstetrics, there is a hemophilia treatment center or a hematologist with expertise in hemostasis. Prior to delivery or any invasive procedures, young women at risk for severe bleeding should receive prophylaxis. Since administration of desmopressin may result in hyponatremia, whenever available, virally inactivated or recombinant clotting factor concentrates should be used for replacement as opposed to fresh frozen plasma or cryoprecipitate. PMID:20934895

  15. Bleeding duodenal lipoma treated with endoscopic polypectomy.

    PubMed

    Mohamed, Harish K; Suresh, Chigamthara C; Alexander, Kadakketh G; Neena, Mampallay

    2008-01-01

    Duodenal lipomas are relatively uncommon and are rarely a source of severe upper gastrointestinal haemorrhage. We report the case of a 70-year-old woman who presented with significant upper GI bleed due to a large bleeding duodenal lipoma that was successfully treated by endoscopic polypectomy. PMID:19115610

  16. Computed tomographic staging of traumatic epidural bleeding

    SciTech Connect

    Zimmerman, R.A.; Bilaniuk, L.T.

    1982-09-01

    The computed tomographic findings in 45 patients with post-traumatic epidural hemotomas are subdivided into three categories (acute, subacute, and chronic) and correlated with the severity of bleeding, clot formation, and clot resorption. Active epidural bleeding may be identified in acute cases.

  17. Persistent Bleeding After Laparoscopic Supracervical Hysterectomy

    PubMed Central

    Cholkeri-Singh, Aarathi; Sulo, Suela; Miller, Charles E.

    2014-01-01

    Background and Objectives: In our clinical experience, there seemed to be a correlation between cervical stump bleeding and adenomyosis. Therefore, we wanted to conduct a study to determine whether there was an actual correlation and to identify other risk factors for persistent bleeding after a laparoscopic supracervical hysterectomy. Methods: The study included women who underwent laparoscopic supracervical hysterectomy from January 1, 2003, through December 31, 2012. Data were collected on age, postmenopausal status, body mass index (BMI), uterine weight, indication for hysterectomy, concomitant bilateral salpingo-oophorectomy (BSO), presence of endometriosis, surgical ablation of the endocervix, adenomyosis, presence of endocervix in the specimen, and postoperative bleeding. Results: The study included 256 patients, of whom 187 had no postoperative bleeding after the operation, 40 had bleeding within 12 weeks, and 29 had bleeding after 12 weeks. The 3 groups were comparable in BMI, postmenopausal status, uterine weight, indication for hysterectomy, BSO, surgical ablation of the endocervix, adenomyosis, and the presence of endocervix. However, patients who had postoperative bleeding at more than 12 weeks were significantly younger (P = .002) and had a higher rate of endometriosis (P < .001). Conclusions: Risks factors for postoperative bleeding from the cervical stump include a younger age at the time of hysterectomy and the presence of endometriosis. Therefore, younger patients and those with endometriosis who desire to have no further vaginal bleeding may benefit from total hysterectomy over supracervical hysterectomy. All patients who are undergoing supracervical hysterectomy should be counseled about the possible alternatives, benefits, and risks, including continued vaginal bleeding from the cervical stump and the possibility of requiring future treatment and procedures. PMID:25516706

  18. Persistent Organic Pollutants in Semi-permeable Membrane Devices (SPMDs) Deployed in the Ambient Air of Alaska

    NASA Astrophysics Data System (ADS)

    Wu, T. H.; Cahill, C. F.

    2005-12-01

    Triolein containing semi-permeable membrane devices (SPMDs) were deployed in the ambient air of Alaska at five locations (Barrow, Poker Flat Research Range, Denali National Park and Preserve, Trapper Creek and Homer) during a one year study. Samples were screened for polychlorinated biphenyls (PCBs), polyaromatic hydrocarbons (PAHs), and organochlorine compounds (OCPs). Total PCBs ranged from 5-30 ng/SPMD for three-month time-integrated samples. Measurements of selected PAH ratios suggest mixed sources (petrogenic and pyrogenic) at the five locations. The percent ratio of pp-DDT [1,1,1-trichloro-2,2-bis(4-chlorophenyl) ethane] to total DDT (DDT and all metabolites) ranged from 17-66%. A higher percentage may indicate the presence of a fresh input of DDT into the atmosphere or non-metabolized DDT that has remained in the environment. Ratio of trans-chlordane (TC) to cis-chlordane (CC) varied from 0.7-1.2. Higher ratios of TC to CC may indicate fresh input into Alaska from various source regions during deployment of SPMDs.

  19. Development of a unique multi-contaminant air sampling device for a childhood asthma cohort in an agricultural environment†

    PubMed Central

    Fitzpatrick, Cole F.; Loftus, Christine T.; Yost, Michael G.; Tchong-French, Maria; Karr, Catherine J.

    2016-01-01

    This research describes the design, deployment, performance, and acceptability of a novel outdoor active air sampler to provide simultaneous measurements of multiple contaminants at timed intervals for the Aggravating Factors of Asthma in Rural Environment (AFARE) study—a longitudinal cohort of 50 children in Yakima Valley, Washington. The sampler was constructed of multiple sampling media connected to individual critical orifices and a rotary vane vacuum pump. It was connected to a timed control valve system to collect 24 hours samples every six days over 18 months. We describe a spatially representative approach with both quantitative and qualitative location criteria to deploy a network of 14 devices at participant residences in a rural region (20 × 60 km). Overall the sampler performed well, as the concurrent mean sample flow rates were within or above the ranges of recommended sampling rates for each exposure metric of interest. Acceptability was high among the study population of Hispanic farmworker participant households. The sampler design may prove useful for future urban and rural community-based studies with aims at collecting multiple contaminant data during specific time periods. PMID:23896655

  20. Effect of municipal solid waste incinerator types on characteristics of ashes from different air pollution control devices.

    PubMed

    Lu, Chien-Hsing; Chuang, Kui-Hao

    2016-01-01

    The purpose of this paper is to investigate the characteristics of fly and bottom ashes sampled from both fluidized bed (FB) and mass-burning (MB) municipal solid waste incinerators (MSWIs), respectively. Fly ashes from different locations at FB and MB MSWIs equipped with a cyclone, a semi-dry scrubber, and a bag filter as air pollution control devices were examined to provide the baseline information between physicochemical properties and leaching ability. Experimental results of leachability indicated that the bag filter fly ash (FB-FA(B)) from the FB incinerator meets Taiwan regulatory standards set through the toxicity characteristic leaching procedure. X-ray diffraction results revealed the presence of Cr5O12 and Pb2O3 in the cyclone fly ash (MB-FA(C)) and bag filter fly ash (MB-FA(B)), respectively, from the MB incinerator. To observe lead incorporation mechanism, mixture of simulate lead-laden waste with bed material were fired between 600 °C and 900 °C in a laboratory scale FB reactor. The results clearly demonstrate a substantial decrease in lead leaching ratio for products with an appropriate temperature. The concentration of Pb in the MB-FA(B) was 250 times that in the FB-FA(B), suggesting that incineration of MSW in FB is a good strategy for stabilizing hazardous metals. PMID:26226945

  1. Heavy menstrual bleeding in adolescents: hormonal or hematologic?

    PubMed

    Appelbaum, H; Acharya, S S

    2011-12-01

    Adolescence in girls is marked by a host of physical and psychological changes including those associated with menstruation. Heavy menstrual bleeding is one of the most commonly encountered medical problems during transition from childhood to adulthood. Although common, it is likely underreported given that the definition is dependent upon personal experience and influenced by their perception of "normal". Anovulatory cycles related to an immaturity of the hypothalamic pituitary ovarian axis seems to be common, however bleeding disorders such as coagulation factor deficiencies including von Willebrand disease, and quantitative and qualitative abnormalities of platelets must be ruled out. Other medical conditions such as endocrinopathies including diabetes mellitus, Cushing syndrome, polycystic ovarian syndrome, hypothyroidism, chronic hepatic and renal disease, anatomical uterine anomalies, pregnancy, obesity, medications causing hyperprolactinemia must also be considered. Management is based on the presence of hemodynamic instability and acuity of presentation. Treatment options include the use of combined oral contraceptive pills and antifibrinolytic agents; levonorgesterel impregnated intrauterine devices and or treatment of the specific underling bleeding disorder or endocrinopathy. Ongoing management needs to be accomplished through a multi disciplinary team approach in a comprehensive care setting with an adolescent gynecologist, hematologist, pediatrician, and nutritionist involved in the program for a better outcome of this problem. PMID:22036758

  2. Critical gastrointestinal bleed due to secondary aortoenteric fistula

    PubMed Central

    Malik, Mohammad U.; Ucbilek, Enver; Sherwal, Amanpreet S.

    2015-01-01

    Secondary aortoenteric fistula (SAEF) is a rare yet lethal cause of gastrointestinal bleeding and occurs as a complication of an abdominal aortic aneurysm repair. Clinical presentation may vary from herald bleeding to overt sepsis and requires high index of suspicion and clinical judgment to establish diagnosis. Initial diagnostic tests may include computerized tomography scan and esophagogastroduodenoscopy. Each test has variable sensitivity and specificity. Maintaining the hemodynamic status, control of bleeding, removal of the infected graft, and infection control may improve clinical outcomes. This review entails the updated literature on diagnosis and management of SAEF. A literature search was conducted for articles published in English, on PubMed and Scopus using the following search terms: secondary, aortoenteric, aorto-enteric, aortoduodenal, aorto-duodenal, aortoesophageal, and aorto-esophageal. A combination of MeSH terms and Boolean operators were used to device search strategy. In addition, a bibliography of clinically relevant articles was searched to find additional articles (Appendix A). The aim of this review is to provide a comprehensive update on the diagnosis, management, and prognosis of SAEF. PMID:26653698

  3. Critical gastrointestinal bleed due to secondary aortoenteric fistula.

    PubMed

    Malik, Mohammad U; Ucbilek, Enver; Sherwal, Amanpreet S

    2015-01-01

    Secondary aortoenteric fistula (SAEF) is a rare yet lethal cause of gastrointestinal bleeding and occurs as a complication of an abdominal aortic aneurysm repair. Clinical presentation may vary from herald bleeding to overt sepsis and requires high index of suspicion and clinical judgment to establish diagnosis. Initial diagnostic tests may include computerized tomography scan and esophagogastroduodenoscopy. Each test has variable sensitivity and specificity. Maintaining the hemodynamic status, control of bleeding, removal of the infected graft, and infection control may improve clinical outcomes. This review entails the updated literature on diagnosis and management of SAEF. A literature search was conducted for articles published in English, on PubMed and Scopus using the following search terms: secondary, aortoenteric, aorto-enteric, aortoduodenal, aorto-duodenal, aortoesophageal, and aorto-esophageal. A combination of MeSH terms and Boolean operators were used to device search strategy. In addition, a bibliography of clinically relevant articles was searched to find additional articles (Appendix A). The aim of this review is to provide a comprehensive update on the diagnosis, management, and prognosis of SAEF. PMID:26653698

  4. Bleeding Risk Index in an Anticoagulation Clinic

    PubMed Central

    Aspinall, Sherrie L; DeSanzo, Beth E; Trilli, Lauren E; Good, Chester B

    2005-01-01

    BACKGROUND The Outpatient Bleeding Risk Index (BRI) prospectively classified patients who were at high, intermediate, or low risk for warfarin-related major bleeding. However, there are only 2 published validation studies of the index and neither included veterans. OBJECTIVE To determine the accuracy of the BRI in patients attending a Veterans Affairs (VA) anticoagulation clinic and to specifically evaluate the accuracy of the BRI in patients with atrial fibrillation. DESIGN Retrospective cohort study. PATIENTS AND MEASUREMENTS Using the BRI, all patients managed by the Anticoagulation Clinic between January 1, 2001 and December 31, 2002 were classified as high, intermediate, or low risk for major bleeding. Bleeds were identified via quality-assurance reports. Poisson regression was used to determine whether there was an association between the index and the development of bleeding. RESULTS The rate of major bleeding was 10.6%, 2.5%, and 0.8% per patient-year of warfarin in the high-, intermediate-, and low-risk groups, respectively. Patients in the high-risk category had 14 times the rate of major bleeding of those in the low-risk group (incidence rate ratio (IRR) 14; 95% confidence interval (CI), 1.9 to 104.7). The rate of major bleeding was significantly different between the high- and intermediate-risk categories (P<.001). Among those with atrial fibrillation, patients in the high-risk category had 6 times the major bleeding rate of those in the intermediate- and low-risk groups combined (IRR=6; 95% CI, 2.4 to 15.3). CONCLUSIONS The BRI discriminates between high- and intermediate-risk patients in a VA anticoagulation clinic, including those with atrial fibrillation. PMID:16307625

  5. Upper gastrointestinal bleeding: etiology and management.

    PubMed

    Arora, N K; Ganguly, S; Mathur, P; Ahuja, A; Patwari, A

    2002-02-01

    Upper gastrointestinal bleeding is a potentially fatal condition at times due to loss of large volumes of blood. Common sources of upper gastrointestinal bleeding in children include mucosal lesions and variceal hemorrhage (most commonly extra hepatic portal venous obstruction) and, in intensive care settings infections and drugs are other etiological factors associated with bleeding. Massive upper GI bleeding is life threatening and requires immediate resuscitation measures in the form of protection of the airways, oxygen administration, immediate volume replacement with ringer lactate or normal saline, transfusion of whole blood or packed cells and also monitoring the adequacy of volume replacement by central venous lines and urine output. Upper GI endoscopy is an effective initial diagnostic modality to localize the site and cause of bleeding in almost 85-90% of patients. Antacids supplemented by H2- receptor antagonists, proton pump inhibitors and sucralfate are the mainstay in the treatment of bleeding from mucosal lesion. For variceal bleeds, emergency endoscopy is the treatment of choice after initial haemodynamic stabilization of patient. If facilities for endoscopic sclerotherapy (EST) are not available, pharmacotherapy which decreases the portal pressure is almost equally effective and should be resorted to. Shunt surgery is reserved for patients who do not respond to the above therapy. Beta blockers combined with sclerotherapy have been shown to be the most effective therapy in significantly reducing the risk of recurrent rebleeding from varices as well as the death rates, as compared to any other modality of treatment. Based on studies among adult patients, presence of shock, co-morbidities, underlying diagnosis, presence of stigmata of recent hemorrhage on endoscopy and rebleeding are independent risk factors for mortality due to upper GI bleeding. Rebleeding is more likely to occur if the patient has hematemesis, liver disease, coagulopathy

  6. Direct Percutaneous Embolization of Bleeding Stomal Varices

    SciTech Connect

    Naidu, Sailen G.; Castle, Erik P.; Kriegshauser, J. Scott; Huettl, Eric A.

    2010-02-15

    Stomal variceal bleeding can develop in patients with underlying cirrhosis and portal hypertension. Most patients are best treated with transjugular intrahepatic portosystemic shunt (TIPS) creation because this addresses the underlying problem of portal hypertension. However, some patients are not good candidates for TIPS creation because they have end-stage liver disease or encephalopathy. We describe such a patient who presented with recurrent bleeding stomal varices, which was successfully treated with percutaneous coil embolization. The patient had bleeding-free survival for 1 month before death from unrelated causes.

  7. Compressor bleed cooling fluid feed system

    DOEpatents

    Donahoo, Eric E; Ross, Christopher W

    2014-11-25

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

  8. Vitamin K deficiency bleeding of the newborn

    MedlinePlus

    ... babies. Vitamin K plays an important role in blood clotting. Babies often have a low level of vitamin ... Blood clotting tests will be done. The diagnosis is confirmed if a vitamin K shot stops the bleeding ...

  9. CLSM bleed water reduction test results

    SciTech Connect

    Langton, C.A.; Rajendran, N.

    1997-04-21

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

  10. Lower GI Bleeding: Epidemiology and Management

    PubMed Central

    Jensen, Dennis M.

    2013-01-01

    Gastrointestinal (GI) bleeding from the colon is a common reason for hospitalization and is becoming more common in the elderly. While most cases will cease spontaneously, patients with ongoing bleeding or major stigmata of hemorrhage require urgent diagnosis and intervention to achieve definitive hemostasis. Colonoscopy is the primary modality for establishing a diagnosis, risk stratification, and treating some of the most common causes of colonic bleeding, including diverticular hemorrhage which is the etiology in 30 % of cases. Other interventions, including angiography and surgery, are usually reserved for instances of bleeding that cannot be stabilized or allow for adequate bowel preparation for colonoscopy. We discuss the colonoscopic diagnosis, risk stratification, and definitive treatment of colonic hemorrhage in patients presenting with severe hematochezia. PMID:23737154

  11. Systemic causes of excessive uterine bleeding.

    PubMed

    Lusher, J M

    1999-07-01

    In assessing a patient with excessive uterine bleeding, the clinician should consider systemic causes in the differential diagnosis. Both hereditary and acquired conditions can result in mucous membrane bleeding, including menorrhagia, epistaxis, and gum bleeding, as well as excessive bruising. Among hereditary conditions, von Willebrand disease (vWD) is by far the most common, affecting an estimated 1% of the population worldwide. It is important to consider the possibility of vWD, and to establish the proper diagnosis (including subtype), as safe, effective, and easy-to-use treatment is available for most persons with this disorder. This review also covers a number of other systemic conditions that can be manifested by excessive uterine bleeding, including congenital deficiency of factor XI, idiopathic thrombocytopenic purpura and other acquired platelet disorders, acquired autoantibodies against factor VIII (FVIII), and vitamin K deficiency states. PMID:10513767

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

    MedlinePlus

    ... develop AUB. Some illnesses (like thyroid disease or polycystic ovary syndrome ) can mess with the body's hormones. Problems like ... sex. Doctors ask these questions because conditions like polycystic ovary syndrome and some STDs can cause abnormal bleeding. If ...

  13. Genetic analysis of bleeding disorders.

    PubMed

    Edison, E; Konkle, B A; Goodeve, A C

    2016-07-01

    Molecular genetic analysis of inherited bleeding disorders has been practised for over 30 years. Technological changes have enabled advances, from analyses using extragenic linked markers to next-generation DNA sequencing and microarray analysis. Two approaches for genetic analysis are described, each suiting their environment. The Christian Medical Centre in Vellore, India, uses conformation-sensitive gel electrophoresis mutation screening of multiplexed PCR products to identify candidate mutations, followed by Sanger sequencing confirmation of variants identified. Specific analyses for F8 intron 1 and 22 inversions are also undertaken. The MyLifeOurFuture US project between the American Thrombosis and Hemostasis Network, the National Hemophilia Foundation, Bloodworks Northwest and Biogen uses molecular inversion probes (MIP) to capture target exons, splice sites plus 5' and 3' sequences and to detect F8 intron 1 and 22 inversions. This allows screening for all F8 and F9 variants in one sequencing run of multiple samples (196 or 392). Sequence variants identified are subsequently confirmed by a diagnostic laboratory. After having identified variants in genes of interest through these processes, a systematic procedure determining their likely pathogenicity should be applied. Several scientific societies have prepared guidelines. Systematic analysis of the available evidence facilitates reproducible scoring of likely pathogenicity. Documentation of frequency in population databases of variant prevalence and in locus-specific mutation databases can provide initial information on likely pathogenicity. Whereas null mutations are often pathogenic, missense and splice site variants often require in silico analyses to predict likely pathogenicity and using an accepted suite of tools can help standardize their documentation. PMID:27405681

  14. Characteristics of ashes from different locations at the MSW incinerator equipped with various air pollution control devices

    SciTech Connect

    Song, Geum-Ju; Kim, Ki-Heon; Seo, Yong-Chil; Kim, Sam-Cwan

    2004-07-01

    The characteristics of ashes from different locations at a municipal solid waste incinerator (MSWI) equipped with a water spray tower (WST) as a cooling system, and a spray dryer adsorber (SDA), a bag filter (BF) and a selective catalytic reactor (SCR) as air pollution control devices (APCD) was investigated to provide the basic data for further treatment of ashes. A commercial MSWI with a capacity of 100 tons per day was selected. Ash was sampled from different locations during the normal operation of the MSWI and was analyzed to obtain chemical composition, basicity, metal contents and leaching behavior of heavy metals. Basicity and pH of ash showed a broad range between 0.08-9.07 and 3.5-12.3, respectively. Some major inorganics in ash were identified and could affect the basicity. This could be one of the factors to determine further treatment means. Partitioning of hazardous heavy metals such as Pb, Cu, Cr, Hg and Cd was investigated. Large portions of Hg and Cd were emitted from the furnace while over 90% of Pb, Cu and Cr remained in bottom ash. However 54% of Hg was captured by WST and 41% by SDA/BF and 3.6% was emitted through the stack, while 81.5% of Cd was captured by SDA/BF. From the analysis data of various metal contents in ash and leach analysis, such capturing of metal was confirmed and some heavy metals found to be easily released from ash. Based on the overall characteristics of ash in different locations at the MSWI during the investigation, some considerations and suggestions for determining the appropriate treatment methods of ash were made as conclusions.

  15. Self-Expandable Metal Stents in the Treatment of Acute Esophageal Variceal Bleeding

    PubMed Central

    Escorsell, Àngels; Bosch, Jaime

    2011-01-01

    Acute variceal bleeding (AVB) is a life-threatening complication in patients with cirrhosis. Hemostatic therapy of AVB includes early administration of vasoactive drugs that should be combined with endoscopic therapy, preferably banding ligation. However, failure to control bleeding or early rebleed within 5 days still occurs in 15–20% of patients with AVB. In these cases, a second endoscopic therapy may be attempted (mild bleeding in a hemodynamically stable patient) or we can use a balloon tamponade as a bridge to definitive derivative treatment (i.e., a transjugular intrahepatic portosystemic shunt). Esophageal balloon tamponade provides initial control in up to 80% of AVB, but it carries a high risk of major complications, especially in cases of long duration of tamponade (>24 h) and when tubes are inserted by inexperienced staff. Preliminary reports suggest that self-expandable covered esophageal metallic stents effectively control refractory AVB (i.e., ongoing bleeding despite pharmacological and endoscopic therapy or massive bleeding precluding endoscopic therapy) with a low incidence of complications. Thus, covered self-expanding metal stents may represent an alternative to the Sengstaken-Blakemore balloon for the temporary control of bleeding in treatment failures. Further studies are required to determine the role of this new device in AVB. PMID:22013436

  16. Cough-induced Tracheobronchial Mucosal Bleeding.

    PubMed

    Hira, Harmanjit Singh

    2011-01-01

    A 56-year-old man presented with moderate hemoptysis. It was preceded by a severe bout of cough. Flexible bronchoscopy showed diffuse tracheobronchial mucosal petechiae and bleeding. The patient was not suffering with any coagulopathies. He did not receive antiplatelet drugs. Hemoptysis resolved with cough suppressant. Subsequent bronchoscopy revealed the complete resolution of petechiae. The mechanism of bleeding after the bout of coughing is discussed. PMID:23169019

  17. Recurrent bleeding of angiomyolipomas in tuberous sclerosis.

    PubMed

    Chatterjee, T; Heindel, W; Vorreuther, R; Engelmann, U; Lackner, K

    1996-01-01

    The diagnostic and therapeutic problems of renal hamartomas are illustrated by a case of recurrence of bleeding angiomyolipomas associated with tuberous sclerosis. Ultrasound and computed tomography provide clear evidence of lipomatous formation while, in rare instances, angiography can demonstrate the existence of multiple vascular tumor compartments. In view of the risk of bleeding, multiple or very large angiomyolipomas should be treated by interventional radiology in the form of superselective tumor embolization or by the most conservative surgery possible. PMID:8903555

  18. Examination of CeFe[subscript 4]Sb[subscript 12] upon exposure to air: Is this material appropriate for use in terrestrial, high-temperature thermoelectric devices?

    SciTech Connect

    Sklad, Alina C.; Gaultois, Michael W.; Grosvenor, Andrew P.

    2010-08-20

    The rare-earth (RE) filled skutterudites (e.g., CeFe{sub 4}Sb{sub 12}) have been proposed for use in the next-generation of high-temperature thermoelectric devices. In this investigation, the influence of air exposure on the stability of CeFe{sub 4}Sb{sub 12} has been studied for temperatures ranging from 300 K to 1073 K. Examination of the material after exposure to air at these temperatures using thermogravimetric analysis, powder X-ray diffraction, and X-ray absorption near-edge spectroscopy has shown that above 573 K, CeFe{sub 4}Sb{sub 12} decomposes and then rapidly oxidizes. This temperature is much lower than the maximum operating temperature proposed for high-temperature thermoelectric devices used to recover the waste heat from vehicle exhaust systems (700-773 K).

  19. Electrosurgical device for both mechanical cutting and coagulation of bleeding

    DOEpatents

    Doss, J.D.; McCabe, C.W.

    1985-02-08

    Bipolar electrical coagulation of tissue using radiofrequency energy is combined with the functions of conventional surgical pressure tissue cutting instruments without significant modification thereof in a single instrument with the result that a surgeon can perform both procedures without having to redirect his attention from the area of the surgery. 4 figs.

  20. Electrosurgical device for both mechanical cutting and coagulation of bleeding

    DOEpatents

    Doss, James D.; McCabe, Charles W.

    1987-01-01

    Bipolar electrical coagulation of tissue using radio-frequency energy is combined with the functions of conventional surgical pressure tissue cutting instruments without significant modification thereof in a single instrument with the result that a surgeon can perform both procedures without having to redirect his attention from the area of the surgery.

  1. Air-gating and chemical-gating in transistors and sensing devices made from hollow TiO2 semiconductor nanotubes

    NASA Astrophysics Data System (ADS)

    Alivov, Yahya; Funke, Hans; Nagpal, Prashant

    2015-07-01

    Rapid miniaturization of electronic devices down to the nanoscale, according to Moore’s law, has led to some undesirable effects like high leakage current in transistors, which can offset additional benefits from scaling down. Development of three-dimensional transistors, by spatial extension in the third dimension, has allowed higher contact area with a gate electrode and better control over conductivity in the semiconductor channel. However, these devices do not utilize the large surface area and interfaces for new electronic functionality. Here, we demonstrate air gating and chemical gating in hollow semiconductor nanotube devices and highlight the potential for development of novel transistors that can be modulated using channel bias, gate voltage, chemical composition, and concentration. Using chemical gating, we reversibly altered the conductivity of nanoscaled semiconductor nanotubes (10-500 nm TiO2 nanotubes) by six orders of magnitude, with a tunable rectification factor (ON/OFF ratio) ranging from 1-106. While demonstrated air- and chemical-gating speeds were slow here (˜seconds) due to the mechanical-evacuation rate and size of our chamber, the small nanoscale volume of these hollow semiconductors can enable much higher switching speeds, limited by the rate of adsorption/desorption of molecules at semiconductor interfaces. These chemical-gating effects are completely reversible, additive between different chemical compositions, and can enable semiconductor nanoelectronic devices for ‘chemical transistors’, ‘chemical diodes’, and very high-efficiency sensing applications.

  2. Air-gating and chemical-gating in transistors and sensing devices made from hollow TiO2 semiconductor nanotubes.

    PubMed

    Alivov, Yahya; Funke, Hans; Nagpal, Prashant

    2015-07-24

    Rapid miniaturization of electronic devices down to the nanoscale, according to Moore's law, has led to some undesirable effects like high leakage current in transistors, which can offset additional benefits from scaling down. Development of three-dimensional transistors, by spatial extension in the third dimension, has allowed higher contact area with a gate electrode and better control over conductivity in the semiconductor channel. However, these devices do not utilize the large surface area and interfaces for new electronic functionality. Here, we demonstrate air gating and chemical gating in hollow semiconductor nanotube devices and highlight the potential for development of novel transistors that can be modulated using channel bias, gate voltage, chemical composition, and concentration. Using chemical gating, we reversibly altered the conductivity of nanoscaled semiconductor nanotubes (10-500 nm TiO2 nanotubes) by six orders of magnitude, with a tunable rectification factor (ON/OFF ratio) ranging from 1-10(6). While demonstrated air- and chemical-gating speeds were slow here (∼seconds) due to the mechanical-evacuation rate and size of our chamber, the small nanoscale volume of these hollow semiconductors can enable much higher switching speeds, limited by the rate of adsorption/desorption of molecules at semiconductor interfaces. These chemical-gating effects are completely reversible, additive between different chemical compositions, and can enable semiconductor nanoelectronic devices for 'chemical transistors', 'chemical diodes', and very high-efficiency sensing applications. PMID:26134618

  3. Secondary electric power generation with minimum engine bleed

    NASA Technical Reports Server (NTRS)

    Tagge, G. E.

    1983-01-01

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

  4. Intrauterine devices.

    PubMed

    Burkman, R T

    1991-08-01

    Approximately 60 million women use the intrauterine device (IUD) worldwide; however, owing primarily to nonmedical reasons, the IUD is far less popular in the United States. Although the contraceptive mechanism of action is unknown, it appears that spermicidal activity may be important. Overall, the efficacy of the copper devices is quite good, such that the overall lifespan can probably be extended. Possible pelvic infection remains the greatest potential risk, although in properly selected women the risk is quite low. Use of prophylactic antibiotics at the time of insertion may offer additional protection against this risk. Although IUD users may have more nonspecific vaginal inflammation than do other women, the clinical significance is probably limited. Further, users do not appear to have elevated risks for cervical infections. Although menometrorrhagia persists as a potential problem, the mechanism for such bleeding is not well understood. Finally, the retroflexed uterine position does not appear to increase the risk of abnormal outcomes. PMID:1878504

  5. Bleeding and clotting in hereditary hemorrhagic telangiectasia

    PubMed Central

    Dittus, Christopher; Streiff, Michael; Ansell, Jack

    2015-01-01

    Hereditary hemorrhagic telangiectasia (HHT) is a relatively common inherited vascular disorder that was first described in 1864, and is notable for epistaxis, telangiectasia, and arterial venous malformations. While genetic tests are available, the diagnosis remains clinical, and is based on the Curacao criteria. Patients with HHT are at increased risk for both bleeding and clotting events. Because of these competing complications, hematologists are often faced with difficult clinical decisions. While the majority of management decisions revolve around bleeding complications, it is not infrequent for these patients to require anticoagulation for thrombosis. Any anticoagulation recommendations must take into account the bleeding risks associated with HHT. Recent reviews have found that HHT patients can be safely anticoagulated, with the most frequent complication being worsened epistaxis. Large clinical trials have shown that factor IIa and Xa inhibitors have less intracranial bleeding than warfarin, and basic coagulation research has provided a possible mechanism. This article describes the anticoagulation dilemma posed when a 62-year-old female patient with a history of bleeding events associated with HHT was diagnosed with a pulmonary embolism. The subsequent discussion focuses on the approach to anticoagulation in the HHT patient, and addresses the role of the new oral anticoagulants. PMID:25879004

  6. NSAIDs and Bleeding in Periodontal Surgery

    PubMed Central

    K, Sharath; Thomas, Biju; Shetty, Nitin; Shetty, Arvind; Shetty, Devanand

    2014-01-01

    Aim: To evaluate and compare the clinical effects of ibuprofen and diclofenac sodium on bleeding during periodontal surgery. Materials and Methods: Thirteen medically healthy men and women of mean age 37.5±17.67 (mean age± standard deviation) were selected for the study. All the subjects were divided into three groups: control (C) and test groups (T1) and (T2). Each subject of T1 group and T2 group was given ibuprofen and diclofenac sodium respectively, prior to surgery. Bleeding times of patients were recorded prior to performance of periodontal flap surgical procedures. Results: It was found that there was increased bleeding time and increased peri-operative bleeding when ibuprofen and diclofenac sodium were taken prior to surgery and this was statistically significant. (2.5538 (T1), 1.8385 (T2) versus 1.2385 (C) minute, p= .001) (mean blood loss) and (62.0325 ± 9.0594 (T1), 51.082 ± 9.792 (T2) versus 37.4992 ± 5.99 (C) millilitre, p = .000). Conclusion: The findings of this study suggested that pre-operative administration of ibuprofen and diclofenac sodium could increase bleeding time and peri - operative blood loss. PMID:24995237

  7. An Unsusual Case of Lower Gastrointestinal Bleeding

    PubMed Central

    Guru, Pramod Kumar; Iyer, Vivek N.

    2016-01-01

    Patient: Female, 81 Final Diagnosis: Gastrointestinal amyloidosis Symptoms: Gastrointesinal haemorrhage • hypotension Medication: — Clinical Procedure: Endoscopy Specialty: Criitcal Care Medicine Objective: Challenging differential diagnosis Background: Amyloidosis is a multisystem disease, and can present with multitude of nonspecific symptoms. Gastrointestinal amyloidosis is common, and gastrointestinal (GI) bleeding in these patients has a wide differential diagnosis. The present case features the distinctive endoscopic finding of submucosal hematoma as a clue to immunoglobin light chain (AL) amyloid involvement of the gastrointestinal tract. Case Report: An 81-year-old woman with AL amyloidosis was transferred to the intensive care unit (ICU) for evaluation of GI bleeding. Prior to the bleeding episode, the patient had undergone paracentesis for management of her ascites related to restrictive cardiomyopathy. Initial evaluation was negative for any intra-abdominal catastrophe related to her recent paracentesis. Upper gastrointestinal endoscopy was negative for any source of bleeding. However, colonoscopy showed a ruptured submucosal hematoma, which is a rare but classical finding in patients with amyloidosis. The patient was managed conservatively and did not have any further episodes of bleeding in the hospital. She unfortunately died due to her primary illness 6 weeks after discharge from the hospital. Conclusions: The finding of submucosal hematoma on endoscopy is a rare but sentinel sign for amyloidosis involvement in the GI tract. PMID:26979633

  8. Aerodynamic Control using Distributed Active Bleed

    NASA Astrophysics Data System (ADS)

    Kearney, John; Glezer, Ari

    2015-11-01

    The global aerodynamic loads on a stationary and pitching airfoil at angles of attack beyond the static and dynamic stall margins, respectively are controlled in wind tunnel experiments using regulated distributed bleed driven by surface pressure differences. High-speed PIV and proper orthogonal decomposition of the vorticity flux on the static airfoil show that the bleed engenders trains of discrete vortices that advect along the surface and are associated with a local instability that is manifested by a time-averaged bifurcation of the vorticity layer near the bleed outlets and alters the vorticity flux over the airfoil and thereby the aerodynamic loads. Active bleed is used on a dynamically pitching airfoil (at reduced frequencies up to k = 0.42) to modulate the evolution of vorticity concentrations during dynamic stall. Time-periodic bleed improved the pitch stability by reducing adverse pitching moment (``negative damping'') that can precipitate structural instabilities. At the same time, the maintains the cycle-average loads to within 5% of the base flow levels by segmenting the vorticity layer during upstroke and promoting early flow attachment during downstroke segments of the pitch cycle. Supported by Georgia Tech VLRCOE.

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

    PubMed

    Lanas, Ángel

    2013-10-01

    This article summarizes the main studies in the field of non-variceal gastrointestinal bleeding reported in the last American Congress of Gastroenterology (Digestive Disease Week) in 2013. Some of these studies have provided new knowledge and expertise in areas of uncertainty. In this context and among other findings, it has been reported that the administration of a proton pump inhibitor (PPI) prior to endoscopy or the early performance of endoscopy-within 6 hours of admission in patients with upper gastrointestinal bleeding (UGIB) (or colonoscopy within 24 hours in patients with lower gastrointestinal bleeding)-does not improve the prognosis of the event. It has also been reported that oral administration of a PPI after endoscopic hemostasis may produce a similar outcome to that of intravenously administered PPI in patients with upper gastrointestinal bleeding (UGIB). In the field of endoscopic therapy, the use of radiofrequency ablation for antral vascular ectasia is of interest. Regarding UGIB and nonsteroidal antiinflammatory drugs (NSAIDs), new data confirm the risk of cardiovascular events by stopping treatment with acetylsalicylic acid (ASA) after an episode of UGIB, the increased risk of UGIB when associating gastrotoxic drugs, and the need to identify both the gastrointestinal and cardiovascular risks of each NSAID and coxib when prescribing these agents. Finally, there is evidence that both environmental and genetic factors are involved in individual susceptibility to gastrointestinal bleeding. PMID:24160953

  10. Endoscopic Management of Nonvariceal Upper Gastrointestinal Bleeding: State of the Art

    PubMed Central

    Kitamura, Shinji; Kimura, Tetsuo; Miyamoto, Hiroshi; Takayama, Tetsuji

    2015-01-01

    Nonvariceal upper gastrointestinal (GI) bleeding is one of the most common reasons for hospitalization and a major cause of morbidity and mortality worldwide. Recently developed endoscopic devices and supporting apparatuses can achieve endoscopic hemostasis with greater safety and efficiency. With these advancements in technology and technique, gastroenterologists should have no concerns regarding the management of acute upper GI bleeding, provided that they are well prepared and trained. However, when endoscopic hemostasis fails, endoscopy should not be continued. Rather, endoscopists should refer patients to radiologists and surgeons without any delay for evaluation regarding the appropriateness of emergency interventional radiology or surgery. PMID:25844335

  11. Application of a high surface area solid-phase microextraction air sampling device: collection and analysis of chemical warfare agent surrogate and degradation compounds.

    PubMed

    Stevens, Michael E; Tipple, Christopher A; Smith, Philip A; Cho, David S; Mustacich, Robert V; Eckenrode, Brian A

    2013-09-17

    This work examines a recently improved, dynamic air sampling technique, high surface area solid-phase microextraction (HSA-SPME), developed for time-critical, high-volume sampling and analysis scenarios. The previously reported HSA-SPME sampling device, which provides 10-fold greater surface area compared to commercially available SPME fibers, allowed for an increased analyte uptake per unit time relative to exhaustive sampling through a standard sorbent tube. This sampling device has been improved with the addition of a type-K thermocouple and a custom heater control circuit for direct heating, providing precise (relative standard deviation ∼1%) temperature control of the desorption process for trapped analytes. Power requirements for the HSA-SPME desorption process were 30-fold lower than those for conventional sorbent-bed-based desorption devices, an important quality for a device that could be used for field analysis. Comparisons of the HSA-SPME device when using fixed sampling times for the chemical warfare agent (CWA) surrogate compound, diisopropyl methylphosphonate (DIMP), demonstrated that the HSA-SPME device yielded a greater chromatographic response (up to 50%) relative to a sorbent-bed method. Another HSA-SPME air sampling approach, in which two devices are joined in tandem, was also evaluated for very rapid, low-level, and representative analysis when using discrete sampling times for the compounds of interest. The results indicated that subparts per billion by volume concentration levels of DIMP were detectable with short sampling times (∼15 s). Finally, the tandem HSA-SPME device was employed for the headspace sampling of a CWA degradation compound, 2-(diisopropylaminoethyl) ethyl sulfide, present on cloth material, which demonstrated the capability to detect trace amounts of a CWA degradation product that is estimated to be less volatile than sarin. The rapid and highly sensitive detection features of this device may be beneficial in decision

  12. Bayesian network modelling of upper gastrointestinal bleeding

    NASA Astrophysics Data System (ADS)

    Aisha, Nazziwa; Shohaimi, Shamarina; Adam, Mohd Bakri

    2013-09-01

    Bayesian networks are graphical probabilistic models that represent causal and other relationships between domain variables. In the context of medical decision making, these models have been explored to help in medical diagnosis and prognosis. In this paper, we discuss the Bayesian network formalism in building medical support systems and we learn a tree augmented naive Bayes Network (TAN) from gastrointestinal bleeding data. The accuracy of the TAN in classifying the source of gastrointestinal bleeding into upper or lower source is obtained. The TAN achieves a high classification accuracy of 86% and an area under curve of 92%. A sensitivity analysis of the model shows relatively high levels of entropy reduction for color of the stool, history of gastrointestinal bleeding, consistency and the ratio of blood urea nitrogen to creatinine. The TAN facilitates the identification of the source of GIB and requires further validation.

  13. Ectopic Variceal Bleeding From Colonic Stoma

    PubMed Central

    Wang, Lei; Zhou, Jiao-lin; Yang, Ning; Zhang, Guan-nan; Lu, Jun-yang; Xiao, Yi; Qiu, Hui-zhong

    2015-01-01

    Abstract Parastomal variceal bleeding is a rare complication of portal hypertension, which often occurs in a recurrent manner and might be life-threatening in extreme situations. Treatment options vary, and no standard therapy has been established. Herein, we report 2 such cases. The first patient suffered from parastomal variceal bleeding after Hartmann procedure for rectal cancer. Stomal revision was performed, but bleeding recurred 1 month later. The second patient developed the disease after Miles procedure for rectal cancer. Embolization via the percutaneous transhepatic approach was performed using the Onyx liquid embolic system (LES) (Micro Therapeutics Inc, dba ev3 Neurovascular) in combination with coils, and satisfactory results were obtained after a 4-month follow-up. Our cases illustrate that surgical revision should be used with caution as a temporary solution due to the high risk of rebleeding, whereas transhepatic embolization via the Onyx LES and coils could be considered a safe and effective choice for skillful managers. PMID:25590847

  14. Re-bleeding events in patients with obscure gastrointestinal bleeding after negative capsule endoscopy

    PubMed Central

    Magalhães-Costa, Pedro; Bispo, Miguel; Santos, Sofia; Couto, Gilberto; Matos, Leopoldo; Chagas, Cristina

    2015-01-01

    AIM: To investigate long-term re-bleeding events after a negative capsule endoscopy in patients with obscure gastrointestinal bleeding (OGIB) and the risk factors associated with the procedure. METHODS: Patients referred to Hospital Egas Moniz (Lisboa, Portugal) between January 2006 and October 2012 with OGIB and a negative capsule endoscopy were retrospectively analyzed. The following study variables were included: demographic data, comorbidities, bleeding-related drug use, hemoglobin level, indication for capsule endoscopy, post procedure details, work-up and follow-up. Re-bleeding rates and associated factors were assessed using a Cox proportional hazard analysis. The Kaplan-Meier method was used to estimate the cumulative incidence of re-bleeding at 1, 3 and 5 years, and the differences between factors were evaluated. RESULTS: The study population consisted of 640 patients referred for OGIB investigation. Wireless capsule endoscopy was deemed negative in 113 patients (17.7%). A total of 64.6% of the population was female, and the median age was 69 years. The median follow-up was forty-eight months (interquartile range 24-60). Re-bleeding occurred in 27.4% of the cases. The median time to re-bleeding was fifteen months (interquartile range 2-33). In 22.6% (n = 7) of the population, small-bowel angiodysplasia was identified as the culprit lesion. A univariate analysis showed that age > 65 years old, chronic kidney disease, aortic stenosis, anticoagulant use and overt OGIB were risk factors for re-bleeding; however, on a multivariate analysis, there were no risk factors for re-bleeding. The cumulative risk of re-bleeding at 1, 3 and 5 years of follow-up was 12.9%, 25.6% and 31.5%, respectively. Patients who presented with overt OGIB tended to re-bleed sooner (median time for re-bleeding: 8.5 mo vs 22 mo). CONCLUSION: Patients with OGIB despite a negative capsule endoscopy have a significant re-bleeding risk; therefore, these patients require an extended follow

  15. Small intestine bleeding due to multifocal angiosarcoma

    PubMed Central

    Zacarias Föhrding, Luisa; Macher, Arne; Braunstein, Stefan; Knoefel, Wolfram Trudo; Topp, Stefan Andreas

    2012-01-01

    We report a case of an 84-year-old male patient with primary small intestinal angiosarcoma. The patient initially presented with anemia and melena. Consecutive endoscopy revealed no signs of upper or lower active gastrointestinal bleeding. The patient had been diagnosed 3 years previously with an aortic dilation, which was treated with a stent. Computed tomography suggested an aorto-intestinal fistula as the cause of the intestinal bleeding, leading to operative stent explantation and aortic replacement. However, an aorto-intestinal fistula was not found, and the intestinal bleeding did not arrest postoperatively. The constant need for blood transfusions made an exploratory laparotomy imperative, which showed multiple bleeding sites, predominately in the jejunal wall. A distal loop jejunostomy was conducted to contain the small intestinal bleeding and a segmental resection for histological evaluation was performed. The histological analysis revealed a less-differentiated tumor with characteristic CD31, cytokeratin, and vimentin expression, which led to the diagnosis of small intestinal angiosarcoma. Consequently, the infiltrated part of the jejunum was successfully resected in a subsequent operation, and adjuvant chemotherapy with paclitaxel was planned. Angiosarcoma of the small intestine is an extremely rare malignant neoplasm that presents with bleeding and high mortality. Early diagnosis and treatment are essential to improve outcome. A small intestinal angiosarcoma is a challenging diagnosis to make because of its rarity, nonspecific symptoms of altered intestinal function, nonspecific abdominal pain, severe melena, and acute abdominal signs. Therefore, a quick clinical and histological diagnosis and decisive measures including surgery and adjuvant chemotherapy should be the aim. PMID:23197897

  16. Immediate bleeding complications in dental implants: A systematic review

    PubMed Central

    Balaguer-Martí, José-Carlos; Peñarrocha-Oltra, David; Balaguer-Martínez, José

    2015-01-01

    Objective: A review is made of the immediate or immediate postoperative bleeding complications in dental implants, with a view to identifying the areas of greatest bleeding risk, the causes of bleeding, the length of the implants associated with bleeding, the most frequently implicated blood vessels, and the treatments used to resolve these complications. Material and Methods: A Medline (PubMed) and Embase search was made of articles on immediate bleeding complications in dental implants published in English up until May 2014. Inclusion criteria: studies in humans subjects with severe bleeding immediately secondary to implant placement, which reported the time until the hemorrhage, the implant lenght, the possible cause of bleeding and the treatment. Exclusion criteria: patients receiving anticoagulation treatment. Results: Fifteen articles met the inclusion criteria. The area with the largest number of bleeding complications corresponded to the mandibular canine. The cause of bleeding was lingual cortical bone perforation during implant placement, with damage to the sublingual artery. The implants associated with bleeding were those measuring 15 mm in length or more. Management focused on securing the airway (with intubation or tracheostomy if necessary), with bleeding control. Conclusions: It’s important to pay special attention when the implants are placed in the mandibular anterior zone, especially if long implants are used. The most frequently cause of bleeding was the perforation of the lingual plate. Treatment involves securing the airway, with bleeding control. Key words:Hemorrhage, complications, immediate, bleeding, dental implants. PMID:25475779

  17. The Approach to Occult Gastrointestinal Bleed.

    PubMed

    Naut, Edgar R

    2016-09-01

    Occult gastrointestinal bleeding is not visible and may present with a positive fecal occult blood test or iron deficiency anemia. Obscure bleeding can be overt or occult, with no source identified despite an appropriate diagnostic workup. A stepwise approach to this evaluation after negative upper and lower endoscopy has been shown to be cost effective. This includes repeat endoscopies if warranted, followed by video capsule endoscopy (VCE) if no obstruction is present. If the VCE is positive then specific endoscopic intervention may be possible. If negative, patients may undergo either repeat testing or watchful waiting with iron supplements. PMID:27542424

  18. Obscure gastrointestinal bleeding: an approach to management.

    PubMed

    Marshall, J K; Lesi, O A; Hunt, R H

    2000-02-01

    Obscure gastrointestinal bleeding provides an uncommon but frustrating and resource-intensive challenge for clinicians. Such patients hemorrhage recurrently from sites within the gastrointestinal tract that are not detected by routine endoscopy or radiography, and require a special diagnostic approach to localize or exclude less common bleeding sources such as small bowel angioectasia or neoplasia. The differential diagnosis of obscure gastrointestinal hemorrhage is discussed, and the performance of available endoscopic, radiological and surgical diagnostic tools including enteroscopy are examined critically. A stepwise management algorithm that progresses from the history and physical examination to surgical exploration is offered to facilitate early and efficient diagnosis. PMID:10694283

  19. Persistent Bleeding Following a Stapled Hemorrhoidopexy

    PubMed Central

    Jung, Sung Taek; Lee, Jae-Bum; Kim, Mi Jung; Lee, Doo-Seok; Youk, Eui-Gon; Kim, Do-Sun; Lee, Doo-Han

    2016-01-01

    A stapled hemorrhoidopexy (SH) is widely used for treatment of patients with grades III and IV hemorrhoids. The SH is easy to perform, is associated with less pain and allows early return to normal activities. However, complications, whether severe or not, have been reported. Here, we present the case of a female patient with persistent bleeding after a SH. The bleeding was caused by the formation of granulation tissue at the stapler line, diagnosed with sigmoidoscopy, and successfully treated via transanal excision (TAE) under spinal anesthesia. The biopsy showed inflammatory granulation tissue. After the TAE, her symptom was completely gone. PMID:27437395

  20. [Jejunal GIST with obscure gastrointestinal bleeding].

    PubMed

    Nelly Manrique, María; Frisancho, Oscar; Rivas Wong, Luz; Palomino, Américo

    2011-01-01

    We report the case of a woman of 84 years with a history of cardiac arrhythmia and hemorrhoids. She had multiple hospitalizations and transfusions for symptomatic iron deficiency anemia, endoscopic studies showed only small diverticula and colon polyps. He was later hospitalized with bloody stools red wines, upper endoscopy and colonoscopy showed gastritis, small colonic ulcers, colonic polyp and multiple diverticula. Readmitted with bleeding of obscure origin, on that occasion showed gastritis, antral erosions, small ulcers, colon polyps and colon ulcers in the process of healing, capsule endoscopy showed angiodysplasia in jejunum, anterograde enteroscopy detected some erythematous lesions in proximal jejunum without evidence of bleeding. Again hospitalized for melena and abdominal. PMID:22086325

  1. Diagnosis and management of obscure gastrointestinal bleeding.

    PubMed Central

    Tarin, D; Allison, D J; Modlin, I M; Neale, G

    1978-01-01

    Twelve consecutive patients presenting with unexplained recurrent gastrointestinal bleeding were investigated by selective visceral angiography. A cause for the bleeding was shown in all 12 cases, and in eight the lesion responsible was diagnosed radiologically as an area of angiodysplasia. Abnormal areas were pinpointed by fluoroscopy and examination of the resected bowel with a dissecting microscope after injecting the vessels with barium. Histologically these areas had various microvascular abnormalities. Angiodysplasia is a useful descriptive radiological term, but does not seem to represent a single pathological entity. Images FIG 1 FIG 2 FIG 3 FIG 4 FIG 5 PMID:308828

  2. Laparoscopic myomectomy: methods to control bleeding.

    PubMed

    Trehan, Nikita

    2011-01-01

    Most of the surgeons find it difficult to perform myomectomy when it bleeds during the procedure as it becomes difficult to get into the correct plane of dissection. If this bleeding or blood staining of tissues is prevented it will be easier to get into the correct plane of dissection. In several studies, it is found that bilateral uterine artery ligation, at origin, does not interfere with future fertility as the end vessels and collaterals of the uterus are not interfered with. As no energy source is used to incise the myoma once Vasopressin has been used, the myomectomy scar integrity is better, as noted by various surgeons. PMID:22442533

  3. [Advanced methods of prehospital bleeding management based on the experience and standards of tactical medicine].

    PubMed

    Kluj, Przemysław; Aleksandrowicz, Dawid; Machała, Waldemar; Gaszyński, Tomasz

    2015-09-01

    Hemostatic agents are currently used in the form of special granules or soaked gauze. Their use is particularly advantageous in difficult body location (e.g. on neck, armpit or groin), where other methods of bleeding control are impossible to use or fail. In a tactical environment tranexamic acid received first class recommendation for use in case of severe bleeding in the US Army. Its application should be considered in case of traumatic amputation, penetrating chest and abdominal trauma or hemorrhagic shock. The aim of the implementation of hypotensive resuscitation is to maintain perfusion of vital organs in patient with hypovolemia, without excessive fluid infusion. Modern method of bleeding control in combat condition are compression clamps. The purpose of these devices is to compress blood vessel by external pressure pads, especially in difficult to access arteries and large veins in the pelvis or in the distal abdominal aorta. PMID:26449585

  4. Endoscopic laser Doppler flowmetry in the experiment and in the bleeding gastric and duodenal ulcer clinic

    NASA Astrophysics Data System (ADS)

    Kapralov, S. V.; Shapkin, Y. G.; Lychagov, V. V.; Tuchin, V. V.

    2007-05-01

    One of the most complex problems of emergency surgery is the choice of surgical tactics to deal with bleeding peptic ulcer. Endoscopic hemostasis is prescribed to patients with continuing bleedings and prerelapse syndrome. But till nowdays the objective verification of the prerelapse condition had not been worked out. What is more there are no objective criteria to judge the effectiveness of the carried endohemostasis. The aim of the study was to work out a new objective diagnostic method of pre-recurrence syndrome that can be able to make prognosis for possible gastroduodenal ulcer bleeding recurrence more precise. Laser Doppler flowmetry was the method of studies the regional perfusion. The device used in this work was made at the Optics and Biophysics Department of Saratov State University.

  5. NANODEVICE: Novel Concepts, Methods, and Technologies for the Production of Portable, Easy-to-use Devices for the Measurement and Analysis of Airborne Engineered Nanoparticles in Workplace Air

    NASA Astrophysics Data System (ADS)

    Sirviö, Sari; Savolainen, Kai

    2011-07-01

    NANODEVICE is a research project funded by the European Commission in the context of the 7th Framework Programme. The duration is 48 months starting 1st of April 2009. Due to their unique properties, engineered nanoparticles (ENP) are now used for a myriad of novel applications, and have a great economic and technological importance. However, some of these properties, especially their surface reactivity, have raised health concerns due to their potential health effects. There is currently a shortage of field-worthy, cost-effective ways - especially in real time - for reliable assessment of exposure levels to ENP in workplace air. NANODEVICE will provide new information on the physico-chemical properties of engineered nanoparticles (ENP) and information about their toxicology. The main emphasis of the project is in the development of novel measuring devices to assess the exposure to ENP's from workplace air. The purpose of the project is also to promote the safe use of ENP through guidance, standards and education, implementing of safety objectives in ENP production and handling, and promotion of safety related collaborations through an international nanosafety forum. The main project goal is to develop innovative concepts and reliable methods for characterizing ENP in workplace air with novel, portable and easy-to-use devices suitable for workplaces.

  6. A noncontact intraocular pressure measurement device using a micro reflected air pressure sensor for the prediagnosis of glaucoma

    NASA Astrophysics Data System (ADS)

    Kim, Kyoung Hwan; Kim, Byeong Hee; Seo, Young Ho

    2012-03-01

    This study investigates a novel, portable tonometer using a micro reflected air pressure sensor for the prediagnosis of glaucoma. Because glaucoma progresses slowly and is not painful, glaucoma patients require a portable prediagnosis system to periodically measure intraocular pressure at home. Conventionally, intraocular pressure is measured by an air-puff tonometer whereby the cornea is deformed by a short pulse of air pressure and the magnitude of the corneal deformation is measured by optic systems such as a combination of laser- and photodiodes. In this study, a micro reflected air pressure sensor was designed, fabricated, and tested in order to measure the magnitude of corneal deformation without optic systems. In an experimental study, artificial eyes with different internal pressures were fabricated and these pressures were measured by the aforementioned system.

  7. The Correlation Between Age and Bleeding Volume in Haemorrhagic Stroke Using Multi Slice CT at District Hospitals in Jakarta.

    PubMed

    Saefudin, Tatan; Apriantoro, Nursama Heru; Hidayat, Ekaputra Syarif; Purnamawati, Schandra

    2016-04-01

    Haemorrhagic Stroke is a common disease in Indonesia. The best imaging modality for this disease is Multi Slice Computed Tomography Scanning (MSCT), as it may help strengthening the diagnosis as well as determining the brain bleeding volume. This study aimed to show correlation between bleeding volume of the brain and patient's age using cross-sectional approach. The 68 samples in this study were taken from secondary data from Head CT Scan of Haemorrhagic Stroke cases.  Brain bleeding volume is the dependent variable, obtained through slice thickness of 5 mm and ABC/2 method with software measurement in MSCT Scan device. The independent variable of this study is the patient's age. The result of the study was the average brain's bleeding volume of 21.76 ml ± 2.48 ml (range of 1.04 ml to 94.73 ml).The slice thickness using ABC/2 method, has a significant correlation with brain's bleeding volume in MSCT Scan examination, with correlation coefficient value r of 0.79. Brain bleeding volume in patients who have ages lower than 50 years and more or equal to 50 years were (18.93 ± 3.26) ml and (23.53 ± 3.47) ml respectively. There is no correlation between age and brain's bleeding volume in haemorrhagic stroke cases, with p value of 0.18, r = 0.19. PMID:26573030

  8. The Correlation Between Age and Bleeding Volume in Haemorrhagic Stroke Using Multi Slice CT at District Hospitals in Jakarta

    PubMed Central

    Saefudin, Tatan; Apriantoro, Nursama Heru; Hidayat, Ekaputra Syarif; Purnamawati, Schandra

    2016-01-01

    Haemorrhagic Stroke is a common disease in Indonesia. The best imaging modality for this disease is Multi Slice Computed Tomography Scanning (MSCT), as it may help strengthening the diagnosis as well as determining the brain bleeding volume. This study aimed to show correlation between bleeding volume of the brain and patient’s age using cross-sectional approach. The 68 samples in this study were taken from secondary data from Head CT Scan of Haemorrhagic Stroke cases. Brain bleeding volume is the dependent variable, obtained through slice thickness of 5 mm and ABC/2 method with software measurement in MSCT Scan device. The independent variable of this study is the patient’s age. The result of the study was the average brain’s bleeding volume of 21.76 ml ± 2.48 ml (range of 1.04 ml to 94.73 ml). The slice thickness using ABC/2 method, has a significant correlation with brain’s bleeding volume in MSCT Scan examination, with correlation coefficient value r of 0.79. Brain bleeding volume in patients who have ages lower than 50 years and more or equal to 50 years were (18.93 ± 3.26) ml and (23.53 ± 3.47) ml respectively. There is no correlation between age and brain’s bleeding volume in haemorrhagic stroke cases, with p value of 0.18, r = 0.19. PMID:26573030

  9. Diagnosis of gastrointestinal bleeding: A practical guide for clinicians

    PubMed Central

    Kim, Bong Sik Matthew; Li, Bob T; Engel, Alexander; Samra, Jaswinder S; Clarke, Stephen; Norton, Ian D; Li, Angela E

    2014-01-01

    Gastrointestinal bleeding is a common problem encountered in the emergency department and in the primary care setting. Acute or overt gastrointestinal bleeding is visible in the form of hematemesis, melena or hematochezia. Chronic or occult gastrointestinal bleeding is not apparent to the patient and usually presents as positive fecal occult blood or iron deficiency anemia. Obscure gastrointestinal bleeding is recurrent bleeding when the source remains unidentified after upper endoscopy and colonoscopic evaluation and is usually from the small intestine. Accurate clinical diagnosis is crucial and guides definitive investigations and interventions. This review summarizes the overall diagnostic approach to gastrointestinal bleeding and provides a practical guide for clinicians. PMID:25400991

  10. Flight vibrations and bleeding in helicoptered patients with pelvic fracture.

    PubMed

    Carchietti, Elio; Cecchi, Adriana; Valent, Francesca; Rammer, Raphael

    2013-01-01

    Depending on their amplitude and frequency, vibrations may facilitate bleeding and worsen the prognosis of patients with pelvic fractures transported by helicopter emergency medical services (HEMS). We measured the range of frequencies and amplitudes of forced vibrations produced by the helicopter used by the HEMS of the Italian Friuli Venezia Giulia region on the pelvis of transported persons. We performed 3 flight tests with 3 different volunteers (mass 70, 80, and 90 kg, respectively) loaded on the helicopter's stretcher and recorded the amplitudes and frequencies of vibrations through a triaxis sensor placed on the HEMS stretcher in the pelvis area. The flight profile planned was identical for each of the 3 iterations. Over the whole flight, the frequencies of vibration were between 26.4 and 53.5 Hz, and the greastest amplitude was 0.035 mm. The vibrations recorded in the helicopter may facilitate bleeding in unstable fractures. In the management of patients with pelvic fractures, HEMS crews should provide prehospital care that includes the use of specific splinting devices in addition to the spinal board, which allows an early immobilization of fractures and the limitation of pelvic motion. PMID:23452365

  11. Gastrointestinal Bleeding - Multiple Languages: MedlinePlus

    MedlinePlus

    ... List of All Topics All Gastrointestinal Bleeding - Multiple Languages To use the sharing features on this page, please enable JavaScript. Arabic (العربية) Chinese - Simplified (简体中文) Chinese - Traditional (繁體中文) French ( ...

  12. [OMEPRAZOL VS RANITIDINE IN UPPER DIGESTIVE BLEEDING

    PubMed

    Regis R, Regina; Bisso A, Aland; Rebaza, Segundo

    1999-01-01

    Pectic ulcer is the most frequent cause of gastrointestinal bleeding. The homeostatic mechanism of bleeding, and coagulation, does not happen with values of pH less than 5,0. Therefore neutralization of gastric acidity (pH more than 5,0) is a recourse of control, improve the evolution and healing of peptic ulcer and to avoid a new bleeding. The aim of this study was to compare the results of treatment with omeprazole and ranitidine, in 57 patients admitted at emergency room of the Hospital Central de la Polic a Nacional del Per with endoscopic diagnosis of peptic ulcer, using Forrest classification. Patients received omeprazole 40 mg in bolus IV, followed by continuos infusion of 8 mg/hour for 72 hours (group A) or ranitidine 50 mg IV each 8 hours for 72 hours (group B). A new endoscopy was made 72 hours after admission demostrated a succesful therapy in both group. Bleeding stopped in 26/27 patients in group A (96,2%) and in 23/30 patients in group B (76,6%) (p<0,05). The results of this study show that the omeprazole IV is more effective than ranitidine IV in the control of UGB because of peptic ulcer and provides a faster healing. PMID:12181579

  13. Acute diquat poisoning with intracerebral bleeding

    PubMed Central

    Saeed, S; Wilks, M; Coupe, M

    2001-01-01

    A case of severe diquat poisoning complicated by the development of aggressive behaviour, oliguric renal failure, and intracerebral bleeding is described. The patient was successfully managed and made a complete recovery. In this paper special attention has been given to the major clinical differences between diquat and paraquat intoxication.


Keywords: poisoning; diquat; paraquat PMID:11320278

  14. Cleaning devices

    NASA Technical Reports Server (NTRS)

    Schneider, Horst W. (Inventor)

    1981-01-01

    Cleaning devices are described which include a vacuum cleaner nozzle with a sharp rim for directing incoming air down against the floor; a vacuum cleaner wherein electrostatically charged brushes that brush dirt off a floor, are electrically grounded to remove charges that could tend to hold dirt to the brushes; a vacuum cleaner head having slots that form a pair of counter-rotating vortices, and that includes an outlet that blows a stream of air at the floor region which lies between the vortices; a cleaning device that sweeps a group of brushes against the ground along a first direction, and then sweeps them along the same ground area but in a second direction angled from the first by an amount such as 90.degree., to sweep up particles lying in crevices extending along any direction; a device that gently cleans a surface to remove bacteria for analysis, including an inclined wall along which cleaning fluid flows onto the surface, a vacuum chamber for drawing in the cleaning fluid, and a dividing wall spaced slightly from the surface to separate the fluid source from the vacuum cleaner chamber; and a device for providing pulses of pressured air including a chamber to which pressured air is supplied, a ball that circulates around the chamber to repeatedly close an outlet, and an air source that directs air circumferentially to move the ball around the chamber.

  15. Endovascular Management of Acute Bleeding Arterioenteric Fistulas

    SciTech Connect

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

    2008-05-15

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

  16. Microcoil Embolization for Acute Lower Gastrointestinal Bleeding

    SciTech Connect

    D'Othee, Bertrand Janne Surapaneni, Padmaja; Rabkin, Dmitry; Nasser, Imad; Clouse, Melvin

    2006-02-15

    Purpose. To assess outcomes after microcoil embolization for active lower gastrointestinal (GI) bleeding. Methods. We retrospectively studied all consecutive patients in whom microcoil embolization was attempted to treat acute lower GI bleeding over 88 months. Baseline, procedural, and outcome parameters were recorded following current Society of Interventional Radiology guidelines. Outcomes included technical success, clinical success (rebleeding within 30 days), delayed rebleeding (>30 days), and major and minor complication rates. Follow-up consisted of clinical, endoscopic, and pathologic data. Results. Nineteen patients (13 men, 6 women; mean age {+-} 95% confidence interval = 70 {+-} 6 years) requiring blood transfusion (10 {+-} 3 units) had angiography-proven bleeding distal to the marginal artery. Main comorbidities were malignancy (42%), coagulopathy (28%), and renal failure (26%). Bleeding was located in the small bowel (n = 5), colon (n 13) or rectum (n = 1). Technical success was obtained in 17 patients (89%); 2 patients could not be embolized due to vessel tortuosity and stenoses. Clinical follow-up length was 145 {+-} 75 days. Clinical success was complete in 13 (68%), partial in 3 (16%), and failed in 2 patients (11%). Delayed rebleeding (3 patients, 27%) was always due to a different lesion in another bowel segment (0 late rebleeding in embolized area). Two patients experienced colonic ischemia (11%) and underwent uneventful colectomy. Two minor complications were noted. Conclusion. Microcoil embolization for active lower GI bleeding is safe and effective in most patients, with high technical and clinical success rates, no procedure-related mortality, and a low risk of bowel ischemia and late rebleeding.

  17. The ORBIT bleeding score: a simple bedside score to assess bleeding risk in atrial fibrillation

    PubMed Central

    O'Brien, Emily C.; Simon, DaJuanicia N.; Thomas, Laine E.; Hylek, Elaine M.; Gersh, Bernard J.; Ansell, Jack E.; Kowey, Peter R.; Mahaffey, Kenneth W.; Chang, Paul; Fonarow, Gregg C.; Pencina, Michael J.; Piccini, Jonathan P.; Peterson, Eric D.

    2015-01-01

    Background Therapeutic decisions in atrial fibrillation (AF) are often influenced by assessment of bleeding risk. However, existing bleeding risk scores have limitations. Objectives We sought to develop and validate a novel bleeding risk score using routinely available clinical information to predict major bleeding in a large, community-based AF population. Methods We analysed data from Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF), a prospective registry that enrolled incident and prevalent AF patients at 176 US sites. Using Cox proportional hazards regression, we identified factors independently associated with major bleeding among patients taking oral anticoagulation (OAC) over a median follow-up of 2 years (interquartile range = 1.6–2.5). We also created a numerical bedside risk score that included the five most predictive risk factors weighted according to their strength of association with major bleeding. The predictive performance of the full model, the simple five-item score, and two existing risk scores (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile INR, elderly, drugs/alcohol concomitantly, HAS-BLED, and anticoagulation and risk factors in atrial fibrillation, ATRIA) were then assessed in both the ORBIT-AF cohort and a separate clinical trial population, Rivaroxaban Once-daily oral direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and embolism trial in atrial fibrillation (ROCKET-AF). Results Among 7411 ORBIT-AF patients taking OAC, the rate of major bleeding was 4.0/100 person-years. The full continuous model (12 variables) and five-factor ORBIT risk score (older age [75+ years], reduced haemoglobin/haematocrit/history of anaemia, bleeding history, insufficient kidney function, and treatment with antiplatelet) both had good ability to identify those who bled vs. not (C-index 0.69 and 0.67, respectively). These scores both had

  18. Evaluation of pilot-scale air pollution control devices on a municipal waterfall incinerator. Project report, June 1978-June 1980

    SciTech Connect

    Hall, F.D.; Bruck, J.M.; Albrinck, D.N.

    1985-10-01

    The project report describes the results of a program for the testing of two pilot-scale pollution control devices, a fabric filter, and a venturi scrubber at the Braintree, Massachusetts Municipal Solid Waste Incinerator. It includes operation, sampling, and analytical efforts and outlines the plant operating conditions at the time of testing of the two pilot control devices. The Braintree Municipal Incinerator is a mass-burn, water-wall type consisting of two furnaces, each designed to burn 4.7 Mg (5 tons) per hour of unprocessed refuse.

  19. Efficient halal bleeding, animal handling, and welfare: A holistic approach for meat quality.

    PubMed

    Aghwan, Z A; Bello, A U; Abubakar, A A; Imlan, J C; Sazili, A Q

    2016-11-01

    Traditional halal slaughter and other forms of religious slaughter are still an issue of debate. Opposing arguments related to pre-slaughter handling, stress and pain associated with restraint, whether the incision is painful or not, and the onset of unconsciousness have been put forward, but no consensus has been achieved. There is a need to strike a balance between halal bleeding in the light of science and animal welfare. There is a paucity of scientific data with respect to animal welfare, particularly the use of restraining devices, animal handling, and efficient halal bleeding. However, this review found that competent handling of animals, proper use of restraining devices, and the efficient bleeding process that follows halal slaughter maintains meat eating quality. In conclusion, halal bleeding, when carried out in accordance with recommended animal welfare procedures, will not only maintain the quality and wholesomeness of meat but could also potentially reduce suffering and pain. Maintained meat quality increases consumer satisfaction and food safety. PMID:27468102

  20. Signs and Symptoms of a Bleeding Disorder in Women

    MedlinePlus

    ... Us Information For... Media Policy Makers Blood Disorders Signs and Symptoms Recommend on Facebook Tweet Share Compartir ... Bleeding Disorders Download and print this fact sheet » Signs and symptoms of a bleeding disorder: I have ...

  1. Installation of a flow control device in an inclined air-curtain fume hood to control wake-induced exposure.

    PubMed

    Chen, Jia-Kun

    2016-08-01

    An inclined plate for flow control was installed at the lower edge of the sash of an inclined air-curtain fume hood to reduce the effects of the wake around a worker standing in front of the fume hood. Flow inside the fume hood is controlled by the inclined air-curtain and deflection plates, thereby forming a quad-vortex flow structure. Controlling the face velocity of the fume hood resulted in convex, straight, concave, and attachment flow profiles in the inclined air-curtain. We used the flow visualization and conducted a tracer gas test with a mannequin to determine the performance of two sash geometries, namely, the half-cylinder and inclined plate designs. When the half-cylinder design was used, the tracer gas test registered a high leakage concentration at Vf ≦ 57.1 fpm or less. This concentration occurred at the top of the sash opening, which was close to the breathing zone of the mannequin placed in front of the fume hood. When the inclined plate design was used, the containment was good, with concentrations of 0.002-0.004 ppm, at Vf ≦ 63.0 fpm. Results indicate that an inclined plate effectively reduces the leakage concentration induced by recirculation flow structures that form in the wake of a worker standing in front of an inclined air-curtain fume hood. PMID:26950527

  2. Gallbladder bleeding-related severe gastrointestinal bleeding and shock in a case with end-stage renal disease

    PubMed Central

    Tsai, Jun-Li; Tsai, Shang-Feng

    2016-01-01

    Abstract Gallbladder (GB) bleeding is very rare and it is caused by cystic artery aneurysm and rupture, or GB wall rupture. For GB rupture, the typical findings are positive Murphy's sign and jaundice. GB bleeding mostly presented as hemobilia. This is the first case presented with severe GI bleeding because of GB rupture-related GB bleeding. After comparing computed tomography, one gallstone spillage was noticed. In addition to gallstones, uremic coagulopathy also worsens the bleeding condition. This is also the first case that patients with GB spillage-related rupture and bleeding were successfully treated by nonsurgical management. Clinicians should bear in mind the rare causes of GI bleeding. Embolization of the bleeding artery should be attempted as soon as possible. PMID:27281100

  3. Bleeding risk assessment and management in atrial fibrillation patients: a position document from the European Heart Rhythm Association, endorsed by the European Society of Cardiology Working Group on Thrombosis.

    PubMed

    Lip, Gregory Y H; Andreotti, Felicita; Fauchier, Laurent; Huber, Kurt; Hylek, Elaine; Knight, Eve; Lane, Deirdre A; Levi, Marcel; Marin, Francisco; Palareti, Gualtiero; Kirchhof, Paulus; Collet, Jean-Philippe; Rubboli, Andrea; Poli, Daniela; Camm, John

    2011-05-01

    Despite the clear net clinical benefit of oral anticoagulation (OAC) in atrial fibrillation (AF) patients at risk for stroke, major bleeding events (especially intra-cranial bleeds) may be devastating events when they do occur. The decision for OAC is often based on a careful assessment of both stroke risk and bleeding risk, but clinical scores for bleeding risk estimation are much less well validated than stroke risk scales. Also, the estimation of bleeding risk is rendered difficult since many of the known factors that increase bleeding risk overlap with stroke risk factors. As well as this, many factors that increase bleeding risk are transient, such as variable international normalized ratio values, operations, vascular procedures, or drug-drug and food-drug interactions. In this Position Document, we comprehensively review the published evidence and propose a consensus on bleeding risk assessments in AF patients, with a view to summarizing 'best practice' when approaching antithrombotic therapy in AF patients. We address the epidemiology and size of the problem of bleeding risk in AF and review established bleeding risk factors. We also summarize definitions of bleeding in the published literature. Patient values and preferences balancing the risk of bleeding against thrombo-embolism is reviewed, and the prognostic implications of bleeding are discussed. We also review bleeding risk stratification and currently published bleeding risk schema. A brief discussion of special situations [e.g. peri-ablation, peri-devices (implantable cardioverter-defibrillator, pacemakers) and presentation with acute coronary syndromes and/or requiring percutaneous coronary interventions/stents and bridging therapy], as well as a discussion of prevention of bleeds and managing bleeding complications, is made. Finally, this document also puts forwards consensus statements that may help to define evidence gaps and assist in everyday clinical practice. Bleeding risk is almost

  4. Exfoliation at the liquid/air interface to assemble reduced graphene oxide ultrathin films for a flexible noncontact sensing device.

    PubMed

    Wang, Xuewen; Xiong, Zuoping; Liu, Zheng; Zhang, Ting

    2015-02-25

    Reduced graphene oxide ultrathin films are fabricated by a reproducible exfoliation method at the liquid/air interface, and they show high transparency, tunable sheet resistance, uniform electric conductivity, and structural homogeneity over a large area. A flexible relative humidity sensing matrix is demonstrated and it is shown to be excellent for close proximity sensing without touching it. This method opens up a novel avenue for future human-machine interaction applications. PMID:25522328

  5. A novel needle trap device with single wall carbon nanotubes sol-gel sorbent packed for sampling and analysis of volatile organohalogen compounds in air.

    PubMed

    Heidari, Mahmoud; Bahrami, Abdolrahman; Ghiasvand, Ali Reza; Shahna, Farshid Ghorbani; Soltanian, Ali Reza

    2012-11-15

    This paper describes a new approach that combines needle trap devices (NTDs) with a newly synthesized silanated nano material as sorbent for sampling and analysis of HVOCs in air. The sol-gel technique was used for preparation of the single wall carbon nanotube (SWCNT)/silica composite as sorbent, packed inside a 21-gauge NTD. Application of this method as an exhaustive sampler device was investigated under different laboratory conditions in this study. Predetermined concentrations of each analyte were prepared in a home-made standard chamber, and the effects of experimental parameters, such as temperature, humidity, sampling air flow rate, breakthrough volume and storage time on NTD, and the sorbent performance were investigated. The proposed NTD was used in two different modes and two different injection methods, and an NTD with a side hole, a narrow neck glass liner and syringe pump assisted injection of carrier gas were applied. The NTD packed with SWCNTs/silica composite was compared to the NTD packed with PDMS and also SPME with CAR/PDMS. For four compounds, LOD was 0.001-0.01 ng mL(-1), LOQ was 0.007-0.03 ng mL(-1), and the relative standard division for repeatability of method was 2.5-6.7%. The results show that the incorporation of NTD and SWCNTs/silica composite is a reliable and effective approach for the sampling and analysis of HVOCs in air. Coupling this system to GC-MS make it more sensitive and powerful technique. PMID:23158328

  6. Effects of diesel exhaust aftertreatment devices on concentrations and size distribution of aerosols in underground mine air.

    PubMed

    Bugarski, Aleksandar D; Schnakenberg, George H; Hummer, Ion A; Cauda, Emanuele; Janisko, Samuel I; Patts, Larry D

    2009-09-01

    Three types of uncatalyzed diesel particulate filter (DPF) systems, three types of high-temperature disposable filter elements (DFEs), and one diesel oxidation catalytic converter (DOC) were evaluated in underground mine conditions for their effects on the concentrations and size distributions of diesel aerosols. Those effects were compared with the effects of a standard muffler. The experimental work was conducted directly in an underground environment using a unique diesel laboratory developed in an underground experimental mine. The DPF systems reduced total mass of aerosols in the mine air approximately 10-fold for light-load and 20-fold or more for high-load test conditions. The DFEs offered similar reductions in aerosol mass concentrations. The efficiency of the new DFEs significantly increased with accumulation of operating time and buildup of diesel particulate matter in the porous structure of the filter elements. A single laundering process did not exhibit substantial effects on performance of the filter element The effectiveness of DPFs and DFEs in removing aerosols by number was strongly influenced by engine operating mode. The concentrations of nucleation mode aerosols in the mine air were found to be substantially higher for both DPFs and DFEs when the engine was operated at high-load modes than at low-load modes. The effects of the DOC on mass and number concentrations of aerosols in mine air were relatively minor when compared to those of the DPF and DFE systems. PMID:19764243

  7. Lower gastrointestinal bleeding in the elderly

    PubMed Central

    Chait, Maxwell M

    2010-01-01

    Lower gastrointestinal bleeding (LGIB) is an important worldwide cause of morbidity and mortality in the elderly. The incidence of LGIB increases with age and corresponds to the increased incidence of specific gastrointestinal diseases that have worldwide regional variation, co-morbid diseases and polypharmacy. The evaluation and treatment of patients is adjusted to the rate and severity of hemorrhage and the clinical status of the patient and may be complicated by the presence of visual, auditory and cognitive impairment due to age and co-morbid disease. Bleeding may be chronic and mild or severe and life threatening, requiring endoscopic, radiologic or surgical intervention. Colonoscopy provides the best method for evaluation and treatment of patients with LGIB. There will be a successful outcome of LGIB in the majority of elderly patients with appropriate evaluation and management. PMID:21160742

  8. Uterine artery embolization for heavy menstrual bleeding.

    PubMed

    Moss, Jonathan; Christie, Andrew

    2016-01-01

    Uterine artery embolization (UAE) as a treatment option for fibroids was first reported by Ravina in 1995. Although rapidly adopted by enthusiasts, many were skeptical and its introduction varied widely across the globe. It was not until randomized controlled trials and registries were published and national guidance statements issued that UAE was accepted as a safe and proven treatment for fibroids. The technique is now established as one of the treatment options to be discussed with patients as an alternative to surgery for fibroid-associated heavy menstrual bleeding. Research is on-going to evaluate the relative merits of UAE compared with other medical and surgical treatment options for heavy menstrual bleeding, particularly for women wishing to maintain their fertility. PMID:26756068

  9. Endoscopy for Nonvariceal Upper Gastrointestinal Bleeding

    PubMed Central

    Kim, Ki Bae; Youn, Sei Jin

    2014-01-01

    Endoscopy for acute nonvariceal upper gastrointestinal bleeding plays an important role in primary diagnosis and management, particularly with respect to identification of high-risk stigmata lesions and to providing endoscopic hemostasis to reduce the risk of rebleeding and mortality. Early endoscopy, defined as endoscopy within the first 24 hours after presentation, improves patient outcome and reduces the length of hospitalization when compared with delayed endoscopy. Various endoscopic hemostatic methods are available, including injection therapy, mechanical therapy, and thermal coagulation. Either single treatment with mechanical or thermal therapy or a treatment that combines more than one type of therapy are effective and safe for peptic ulcer bleeding. Newly developed methods, such as Hemospray powder and over-the-scope clips, may provide additional options. Appropriate decisions and specific treatment are needed depending upon the conditions. PMID:25133117

  10. Endoscopy for nonvariceal upper gastrointestinal bleeding.

    PubMed

    Kim, Ki Bae; Yoon, Soon Man; Youn, Sei Jin

    2014-07-01

    Endoscopy for acute nonvariceal upper gastrointestinal bleeding plays an important role in primary diagnosis and management, particularly with respect to identification of high-risk stigmata lesions and to providing endoscopic hemostasis to reduce the risk of rebleeding and mortality. Early endoscopy, defined as endoscopy within the first 24 hours after presentation, improves patient outcome and reduces the length of hospitalization when compared with delayed endoscopy. Various endoscopic hemostatic methods are available, including injection therapy, mechanical therapy, and thermal coagulation. Either single treatment with mechanical or thermal therapy or a treatment that combines more than one type of therapy are effective and safe for peptic ulcer bleeding. Newly developed methods, such as Hemospray powder and over-the-scope clips, may provide additional options. Appropriate decisions and specific treatment are needed depending upon the conditions. PMID:25133117

  11. Comparative parallel assessment of a transfer device in reducing 5-fluorouracil environmental contamination inside positive air pressure isolators.

    PubMed

    Forges, Fabien; Simoens, Xavier; Chauvin, Franck

    2011-03-01

    The environmental contamination of the antineoplastic drugs circuit, due to the centralization of preparation and the increased number of the patients treated, brought about a new occupational hazard: the chronic exposure to low doses of antineoplastic drugs. The rationalization of the hospital budgets imposes a meticulous assessment of the devices available for the preparation, in order to justify their interest, even their cost. A prospective comparative study with parallel arms was led inside the Pharmacy of the Institut de Cancerologie de la Loire in order to evaluate the Spike Swan®, a transfer device. The aim was to assess the Spike Swan® effectiveness. The antineoplastic drugs environmental contamination within the isolators is considered as a potential starting point for a larger dissemination of cytotoxic products. Therefore, the primary endpoint was the surface contamination level with 5-fluorouracil and the comparator was the standard preparation technique using needles and aeration needles. This study did not show significant effectiveness for the Spike Swan® in reducing surface contamination. Nevertheless, this device could be used to prepare large volumes and to secure occasional handlers, because it is easy to handle. PMID:20699332

  12. A rare cause of lower GI bleeding.

    PubMed

    Waleed, Mohammad; Ali, A Mohamed; Saraj, Othman; Babu, Sathish; Morgan, Russell

    2012-01-01

    The authors present a rare case of lower gastrointestinal (GI) bleed due to GI amyloidosis secondary to multiple myeloma. A 79-year-old lady who presented with bloody diarrhoea for 4 weeks. Flexible sigmoidoscopy showed slight oedematous mucosa extending up to the sigmoid colon. CT abdomen showed lytic lesions in the vertebral bodies. 24 h protein analysis and serum electrophoresis suggestive of multiple myeloma, which was confirmed with bone marrow biopsy, revealed plasma cell myeloma. PMID:22962379

  13. Mechanisms of Normal and Abnormal Endometrial Bleeding

    PubMed Central

    Lockwood, Charles J.

    2011-01-01

    Expression of tissue factor (TF), the primary initiator of coagulation, is enhanced in decidualized human endometrial stromal cells (HESC) during the progesterone-dominated luteal phase. Progesterone also augments a second HESC hemostatic factor, plasminogen activator inhibitor-1 (PAI-1). In contrast, progestins inhibit HESC matrix metalloproteinase (MMP)-1, 3 and 9 expression to stabilize endometrial stromal and vascular extracellular matrix. Through these mechanisms decidualized endometrium is rendered both hemostatic and resistant to excess trophoblast invasion in the mid-luteal phase and throughout gestation to prevent hemorrhage and accreta. In non-fertile cycles, progesterone withdrawal results in decreased HESC TF and PAI-expression and increased MMP activity and inflammatory cytokine production promoting the controlled hemorrhage of menstruation and related tissue sloughing. In contrast to these well ordered biochemical processes, unpredictable endometrial bleeding associated with anovulation reflects absence of progestational effects on TF, PAI-1 and MMP activity as well as unrestrained angiogenesis rendering the endometrium non-hemostatic, proteolytic and highly vascular. Abnormal bleeding associated with long-term progestin-only contraceptives results not from impaired hemostasis but from unrestrained angiogenesis leading to large fragile endometrial vessels. This abnormal angiogenesis reflects progestational inhibition of endometrial blood flow promoting local hypoxia and generation of reactive oxygen species that increase production of angiogenic factors such as vascular endothelial growth factor (VEGF) in HESCs and Angiopoietin-2 (Ang-2) in endometrial endothelial cells while decreasing HESC expression of angiostatic, Ang-1. The resulting vessel fragility promotes bleeding. Aberrant angiogenesis also underlies abnormal bleeding associated with myomas and endometrial polyps however there are gaps in our understanding of this pathology. PMID:21499503

  14. Angioembolisation of a Bleeding Meckel's Diverticulum.

    PubMed

    Liu, Xuandao; Chan, Dedrick Kok-Hong; Tan, Ker-Kan

    2015-12-01

    We describe the diagnosis of an adult who presented with hematochezia. This was investigated and found to be from a bleeding Meckel's diverticulum. As this condition is rare in adults, there is no consensus regarding the optimal mode of management. We propose the use of angioembolisation in the diagnostic and therapeutic management of this condition. Our case showed that this strategy is indeed feasible and can achieve good short-term control, allowing for definitive surgery in an elective setting. PMID:26373773

  15. [Catamenial rectal bleeding and sigmoid endometriosis].

    PubMed

    Kazadi Buanga, J; Alcazar, J L; Laparte, M C; Lopez Garcia, G

    1992-01-01

    We describe a case of menstrual rectal bleeding due to sigmoid endometriosis. The history led us to the diagnosis and since a small biopsy of the lesion and scanning could not help us to a conclusive diagnosis we carried out histological examination of a piece removed at operation. This case has led us to estimate the incidence, the difficulties of diagnosis and the present therapeutic measures. PMID:1469232

  16. Use of electrospinning and dynamic air focusing to create three-dimensional cell culture scaffolds in microfluidic devices.

    PubMed

    Chen, Chengpeng; Mehl, Benjamin T; Sell, Scott A; Martin, R Scott

    2016-09-21

    Organs-on-a-chip has emerged as a powerful tool for pharmacological and physiological studies. A key part in the construction of such a model is the ability to pattern or culture cells in a biomimetic fashion. Most of the reported cells-on-a-chip models integrate cells on a flat surface, which does not accurately represent the extracellular matrix that they experience in vivo. Electrospinning, a technique used to generate sub-micron diameter polymer fibers, has been used as an in vitro cell culture substrate and for tissue engineering applications. Electrospinning of fibers directly into a fully sealed fluidic channel using a conventional setup has not been possible due to issues of confining the fibers into a discrete network. In this work, a dynamic focusing method was developed, with this approach enabling direct deposition of electrospun fibers into a fully sealed fluidic channel, to act as a matrix for cell culture and subsequent studies under continuous flowing conditions. Scanning electron microscopy of electrospun polycaprolactone fibers shows that this method enables the formation of fibrous layers on the inner wall of a 3D-printed fluidic device (mean fiber size = 1.6 ± 0.6 μm and average pore size = 113 ± 19 μm(2)). Cells were able to be cultured in this 3D scaffold without the addition of adhesion proteins. Media was pumped through the channel at high flow rates (up to 400 μL min(-1)) during a dynamic cell culture process and both the fibers and the cells were found to be strongly adherent. A PDMS fluidic device was also prepared (from a 3D printed mold) and coated with polycaprolactone fibers. The PDMS device enables optical detection and confocal imaging of cultured cells on the fibers. Finally, macrophages were cultured in the devices to study how the fibrous scaffold can affect cell behavior. It was found that under lipopolysaccharide stimulation, macrophages cultured on PCL fibers inside of a channel secreted significantly more cytokines than

  17. Occurrence of thrombosis in rare bleeding disorders.

    PubMed

    Ruiz-Saez, Arlette

    2013-09-01

    Paradoxically, there are reports of thrombotic events for some rare bleeding disorders associated with significant bleeding tendency. Afibrinogenemia, factor (F) VII, or FXI deficiencies are those most commonly associated with venous or arterial thrombosis. Pathogenesis is multifactorial and the main conditions associated with this complication relate to the coexistence of inherited or acquired thrombotic risk factors linked to certain specific characteristics of the underlying defect. Patients with afibrinogenemia can develop severe, spontaneous, or recurrent thromboembolic disease. Up to 20% of congenital dysfibrinogenemia patients show predisposition to thrombosis. Thrombotic episodes, particularly deep vein thrombosis, have been reported in 3 to 4% FVII deficient patients, even those who were severely affected. These events have been reported either after infusion of plasma derived FXI concentrate or recombinant activated FVII in FXI deficient patients. So, in addition to factor level, replacement therapy must be individualized and should take into account past personal or family history of bleeding and thrombosis, and other prothrombotic risk factors. Treatment of thrombosis represents a challenge. For mild factor deficiencies, antithrombotic prophylaxis must be considered with or without concomitant use of replacement therapy. For all patients, it is also recommended to control known cardiovascular disease risk factors. PMID:23929306

  18. [Obscure digestive bleeding by ileal carcinoid tumor].

    PubMed

    Nelly Manrique, María; Frisancho, Oscar; Zumaeta, Eduardo; Palomino, Américo; Rodriguez, César

    2011-01-01

    The patient is an 82 year-old female with a history of osteoarthritis, hypothyroidism and anemia for 14 years (receiving blood transfusions). She was admited to our hospital with a nine months history of malaise, anorexia, fatigue and weakness, associated with intermitten episodes of abdominal pain. She was diagnosed anemia and occult blood positive stools. Physical examination revealed a patient in generally fair condition, obese, with mild edema of lower limbs, no changes in the evaluation of chest, cardiovascular, abdomen, etc. Laboratory data was unremarkable, except for iron deficiency anemia. The upper endoscopy showed duodenal ulcer scar, fundic polyposis and chronic gastritis. Colonoscopy revealed some diverticula, a small sessile polyp and internal hemorrhoids. The diagnosis of obscure gastrointestinal bleeding was made. The CT scan of the abdomen showed gallstones and fatty liver; a radiograph of intestinal transit detected a lesion apparently protruded intestinal loop for distal jejunum; enteroscopy was performed (with one team ball) anterograde and retrograde achieving assess distal jejunum and distal ileum without observing any injuries. The study of capsule endoscopy showed a polypoid tumor intestinal with evidence of having bleeding. Surgery detected the tumor in proximal ileum. The surgical specimen findings showed three tumors 0.7 mm, 10 mm and 15 mm on the proximal ileum. The microscopic examination revealed that these lesions were neuroendocrine tumors (carcinoid). The Ileal carcinoid tumor may rarely presented with obscure gastrointestinal bleeding. PMID:21544161

  19. Air Apparent.

    ERIC Educational Resources Information Center

    Harbster, David A.

    1988-01-01

    Explains the principle upon which a barometer operates. Describes how to construct two barometric devices for use in the classroom that show air's changing pressure. Cites some conditions for predicting weather. (RT)

  20. Patterns of bleeding in adolescents with severe haemophilia A.

    PubMed Central

    Aronstam, A; Rainsford, S G; Painter, M J

    1979-01-01

    Eighty-two boys with severe haemophilia A who spent some time at Lord Mayor Treloar College during 1973-7 were studied. All episodes of bleeding that occurred during term time were recorded, along with the number of transfusions. The bleeding frequency among these boys, most of them aged 10-17 years, increased steadily from 8,31 episodes/100 days in 1973 to 12,63 episodes/100 days in 1977. At the same time there was a steady fall in bleeding frequency with age. Altogether 24% of bleeding episodes were into the elbow joint, 22% into the knee, and 15% into the ankle. As the boys grew older the proportion of bleeding episodes in the legs declined and that in the arms increased. The overall results reflect the fact that special schools now see only the severest cases of haemophilia. The pattern of bleeding during adolescence suggests that concepts of management of arm bleeding need modifying. PMID:427411

  1. Investigation of Tractor Base Bleeding for Heavy Vehicle Aerodynamic Drag Reduction

    SciTech Connect

    Ortega, J; Salari, K; Storms, B

    2007-10-25

    One of the main contributors to the aerodynamic drag of a heavy vehicle is tractor-trailer gap drag, which arises when the vehicle operates within a crosswind. Under this operating condition, freestream flow is entrained into the tractor-trailer gap, imparting a momentum exchange to the vehicle and subsequently increasing the aerodynamic drag. While a number of add-on devices, including side extenders, splitter plates, vortex stabilizers, and gap sealers, have been previously tested to alleviate this source of drag, side extenders remain the primary add-on device of choice for reducing tractor-trailer gap drag. However, side extenders are not without maintenance and operational issues. When a heavy vehicle pivots sharply with respect to the trailer, as can occur during loading or unloading operations, the side extenders can become crushed against the trailer. Consequently, fleet operators are forced to incur additional costs to cover the repair or replacement of the damaged side extenders. This issue can be overcome by either shortening the side extenders or by devising an alternative drag reduction concept that can perform just as effectively as side extenders. To explore such a concept, we investigate tractor base bleeding as a means of reducing gap drag. Wind tunnel measurements are made on a 1:20 scale heavy vehicle model at a vehicle width-based Reynolds number of 420,000. The tractor bleeding flow, which is delivered through a porous material embedded within the tractor base, is introduced into the tractor-trailer gap at bleeding coefficients ranging from 0.0-0.018. To determine the performance of tractor base bleeding under more realistic operating conditions, computational fluid dynamics simulations are performed on a full-scale heavy vehicle within a crosswind for bleeding coefficients ranging from 0.0-0.13.

  2. Microfluidic device for robust generation of two-component liquid-in-air slugs with individually controlled composition

    PubMed Central

    Liu, Kan; Chen, Yi-Chun; Tseng, Hsian-Rong

    2010-01-01

    Using liquid slugs as microreactors and microvessels enable precise control over the conditions of their contents on short-time scales for a wide variety of applications. Particularly for screening applications, there is a need for control of slug parameters such as size and composition. We describe a new microfluidic approach for creating slugs in air, each comprising a size and composition that can be selected individually for each slug. Two-component slugs are formed by first metering the desired volume of each reagent, merging the two volumes into an end-to-end slug, and propelling the slug to induce mixing. Volume control is achieved by a novel mechanism: two closed chambers on the chip are initially filled with air, and a valve in each is briefly opened to admit one of the reagents. The pressure of each reagent can be individually selected and determines the amount of air compression, and thus the amount of liquid that is admitted into each chamber. We describe the theory of operation, characterize the slug generation chip, and demonstrate the creation of slugs of different compositions. The use of microvalves in this approach enables robust operation with different liquids, and also enables one to work with extremely small samples, even down to a few slug volumes. The latter is important for applications involving precious reagents such as optimizing the reaction conditions for radiolabeling biological molecules as tracers for positron emission tomography. Electronic supplementary material The online version of this article (doi:10.1007/s10404-010-0617-0) contains supplementary material, which is available to authorized users. PMID:20930933

  3. Treating traumatic bleeding in a combat setting.

    PubMed

    Clifford, C Cloonan

    2004-12-01

    Bleeding is clearly a major cause of morbidity and death after trauma. When bleeding is attributable to transection of major vessels, surgical repair is appropriate. Posttraumatic microvascular bleeding attributable to coagulopathy secondary to metabolic derangements, hypothermia, and depletion or dysfunction of cellular and protein components requires a different approach. Although transfusion of blood products may be necessary to replace the blood loss, it does not always correct the problem of microvascular bleeding. The type of injury, mode of care, and treatment objectives differ significantly for combat-wounded soldiers versus civilian trauma patients. Although hemorrhage is responsible for 50% of combat deaths, published information about coagulation monitoring among combat patients is very limited. These articles summarize the appropriate monitoring of hemostasis among combat trauma patients, review the unique nature of combat casualties and the medical system used to treat them, and discuss information available from civilian studies. Because the development of coagulopathy is relatively infrequent in the young, otherwise healthy, military population, the routine screening measures currently used are adequate to guide initial blood product administration. However, as new intravenous hemostatic agents are used for these patients, better laboratory measures will be required. Although hemorrhage is the leading cause of death for combat casualties, catastrophic hemorrhage is rarely a prehospital combat medical management problem because, when it occurs, it tends to cause death before medical care can be provided. In civilian environments, most seriously injured victims can be reached and transported by emergency medical services personnel within minutes; in combat, it often takes hours simply to transport casualties off the battlefield. In combat situations, even if the transport distances are small, the hazardous nature of the forward combat areas frequently

  4. The cellular basis of traumatic bleeding.

    PubMed

    Hoffman, Maureane

    2004-12-01

    Bleeding is clearly a major cause of morbidity and death after trauma. When bleeding is attributable to transection of major vessels, surgical repair is appropriate. Posttraumatic microvascular bleeding attributable to coagulopathy secondary to metabolic derangements, hypothermia, and depletion or dysfunction of cellular and protein components requires a different approach. Although transfusion of blood products may be necessary to replace the blood loss, it does not always correct the problem of microvascular bleeding. The type of injury, mode of care, and treatment objectives differ significantly for combat-wounded soldiers versus civilian trauma patients. Although hemorrhage is responsible for 50% of combat deaths, published information about coagulation monitoring among combat patients is very limited. These articles summarize the appropriate monitoring of hemostasis among combat trauma patients, review the unique nature of combat casualties and the medical system used to treat them, and discuss information available from civilian studies. Because the development of coagulopathy is relatively infrequent in the young, otherwise healthy, military population, the routine screening measures currently used are adequate to guide initial blood product administration. However, as new intravenous hemostatic agents are used for these patients, better laboratory measures will be required. Although hemorrhage is the leading cause of death for combat casualties, catastrophic hemorrhage is rarely a prehospital combat medical management problem because, when it occurs, it tends to cause death before medical care can be provided. In civilian environments, most seriously injured victims can be reached and transported by emergency medical services personnel within minutes; in combat, it often takes hours simply to transport casualties off the battlefield. In combat situations, even if the transport distances are small, the hazardous nature of the forward combat areas frequently

  5. Lower gastrointestinal bleeding in the elderly: a rare aetiology masquerading as a diverticular bleed.

    PubMed

    Bhatt, Nikita R; Boland, Michael R; Abdelraheem, Omar; Merrigan, Anne B

    2016-01-01

    Bleeding per rectum is a relatively common acute surgical presentation. Common causes include diverticular disease, colitis, haemorrhoids, polyps, etc. An 83-year-old man with a history of recurrent rectosigmoid diverticulitis and bilateral internal iliac artery aneurysms for 2 years presented with rectal bleeding. He was suspected to have a diverticular bleed based on history and examination. A CT scan revealed a large haematoma adjacent to the right isolated internal iliac artery aneurysm (IIIAA) almost indistinguishable from the adjacent rectosigmoid, consistent with a ruptured IIIAA and an ileorectal fistula. The fistula was of a primary vascular enteric type and was accentuated by the inflammation arising from the diverticulitis. Hence, presence of more common or apparently obvious causes should not deter clinicians from thoroughly investigating the case. Rare causes should be kept in mind while dealing with common acute presentations, especially in elderly patients with multiple comorbidities. PMID:27033287

  6. Effects of bleed-hole geometry and plenum pressure on three-dimensional shock-wave/boundary-layer/bleed interactions

    NASA Technical Reports Server (NTRS)

    Chyu, Wei J.; Rimlinger, Mark J.; Shih, Tom I.-P.

    1993-01-01

    A numerical study was performed to investigate 3D shock-wave/boundary-layer interactions on a flat plate with bleed through one or more circular holes that vent into a plenum. This study was focused on how bleed-hole geometry and pressure ratio across bleed holes affect the bleed rate and the physics of the flow in the vicinity of the holes. The aspects of the bleed-hole geometry investigated include angle of bleed hole and the number of bleed holes. The plenum/freestream pressure ratios investigated range from 0.3 to 1.7. This study is based on the ensemble-averaged, 'full compressible' Navier-Stokes (N-S) equations closed by the Baldwin-Lomax algebraic turbulence model. Solutions to the ensemble-averaged N-S equations were obtained by an implicit finite-volume method using the partially-split, two-factored algorithm of Steger on an overlapping Chimera grid.

  7. ACG Clinical Guideline: Diagnosis and Management of Small Bowel Bleeding.

    PubMed

    Gerson, Lauren B; Fidler, Jeff L; Cave, David R; Leighton, Jonathan A

    2015-09-01

    Bleeding from the small intestine remains a relatively uncommon event, accounting for ~5-10% of all patients presenting with gastrointestinal (GI) bleeding. Given advances in small bowel imaging with video capsule endoscopy (VCE), deep enteroscopy, and radiographic imaging, the cause of bleeding in the small bowel can now be identified in most patients. The term small bowel bleeding is therefore proposed as a replacement for the previous classification of obscure GI bleeding (OGIB). We recommend that the term OGIB should be reserved for patients in whom a source of bleeding cannot be identified anywhere in the GI tract. A source of small bowel bleeding should be considered in patients with GI bleeding after performance of a normal upper and lower endoscopic examination. Second-look examinations using upper endoscopy, push enteroscopy, and/or colonoscopy can be performed if indicated before small bowel evaluation. VCE should be considered a first-line procedure for small bowel investigation. Any method of deep enteroscopy can be used when endoscopic evaluation and therapy are required. VCE should be performed before deep enteroscopy if there is no contraindication. Computed tomographic enterography should be performed in patients with suspected obstruction before VCE or after negative VCE examinations. When there is acute overt hemorrhage in the unstable patient, angiography should be performed emergently. In patients with occult hemorrhage or stable patients with active overt bleeding, multiphasic computed tomography should be performed after VCE or CTE to identify the source of bleeding and to guide further management. If a source of bleeding is identified in the small bowel that is associated with significant ongoing anemia and/or active bleeding, the patient should be managed with endoscopic therapy. Conservative management is recommended for patients without a source found after small bowel investigation, whereas repeat diagnostic investigations are recommended

  8. Endoscopic hemostasis state of the art - Nonvariceal bleeding

    PubMed Central

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

    2016-01-01

    New endoscopic techniques for hemostasis in nonvariceal bleeding were introduced and known methods further improved. Hemospray and Endoclot are two new compounds for topical treatment of bleeding. Initial studies in this area have shown a good hemostatic effect, especially in active large scale oozing bleeding, e.g., tumor bleedings. For further evaluation larger prospective studies comparing the substanced with other methods of endoscopic hemostasis are needed. For localized active arterial bleeding primary injection therapy in the area of ​​bleeding as well as in the four adjacent quadrants offers a good method to reduce bleeding activity. The injection is technically easy to learn and practicable. After bleeding activity is reduced the bleeding source can be localized more clearly for clip application. Today many different through-the-scope (TTS) clips are available. The ability to close and reopen a clip can aid towards good positioning at the bleeding site. Even more important is the rotatability of a clip before application. Often multiple TTS clips are required for secure closure of a bleeding vessel. One model has the ability to use three clips in series without changing the applicator. Severe arterial bleeding from vessels larger than 2 mm is often unmanageable with these conventional methods. Here is the over-the-scope-clip system another newly available method. It is similar to the ligation of esophageal varices and involves aspiration of tissue into a transparent cap before closure of the clip. Thus a greater vascular occlusion pressure can be achieved and larger vessels can be treated endoscopically. Patients with severe arterial bleeding from the upper gastrointestinal tract have a very high rate of recurrence after initial endoscopic treatment. These patients should always be managed in an interdisciplinary team of interventional radiologist and surgeons. PMID:26962402

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

    PubMed

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

    2016-02-25

    New endoscopic techniques for hemostasis in nonvariceal bleeding were introduced and known methods further improved. Hemospray and Endoclot are two new compounds for topical treatment of bleeding. Initial studies in this area have shown a good hemostatic effect, especially in active large scale oozing bleeding, e.g., tumor bleedings. For further evaluation larger prospective studies comparing the substanced with other methods of endoscopic hemostasis are needed. For localized active arterial bleeding primary injection therapy in the area of ​​bleeding as well as in the four adjacent quadrants offers a good method to reduce bleeding activity. The injection is technically easy to learn and practicable. After bleeding activity is reduced the bleeding source can be localized more clearly for clip application. Today many different through-the-scope (TTS) clips are available. The ability to close and reopen a clip can aid towards good positioning at the bleeding site. Even more important is the rotatability of a clip before application. Often multiple TTS clips are required for secure closure of a bleeding vessel. One model has the ability to use three clips in series without changing the applicator. Severe arterial bleeding from vessels larger than 2 mm is often unmanageable with these conventional methods. Here is the over-the-scope-clip system another newly available method. It is similar to the ligation of esophageal varices and involves aspiration of tissue into a transparent cap before closure of the clip. Thus a greater vascular occlusion pressure can be achieved and larger vessels can be treated endoscopically. Patients with severe arterial bleeding from the upper gastrointestinal tract have a very high rate of recurrence after initial endoscopic treatment. These patients should always be managed in an interdisciplinary team of interventional radiologist and surgeons. PMID:26962402

  10. Management of bleeding in vascular surgery.

    PubMed

    Chee, Y E; Liu, S E; Irwin, M G

    2016-09-01

    Management of acute coagulopathy and blood loss during major vascular procedures poses a significant haemostatic challenge to anaesthetists. The acute coagulopathy is multifactorial in origin with tissue injury and hypotension as the precipitating factors, followed by dilution, hypothermia, acidemia, hyperfibrinolysis and systemic inflammatory response, all acting as a self-perpetuating spiral of events. The problem is confounded by the high prevalence of antithrombotic agent use in these patients and intraoperative heparin administration. Trials specifically examining bleeding management in vascular surgery are lacking, and much of the literature and guidelines are derived from studies on patients with trauma. In general, it is recommended to adopt permissive hypotension with a restrictive fluid strategy, using a combination of crystalloid and colloid solutions up to one litre during the initial resuscitation, after which blood products should be administered. A restrictive transfusion trigger for red cells remains the mainstay of treatment except for the high-risk patients, where the trigger should be individualized. Transfusion of blood components should be initiated by clinical evidence of coagulopathy such as diffuse microvascular bleeding, and then guided by either laboratory or point-of-care coagulation testing. Prophylactic antifibrinolytic use is recommended for all surgery where excessive bleeding is anticipated. Fibrinogen and prothrombin complex concentrates administration are recommended during massive transfusion, whereas rFVIIa should be reserved until all means have failed. While debates over the ideal resuscitative strategy continue, the approach to vascular haemostasis should be scientific, rational, and structured. As far as possible, therapy should be monitored and goal directed. PMID:27566811

  11. An Unusual Case of Gastrointestinal Bleeding

    PubMed Central

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

    2011-01-01

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

  12. Comparison of Lichen, Conifer Needles, Passive Air Sampling Devices, and Snowpack as Passive Sampling Media to Measure Semi-Volatile Organic Compounds in Remote Atmospheres

    PubMed Central

    SCHRLAU, JILL E.; GEISER, LINDA; HAGEMAN, KIMBERLY J.; LANDERS, DIXON H.

    2011-01-01

    A wide range of semi-volatile organic compounds (SOCs), including pesticides and polycyclic aromatic hydrocarbons (PAHs), were measured in lichen, conifer needles, snowpack and XAD-based passive air sampling devices (PASDs) collected from 19 different U.S. national parks in order to compare the magnitude and mechanism of SOC accumulation in the different passive sampling media. Lichen accumulated the highest SOC concentrations, in part because of its long (and unknown) exposure period, while PASDs accumulated the lowest concentrations. However, only the PASD SOC concentrations can be used to calculate an average atmospheric gas-phase SOC concentration because the sampling rates are known and the media is uniform. Only the lichen and snowpack SOC accumulation profiles were statistically significantly correlated (r = 0.552, p-value <0.0001) because they both accumulate SOCs present in the atmospheric particle-phase. This suggests that needles and PASDs represent a different composition of the atmosphere than lichen and snowpack and that the interpretation of atmospheric SOC composition is dependent on the type of passive sampling media used. All four passive sampling media preferentially accumulated SOCs with relatively low air-water partition coefficients, while snowpack accumulated SOCs with higher log KOA values compared to the other media. Lichen accumulated more SOCs with log KOA > 10 relative to needles and showed a greater accumulation of particle-phase PAHs. PMID:22087860

  13. Bleeding risk assessment and management in atrial fibrillation patients. Executive Summary of a Position Document from the European Heart Rhythm Association [EHRA], endorsed by the European Society of Cardiology [ESC] Working Group on Thrombosis.

    PubMed

    Lip, Gregory Y H; Andreotti, Felicita; Fauchier, Laurent; Huber, Kurt; Hylek, Elaine; Knight, Eve; Lane, Deirdre; Levi, Marcel; Marín, Francisco; Palareti, Gualtiero; Kirchhof, Paulus

    2011-12-01

    In this executive summary of a Consensus Document from the European Heart Rhythm Association, endorsed by the European Society of Cardiology Working Group on Thrombosis, we comprehensively review the published evidence and propose a consensus on bleeding risk assessments in atrial fibrillation (AF) patients. The main aim of the document was to summarise 'best practice' in dealing with bleeding risk in AF patients when approaching antithrombotic therapy, by addressing the epidemiology and size of the problem, and review established bleeding risk factors. We also summarise definitions of bleeding in the published literature. Patient values and preferences balancing the risk of bleeding against thromboembolism as well as the prognostic implications of bleeding are reviewed. We also provide an overview of published bleeding risk stratification and bleeding risk schema. Brief discussion of special situations (e.g. periablation, peri-devices such as implantable cardioverter defibrillators [ICD] or pacemakers, presentation with acute coronary syndromes and/or requiring percutanous coronary interventions/stents and bridging therapy) is made, as well as a discussion of the prevention of bleeds and managing bleeding complications. Finally, this document puts forwards consensus statements that may help to define evidence gaps and assist in everyday clinical practice. PMID:22048796

  14. Porcine survival model to simulate acute upper gastrointestinal bleedings.

    PubMed

    Prosst, Ruediger L; Schurr, Marc O; Schostek, Sebastian; Krautwald, Martina; Gottwald, Thomas

    2016-06-01

    The existing animal models used for the simulation of acute gastrointestinal bleedings are usually non-survival models. We developed and evaluated a new porcine model (domestic pig, German Landrace) in which the animal remains alive and survives the artificial bleeding without any cardiovascular impairment. This consists of a bleeding catheter which is implanted into the stomach, then subcutaneously tunnelled from the abdomen to the neck where it is exteriorized and fixed with sutures. Using the injection of porcine blood, controllable and reproducible acute upper gastrointestinal bleeding can be simulated while maintaining normal gastrointestinal motility and physiology. Depending on the volume of blood applied through the gastric catheter, the bleeding intensity can be varied from traces of blood to a massive haemorrhage. This porcine model could be valuable, e.g. for testing the efficacy of new bleeding diagnostics in large animals before human use. PMID:26306615

  15. [EMERGENCY TREATMENT OF BLEEDING IN PATIENTS TAKING WARFARIN].

    PubMed

    Prasolov, N V; Shulutko, E M; Bulanov, A Yu; Yatskov, K V; Shcherbakov, O V

    2015-01-01

    Anticoagulant therapy with vitamin K antagonists (AVK) is an effective treatment and prevention of thrombosis. One of the major disadvantages of the AVK is a risk for serious bleeding. Prothrombin complex concentrates (PCC), fresh frozen plasma (FFP) and vitamin K1 are available for control of these situations. The experience of special team ofthe Scientific Center for Hematology was the basis for presented retrospective study. Three regimens of warfarin-related bleeding were compared: PCC+ VK for several bleeding, FFP+ VK for different clinical situations and VKfor light bleeding. PCC showed himself as effective and safe hemostatic agent. Transfusions of FFP were sometimes not effective, sometimes led to TACO. Supplementation of vitamin K1 for patients of I and II groups provided more stable control of hemostasis. In III group VK vas effective to stop bleeding. Two impotent sings for conclusion: necessary of laboratory monitoring, TEG first of all; individual balance of hemostasis base of bleeding or thrombotic risks. PMID:26148369

  16. Cerebral air embolism and subsequent transient neurologic abnormalities in a liver transplant recipient following the removal of the pulmonary artery catheter from the central venous access device: a case report

    PubMed Central

    Kim, Sun-Key; Jun, In-Gu; Jang, Dong-Min; Lim, Jinwook; Hwang, Gyu-Sam

    2016-01-01

    Cerebral air embolism is a rare but potentially life-threatening complication. We experienced a living-donor liver transplant recipient who presented with unexpected cerebral air embolism and transient neurologic abnormalities that subsequently developed just after the removal of the pulmonary artery catheter from the central venous access device. One day after the initial event, the patient's neurologic status gradually improved. The patient was discharged 30 days after liver transplantation without neurologic sequelae. PMID:26885308

  17. Endovascular Management of Acute Enteric Bleeding from Pancreas Transplant

    SciTech Connect

    Semiz-Oysu, Aslihan; Cwikiel, Wojciech

    2007-04-15

    Arterioenteric fistula is a rare but serious complication of enteric drained pancreas transplant, which may lead to massive gastrointestinal bleeding. We present 3 patients with failed enteric drained pancreas transplants and massive gastrointestinal bleeding secondary to arterioenteric fistula. One patient was treated by embolization and the 2 others by stent graft placement. Bleeding was successfully controlled in all cases, at follow up of 5 days, 8 months, and 12 months, respectively. One patient died 24 days after embolization, of unknown causes.

  18. New Trends in Acute Management of Colonic Diverticular Bleeding

    PubMed Central

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

    2015-01-01

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

  19. [Avoiding and dealing with bleeding during endoscopic sinus surgery].

    PubMed

    Leunig, A

    2006-04-01

    Endoscopic sinus surgery is one of the most frequent surgical ENT-procedures. Bleeding during surgery may increase complications and may have negative effects on surgery and outcome. The present paper describes strategies to prevent and deal with bleeding during sinus surgery. Preoperative conservative treatment of mucosal inflammation as well the use of adrenalin for decongestion may reduce intraoperative bleeding and hence complications. PMID:16615029

  20. Multiple Polypoid Angiodysplasia with Obscure Overt Bleeding

    PubMed Central

    Lee, Jooyoung; Hwang, Sung Wook; Kim, Jihye; Kang, Jinwoo; Kang, Gyeong Hoon; Park, Kyu Joo; Im, Jong Pil; Kim, Joo Sung

    2016-01-01

    Angiodysplasia (AD) is increasingly being recognized as a major cause of gastrointestinal bleeding. Morphologically flat lesions are common types of AD, whereas the polypoid types are rare. We report a case of multiple polypoid AD in the small bowel causing severe anemia and requiring surgical treatment. A 60-year-old male patient visited our hospital with dyspnea and hematochezia. He had a history of myocardial infarction and was taking both aspirin and clopidogrel. Capsule endoscopy, enteroscopy, computed tomography, and angiography revealed multifocal vascular lesions with a polypoid shape in the jejunum. Surgical resection was performed because endoscopic treatment was considered impossible with the number and the location of lesions. The risk of recurrent bleeding related to the use of antiplatelet agents also contributed to the decision to perform surgery. AD was histologically diagnosed from the surgical specimen. He resumed taking both aspirin and clopidogrel after surgery. He fully recovered and has been doing well during the several months of follow-up. PMID:26855931

  1. Hemophilic bleeding evaluated by blood pool scanning.

    PubMed

    Green, D; Spies, S M; Rana, N A; Milgram, J W; Mintzer, R

    1981-06-30

    The technique of blood pool scanning was used to examine 15 hemophilic subjects. Employing an in vivo method for erythrocyte labeling with Technetium-99 m, a dynamic perfusion sequence is obtained using a scintillation camera positioned over the area to be examined. This demonstrates the vascularity of the tissue. Subsequently, equilibrium blood pool images of the area are obtained and analyzed with a densitometer to assess relative regional blood volume. In patients who were not bleeding but had chronic arthropathy, vascularity was not increased, and the blood volume of comparable joints was similar. By contrast, marked increases in vascularity and image density were observed in studies of acutely bleeding joints. Chronic hemarthroses were associated with persistent, but less marked increases in joint perfusion. Transient increases in joint vascularity were demonstrated after insertion of knee prostheses. In a patient with a thigh hematoma, the dimensions of the hemorrhage were clearly delineated. Since only a tracer dose of nuclide is infused intravenously, there are no allergic reactions or other side effects of the procedure. Blood pool scanning is a safe, non-invasive technique that augments clinical and radiographic evaluations, and provides a new dimension in the assessment of the hemophilic patient. PMID:6269248

  2. Abnormal Bleeding During Menopause Hormone Therapy: Insights for Clinical Management

    PubMed Central

    de Medeiros, Sebastião Freitas; Yamamoto, Márcia Marly Winck; Barbosa, Jacklyne Silva

    2013-01-01

    Objective Our objective was to review the involved mechanisms and propose actions for controlling/treating abnormal uterine bleeding during climacteric hormone therapy. Methods A systemic search of the databases SciELO, MEDLINE, and Pubmed was performed for identifying relevant publications on normal endometrial bleeding, abnormal uterine bleeding, and hormone therapy bleeding. Results Before starting hormone therapy, it is essential to exclude any abnormal organic condition, identify women at higher risk for bleeding, and adapt the regimen to suit eachwoman’s characteristics. Abnormal bleeding with progesterone/progestogen only, combined sequential, or combined continuous regimens may be corrected by changing the progestogen, adjusting the progestogen or estrogen/progestogen doses, or even switching the initial regimen to other formulation. Conclusion To diminish the occurrence of abnormal bleeding during hormone therapy (HT), it is important to tailor the regimen to the needs of individual women and identify those with higher risk of bleeding. The use of new agents as adjuvant therapies for decreasing abnormal bleeding in women on HT awaits future studies. PMID:24665210

  3. Low hemoglobin levels are associated with upper gastrointestinal bleeding

    PubMed Central

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

    2016-01-01

    Upper gastrointestinal (GI) bleeding can be fatal. Blood test variables were reviewed in search of threshold values to detect the presence of occult upper GI bleeding. The records of 1,023 patients who underwent endoscopy at the National Hospital Organization Shimoshizu Hospital from October 2014, to September 2015, were retrospectively reviewed. Of those, 95 had upper GI bleeding. One-way analysis of variance was applied to blood test variables comparing patients with and without upper GI bleeding. Logistic regression analysis was applied to detect the association of blood test parameters with upper GI bleeding, and receiver-operator characteristics were applied to establish threshold values. White blood cell count (WBC), platelet (Plt) count, and blood urea nitrogen (BUN) levels were higher, and hemoglobin (Hb) and albumin (Alb) levels were lower in patients with upper GI bleeding. Logistic regression analysis showed that low Hb was significantly associated with upper GI bleeding and a Hb value of 10.8 g/dl was established as the threshold for the diagnosis. In patients with upper GI bleeding, WBC, Plt count, and BUN levels were higher and Hb and Alb levels were reduced. Hb at 10.8 g/dl was established as a threshold value to detect upper GI bleeding. PMID:27588176

  4. Modeling of Fixed-Exit Porous Bleed Systems

    NASA Technical Reports Server (NTRS)

    Slater, John W.; Saunders, John D.

    2008-01-01

    A model has been developed to simulate a fixed-exit porous bleed system for supersonic inlets. The fixed-exit model allows the amount of bleed flow to vary according to local flow conditions and fixed-exit characteristics of the bleed system. This variation is important for the control of shock-wave/boundary-layer interactions within the inlet. The model computes the bleed plenum static pressure rather than requiring its specification. The model was implemented in the Wind-US computational fluid dynamics code. The model was then verified and validated against experimental data for bleed on a flat plate with and without an impinging oblique shock and for bleed in a Mach 3.0 axisymmetric, mixed-compression inlet. The model was able to accurately correlate the plenum pressures with bleed rates and simulate the effect of the bleed on the downstream boundary layer. Further, the model provided a realistic simulation of the initiation of inlet unstart. The results provide the most in-depth examination to date of bleed models for use in the simulation of supersonic inlets. The results also highlight the limitations of the models and aspects that require further research.

  5. Serotonin Reuptake Inhibitors and Risk of Abnormal Bleeding.

    PubMed

    Andrade, Chittaranjan; Sharma, Eesha

    2016-09-01

    Serotonin reuptake inhibitors (SRIs) increase the risk of abnormal bleeding by lowering platelet serotonin and hence the efficiency of platelet-driven hemostasis; by increasing gastric acidity and possibly gastric ulceration; and by other mechanisms. The upper gastrointestinal tract is the commonest site of SRI-related abnormal bleeding; bleeding at this location may be increased by concurrent nonsteroidal anti-inflammatory drug therapy and by treatment with antiplatelet or anticoagulant drugs. Bleeding at this location may be reduced by concurrent administration of acid-suppressing drugs. PMID:27514297

  6. Photocoagulation in the treatment of bleeding peptic ulcer

    NASA Astrophysics Data System (ADS)

    Otto, Wlodzimierz; Paczkowski, Pawel M.

    1996-03-01

    The authors present their experience in the endoscopic laser photocoagulation of bleeding peptic ulcer. From 1991 to June 1995, 203 patients admitted for UGI bleeding from peptic ulcer have been treated by this method. The source of bleeding was confirmed by endoscopy. The patients were divided into two groups: actively bleeding peptic ulcer (group IA and IB according to Forrest's classification) and ulcer with stigmata of recent bleeding (group IIA/IIB). The former group consisted of 106 patients, among whom over 40 percent (45 patients) presented signs of hypovolemic shock on admission. Nd:YAG laser (Surgical Laser Technologies) was used in a continuous mode with a contact (8 - 20 watts) or non-contact (over 50 watts) method of coagulation. In actively bleeding patients photocoagulation resulted in stopping the hemorrhage in 95 (90%). Recurrent bleeding occurred in 16 cases; in 9 of them it was stopped by repeated photocoagulation. In this group 18 patients required surgical intervention. The mortality was of 10.3% (11 patients). In 97 patients with recent bleeding stigmata photocoagulation provoked heavy hemorrhage in 3 (in 2 cases stopped by prolonged coagulation). In 9 of the remaining 94 patients recurrent bleeding occurred. Nine patients required surgical intervention. Mortality in this group was of 6%.

  7. The Safety of Thoracentesis in Patients with Uncorrected Bleeding Risk

    PubMed Central

    Argento, A. Christine; Murphy, Terrence E.; Araujo, Katy L. B.; Pisani, Margaret A.

    2013-01-01

    Background: Thoracentesis is commonly performed to evaluate pleural effusions. Many medications (warfarin, heparin, clopidogrel) or physiological factors (elevated International Normalized Ratio [INR], thrombocytopenia, uremia) increase the risk for bleeding. Frequently these medications are withheld or transfusions are performed to normalize physiological parameters before a procedure. The safety of performing thoracentesis without correction of these bleeding risks has not been prospectively evaluated. Methods: This prospective observational cohort study enrolled 312 patients who underwent thoracentesis. All patients were evaluated for the presence of risk factors for bleeding. Hematocrit levels were obtained pre- and postprocedure, and the occurrence of postprocedural hemothorax was evaluated. Measurements and Main Results: Thoracenteses were performed in 312 patients, 42% of whom had a risk for bleeding. Elevated INR, secondary to liver disease or warfarin, and renal disease were the two most common etiologies for bleeding risk, although many patients had multiple potential bleeding risks. There was no significant difference in pre- and postprocedural hematocrit levels in patients with a bleeding risk when compared with patients with no bleeding risk. No patient developed a hemothorax as a result of the thoracentesis. Conclusions: This single-center, observational study suggests that thoracentesis may be safely performed without prior correction of coagulopathy, thrombocytopenia, or medication-induced bleeding risk. This may reduce the morbidity associated with transfusions or withholding of medications. PMID:23952852

  8. Hemostatic Powders in Gastrointestinal Bleeding: A Systematic Review.

    PubMed

    Chen, Yen-I; Barkun, Alan N

    2015-07-01

    Topical hemostatic agents and powders are an emerging modality in the endoscopic management of upper and lower gastrointestinal bleeding. This systematic review demonstrates the effectiveness and safety of these agents with special emphasis on TC-325 and Ankaferd Blood Stopper. The unique noncontact/nontraumatic application, ability to cover large areas of bleed, and ease of use make these hemostatic agents an attractive option in certain clinical situations, such as massive bleeding with poor visualization, salvage therapy, and diffuse bleeding from luminal malignancies. PMID:26142037

  9. Improvements in Modeling 90 degree Bleed Holes for Supersonic Inlets

    NASA Technical Reports Server (NTRS)

    Slater, John W.

    2009-01-01

    The modeling of porous bleed regions as boundary conditions in computational fluid dynamics (CFD) simulations of supersonic inlet flows has been improved through a scaling of sonic flow coefficient data for 90deg bleed holes. The scaling removed the Mach number as a factor in computing the sonic flow coefficient and allowed the data to be fitted with a quadratic equation, with the only factor being the ratio of the plenum static pressure to the surface static pressure. The implementation of the bleed model into the Wind-US CFD flow solver was simplified by no longer requiring the evaluation of the flow properties at the boundary-layer edge. The quadratic equation can be extrapolated to allow the modeling of small amounts of blowing, which can exist when recirculation of the bleed flow occurs within the bleed region. The improved accuracy of the bleed model was demonstrated through CFD simulations of bleed regions on a flat plate in supersonic flow with and without an impinging oblique shock. The bleed model demonstrated good agreement with experimental data and three-dimensional CFD simulations of bleed holes.

  10. Emergency diagnosis of upper gastrointestinal bleeding by fiberoptic endoscopy.

    PubMed Central

    Villar, H V; Roberts Fender, H; Watson, L C; Thompson, J C

    1977-01-01

    Emergency esophagogastroduodenoscopy has been performed in 192 consecutive patients admitted with massive gastrointestinal bleeding. Accurate endoscopic diagnosis was made in 184 or 96%; 58 patients underwent emergency operations to control bleeding with an overall operative mortality of 26%. Excluding 16 patients who underwent emergency portacaval shunting, the operative mortality was 7%. In 6 patients, the bleeding was controlled by endoscopic electrocoagulation. There were no complications. Emergency endoscopy should be done routinely as the primary diagnostic approach in the diagnosis of upper gastrointestinal bleeding. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. Fig. 5. PMID:300236

  11. Unusual Bleeding From Hepaticojejunostomy Controlled by Adult Variable Stiffness Colonoscopy: Report of a Case and Literature Review

    PubMed Central

    Baba, Hiroyuki; Wakabayashi, Mai; Oba, Atsushi; Baba, Hironobu; Mitsuoka, Akito; Nakamura, Hiroshi; Sanada, Takahiro; Kuwabara, Hiroshi; Nakajima, Kazumi; Goseki, Narihide; Ishida, Hideyuki

    2014-01-01

    We herein present a case of a 59-year-old man who had undergone pylorus preserving pancreaticoduodenectomy with regional lymph node dissection prior to episodes of melena. Series of conventional endoscopic investigations failed to identify the bleeding source. Enhanced computed tomography scan revealed complete obstruction of the main portal vein with numerous collateral veins running towards the hepatic hilus. Comprehensively, hemorrhage from the jejunal varices caused by postoperative portal hypertension was highly suspected. As the jejunal loop was out of reach, adult variable-stiffness colonoscope (AVSC) was utilized to solve the Roux-en-Y anatomy. Numerous telangiectasis and small varices at hepaticojejunostomy were observed and in the mean time, bleeding was noticed and endoclips were placed without any delay. Ectopic variceal bleeding in jejunal loop after pancreaticoduodenectomy is difficult to manage. We believe that AVSC is an alternative device when specialized jejunal endoscopy is not available. PMID:25216425

  12. Heat tube device

    NASA Technical Reports Server (NTRS)

    Khattar, Mukesh K. (Inventor)

    1990-01-01

    The present invention discloses a heat tube device through which a working fluid can be circulated to transfer heat to air in a conventional air conditioning system. The heat tube device is disposable about a conventional cooling coil of the air conditioning system and includes a plurality of substantially U-shaped tubes connected to a support structure. The support structure includes members for allowing the heat tube device to be readily positioned about the cooling coil. An actuatable adjustment device is connected to the U-shaped tubes for allowing, upon actuation thereof, for the heat tubes to be simultaneously rotated relative to the cooling coil for allowing the heat transfer from the heat tube device to air in the air conditioning system to be selectively varied.

  13. Testing Percutaneous Arterial Closure Devices: An Animal Model

    SciTech Connect

    Ni Ruifang; Kranokpiraksa, Pawanrat; Pavcnik, Dusan Kakizawa, Hideaki; Uchida, Barry T.; Keller, Frederick S.; Roesch, Josef

    2009-03-15

    The ovine superficial femoral artery was used for testing the efficacy of percutaneous arterial closure devices (PACDs) in their developmental stage. Two topical devices containing chitostan, one staple-mediated PACD and a porcine small intestinal submucosa plug, were tested by follow-up angiography in 37 sheep. Absence or presence of bleeding and time to bleeding cessation were the main criteria for evaluation of PAVD efficacy. The results of these tests directed modification of individual PACDs and improved their efficacy.

  14. Impact on postoperative bleeding and cost of recombinant activated factor VII in patients undergoing heart transplantation

    PubMed Central

    Hollis, Allison L.; Lowery, Ashleigh V.; Pajoumand, Mehrnaz; Pham, Si M.; Slejko, Julia F.; Tanaka, Kenichi A.; Mazzeffi, Michael

    2016-01-01

    Background: Cardiac transplantation can be complicated by refractory hemorrhage particularly in cases where explantation of a ventricular assist device is necessary. Recombinant activated factor VII (rFVIIa) has been used to treat refractory bleeding in cardiac surgery patients, but little information is available on its efficacy or cost in heart transplant patients. Methods: Patients who had orthotopic heart transplantation between January 2009 and December 2014 at a single center were reviewed. Postoperative bleeding and the total costs of hemostatic therapies were compared between patients who received rFVIIa and those who did not. Propensity scores were created and used to control for the likelihood of receiving rFVIIa in order to reduce bias in our risk estimates. Results: Seventy-six patients underwent heart transplantation during the study period. Twenty-one patients (27.6%) received rFVIIa for refractory intraoperative bleeding. There was no difference in postoperative red blood cell transfusion, chest tube output, or surgical re-exploration between patients who received rFVIIa and those who did not, even after adjusting with the propensity score (P = 0.94, P = 0.60, and P = 0.10, respectively). The total cost for hemostatic therapies was significantly higher in the rFVIIa group (median $10,819 vs. $1,985; P < 0.0001). Subgroup analysis of patients who underwent redo-sternotomy with left ventricular assist device explantation did not show any benefit for rFVIIa either. Conclusions: In this relatively small cohort, rFVIIa use was not associated with decreased postoperative bleeding in patients undergoing heart transplantation; however, it led to significantly higher cost. PMID:27397445

  15. Medical management of heavy menstrual bleeding

    PubMed Central

    Maybin, Jacqueline A; Critchley, Hilary OD

    2016-01-01

    Women with benign heavy menstrual bleeding have the choice of a number of medical treatment options to reduce their blood loss and improve quality of life. The role of the clinician is to provide information to facilitate women in making an appropriate choice. Unfortunately, many options can be associated with hormonal side effects, prevention of fertility and lack of efficacy, leading to discontinuation and progression to surgical interventions. Herein, we discuss the various options currently available to women, including antifibrinolytics, nonsteroidal anti-inflammatory preparations, oral contraceptive pills and oral, injectable and intrauterine progestogens. In addition, we describe the more novel option of selective progesterone receptor modulators and their current benefits and limitations. PMID:26695687

  16. Medical management of heavy menstrual bleeding.

    PubMed

    Maybin, Jacqueline A; Critchley, Hilary O D

    2016-01-01

    Women with benign heavy menstrual bleeding have the choice of a number of medical treatment options to reduce their blood loss and improve quality of life. The role of the clinician is to provide information to facilitate women in making an appropriate choice. Unfortunately, many options can be associated with hormonal side effects, prevention of fertility and lack of efficacy, leading to discontinuation and progression to surgical interventions. Herein, we discuss the various options currently available to women, including antifibrinolytics, nonsteroidal anti-inflammatory preparations, oral contraceptive pills and oral, injectable and intrauterine progestogens. In addition, we describe the more novel option of selective progesterone receptor modulators and their current benefits and limitations. PMID:26695687

  17. Prostatic carcinoma: rectal bleeding after radiation therapy

    SciTech Connect

    Kagan, A.R.; Steckel, R.J.

    1981-06-01

    A 64-year-old man had a prostatic nodule on routine physical examination; per-rectal needle biopsies revealed a single focus of well differentiated adenocarcinoma. The patient had no history of urinary obstruction or of bowel difficulties. Accordingly, this was clinical stage II carcinoma of the prostate. The patient chose to receive external radiation therapy and was given small-field rotational treatment to a dose of 7000 rad (70 Gy) at a rate of 800 rad (8 Gy) weekly. Late in treatment, he experienced transitory diarrhea with flatulence, but this cleared with completion of treatment. Twenty months later he began to note frequent soft bowel movements, occasionally with red blood. At sigmoidoscopy 24 months after completion of treatment, the rectal mucosa was noted to be friable with minimal bleeding, presumably the result of radiation proctitis.

  18. Platelet Function Tests in Bleeding Disorders.

    PubMed

    Lassila, Riitta

    2016-04-01

    Functional disorders of platelets can involve any aspect of platelet physiology, with many different effects or outcomes. These include platelet numbers (thrombocytosis or thrombocytopenia); changes in platelet production or destruction, or capture to the liver (Ashwell receptor); altered adhesion to vascular injury sites and/or influence on hemostasis and wound healing; and altered activation or receptor functions, shape change, spreading and release reactions, procoagulant and antifibrinolytic activity. Procoagulant membrane alterations, and generation of thrombin and fibrin, also affect platelet aggregation. The above parameters can all be studied, but standardization and quality control of assay methods have been limited despite several efforts. Only after a comprehensive clinical bleeding assessment, including family history, information on drug use affecting platelets, and exclusion of coagulation factor, and tissue deficits, should platelet function testing be undertaken to confirm an abnormality. Current diagnostic tools include blood cell counts, platelet characteristics according to the cell counter parameters, peripheral blood smear, exclusion of pseudothrombocytopenia, whole blood aggregometry (WBA) or light transmission aggregometry (LTA) in platelet-rich plasma, luminescence, platelet function analysis (PFA-100) for platelet adhesion and deposition to collagen cartridges under blood flow, and finally transmission electron microscopy to exclude rare structural defects leading to functional deficits. The most validated test panels are included in WBA, LTA, and PFA. Because platelets are isolated from their natural environment, many simplifications occur, as circulating blood and interaction with vascular wall are omitted in these assays. The target to reach a highly specific platelet disorder diagnosis in routine clinical management can be exhaustive, unless needed for genetic counseling. The elective overall assessment of platelet function disorder

  19. Value of early capsular endoscopy for severe gastrointestinal bleeding.

    PubMed Central

    Cummings, Clinton L.

    2004-01-01

    This case illustrates the importance of early capsule endoscopy in cases of severe rectal bleeding when initial diagnostic tests do not document the site of bleeding. Although this case occurred in a community hospital capable of performing capsule endoscopy, I practice at a city hospital that serves the poor and underserved and currently does not have capsule endoscopy capability. Over the years, we have seen several cases of severe rectal bleeding where the site of bleeding was never identified, despite multiple diagnostic procedures short of capsule endoscopy. Often times, the bleeding stops spontaneously or ends in emergency surgery where morbidity or mortality is increased. Physicians like myself need to be made aware of this relatively new diagnostic tool that provides added value to standard diagnostic tests for evaluating severe rectal bleeding of unknown etiology. Early identification of the site of rectal bleeding may curtail the need for multiple transfusions, resolve economical burden, and reduce morbidity and mortality associated with severe rectal bleeding. Images Figure 1 Figure 2 PMID:15622697

  20. Portal hypertension and gastrointestinal bleeding: Diagnosis, prevention and management

    PubMed Central

    Biecker, Erwin

    2013-01-01

    Bleeding from esophageal varices is a life threatening complication of portal hypertension. Primary prevention of bleeding in patients at risk for a first bleeding episode is therefore a major goal. Medical prophylaxis consists of non-selective beta-blockers like propranolol or carvedilol. Variceal endoscopic band ligation is equally effective but procedure related morbidity is a drawback of the method. Therapy of acute bleeding is based on three strategies: vasopressor drugs like terlipressin, antibiotics and endoscopic therapy. In refractory bleeding, self-expandable stents offer an option for bridging to definite treatments like transjugular intrahepatic portosystemic shunt (TIPS). Treatment of bleeding from gastric varices depends on vasopressor drugs and on injection of varices with cyanoacrylate. Strategies for primary or secondary prevention are based on non-selective beta-blockers but data from large clinical trials is lacking. Therapy of refractory bleeding relies on shunt-procedures like TIPS. Bleeding from ectopic varices, portal hypertensive gastropathy and gastric antral vascular ectasia-syndrome is less common. Possible medical and endoscopic treatment options are discussed. PMID:23964137

  1. Gastrointestinal Bleeding in Cirrhotic Patients with Portal Hypertension

    PubMed Central

    Biecker, Erwin

    2013-01-01

    Gastrointestinal bleeding related to portal hypertension is a serious complication in patients with liver cirrhosis. Most patients bleed from esophageal or gastric varices, but bleeding from ectopic varices or portal hypertensive gastropathy is also possible. The management of acute bleeding has changed over the last years. Patients are managed with a combination of endoscopic and pharmacologic treatment. The endoscopic treatment of choice for esophageal variceal bleeding is variceal band ligation. Bleeding from gastric varices is treated by injection with cyanoacrylate. Treatment with vasoactive drugs as well as antibiotic treatment is started before or at the time point of endoscopy. The first-line treatment for primary prophylaxis of esophageal variceal bleeding is nonselective beta blockers. Pharmacologic therapy is recommended for most patients; band ligation is an alternative in patients with contraindications for or intolerability of beta blockers. Treatment options for secondary prophylaxis include variceal band ligation, beta blockers, a combination of nitrates and beta blockers, and combination of band ligation and pharmacologic treatment. A clear superiority of one treatment over the other has not been shown. Bleeding from portal hypertensive gastropathy or ectopic varices is less common. Treatment options include beta blocker therapy, injection therapy, and interventional radiology. PMID:27335828

  2. Management of bleeding complications in patients with cancer on DOACs.

    PubMed

    Schulman, Sam; Shrum, Jeffrey; Majeed, Ammar

    2016-04-01

    There has been a concern that major bleeding events (MBE) on direct-acting oral anticoagulants (DOACs) will be more difficult to manage than on vitamin K antagonists. Patients with cancer and DOAC-associated bleeding may be even more of a challenge to manage. We therefore reviewed the literature on bleeding in patients with cancer on DOACs. In addition, we performed an analysis of individual patient data from 5 phase III trials on treatment with dabigatran with focus on those with cancer. In 6 randomized trials the risk of MBE in patients with cancer was similar on treatment with DOACs compared to vitamin K antagonists. Bleeding was in the majority of patients managed with supportive therapy alone. In the individual patient data analysis there were no significant differences in use of hemostatic products, transfusion of red cells, effectiveness of management, bleeding-related mortality or 30-day all-cause mortality between patients with cancer treated with dabigatran or with warfarin. Local hemostatic therapy, including resection of the cancer site was more common in patients with gastrointestinal bleeding with cancer than among those without cancer. We conclude that management of bleeding in patients with cancer and on a DOAC does not pose a greater challenge than management of bleeding in patients without cancer. PMID:27067968

  3. Early lactate clearance for predicting active bleeding in critically ill patients with acute upper gastrointestinal bleeding: a retrospective study.

    PubMed

    Wada, Tomoki; Hagiwara, Akiyoshi; Uemura, Tatsuki; Yahagi, Naoki; Kimura, Akio

    2016-08-01

    Not all patients with upper gastrointestinal bleeding (UGIB) require emergency endoscopy. Lactate clearance has been suggested as a parameter for predicting patient outcomes in various critical care settings. This study investigates whether lactate clearance can predict active bleeding in critically ill patients with UGIB. This single-center, retrospective, observational study included critically ill patients with UGIB who met all of the following criteria: admission to the emergency department (ED) from April 2011 to August 2014; had blood samples for lactate evaluation at least twice during the ED stay; and had emergency endoscopy within 6 h of ED presentation. The main outcome was active bleeding detected with emergency endoscopy. Classification and regression tree (CART) analyses were performed using variables associated with active bleeding to derive a prediction rule for active bleeding in critically ill UGIB patients. A total of 154 patients with UGIB were analyzed, and 31.2 % (48/154) had active bleeding. In the univariate analysis, lactate clearance was significantly lower in patients with active bleeding than in those without active bleeding (13 vs. 29 %, P < 0.001). Using the CART analysis, a prediction rule for active bleeding is derived, and includes three variables: lactate clearance; platelet count; and systolic blood pressure at ED presentation. The rule has 97.9 % (95 % CI 90.2-99.6 %) sensitivity with 32.1 % (28.6-32.9 %) specificity. Lactate clearance may be associated with active bleeding in critically ill patients with UGIB, and may be clinically useful as a component of a prediction rule for active bleeding. PMID:26837207

  4. The role of capsule endoscopy in acute gastrointestinal bleeding

    PubMed Central

    Nadler, Moshe

    2014-01-01

    Acute gastrointestinal (GI) bleeding is a common cause of hospitalization, resulting in about 400,000 hospital admissions annually, with a mortality rate of 5–10%. It is estimated that 5% of acute GI bleedings are of obscure origin with a normal esophagogastroduodenoscopy and ileocolonoscopy. Capsule endoscopy is the state-of-the-art procedure for inspection of the entire small bowel with a high sensitivity for the detection of causes of bleeding. In recent years, many studies have addressed the sensitivity and outcome of capsule-endoscopy procedures in patients with acute GI bleeding. This review looks at the role of capsule endoscopy in the evaluation of patients with acute GI bleeding from either the upper GI tract or small bowel. PMID:24587821

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

    SciTech Connect

    Pabon-Ramos, Waleska M.; Niemeyer, Matthew M.; Dasika, Narasimham L.

    2013-10-15

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

  6. Endoscopic Management of Tumor Bleeding from Inoperable Gastric Cancer

    PubMed Central

    Kim, Young-Il

    2015-01-01

    Tumor bleeding is not a rare complication in patients with inoperable gastric cancer. Endoscopy has important roles in the diagnosis and primary treatment of tumor bleeding, similar to its roles in other non-variceal upper gastrointestinal bleeding cases. Although limited studies have been performed, endoscopic therapy has been highly successful in achieving initial hemostasis. One or a combination of endoscopic therapy modalities, such as injection therapy, mechanical therapy, or ablative therapy, can be used for hemostasis in patients with endoscopic stigmata of recent hemorrhage. However, rebleeding after successful hemostasis with endoscopic therapy frequently occurs. Endoscopic therapy may be a treatment option for successfully controlling this rebleeding. Transarterial embolization or palliative surgery should be considered when endoscopic therapy fails. For primary and secondary prevention of tumor bleeding, proton pump inhibitors can be prescribed, although their effectiveness to prevent bleeding remains to be investigated. PMID:25844339

  7. Successful hemostasis of intractable rectal variceal bleeding using variceal embolization.

    PubMed

    Ahn, Sung Soo; Kim, Eun Hye; Kim, Man Deuk; Lee, Won Jae; Kim, Seung Up

    2015-02-28

    Portal hypertension causes portosystemic shunting along the gastrointestinal tract, resulting in gastrointestinal varices. Rectal varices and their bleeding is a rare complication, but it can be fatal without appropriate treatment. However, because of its rarity, no established treatment strategy is yet available. In the setting of intractable rectal variceal bleeding, a transjugular intravenous portosystemic shunt can be a treatment of choice to enable portal decompression and thus achieve hemostasis. However, in the case of recurrent rectal variceal bleeding despite successful transjugular intravenous portosystemic shunt, alternative measures to control bleeding are required. Here, we report on a patient with liver cirrhosis who experienced recurrent rectal variceal bleeding even after successful transjugular intravenous portosystemic shunt and was successfully treated with variceal embolization. PMID:25741168

  8. On Supersonic-Inlet Boundary-Layer Bleed Flow

    NASA Technical Reports Server (NTRS)

    Harloff, Gary J.; Smith, Gregory E.

    1995-01-01

    Boundary-layer bleed in supersonic inlets is typically used to avoid separation from adverse shock-wave/boundary-layer interactions and subsequent total pressure losses in the subsonic diffuser and to improve normal shock stability. Methodologies used to determine bleed requirements are reviewed. Empirical sonic flow coefficients are currently used to determine the bleed hole pattern. These coefficients depend on local Mach number, pressure ratio, hole geometry, etc. A new analytical bleed method is presented to compute sonic flow coefficients for holes and narrow slots and predictions are compared with published data to illustrate the accuracy of the model. The model can be used by inlet designers and as a bleed boundary condition for computational fluid dynamic studies.

  9. New insights to occult gastrointestinal bleeding: From pathophysiology to therapeutics

    PubMed Central

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

    2014-01-01

    Obscure gastrointestinal bleeding is still a clinical challenge for gastroenterologists. The recent development of novel technologies for the diagnosis and treatment of different bleeding causes has allowed a better management of patients, but it also determines the need of a deeper comprehension of pathophysiology and the analysis of local expertise in order to develop a rational management algorithm. Obscure gastrointestinal bleeding can be divided in occult, when a positive occult blood fecal test is the main manifestation, and overt, when external sings of bleeding are visible. In this paper we are going to focus on overt gastrointestinal bleeding, describing the physiopathology of the most usual causes, analyzing the diagnostic procedures available, from the most classical to the novel ones, and establishing a standard algorithm which can be adapted depending on the local expertise or availability. Finally, we will review the main therapeutic options for this complex and not so uncommon clinical problem. PMID:25133028

  10. Periprocedural Bleeding Complications of Brain AVM Embolization with Onyx

    PubMed Central

    Liu, L.; Jiang, C.; He, H.; Li, Y.; Wu, Z.

    2010-01-01

    Summary The advent of Onyx has provided a new method for neurointerventional therapists to treat brain AVMs. Although some retrospective studies have reported complications for AVM embolization with Onyx, periprocedural bleeding complications with Onyx embolization have not yet been described in detail. The aim of this retrospective study was to analyze the factors of Onyx-related bleeding complications and to find a way to avoid and manage these complications. From January 2003, patients with AVMs recruited in our institution started to be treated by Onyx embolization. From January 2007 to July 2009, 143 consecutive interventions were performed in 126 patients using flow-independent microcatheters and Onyx as embolic agents. Seven patients encountered bleeding complications (5.4% per patients and 4.7% per procedures) during or after the endovascular procedures. Among them, five bleeding episodes occurred during procedures, the other two after procedures. Details of the seven patients' clinical presentations, imaging presentations, speculative reasons and management of these complications were recorded. Follow-up data, including postoperative course, clinical symptoms and duration of follow-up were documented. The five active bleedings discovered in procedures were managed in time, and the patients recovered without any new neurological symptoms compared with preoperation. However, of the two bleeding episodes that occurred after interventional procedures, one was detected half an hour later: the patient was remained comatose two months later after resection of right occipital hematoma; the other who encountered intraventricular and midbrain hemorrhage was treated conservatively and suffered Parinaud syndrome and hemianesthesia. Conclusion: Periprocedural bleeding of AVMs embolization is considered a severe and devastating complication. The clinical course and prognosis of bleeding mostly depends on prompt detection and management. Interventional embolization is an

  11. Management of bleeding following major trauma: a European guideline

    PubMed Central

    Spahn, Donat R; Cerny, Vladimir; Coats, Timothy J; Duranteau, Jacques; Fernández-Mondéjar, Enrique; Gordini, Giovanni; Stahel, Philip F; Hunt, Beverley J; Komadina, Radko; Neugebauer, Edmund; Ozier, Yves; Riddez, Louis; Schultz, Arthur; Vincent, Jean-Louis; Rossaint, Rolf

    2007-01-01

    Introduction Evidence-based recommendations can be made with respect to many aspects of the acute management of the bleeding trauma patient, which when implemented may lead to improved patient outcomes. Methods The multidisciplinary Task Force for Advanced Bleeding Care in Trauma was formed in 2005 with the aim of developing guidelines for the management of bleeding following severe injury. Recommendations were formulated using a nominal group process and the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) hierarchy of evidence and were based on a systematic review of published literature. Results Key recommendations include the following: The time elapsed between injury and operation should be minimised for patients in need of urgent surgical bleeding control, and patients presenting with haemorrhagic shock and an identified source of bleeding should undergo immediate surgical bleeding control unless initial resuscitation measures are successful. A damage control surgical approach is essential in the severely injured patient. Pelvic ring disruptions should be closed and stabilised, followed by appropriate angiographic embolisation or surgical bleeding control, including packing. Patients presenting with haemorrhagic shock and an unidentified source of bleeding should undergo immediate further assessment as appropriate using focused sonography, computed tomography, serum lactate, and/or base deficit measurements. This guideline also reviews appropriate physiological targets and suggested use and dosing of blood products, pharmacological agents, and coagulation factor replacement in the bleeding trauma patient. Conclusion A multidisciplinary approach to the management of the bleeding trauma patient will help create circumstances in which optimal care can be provided. By their very nature, these guidelines reflect the current state-of-the-art and will need to be updated and revised as important new evidence becomes available. PMID:17298665

  12. The utility of International Society on Thrombosis and Haemostasis-Bleeding Assessment Tool and other bleeding questionnaires in assessing the bleeding phenotype in two platelet function defects.

    PubMed

    Kaur, Harmanpreet; Borhany, Munira; Azzam, Hanan; Costa-Lima, Carolina; Ozelo, Margareth; Othman, Maha

    2016-07-01

    The main objective of this study is to investigate the utility of International Society on Thrombosis and Haemostasis-Bleeding Assessment Tool (ISTH-BAT) in comparison with the condensed form of Molecular and Clinical Markers for the Diagnosis and Management of type 1 and WHO BATs, in assessing bleeding in two well known and clinically significant platelet function defects. Thirty-eight patients previously diagnosed with Glanzmann's thrombasthenia and 10 with Bernard-Soulier syndrome (BSS) were analyzed. Bleeding scores were significantly higher than that of controls using both electronic bleeding questionnaire (eBQ) and ISTH-BAT with no significant difference between both tools. ISTH-BAT had a sensitivity, specificity, positive predictive value and negative predictive value of 100%, 76.2%, 0.9 and 1. This was closely similar to eBQ. Both ISTH-BAT and eBQ are efficient in BSS and Glanzmann's thrombasthenia. However, given the ISTH recommendation, ISTH-BAT should be adopted. Larger study including other platelet defects will enhance its utility and support the integration of bleeding scores with standardized laboratory testing to allow for a universal diagnostic approach to patients with suspected bleeding disorders. PMID:27100304

  13. Impact Of Standing Bleed Water On Saltstone Placement

    SciTech Connect

    Cozzi, A. D.; Pickenheim, B. R.

    2012-09-28

    The amount of water present during placement and subsequent curing of saltstone has the potential to impact several properties important for grout quality. An active drain water system can remove residual standing water and expose the surface of the placed saltstone to air. Oxidation of the saltstone may result in an increase in the leachability of redox sensitive elements. A dry surface can lead to cracking, causing an increase in hydraulic conductivity. An inactive drain water system can allow standing water that generates unnecessary hydrostatic head on the vault walls. Standing water that cannot be removed via the drain system will be available for potential incorporation into subsequent grout placements. The objective of this work is to study the impact of standing water on grout quality pertaining to disposal units. A series of saltstone mixes were prepared, and cured at ambient temperature to evaluate the impact of standing water on saltstone placement. The samples were managed to control drying effects on leachability by either exposing or capping the samples. The water to premix ratio was varied to represent a range of processing conditions. Samples were analyzed for density, leachability, and hydraulic conductivity. A monolith of each composition was cut into four sections to analyze the homogeneity of the sample with respect to vertical position within the sample. The density of each section was measured by two methods, helium pycnometry and by ASTM 642-06. The results show a trend of increasing density with increasing depth in the samples. This effect is more pronounced with the inclusion of excess bleed water and indicative of increased settling. The leachability of the eight different samples was analyzed by ANS/ANSI 16.1 method. These results indicate that drying of the saltstone during curing leads to decreased Leachability Indices (indicative of more release) for potassium, sodium, rhenium, nitrite, and nitrate. This may be caused by shrinkage

  14. Major Bleeding after Percutaneous Image-Guided Biopsies: Frequency, Predictors, and Periprocedural Management

    PubMed Central

    Kennedy, Sean A.; Milovanovic, Lazar; Midia, Mehran

    2015-01-01

    Major bleeding remains an uncommon yet potentially devastating complication following percutaneous image-guided biopsy. This article reviews two cases of major bleeding after percutaneous biopsy and discusses the frequency, predictors, and periprocedural management of major postprocedural bleeding. PMID:25762845

  15. Lubricating system for an engine balancing device

    SciTech Connect

    Candea, C.

    1987-07-07

    An internal combustion engine is described having an engine block with cylinder bores, pistons, connecting rods and a crankshaft with the pistons and associated connecting rods movable in the parallel cylinder bores of the engine block when the crankshaft rotates. It generates a periodic unbalance force with each half-rotation of the crankshaft. An improved balancing device generates an opposing force to effectively cancel the unbalance forces of the pistons and connecting rods, comprising: the balancing device including a housing enclosure located beneath the crankshaft and block. The housing has a hollow interior and a pair of apertures at either end. A pair of elongated balance shafts extend in parallelism through the hollow interior with adjacent end portions projecting through the apertures supporting the balance shafts for rotation in the housing; the housing is supported by the block and beneath the crankshaft and with the balance shafts in parallelism with the crankshaft axis. Means are attached to the housing forming an enclosure having an interior enclosing adjacent end portions of the balance shafts which project from an end of the housing; means lubricate the shaft mounting apertures and discharge oil from the interiors of the housing and the enclosure means; a vacuum breaks air bleed means in an upper portion of the enclosure for facilitating the discharge of oil from the enclosure interior.

  16. Distribution of bleeding gastrointestinal angioectasias in a Western population

    PubMed Central

    Bollinger, Elizabeth; Raines, Daniel; Saitta, Patrick

    2012-01-01

    AIM: To define which segments of the gastrointestinal tract are most likely to yield angioectasias for ablative therapy. METHODS: A retrospective chart review was performed for patients treated in the Louisiana State University Health Sciences Center Gastroenterology clinics between the dates of July 1, 2007 and October 1, 2010. The selection of cases for review was initiated by use of our electronic medical record to identify all patients with a diagnosis of angioectasia, angiodysplasia, or arteriovenous malformation. Of these cases, chart reviews identified patients who had a complete evaluation of their gastrointestinal tract as defined by at least one upper endoscopy, colonoscopy and small bowel capsule endoscopy within the past three years. Patients without evidence of overt gastrointestinal bleeding or iron deficiency anemia associated with intestinal angioectasias were classified as asymptomatic and excluded from this analysis. Thirty-five patients with confirmed, bleeding intestinal angioectasias who had undergone complete endoscopic evaluation of the gastrointestinal tract were included in the final analysis. RESULTS: A total of 127 cases were reviewed. Sixty-six were excluded during subsequent screening due to lack of complete small bowel evaluation and/or lack of documentation of overt bleeding or iron deficiency anemia. The 61 remaining cases were carefully examined with independent review of endoscopic images as well as complete capsule endoscopy videos. This analysis excluded 26 additional cases due to insufficient records/images for review, incomplete capsule examination, poor capsule visualization or lack of confirmation of typical angioectasias by the principal investigator on independent review. Thirty-five cases met criteria for final analysis. All study patients were age 50 years or older and 13 patients (37.1%) had chronic kidney disease stage 3 or higher. Twenty of 35 patients were taking aspirin (81 mg or 325 mg), clopidogrel, and/or warfarin

  17. Reference values and repeatability of buccal mucosal bleeding time in healthy sedated cats.

    PubMed

    Alatzas, Dimitrios G; Mylonakis, Mathios E; Kazakos, Giorgos M; Kostoulas, Polychronis; Kritsepi-Konstantinou, Maria; Polizopoulou, Zoe S

    2014-02-01

    Bleeding time is a screening test for the evaluation of primary haemostasis. As there is currently limited information on the reference interval (RI) and repeatability of the test in the cat compared with the dog, the purpose of the study was to establish the RI of buccal mucosa bleeding time (BMBT) in healthy cats and to investigate the intra-observer repeatability of the test. Fifty-six cats were prospectively enrolled in the study. The animals were deemed to be healthy based on history, physical examination, complete blood count, serum biochemistry, and negative serological testing for feline leukaemia and immunodeficiency viruses. All cats were sedated with ketamine, dexmedetomidine and morphine, and the BMBT was sequentially measured in the left and right exposed buccal mucosa following a standardised incision made by a commercially available, disposable, bleeding time device. The mean BMBT was 58.6 s and the RIs ranged from 34 to 105 s (Bootstrap estimation). The intra-observer repeatability was up to 87 s (Bland-Altman plot). The results of this study imply that the combination of ketamine, dexmedetomidine and morphine is a safe and useful sedative protocol allowing for the reliable measurement of BMBT in the cat. The RI of feline BMBT may range from 34 to 105 s and the BMBT may differ by up to 87 s for any two consecutive readings for an individual cat. PMID:23985755

  18. Ultrasonographic monitoring of the placenta in patients with bleeding during the first and second trimesters.

    PubMed

    Takeda, S; Baba, K; Kojima, T; Kinoshita, K; Satoh, K; Sakamoto, S

    1990-09-01

    Thirteen patients with vaginal bleeding in the first and second trimester, in 730 pregnancies confirmed with live fetuses, were diagnosed as having subchorionic hematoma at the perivillous or periplacental region by a real-time B-mode scan device. In 9 of the 13 patients, the hematoma disappeared within 1 to 3 months after detection, while in 2 patients it increased in size. Seven of the 13 pregnancies progressed to full term (53.8%), 3 ended in premature deliveries (23.1%) and 3 in spontaneous abortions (23.1%). In 5 of the 13 patients, PROM occurred. Pathological examinations revealed 5 circumvallate (38.5%) and 2 circummarginate (15.4%) placentas. Since our clinical observation indicates that subchorionic hematoma and marginal separation of the placenta may be important causes of bleeding during pregnancy, monitoring of the placenta and fetus by ultrasound was used to obtain precise information in order to manage patients with bleeding. It might be speculated that extrachorial placenta results from subchorionic hematoma or its absorption. PMID:2088244

  19. Direct Versus Video Laryngoscopy for Intubating Adult Patients with Gastrointestinal Bleeding

    PubMed Central

    Carlson, Jestin N.; Crofts, Jason; Walls, Ron M.; Brown, Calvin A.

    2015-01-01

    Introduction Video laryngoscopy (VL) has been advocated for several aspects of emergency airway management; however, there are still concerns over its use in select patient populations such as those with large volume hematemesis secondary to gastrointestinal (GI) bleeds. Given the relatively infrequent nature of this disease process, we sought to compare intubation outcomes between VL and traditional direct laryngoscopy (DL) in patients intubated with GI bleeding, using the third iteration of the National Emergency Airway Registry (NEARIII). Methods We performed a retrospective analysis of a prospectively collected national database (NEARIII) of intubations performed in United States emergency departments (EDs) from July 1, 2002, through December 31, 2012. All cases where the indication for intubation was “GI bleed” were analyzed. We included patient, provider and intubation characteristics. We compared data between intubation attempts initiated as DL and VL using parametric and non-parametric tests when appropriate. Results We identified 325 intubations, 295 DL and 30 VL. DL and VL cases were similar in terms of age, sex, weight, difficult airway predictors, operator specialty (emergency medicine, anesthesia or other) and level of operator training (post-graduate year 1, 2, etc). Proportion of successful first attempts (DL 261/295 (88.5%) vs. VL 28/30 (93.3%) p=0.58) and Cormack-Lehane grade views (p=0.89) were similar between devices. The need for device change was similar between DL [2/295 (0.7%) and VL 1/30 (3.3%); p=0.15]. Conclusion In this national registry of intubations performed in the ED for patients with GI bleeds, both DL and VL had similar rates of success, glottic views and need to change devices. PMID:26759653

  20. BLEEDING OF FEMORAL HEAD DURING TOTAL HIP ARTHROPLASTY FOR OSTEOARTHROSIS

    PubMed Central

    Schwartsmann, Carlos Roberto; Spinelli, Leandro de Freitas; Sotomayor, Marco Yánez; Yépez, Anthony Kerbes; Boschin, Leonardo Carbonera; Silva, Marcelo Faria

    2015-01-01

    ABSTRACT Objective: To evaluate the bleeding of the femoral head on hip osteoarthritis in patients who underwent total hip arthroplasty. Methods: One hundred and three hips affected by primary hip osteoarthritis were evaluated. After surgical dislocation, the femoral head was divided into four quadrants, and micro perforations were made in order to observe and assess the presence of bleeding, as early type (EB), late type (LB) or without bleeding (WB). Results: We observed early bleeding (EB) in the upper quadrant in 16 hips (15.5%), late bleeding in 14 hips (13.6%) and no bleeding (WB) in 73 hips (70.9%). The anterior quadrant showed EB in 24 hips (23.3%), LB in 7 hips (6.8%) and WB in 72 hips (69.9%). The lower quadrant presented EB in 40 hips (38.8%), LB 14 hips (13.6%) and WB in 49 hips (47.6%). The posterior quadrant showed EB in 39 hips (37.9%), LB 19 hips (18.4%) and WB in 45 hips (43.7%). Comparing BMI and gender, we found no association between these parameters (p> 0.05). Conclusions: The inferior and posterior quadrant had the highest bleeding levels, following the path of the medial circumflex artery. Level of Evidence III, Therapeutic Study. PMID:26981036

  1. Endoscopic sclerotherapy for hemostasis of acute esophageal variceal bleeding

    PubMed Central

    ROMANO, G.; AGRUSA, A.; AMATO, G.; DE VITA, G.; FRAZZETTA, G.; CHIANETTA, D.; SORCE, V.; DI BUONO, G.; GULOTTA, G.

    2014-01-01

    Introduction Currently the most widely used methods for endoscopic control of esophageal varices bleeding are sclerotherapy and rubber band ligation. Although the superiority of band ligation (BL) over endoscopic sclerotherapy (SCL) for the secondary prophylaxis of variceal hemorrhage has been proven, the best approach for acute bleeding remains controversial. Patients and methods We performed a retrospective study between January 2005 and May 2013. We selected 104 patients with gastrointestinal hemorrhage from rupture of esophageal varices treated with endoscopic sclerotherapy. The sclerosing agent used was 1% polidocanol in 89 cases, butyl-cyanoacrylate in 8 cases and sodium tetra-decylsulfate in 4 cases. In 3 cases had not been carried sclerosis because it was not possible to identify the bleeding site. Results Among the 101 patients who underwent endoscopic sclerotherapy 4 presented re-bleeding within 12 hours from first treatment. Other 10 patients (9.9%) presented re-bleeding within a 5-days period. The most frequent complication was ulceration, observed in 4 cases (3.8%). There was only one case of perforation treated conservatively. Conclusions The general improvement in the results of the treatment of variceal acute bleeding might be attributed to better clinical management of these patients. In literature no consensus exists regarding the preferred endoscopic treatment. To date, there is no single method applicable to all patients with bleeding esophageal varices, but sclerotherapy is considered effective, safe and repeatable in experienced hands. PMID:24841679

  2. Variceal bleeding and portal hypertension: new lights on old horizon.

    PubMed

    Bhasin, D K; Siyad, I

    2004-02-01

    New clinical, endoscopic, and imaging modalities for diagnosing varices and predicting bleeding are being investigated. Transnasal endoscopy and ultrathin battery-powered esophagoscopes are being used to improve patient comfort and compliance. Patients who respond to portal pressure-reducing drugs not only have a reduced risk of bleeding, but also a reduced risk of developing other complications, with improved survival. Nitrates have been shown to have no definite role in primary prophylaxis against variceal bleeding. The hemodynamic response to treatment has an independent prognostic value for the risk of variceal bleeding. Newer drugs have been investigated for reducing the hepatic venous pressure gradient, but with little success. Survival after bleeding has increased due to improved patient care and technological advances. Combined radiographic and endoscopic management of gastric varices is evolving and appears to be promising. Nonvariceal bleeding from portal hypertensive gastropathy is increasingly being recognized as a potential cause of bleeding in patients with portal hypertension, and pharmacotherapy with octreotide appears to be promising for the treatment of this condition. Variceal band ligation in children has been found to be as safe and effective as in adults. PMID:14765309

  3. Flow Coefficient Behavior for Boundary Layer Bleed Holes and Slots

    NASA Technical Reports Server (NTRS)

    Willis, B. P.; Davis, D. O.; Hingst, W. R.

    1995-01-01

    An experimental investigation into the flow coefficient behavior for nine boundary layer bleed orifice configurations is reported. This test was conducted for the purposes of exploring boundary layer control through mass flow removal and does not address issues of stability bleed. Parametric data consist of bleed region flow coefficient as a function of Mach number, bleed plenum pressure, and bleed orifice geometry. Seven multiple hole configurations and two single slot configurations were tested over a supersonic Mach number range of 1.3 to 2.5 (nominal). Advantages gained by using multiple holes in a bleed region instead of a single spanwise slot are discussed and the issue of modeling an entire array of bleed orifices based on the performance of a single orifice is addressed. Preconditioning the flow approaching a 90 degree inclined (normal) hole configuration resulted in a significant improvement in the performance of the configuration. The same preconditioning caused only subtle changes in performance for a 20 degree inclined (slanted) configuration.

  4. Impaired renal function and bleeding in elderly treated with dabigatran.

    PubMed

    Berthelot, Emmanuelle; Lavenu-Bombled, Cecile; Orostegui-Giron, Lupe; Desconclois, Céline; Assayag, Patrick

    2014-09-01

    Advantages of dabigatran, a thrombin inhibitor, for stroke prevention in patients with atrial fibrillation are numerous. Elderly patients with impaired renal function are at high risk of bleeding. Recommendations about the renal monitoring in elderly patients are not precise enough. The hemoclot direct thrombin inhibitor (HTI) assay measures accurately the dabigatran activity. Both could help managing serious bleeding events in selected populations. Four elderly patients recently treated with appropriate doses of dabigatran were hospitalized for major bleeding. Three patients were very elderly (> 80 years) and three had impaired renal function (clearance < 50 ml/min) before treatment initiation. Serious bleeding events occurred shortly after dabigatran initiation (< 2 months). In all cases, there was a documented dabigatran plasma overdose associated with a renal function impairment concomitant with the bleeding. Why should physicians be aware of this finding?: A close follow-up of the renal function in clinically fragile elderly patient, before and during the weeks following dabigatran initiation, could help to detect the risk of major bleeding event. The HTI dosage could help managing the treatment in case of severe bleeding event. PMID:24509332

  5. Obscure bleeding colonic duplication responds to proton pump inhibitor therapy.

    PubMed

    Jacques, Jérémie; Projetti, Fabrice; Legros, Romain; Valgueblasse, Virginie; Sarabi, Matthieu; Carrier, Paul; Fredon, Fabien; Bouvier, Stéphane; Loustaud-Ratti, Véronique; Sautereau, Denis

    2013-09-21

    We report the case of a 17-year-old male admitted to our academic hospital with massive rectal bleeding. Since childhood he had reported recurrent gastrointestinal bleeding and had two exploratory laparotomies 5 and 2 years previously. An emergency abdominal computed tomography scan, gastroscopy and colonoscopy, performed after hemodynamic stabilization, were considered normal. High-dose intravenous proton pump inhibitor (PPI) therapy was initiated and bleeding stopped spontaneously. Two other massive rectal bleeds occurred 8 h after each cessation of PPI which led to a hemostatic laparotomy after negative gastroscopy and small bowel capsule endoscopy. This showed long tubular duplication of the right colon, with fresh blood in the duplicated colon. Obscure lower gastrointestinal bleeding is a difficult medical situation and potentially life-threatening. The presence of ulcerated ectopic gastric mucosa in the colonic duplication explains the partial efficacy of PPI therapy. Obscure gastrointestinal bleeding responding to empiric anti-acid therapy should probably evoke the diagnosis of bleeding ectopic gastric mucosa such as Meckel's diverticulum or gastrointestinal duplication, and gastroenterologists should be aware of this potential medical situation. PMID:24124344

  6. Intraoperative bleeding control by uniportal video-assisted thoracoscopic surgery†.

    PubMed

    Gonzalez-Rivas, Diego; Stupnik, Tomaz; Fernandez, Ricardo; de la Torre, Mercedes; Velasco, Carlos; Yang, Yang; Lee, Wentao; Jiang, Gening

    2016-01-01

    Owing to advances in video-assisted thoracic surgery (VATS), the majority of pulmonary resections can currently be performed by VATS in a safe manner with a low level of morbidity and mortality. The majority of the complications that occur during VATS can be minimized with correct preoperative planning of the case as well as careful pulmonary dissection. Coordination of the whole surgical team is essential when confronting an emergency such as major bleeding. This is particularly important during the VATS learning curve, where the occurrence of intraoperative complications, particularly significant bleeding, usually ends in a conversion to open surgery. However, conversion should not be considered as a failure of the VATS approach, but as a resource to maintain the patient's safety. The correct assessment of any bleeding is of paramount importance during major thoracoscopic procedures. Inadequate management of the source of bleeding may result in major vessel injury and massive bleeding. If bleeding occurs, a sponge stick should be readily available to apply pressure immediately to control the haemorrhage. It is always important to remain calm and not to panic. With the bleeding temporarily controlled, a decision must be made promptly as to whether a thoracotomy is needed or if the bleeding can be solved through the VATS approach. This will depend primarily on the surgeon's experience. The operative vision provided with high-definition cameras, specially designed or adapted instruments and the new sealants are factors that facilitate the surgeon's control. After experience has been acquired with conventional or uniportal VATS, the rate of complications diminishes and the majority of bleeding events are controlled without the need for conversion to thoracotomy. PMID:26424873

  7. Bleeding complications in critically ill patients with liver cirrhosis

    PubMed Central

    Cho, Jaeyoung; Choi, Sun Mi; Yu, Su Jong; Park, Young Sik; Lee, Chang-Hoon; Lee, Sang-Min; Yim, Jae-Joon; Yoo, Chul-Gyu; Kim, Young Whan; Han, Sung Koo; Lee, Jinwoo

    2016-01-01

    Background/Aims: Patients with liver cirrhosis (LC) are at risk for critical events leading to Intensive Care Unit (ICU) admission. Coagulopathy in cirrhotic patients is complex and can lead to bleeding as well as thrombosis. The aim of this study was to investigate bleeding complications in critically ill patients with LC admitted to a medical ICU (MICU). Methods: All adult patients admitted to our MICU with a diagnosis of LC from January 2006 to December 2012 were retrospectively assessed. Patients with major bleeding at the time of MICU admission were excluded from the analysis. Results: A total of 205 patients were included in the analysis. The median patient age was 62 years, and 69.3% of the patients were male. The most common reason for MICU admission was acute respiratory failure (45.4%), followed by sepsis (27.3%). Major bleeding occurred in 25 patients (12.2%). The gastrointestinal tract was the most common site of bleeding (64%), followed by the respiratory tract (20%). In a multivariate analysis, a low platelet count at MICU admission (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97 to 0.99) and sepsis (OR, 8.35; 95% CI, 1.04 to 67.05) were independent risk factors for major bleeding. The ICU fatality rate was significantly greater among patients with major bleeding (84.0% vs. 58.9%, respectively; p = 0.015). Conclusions: Major bleeding occurred in 12.2% of critically ill cirrhotic patients admitted to the MICU. A low platelet count at MICU admission and sepsis were associated with an increased risk of major bleeding during the MICU stay. Further study is needed to better understand hemostasis in critically ill patients with LC. PMID:26805633

  8. Investigation of women with postmenopausal uterine bleeding: clinical practice recommendations.

    PubMed

    Munro, Malcolm G

    2014-01-01

    Postmenopausal uterine bleeding is defined as uterine bleeding after permanent cessation of menstruation resulting from loss of ovarian follicular activity. Bleeding can be spontaneous or related to ovarian hormone replacement therapy or to use of selective estrogen receptor modulators (eg, tamoxifen adjuvant therapy for breast carcinoma). Because anovulatory "cycles" with episodes of multimonth amenorrhea frequently precede menopause, no consensus exists regarding the appropriate interval of amenorrhea before an episode of bleeding that allows for the definition of postmenopausal bleeding. The clinician faces the possibility that an underlying malignancy exists, knowing that most often the bleeding comes from a benign source. Formerly, the gold-standard clinical investigation of postmenopausal uterine bleeding was institution-based dilation and curettage, but there now exist office-based methods for the evaluation of women with this complaint. Strategies designed to implement these diagnostic methods must be applied in a balanced way considering the resource utilization issues of overinvestigation and the risk of missing a malignancy with underinvestigation. Consequently, guidelines and recommendations were developed to consider these issues and the diverse spectrum of practitioners who evaluate women with postmenopausal bleeding. The guideline development group determined that, for initial management of spontaneous postmenopausal bleeding, primary assessment may be with either endometrial sampling or transvaginal ultrasonography, allowing patients with an endometrial echo complex thickness of 4 mm or less to be managed expectantly. Guidelines are also provided for patients receiving selective estrogen receptor modulators or hormone replacement therapy, and for an endometrial echo complex with findings consistent with fluid in the endometrial cavity.� PMID:24377427

  9. Investigation of Women with Postmenopausal Uterine Bleeding: Clinical Practice Recommendations

    PubMed Central

    Munro, Malcolm G

    2014-01-01

    Postmenopausal uterine bleeding is defined as uterine bleeding after permanent cessation of menstruation resulting from loss of ovarian follicular activity. Bleeding can be spontaneous or related to ovarian hormone replacement therapy or to use of selective estrogen receptor modulators (eg, tamoxifen adjuvant therapy for breast carcinoma). Because anovulatory “cycles” with episodes of multimonth amenorrhea frequently precede menopause, no consensus exists regarding the appropriate interval of amenorrhea before an episode of bleeding that allows for the definition of postmenopausal bleeding. The clinician faces the possibility that an underlying malignancy exists, knowing that most often the bleeding comes from a benign source. Formerly, the gold-standard clinical investigation of postmenopausal uterine bleeding was institution-based dilation and curettage, but there now exist office-based methods for the evaluation of women with this complaint. Strategies designed to implement these diagnostic methods must be applied in a balanced way considering the resource utilization issues of overinvestigation and the risk of missing a malignancy with underinvestigation. Consequently, guidelines and recommendations were developed to consider these issues and the diverse spectrum of practitioners who evaluate women with postmenopausal bleeding. The guideline development group determined that, for initial management of spontaneous postmenopausal bleeding, primary assessment may be with either endometrial sampling or transvaginal ultrasonography, allowing patients with an endometrial echo complex thickness of 4 mm or less to be managed expectantly. Guidelines are also provided for patients receiving selective estrogen receptor modulators or hormone replacement therapy, and for an endometrial echo complex with findings consistent with fluid in the endometrial cavity. PMID:24377427

  10. Leukemia following radiotherapy for uterine bleeding

    SciTech Connect

    Inskip, P.D.; Monson, R.R.; Wagoner, J.K.; Stovall, M.; Davis, F.G.; Kleinerman, R.A.; Boice, J.D. Jr. )

    1990-05-01

    Mortality due to leukemia among 4483 women treated with radiation to control uterine bleeding between 1925 and 1965 was twice as high as expected based on U.S. population rates (standardized mortality ratio (SMR) = 2.0; 95% confidence interval (CI): 1.4 to 2.8). Women were followed for an average of 26.4 years. Relative risk was highest 2 to 5 years after treatment (SMR = 8.1) and among women over 55 years at irradiation (SMR = 5.8). The usual method of treatment was intrauterine radium. Average radiation dose to active bone marrow was estimated on the basis of original radiotherapy records (median, 53 cGy). A linear dose-response model provided an adequate fit to the data. The average excess relative risk was 1.9% per cGy (95% CI: 0.8 to 3.2), and the average absolute risk was 2.6 excess leukemia deaths per million women per year per cGy (95% CI: 0.9 to 4.8). Chronic myeloid leukemia predominated during the first 15 years following exposure, whereas acute leukemias and chronic lymphatic leukemia were most common thereafter. The radiation doses experienced during treatment of benign gynecologic disease appear to result in greater leukemia risk per cGy average marrow dose than the considerably higher doses used to treat malignant disease, perhaps because of a decreased likelihood of killing potentially leukemic cells.

  11. Quality laboratory issues in bleeding disorders.

    PubMed

    Adcock, D M; Mammen, J; Nair, S C; de Lima Montalvão, S A

    2016-07-01

    Selected quality issues pertinent to the determination of accurate results in the haemostasis laboratory are discussed. Specifically, the implementation of a successful external quality-assessment scheme is described, including its impact on result accuracy as well as the programme's unique challenges and opportunities. Errors in the preanalytical phase of laboratory testing represent the greatest source for reporting incorrect test results. Some of the most common preanalytical errors are described including those that necessitate sample rejection. Analytical means to identify potential sources of error and analytical means to overcome particular interferences are described. Representing the most important clinical complication in the treatment of patients with haemophilia, quality issues related to determination of the presence of inhibitory antibodies against factor VIII (FVIII) are reviewed. Heat treatment of patient plasma prior to testing, particularly in patients receiving replacement FVIII concentrate or during induction of immune tolerance to achieve more accurate results is recommended, while screening activated partial thromboplastin time-based mixing tests to rule out inhibitor presence is discouraged. The initiatives presented in this review can be implemented in robust and resource restricted settings to improve the quality of laboratory testing in patients with bleeding disorders. PMID:27405682

  12. Guideline for Capsule Endoscopy: Obscure Gastrointestinal Bleeding

    PubMed Central

    Shim, Ki-Nam; Moon, Jeong Seop; Chang, Dong Kyung; Do, Jae Hyuk; Kim, Ji Hyun; Min, Byung Hoon; Jeon, Seong Ran; Choi, Myung-Gyu

    2013-01-01

    Capsule endoscopy (CE) is considered as a noninvasive and reliable diagnostic tool of examining the entire small bowel. CE has been performed frequently at many medical centers in South Korea; however, there is no evidence-based CE guideline for adequate diagnostic approaches. To provide accurate information and suggest correct testing approaches for small bowel disease, the guideline on CE was developed by the Korean Gut Image Study Group, a part of the Korean Society of Gastrointestinal Endoscopy. Operation teams for developing the guideline were organized into four areas: obscure gastrointestinal bleeding, small bowel preparation, Crohn's disease, and small bowel tumor. A total of 20 key questions were selected. In preparing this guideline, MEDLINE, Cochrane library, KMbase, KISS, and KoreaMed literature searches were performed. After writing a draft of the guideline, opinions from various experts were reflected before approving the final document. The guideline should be regarded as recommendations only to gastroenterologists in providing care to their patients. These are not absolute rules and should not be construed as establishing a legal standard of care. Although further revision may be necessary as new data appear, this guideline is expected to play a role for adequate diagnostic approaches of various small bowel diseases. PMID:23423225

  13. Bleeding following deep hypothermia and circulatory arrest in children.

    PubMed

    Mossad, Emad B; Machado, Sandra; Apostolakis, John

    2007-03-01

    Deep hypothermic circulatory arrest (DHCA) is a technique of extracorporeal circulation commonly used in children with complex congenital heart defects undergoing surgical repairs. The use of profound cooling (20 degrees C) and complete cessation of circulation allow adequate exposure and correction of these complex lesions, with enhanced cerebral protection. However, the profound physiologic state of DHCA results in significant derangement of the coagulation system and a high incidence of postoperative bleeding. This review examines the impact of DHCA on bleeding and transfusion requirements in children and the pathophysiology of DHCA-induced platelet dysfunction. It also focuses on possible pharmacologic interventions to decrease bleeding following DHCA in children. PMID:17484172

  14. Scintigraphic demonstration of gastrointestinal bleeding due to mesenteric varices

    SciTech Connect

    Hansen, M.E.; Coleman, R.E. )

    1990-07-01

    Mesenteric varices can appear as massive, acute lower gastrointestinal bleeding. The small bowel or colon may be involved, varices usually developing at sites of previous surgery or inflammation in patients with portal hypertension. Two patients with alcoholic cirrhosis and protal hypertension presented with rectal bleeding. Tc-99m RBC studies demonstrated varices and extravasation into the adjacent bowel. The varices were documented by mesenteric angiography. Characteristic features of Tc-99m labeled RBC studies can identify mesenteric varices as the cause of intestinal bleeding and localize the abnormal vessels.

  15. Profusely bleeding oral pyogenic granuloma in a teenage girl.

    PubMed

    Singh, Rajeev Kumar; Kaushal, Ambrish; Kumar, Rakesh; Pandey, Ramesh Kumar

    2013-01-01

    Pyogenic granuloma (PG) is a kind of inflammatory hyperplastic soft tissue lesion of the oral cavity. The lesion, however, is not related to infection and arise as a reactive growth in response to various stimuli. It has a very high vascularity because of the presence of numerous prominent capillaries. The lesion has a bleeding tendency, even after a minor traumatic episode, such as during mastication. Bleeding may be at times very severe and difficult to control. We present the case of a profusely bleeding young PG in a young teenage child. PMID:23486345

  16. Embolization of Bleeding Stomal Varices by Direct Percutaneous Approach

    SciTech Connect

    Arulraj, Ramakrishnan; Mangat, Kamarjit S.; Tripathi, Dhiraj

    2011-02-15

    Stomal varices can occur in patients with stoma in the presence of portal hypertension. Suture ligation, sclerotherapy, angiographic embolization, stoma revision, beta blockade, portosystemic shunt, and liver transplantation have been described as therapeutic options for bleeding stomal varices. We report the case of a 21-year-old patient with primary sclerosing cholangitis and colectomy with ileostomy for ulcerative colitis, where stomal variceal bleeding was successfully treated by direct percutaneous embolization. We consider percutaneous embolization to be an effective way of treating acute stomal bleeding in decompensated patients while awaiting decisions regarding shunt procedures or liver transplantation.

  17. Surgical treatment of fibroids in heavy menstrual bleeding.

    PubMed

    Saridogan, Ertan

    2016-01-01

    Uterine fibroids can cause abnormal uterine bleeding and their removal is beneficial in the treatment of heavy menstrual bleeding associated with fibroids for women who would like to preserve their uterus and fertility. Endoscopic (hysteroscopic and laparoscopic) approaches are the preferred methods of fibroid removal when appropriate. In the presence of submucosal fibroids, hysteroscopic resection is a simple, safe and effective treatment for heavy menstrual bleeding and reduces the need for more major surgery, such as hysterectomy. When abdominal myomectomy is required, laparoscopic myomectomy is the preferred choice in selected cases due to its advantages over open myomectomy. PMID:26693796

  18. Association of Short-term Bleeding and Cramping Patterns with Long-Acting Reversible Contraceptive Method Satisfaction

    PubMed Central

    Diedrich, Justin T.; Desai, Sanyukta; Zhao, Qiuhong; Secura, Gina; Madden, Tessa; Peipert, Jeffrey F.

    2014-01-01

    Objectives To examine the short-term (3 and 6-month), self-reported bleeding and cramping patterns with intrauterine devices (IUDs) and the contraceptive implant, and the association of these symptoms with method satisfaction. Study Design We analyzed 3 and 6-month survey data from IUD and implant users in the Contraceptive CHOICE Project, a prospective cohort study. Participants who received a long-acting reversible contraceptive (LARC) method (levonorgestrel intrauterine system (LNG-IUS), copper IUD, or the etonogestrel implant) and completed their 3- and 6-month surveys were included. Univariable and multivariable analyses were performed to examine the association of bleeding and cramping patterns with short-term satisfaction. Results Our analytic sample included 5,011 CHOICE participants: 3001 LNG-IUS users, 826 copper IUD users, and 1184 implant users. At 3 months, over 65% of LNG-IUS and implant users reported no change or decreased cramping, while 63% of copper IUD users reported increased menstrual cramping. Lighter bleeding was reported by 67% of LNG-IUS users, 58% of implant users, and 8% of copper IUD users. Satisfaction of all LARC methods was high (≥90%) and significantly higher than non-LARC methods (p<0.001). LARC users with increased menstrual cramping (HR 0.96, 95% CI 0.92 – 0.99), heavier bleeding (HR 0.91, 95% CI 0.87 – 0.96), and increased bleeding frequency (HR 0.92, 95% CI 0.89 – 0.96) were less likely to report being very satisfied at 6 months. Conclusion Regardless of the LARC method, satisfaction at 3 and 6 months is very high. Changes in self-reported bleeding and cramping are associated with short-term LARC satisfaction. PMID:25046805

  19. Improving the management of gastrointestinal bleeding in patients with cirrhosis.

    PubMed

    Williams, Michael J; Hayes, Peter

    2016-04-01

    Gastrointestinal bleeding remains a major cause of mortality in patients with cirrhosis. The most common source of bleeding is from gastroesophageal varices but non-variceal bleeding from peptic ulcer disease also carries a significant risk in patients with liver disease. The prognosis is related to the severity of the underlying liver disease, and deaths often occur due to liver failure, infection or renal failure. Optimal management should therefore not only achieve haemostasis but address these complications as well. The management of gastrointestinal bleeding in patients with cirrhosis includes a range of medical, endoscopic and radiological interventions. This article updates the recent developments in this area and highlights topics where further research is still required. PMID:26581713

  20. Post-biliary sphincterotomy bleeding despite covered metallic stent deployment

    PubMed Central

    Donatelli, Gianfranco; Cereatti, Fabrizio; Dumont, Jean-Loup; Dhumane, Parag; Tuszynski, Thierry; Vergeau, Bertrand Marie; Meduri, Bruno

    2016-01-01

    Objectives: Several endoscopic techniques have been proposed for the management of post-sphincterotomy bleeding. Lately, self-expandable metal stents deployment has gained popularity especially as a rescue therapy when other endoscopic techniques fail. Methods-results: We report the case report of a massive post-sphincterotomy bleeding in a patient with a self-expandable metal stent in the biliary tree. Despite the presence of a correctly positioned self-expandable metal stent, a new endoscopic session was required to control the bleeding. Conclusions: Self-expandable metal stent may be useful to manage post-endoscopic sphincterotomy bleeding. However, up to now there is no specifically designed self-expandable metal stent for such complication. Large new designed self-expandable metal stent may be a useful tool for biliary endoscopist. PMID:27489716

  1. Beware of Bleeding Risks with Antacids Containing Aspirin

    MedlinePlus

    ... fullstory_159221.html Beware of Bleeding Risks With Antacids Containing Aspirin Alka Seltzer, Bromo Seltzer among over- ... 6, 2016 MONDAY, June 6, 2016 (HealthDay News) -- Antacids that contain aspirin may cause stomach or intestinal ...

  2. The comparison of bacteremia and amount of bleeding during septoplasty.

    PubMed

    Koc, Sema; Uysal, Ismail Onder; Uysal, Elif Bilge; Yenişehirli, Gülgün; Duygu, Fazilet

    2012-04-01

    The aim of this study was to investigate the relationship between the amount of bleeding and bacteremia during nasal septal surgery. Seventy-one patients undergoing septoplasty were enrolled in the present study. The amount of bleeding was measured and recorded for each patient. Preoperative and postoperative blood cultures were collected immediately after the induction of anesthesia and 20 min after the operation, respectively. While none of the blood cultures taken preoperatively were positive for any organism, the cultures obtained postoperatively were positive in 9 (12.7%) of 71 patients who underwent septoplasty, and bacteremia was more frequent among those with a greater amount of bleeding during the surgery. The results of this study suggest that although bacteremia had no clinical consequences for patients, patients with more bleeding have an increased risk of developing bacteremia which may cause complications in higher risk individuals. PMID:22037718

  3. Non-endoscopic management strategies for acute esophagogastric variceal bleeding

    PubMed Central

    Satapathy, Sanjaya K.; Sanyal, Arun J

    2014-01-01

    Acute variceal bleeding is a potentially life threatening complication of portal hypertension. Management consists of emergent hemostasis, therapy directed at hemodynamic resuscitation, protection of the airway, and prevention and treatment of complications including prophylactic use of antibiotics. Endoscopic treatment remains the mainstay in the management of acute variceal bleeding in combination with pharmacotherapy aimed at reducing portal pressure. Patients failing first-line therapy are triaged for non-endoscopic means of achieving hemostasis such as TIPS, BRTO or surgically created shunt procedures as rescue procedures, the choice depends on the source of bleeding (esophageal or gastric), size of the varices, portal vein patency, presence or absence of gastro-renal shunt, hepatic reserve and local expertise. The current chapter, intends to highlight only the current non endoscopic treatment approaches for control of acute variceal bleeding. PMID:25440928

  4. Hemospray treatment is effective for lower gastrointestinal bleeding.

    PubMed

    Holster, I Lisanne; Brullet, Enric; Kuipers, Ernst J; Campo, Rafel; Fernández-Atutxa, Alberto; Tjwa, Eric T T L

    2014-01-01

    Acute lower gastrointestinal bleeding (LGIB) is diverse in origin and can be substantial, requiring urgent hemostasis. Hemospray is a promising novel hemostatic agent for upper gastrointestinal bleeding (UGIB). It has been claimed in a small series that the use of Hemospray is also feasible in LGIB. We aimed to expand our knowledge of the application of Hemospray for the treatment of LGIB in a wider range of conditions to further define the optimal patient population for this new therapeutic modality. We analyzed the outcomes of nine unselected consecutive patients with active LGIB treated with Hemospray in two major hospitals in Europe. Initial hemostasis was achieved after Hemospray application in all patients. Rebleeding occurred in two patients (22%) who were on acetyl salicylic acid and presented with spurting bleeds. These preliminary data show that Hemospray can be effective in the management of LGIB, but suggest cautious use for patients on antithrombotic therapy and spurting bleeds. PMID:24218304

  5. Bleeding oesophageal varices with long term follow up.

    PubMed Central

    Spence, R A; Johnston, G W; Odling-Smee, G W; Rodgers, H W

    1984-01-01

    Complete long term follow up was obtained in 27 children who had bled from oesophageal varices. Most presented with haematemesis or melaena at an average age of 5.2 years in the portal vein thrombosis group (20 children) and 9.5 years in the intrahepatic group (7 children). All had splenomegaly. Only 6 of 20 children with portal vein thrombosis had a possible precipitating factor. A total of 182 admissions for bleeding are reported, in 68 of which injection sclerotherapy was used to control bleeding. Control rate with injection sclerotherapy was 97%. Shunts performed below age 10 years were associated with a high thrombosis rate. A conservative approach to bleeding varices in children is recommended with transfusion, pitressin, and injection sclerotherapy. Oesophageal transection may have a role in the emergency management of the few children in whom bleeding is not controlled by injection sclerotherapy. PMID:6609683

  6. Brain Bleed Risk from Warfarin May Be Higher Than Thought

    MedlinePlus

    ... older, with a common heart rhythm disorder called atrial fibrillation. The investigators found that almost one in three ... intracranial" bleed while taking warfarin for the condition. "Atrial fibrillation ("a-fib") is a common heart rhythm disorder ...

  7. Women Smokers at Higher Risk for Brain Bleed

    MedlinePlus

    ... type of stroke usually results from a bleeding aneurysm in the brain. An aneurysm is a small weak spot in a blood ... factors likely increase the risk of developing an aneurysm that eventually ruptures and causes a subarachnoid hemorrhage, ...

  8. Transarterial embolization for management of severe postcoital bleeding

    PubMed Central

    Eskandari, Armen; Mukherjee, Ashis; McHugh, John

    2016-01-01

    Objectives: Postcoital bleeding is an uncommon cause of gynecologic hemorrhage; however, it can be severe in a majority of cases necessitating surgical management. Methods: We report a case of severe postcoital bleeding in a young woman requiring blood transfusion. Results: Hemostasis was achieved using subselective embolization of cervical artery by metallic coils. Conclusion: Our case demonstrates a minimally invasive treatment for control of non-obstetric hemorrhage. PMID:27551425

  9. Jejunal Amyloidoma - a rare cause of gastrointestinal bleeding

    PubMed Central

    2009-01-01

    We report a case of localized amyloid tumor of the jejunum which presented with abdominal pain and gastrointestinal bleeding. We reviewed the pathophysiologic process that precipitates bleeding in this rare tumor. We also examined the documented radiologic and endoscopic features of amyloidosis of the small bowel in the light of our reported case. All with a view to add to the growing evidence on this rare tumor which will facilitate accurate diagnosis and management. PMID:20062677

  10. ENDOSCOPIC DIAGNOSIS AND THERAPY IN GASTRO-ESOPAGEAL VARICEAL BLEEDING

    PubMed Central

    Sanyal, Arun J.

    2016-01-01

    Gastroesophageal variceal hemorrhage is a medical emergency with high morbidity and mortality. Endoscopic therapy is the mainstay of management of bleeding varices. It requires attention to technique and the appropriate choice of therapy for a given patient at a given point in time. Subjects must be monitored continuously after initiation of therapy for control of bleeding and second line definitive therapies introduced quickly if endoscopic and pharmacologic treatment fails. PMID:26142034

  11. Baseline platelet indices and bleeding after transcatheter aortic valve implantation.

    PubMed

    Huczek, Zenon; Kochman, Janusz; Kowara, Michal Krzysztof; Wilimski, Radoslaw; Scislo, Piotr; Scibisz, Anna; Rymuza, Bartosz; Andrzejewska, Renata; Stanecka, Paulina; Filipiak, Krzysztof J; Opolski, Grzegorz

    2015-07-01

    Bleeding complications are frequent and independently predict mortality after transcatheter aortic valve implantation (TAVI). It has been demonstrated that certain platelet parameters are indicative of platelet reactivity. We sought to determine the possible correlation between simple platelet indices and bleeding complications in patients undergoing TAVI. Platelet indices--platelet count, mean platelet volume (MPV), platelet distribution width and plateletcrit--were measured in 110 consecutive patients on the day preceding TAVI. In-hospital bleeding events after TAVI were assessed according to the Valve Academic Research Consortium-2 classification as any bleeding, major and life-threatening bleeding (MLTB) and need for transfusion. By receiver-operating characteristic analysis, only MPV was able to distinguish between patients with and without any bleeding [area under the curve (AUC) 0.629, 95% confidence interval (CI) 0.531-0.719, P = 0.0342], MLTB (AUC 0.730, 95% CI 0.637-0.811, P = 0.0004) and need for transfusion (AUC 0.660, 95% CI 0.563-0.747, P = 0.0045). By multivariate logistic regression, high MPV (>10.6) and low platelet distribution width (<14.8) were associated with increased risk of any bleeding [odds ratio (OR) 4.08, 95% CI 1.66-10.07, P = 0.0022; and OR 3.82, 95% CI 1.41-10.36, P = 0.0084, respectively] and MLTB (OR 10.76, 95% CI 3.05-38, P = 0.0002; and OR 8.46, 95% CI 1.69-42.17, P = 0.0092, respectively). Additionally, high MPV independently correlated with the need for transfusion (OR 4.11, 95% CI 1.71-9.86, P = 0.0016). Larger and less heterogenic platelets may be associated with increased risk of short-term bleeding complications after TAVI. PMID:25811449

  12. Practical approach to endoscopic management for bleeding gastric varices.

    PubMed

    Lim, Young-Suk

    2012-01-01

    Bleeding from gastric varices is generally more severe than bleeding from esophageal varices, although it occurs less frequently. Recently, new endoscopic treatment options and interventional radiological procedures have broadened the therapeutic armamentarium for gastric varices. This review provides an overview of the classification and pathophysiology of gastric varices, an introduction to current endoscopic and interventional radiological management options for gastric varices, and details of a practical approach to endoscopic variceal obturation using N-butyl-2-cyanoacrylate. PMID:22563286

  13. A pediatric case of factitious disorder with unexplained bleeding symptoms.

    PubMed

    Uzuner, Selcuk; Bahali, Kayhan; Kurban, Sema; Erenberk, Ufuk; Cakir, Erkan

    2013-01-01

    Factitious disorder is characterized by deliberate production or imitation of physical or psychological symptoms in order to adopt the sick role. The disorder can be seen as factitious bleeding. Factitious bleeding is a rare disorder in pediatric population. The concomitant appearance of hemoptysis and hematuria in the same patient has not been previously reported. In this case report, we present a pediatric case of factitious disorder with both hemoptysis and hematuria. PMID:24199786

  14. Amphetamine-related ischemic colitis causing gastrointestinal bleeding

    PubMed Central

    Panikkath, Deepa

    2016-01-01

    A 43-year-old woman presented with acute lower intestinal bleeding requiring blood transfusion. Multiple initial investigations did not reveal the cause of the bleeding. Colonoscopy performed 2 days later showed features suggestive of ischemic colitis. On detailed history, the patient admitted to using amphetamines, and her urine drug screen was positive for them. She was managed conservatively and advised not to use amphetamines again. She did not have any recurrence on 2-year follow-up. PMID:27365888

  15. Endoscopic Diagnosis and Therapy in Gastroesophageal Variceal Bleeding.

    PubMed

    Kapoor, Ashwani; Dharel, Narayan; Sanyal, Arun J

    2015-07-01

    Gastroesophageal variceal hemorrhage is a medical emergency with high morbidity and mortality. Endoscopic therapy is the mainstay of management of bleeding varices. It requires attention to technique and the appropriate choice of therapy for a given patient at a given point in time. Subjects must be monitored continuously after initiation of therapy for control of bleeding, and second-line definitive therapies must be introduced quickly if endoscopic and pharmacologic treatment fails. PMID:26142034

  16. Seven cases of upper gastrointestinal bleeding after cold biopsy

    PubMed Central

    Alneaimi, Khaled; Abdelmoula, Ali; Vincent, Magalie; Savale, Camille; Baye, Birane; Lesur, Gilles

    2016-01-01

    Background and study aims: Routine biopsy of the upper gastrointestinal tract is performed with increasing frequency. It is generally considered to be safe without significant complication. However, gastrointestinal bleeding as a result of cold biopsy is a known complication. We report seven cases of upper gastrointestinal bleeding after cold biopsy and discuss clinical data, risks factors, severity and management of this event. We suggest that physicians must be more cautious with this rare but potentially severe complication.

  17. Diagnosis and therapy of non-variceal upper gastrointestinal bleeding.

    PubMed

    Biecker, Erwin

    2015-11-01

    Non-variceal upper gastrointestinal bleeding (UGIB) is defined as bleeding proximal to the ligament of Treitz in the absence of oesophageal, gastric or duodenal varices. The clinical presentation varies according to the intensity of bleeding from occult bleeding to melena or haematemesis and haemorrhagic shock. Causes of UGIB are peptic ulcers, Mallory-Weiss lesions, erosive gastritis, reflux oesophagitis, Dieulafoy lesions or angiodysplasia. After admission to the hospital a structured approach to the patient with acute UGIB that includes haemodynamic resuscitation and stabilization as well as pre-endoscopic risk stratification has to be done. Endoscopy offers not only the localisation of the bleeding site but also a variety of therapeutic measures like injection therapy, thermocoagulation or endoclips. Endoscopic therapy is facilitated by acid suppression with proton pump inhibitor (PPI) therapy. These drugs are highly effective but the best route of application (oral vs intravenous) and the adequate dosage are still subjects of discussion. Patients with ulcer disease are tested for Helicobacter pylori and eradication therapy should be given if it is present. Non-steroidal anti-inflammatory drugs have to be discontinued if possible. If discontinuation is not possible, cyclooxygenase-2 inhibitors in combination with PPI have the lowest bleeding risk but the incidence of cardiovascular events is increased. PMID:26558151

  18. Lower Gastrointestinal Bleeding: Is Urgent Colonoscopy Necessary for All Hematochezia?

    PubMed Central

    2013-01-01

    Lower gastrointestinal bleeding (LGIB) is defined as acute or chronic abnormal blood loss distal to the ligament of Treitz. The incidence of LGIB is only one fifth of that of the upper gastrointestinal tract and is estimated to be 21 to 27 cases per 100,000 adults per year. Acute bleeding is arbitrarily defined as bleeding of <3 days' duration resulting in instability of vital signs, anemia, and/or need for blood transfusion. Chronic bleeding is defined as slow blood loss over a period of several days or longer presenting with symptoms of occult fecal blood, intermittent melena, or scant hematochezia. Bleeding means that the amounts of blood in the feces are too small to be seen but detectable by chemical tests. LGIB is usually chronic and stops spontaneously. Bleeding stop (80%), but male gender and older patients suffer from more severe LGIB. The optimal timing of colonoscopic intervention for LGIB remains uncertain. Urgent colonoscopy may serve to decrease hospital stay. However, urgent colonoscopy is difficult to control, and showed no evidence of improving clinical outcomes or lowering costs as compared with routine elective colonoscopy. PMID:24143306

  19. Bleeding after endoscopic submucosal dissection: Risk factors and preventive methods

    PubMed Central

    Kataoka, Yosuke; Tsuji, Yosuke; Sakaguchi, Yoshiki; Minatsuki, Chihiro; Asada-Hirayama, Itsuko; Niimi, Keiko; Ono, Satoshi; Kodashima, Shinya; Yamamichi, Nobutake; Fujishiro, Mitsuhiro; Koike, Kazuhiko

    2016-01-01

    Endoscopic submucosal dissection (ESD) has become widely accepted as a standard method of treatment for superficial gastrointestinal neoplasms because it enables en block resection even for large lesions or fibrotic lesions with minimal invasiveness, and decreases the local recurrence rate. Moreover, specimens resected in an en block fashion enable accurate histological assessment. Taking these factors into consideration, ESD seems to be more advantageous than conventional endoscopic mucosal resection (EMR), but the associated risks of perioperative adverse events are higher than in EMR. Bleeding after ESD is the most frequent among these adverse events. Although post-ESD bleeding can be controlled by endoscopic hemostasis in most cases, it may lead to serious conditions including hemorrhagic shock. Even with preventive methods including administration of acid secretion inhibitors and preventive hemostasis, post-ESD bleeding cannot be completely prevented. In addition high-risk cases for post-ESD bleeding, which include cases with the use of antithrombotic agents or which require large resection, are increasing. Although there have been many reports about associated risk factors and methods of preventing post-ESD bleeding, many issues remain unsolved. Therefore, in this review, we have overviewed risk factors and methods of preventing post-ESD bleeding from previous studies. Endoscopists should have sufficient knowledge of these risk factors and preventive methods when performing ESD. PMID:27468187

  20. Diagnosis and therapy of non-variceal upper gastrointestinal bleeding

    PubMed Central

    Biecker, Erwin

    2015-01-01

    Non-variceal upper gastrointestinal bleeding (UGIB) is defined as bleeding proximal to the ligament of Treitz in the absence of oesophageal, gastric or duodenal varices. The clinical presentation varies according to the intensity of bleeding from occult bleeding to melena or haematemesis and haemorrhagic shock. Causes of UGIB are peptic ulcers, Mallory-Weiss lesions, erosive gastritis, reflux oesophagitis, Dieulafoy lesions or angiodysplasia. After admission to the hospital a structured approach to the patient with acute UGIB that includes haemodynamic resuscitation and stabilization as well as pre-endoscopic risk stratification has to be done. Endoscopy offers not only the localisation of the bleeding site but also a variety of therapeutic measures like injection therapy, thermocoagulation or endoclips. Endoscopic therapy is facilitated by acid suppression with proton pump inhibitor (PPI) therapy. These drugs are highly effective but the best route of application (oral vs intravenous) and the adequate dosage are still subjects of discussion. Patients with ulcer disease are tested for Helicobacter pylori and eradication therapy should be given if it is present. Non-steroidal anti-inflammatory drugs have to be discontinued if possible. If discontinuation is not possible, cyclooxygenase-2 inhibitors in combination with PPI have the lowest bleeding risk but the incidence of cardiovascular events is increased. PMID:26558151