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Sample records for intra-abdominal pressure levels

  1. Intra-abdominal pressure: an integrative review.

    PubMed

    Milanesi, Rafaela; Caregnato, Rita Catalina Aquino

    2016-01-01

    There is a growing request for measuring intra-abdominal pressure in critically ill patients with acute abdominal pain to be clarified. Summarizing the research results on measurement of vesical intra-abdominal pressure and analyzing the level of evidence were the purposes of this integrative literature review, carried out based on the databases LILACS, MEDLINE and PubMed, from 2005 to July 2012. Twenty articles were identified, in that, 12 literature reviews, 4 descriptive and exploratory studies, 2 expert opinions, one prospective cohort study and one was an experience report. The vesical intra-abdominal pressure measurement was considered gold standard. There are variations in the technique however, but some common points were identified: complete supine position, in absence of abdominal contracture, in the end of expiration and expressed in mmHg. Most research results indicate keeping the transducer zeroed at the level of the mid-axillary line at the iliac crest level, and instill 25mL of sterile saline. Strong evidence must be developed. RESUMO Em pacientes críticos com quadros abdominais agudos a esclarecer é crescente a solicitação da aferição da pressão intra-abdominal. Sintetizar resultados de pesquisas sobre a mensuração da pressão intra-abdominal pela via vesical e analisar o nível de evidência foram os objetivos desta revisão integrativa da literatura, realizada nas bases LILACS, MEDLINE e PubMed, no período de 2005 a julho de 2012. Identificaram-se 20 artigos, sendo 12 revisões de literatura, 4 estudos exploratório-descritivos, 2 opiniões de especialistas, 1 estudo de coorte prospectivo e 1 relato de experiência. O método vesical para mensuração da pressão intra-abdominal foi considerado padrão-ouro. Existem variações na técnica, entretanto pontos em comum foram identificados: posição supina completa, na ausência de contratura abdominal, ao final da expiração e expressa em mmHg. A maioria indica posicionar o ponto zero do

  2. Intra-abdominal pressure: an integrative review

    PubMed Central

    Milanesi, Rafaela; Caregnato, Rita Catalina Aquino

    2016-01-01

    ABSTRACT There is a growing request for measuring intra-abdominal pressure in critically ill patients with acute abdominal pain to be clarified. Summarizing the research results on measurement of vesical intra-abdominal pressure and analyzing the level of evidence were the purposes of this integrative literature review, carried out based on the databases LILACS, MEDLINE and PubMed, from 2005 to July 2012. Twenty articles were identified, in that, 12 literature reviews, 4 descriptive and exploratory studies, 2 expert opinions, one prospective cohort study and one was an experience report. The vesical intra-abdominal pressure measurement was considered gold standard. There are variations in the technique however, but some common points were identified: complete supine position, in absence of abdominal contracture, in the end of expiration and expressed in mmHg. Most research results indicate keeping the transducer zeroed at the level of the mid-axillary line at the iliac crest level, and instill 25mL of sterile saline. Strong evidence must be developed. PMID:26958978

  3. Elevated intra-abdominal pressure limits venous return during exercise in Varanus exanthematicus.

    PubMed

    Munns, Suzanne L; Hartzler, Lynn K; Bennett, Albert F; Hicks, James W

    2004-11-01

    The effects of treadmill exercise on components of the cardiovascular (venous return, heart rate, arterial blood pressure) and respiratory systems (minute ventilation, tidal volume, breathing frequency, oxygen consumption, carbon dioxide production) and intra-abdominal pressure were investigated in the Savannah monitor lizard, Varanus exanthematicus B., at 35 degrees C. Compared with resting conditions, treadmill exercise significantly increased lung ventilation, gular pumping, intra-abdominal pressure, mean arterial blood pressure and venous return (blood flow in the post caval vein). However, venous return declines at high levels of activity, and mean arterial pressure and venous return did not attain peak values until the recovery period, immediately following activity. Elevating intra-abdominal pressure in resting lizards (via saline infusion) resulted in significant reductions in venous return when the transmural pressure of the post caval vein became negative (i.e. when intra-abdominal pressure exceeded central venous pressure). Together these results suggest that increments in intra-abdominal pressure compress the large abdominal veins and inhibit venous return. During locomotion, the physical compression of the large abdominal veins may represent a significant limitation to cardiac output and maximal oxygen consumption in lizards.

  4. Relationship between Sequential Organ Failure Assessment (SOFA) and intra-abdominal pressure in intensive care unit

    PubMed Central

    de FREITAS, Gustavo Rocha Costa; da FONSECA-NETO, Olival Cirilo Lucena; PINHEIRO, Carla Larissa Fernandes; ARAÚJO, Luiz Clêiner; BARBOSA, Roberto Esmeraldo Nogueira; ALVES, Pedro

    2014-01-01

    Background Patients in the intensive care unit are at risk of developing intra-abdominal hypertension and abdominal compartment syndrome. Aim To describe the relation between Sequential Organ Failure Assessment (SOFA) vs. intra-abdominal pressure and the relation between SOFA and risk factors for intra-abdominal hypertension. Method In accordance with the recommendations of the World Society of the Abdominal Compartment Syndrome, the present study measured the intra-abdominal pressure of patients 24 h and 48 h after admission to the unit and calculated the SOFA after 24 h and 48 h. Data was collected over two-month period. Results No correlation was found between SOFA and intra-abdominal pressure. Seventy percent of the patients were men and the mean age was 44 years, 10% had been referred from general surgery (with a mean intra-abdominal pressure of 11) and 65% from neurosurgery (with a mean intra-abdominal of 6.7). Only three (7.5%) presented with intra-abdominal hypertension. The highest SOFA was 15 and the most frequent kind of organ failure was neurological, with a frequency of 77%. There was a strong correlation between the SOFA after 24 h and 48 h and peak respiratory pressure (ρ=0.43/p=0.01; ρ=0.39/p=0.02). Conclusion No correlation was found between SOFA and intra-abdominal pressure in the patients covered by the present study. However, it is possible in patients undergoing abdominal surgery or those with abdominal sepsis. Não houve correlação entre o SOFA e a pressão intra-abdominal nos pacientes aqui estudados; contudo, sinalizou ser possível em pacientes com operação abdominal ou naqueles com sepse abdominal. PMID:25626934

  5. Intra-Abdominal Pressure Correlates with Extracellular Water Content

    PubMed Central

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

    2015-01-01

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

  6. Effects of intra-abdominal pressure on adrenal gland function and morphology in rats.

    PubMed

    Akkapulu, Nezih; Tirnaksiz, Mehmet Bulent; Kulac, Ibrahim; Tezel, Gaye Guler; Hayran, Mutlu; Dogrul, Ahmet Bulent; Cetinkaya, Erdinc; Yorganci, Kaya

    2015-01-01

    Intra-abdominal hypertension and abdominal compartment syndrome (IAH/ACS) are life-threatening conditions and caused by several clinical status. Although there is insufficient data regarding its effects on adrenal glands. This study aimed to identify whether elevated intra-abdominal pressure (IAP) caused any alteration on the morphology and function of adrenal glands in a rat model. Twenty four Sprague-Dawley male rats were included in the study. Animals were allocated into 4 groups. IAP was elevated to 15 mmHg for one hour and four hours in group 2 and 4. Group 1 and 3 were sham groups. Blood samples were taken for the assessment of plasma adrenaline, noradrenaline, and corticosterone levels and adrenalectomies were performed to evaluate apoptosis. Blood adrenaline, noradrenaline and corticosterone levels were significantly higher in the study groups compared with the sham groups. However, there were no significant changes in apoptotic index scores in the study groups as compared to sham groups. These results support that increased IAH leads to discharge of catecholamine and corticosterone from the adrenal glands. Failure to demonstrate similar changes in apoptotic index score may be concluded as apoptosis is not a leading pathway for impairment of adrenal glands during IAH period.

  7. Effects of intra-abdominal pressure on adrenal gland function and morphology in rats

    PubMed Central

    Akkapulu, Nezih; Tirnaksiz, Mehmet Bulent; Kulac, Ibrahim; Tezel, Gaye Guler; Hayran, Mutlu; Dogrul, Ahmet Bulent; Cetinkaya, Erdinc; Yorganci, Kaya

    2015-01-01

    Intra-abdominal hypertension and abdominal compartment syndrome (IAH/ACS) are life-threatening conditions and caused by several clinical status. Although there is insufficient data regarding its effects on adrenal glands. This study aimed to identify whether elevated intra-abdominal pressure (IAP) caused any alteration on the morphology and function of adrenal glands in a rat model. Twenty four Sprague-Dawley male rats were included in the study. Animals were allocated into 4 groups. IAP was elevated to 15 mmHg for one hour and four hours in group 2 and 4. Group 1 and 3 were sham groups. Blood samples were taken for the assessment of plasma adrenaline, noradrenaline, and corticosterone levels and adrenalectomies were performed to evaluate apoptosis. Blood adrenaline, noradrenaline and corticosterone levels were significantly higher in the study groups compared with the sham groups. However, there were no significant changes in apoptotic index scores in the study groups as compared to sham groups. These results support that increased IAH leads to discharge of catecholamine and corticosterone from the adrenal glands. Failure to demonstrate similar changes in apoptotic index score may be concluded as apoptosis is not a leading pathway for impairment of adrenal glands during IAH period. PMID:26045846

  8. Wireless system for monitoring Intra-abdominal pressure in patient with severe abdominal pathology

    NASA Astrophysics Data System (ADS)

    Sokolovskiy, S. S.; Shtotskiy, Y. V.; Leljanov, A. D.

    2017-01-01

    The paper discusses an experimental design of the wireless system for monitoring intra-abdominal pressure (IAP) using Bluetooth Low Energy technology. The possibility of measuring IAP via the bladder using a wireless pressure sensor with a hydrophobic bacteria filter between the liquid transmitting medium and the sensor element is grounded.

  9. Intra-Abdominal Pressure Measurements in Term Pregnancy and Postpartum: An Observational Study

    PubMed Central

    Staelens, Anneleen S. E.; Van Cauwelaert, Stefan; Tomsin, Kathleen; Mesens, Tinne; Malbrain, Manu L. N.; Gyselaers, Wilfried

    2014-01-01

    Objective To determine intra-abdominal pressure (IAP) and to evaluate the reproducibility of IAP-measurements using the Foley Manometer Low Volume (FMLV) in term uncomplicated pregnancies before and after caesarean section (CS), relative to two different reference points and to non-pregnant values. Design Observational cohort study. Setting Secondary level referral center for feto-maternal medicine. Population Term uncomplicated pregnant women as the case-group and non-pregnant patients undergoing a laparoscopic assisted vaginal hysterectomy (LAVH) as control group. Methods IAP was measured in 23 term pregnant patients, before and after CS and in 27 women immediately after and 1 day after LAVH. The midaxillary line was used as zero-reference (IAPMAL) in all patients and in 13 CS and 13 LAVH patients, the symphysis pubis (IAPSP) was evaluated as additional zero-reference. Intraobserver correlation (ICC) was calculated for each zero-reference. Paired student's t-tests were performed to compare IAP values and Pearson's correlation was used to assess correlations between IAP and gestational variables. Main outcome measures ICC before and after surgery, IAP before and after CS, IAP after CS and LAVH. Results The ICC for IAPMAL before CS was lower than after (0.71 versus 0.87). Both mean IAPMAL and IAPSP were significantly higher before CS than after: 14.0±2.6 mmHg versus 9.8±3.0 mmHg (p<0.0001) and 8.2±2.5 mmHg versus 3.5±1.9 mmHg (p = 0.010), respectively. After CS, IAP was not different from values measured in the LAVH-group. Conclusion IAP-measurements using FMLV is reproducible in pregnant women. Before CS, IAP is increased in the range of intra-abdominal hypertension for non-pregnant individuals. IAP significantly decreases to normal values after delivery. PMID:25117778

  10. Effects of a Belt on Intra-Abdominal Pressure during Weight Lifting.

    DTIC Science & Technology

    1988-03-01

    potentially injurious b compressive forces on spinal discs during lifting. To investigate the effects of a standard lifting belt on lAP and lifting mechanics...injurious compressive forces on spinal discs during lifting. To investigate the effects of a standard lifting belt on IAP and lifting ! mechanics...pressure has been estimated to reduce spinal disc compressive forces by up to 40% (6,9,12,14). High intra-abdominal pressures have been recorded during

  11. Effects of back support on intra-abdominal pressure and lumbar kinetics during heavy lifting.

    PubMed

    Woodhouse, M L; McCoy, R W; Redondo, D R; Shall, L M

    1995-09-01

    Lumbosacral supports (LSSs) have been used to minimize the risk of lower back injuries. Theoretically, an LSS will raise intra-abdominal pressure (IAP) and reduce loads in the lower back region. This investigation compared three different LSSs with an unsupported condition. Nine males lifted a weighted box four times, once per condition, at 90% of their one-repetition maximum. Conditions were compared in terms of effects on IAP and its relieving force on L5-S1 kinetics. A multivariate analysis of covariance revealed no statistically significant differences among the three LSSs and the nonsupport conditions on the aforementioned dependent variables. This suggests that there is no difference among LSSs in terms of their biomechanical effects on the lower back region and that the use of any LSS does not necessarily afford more protection than a proper lift without one.

  12. Intra-abdominal Pressure during Pilates: Unlikely to Cause Pelvic Floor Harm

    PubMed Central

    Coleman, Tanner J.; Holder, Dannielle N.; Egger, Marlene J.; Hitchcock, Robert

    2015-01-01

    Aims To describe intra-abdominal pressures (IAP) generated during Pilates Mat and Reformer activities, and determine whether these activities generate IAP above a sit-to-stand threshold. Methods Twenty healthy women with no symptomatic vaginal bulge, median age 43 (range 22 – 59 years), completed Pilates Mat and Reformer exercise routines each consisting of 11 exercises. IAP was collected by an intra-vaginal pressure transducer, transmitted wirelessly to a base station, and analyzed for maximal and area under the curve (AUC) IAP. Results There were no statistically significant differences in mean max IAP between sit-to-stand and any of the Mat or Reformer exercises in the study population. Six to twenty-five percent of participants exceeded their individual mean max IAP sit-to-stand thresholds for 10 of the 22 exercises. When measuring AUC from 0 cm H2O, half the exercises exceeded the mean AUC of sit-to-stand but only Pilates Reformer and Mat roll-ups exceeded the mean AUC of sit-to-stand when calculated from a threshold of 40 cm H2O (consistent with, for example, walking). Conclusion Our results support recommending this series of introductory Pilates exercises including five Mat exercises and six Reformer exercises to women desiring a low IAP exercise routine. More research is needed to determine the long term effects of Pilates exercise on post-surgical exercise rehabilitation and pelvic floor health. PMID:25672647

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

    PubMed Central

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

    2015-01-01

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

  14. More complicated than it looks: The vagaries of calculating intra-abdominal pressure

    PubMed Central

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

    2013-01-01

    Activities thought to induce high intra-abdominal pressure (IAP), such as lifting weights, are restricted in women with pelvic floor disorders. Standardized procedures to assess IAP during activity are lacking and typically only focus on maximal IAP, variably defined. Our intent in this methods paper is to establish the best strategies for calculating maximal IAP and to add area under the curve and first moment of the area as potentially useful measures in understanding biologic effects of IAP. Thirteen women completed a range of activities while wearing an intra-vaginal pressure transducer. We first analyzed various strategies heuristically using data from 3 women. The measure that appeared to best represent maximal IAP was an average of the three, five or ten highest values, depending on activity, determined using a top down approach, with peaks at least 1 second apart using algorithms written for Matlab computer software, we then compared this strategy with others commonly reported in the literature quantitatively using data from 10 additional volunteers. Maximal IAP calculated using the top down approach differed for some, but not all, activities compared to the single highest peak or to averaging all peaks. We also calculated area under the curve, which allows for a time component, and first moment of the area, which maintains the time component while weighting pressure amplitude. We validated methods of assessing IAP using computer-generated sine waves. We offer standardized methods for assessing maximal, area under the curve and first moment of the area for IAP to improve future reporting and application of this clinically relevant measure in exercise science. PMID:23439349

  15. Influence of two different levels of intra-abdominal hypertension on bacterial translocation in a porcine model

    PubMed Central

    2012-01-01

    Background The purpose of the present study was to quantify bacterial translocation to mesenteric lymph nodes due to different levels of intra-abdominal hypertension (IAH; 15 vs. 30 mmHg) lasting for 24 h in a porcine model. Methods We examined 18 anesthetized and intubated pigs (52.3 ± 4.7 kg) which were randomly allocated to three experimental groups (each n = 6) and studied over a period of 24 h. After preparation and establishing a steady state, the intra-abdominal pressure (IAP) was increased stepwise to 30 mmHg in six animals using a carbon dioxide (CO2) insufflator (IAP-30 group). In the second group, IAP was increased to 15 mmHg (IAP-15 group), while IAP remained unchanged in another six pigs (control group). Using a pulse contour cardiac output (PiCCO®) monitoring system, hemodynamic parameters as well as blood gases were recorded periodically. Moreover, peripheral and portal vein blood samples were taken for microbiological examinations. Lymph nodes from the ileocecal junction were sampled during an intra-vital laparotomy at the end of the observational period. After sacrificing the animals, bowel tissue samples and corresponding mesenteric lymph nodes (MLN) were extracted for histopathological and microbiological analyses. Results Cardiac output decreased in all groups. In IAP-30 animals, volumetric preload indices significantly decreased, while those of IAP-15 pigs did not differ from those of controls. Under IAH, the mean arterial pressure (MAP) in the IAP-30 group declined, while MAP in the IAP-15 group was significantly elevated (controls unchanged). PO2 and PCO2 remained unchanged. The grade of ischemic damage of the intestines (histopathologically quantified using the Park score) increased significantly with different IAH levels. Accordingly, the amount of translocated bacteria in intestinal wall specimens as well as in MLN significantly increased with the level of IAH. Lymph node cultures confirmed the relation between bacterial translocation

  16. A Novel Method (CiMON) for Continuous Intra-Abdominal Pressure Monitoring: Pilot Test in a Pig Model.

    PubMed

    Wauters, Joost; Spincemaille, Liesbeth; Dieudonne, Anne-Sophie; Van Zwam, Kenny; Wilmer, Alexander; Malbrain, Manu L N G

    2012-01-01

    Background. Intravesical pressure (IAP(ivp)) measurement is considered to be the gold standard for assessment of intra-abdominal pressure (IAP). This study evaluated a new minimally invasive IAP monitoring device (CiMON) against three other devices in a wide range of clinically relevant IAP and in different body positions in healthy pigs. Methods. The CiMON catheter (IAP(CiM)) and another balloon-tipped catheter (IAP(spie)) were positioned into the stomach. Fluid-filled catheters were used for direct intraperitoneal (IAP(dir)) and IAP(ivp) measurement. Both in supine and 25° head-of-bed positions, IAP was increased from baseline to 30 mmHg. At every IAP level, 4 IAP measurements were recorded simultaneously. Mean differences and the limits of agreement were calculated. Results. Bias between IAP(CiM) and IAP(spie) was nearly zero with very good agreement, both in supine and 25° position. In supine position, IAP(CiM) slightly overestimated IAP(ivp) and IAP(dir) by 1.5 and 2.1 mmHg with reasonable agreement. In 25° position, IAP(CiM) underestimated IAP(ivp) and IAP(dir) by 1.0 and 0.5 mmHg, again with reasonable agreement. Conclusions. Agreement between IAP(CiM) and IAP(spie) was very good, while good-to-moderate agreement exists between IAP(CiM) and IAP(dir) or IAP(ivp). Simplicity, continuous monitoring, and the combination with a feeding tube should lead to further clinical studies, evaluating this new CiMON device.

  17. Direct intra-abdominal pressure monitoring via piezoresistive pressure measurement: a technical note

    PubMed Central

    Otto, Jens; Kaemmer, Daniel; Binnebösel, Marcel; Jansen, Marc; Dembinski, Rolf; Schumpelick, Volker; Schachtrupp, Alexander

    2009-01-01

    Background Piezoresistive pressure measurement technique (PRM) has previously been applied for direct IAP measurement in a porcine model using two different devices. Aim of this clinical study was to assess both devices regarding complications, reliability and agreement with IVP in patients undergoing elective abdominal surgery. Methods A prospective cohort study was performed in 20 patients randomly scheduled to receive PRM either by a Coach®-probe or an Accurate++®-probe (both MIPM, Mammendorf, Germany). Probes were placed on the greater omentum and passed through the abdominal wall paralleling routine drainages. PRM was compared with IVP measurement by t-testing and by calculating mean difference as well as limits of agreement (LA). Results There were no probe related complications. Due to technical limitations, data could be collected in 3/10 patients with Coach® and in 7/10 patients with Accurate++®. Analysis was carried out only for Accurate++®. Mean values did not differ to mean IVP values. Mean difference to IVP was 0.1 ± 2.8 mmHg (LA: -5.5 to 5.6 mmHg). Conclusion Direct IAP measurement was clinically uneventful. Although results of Accurate++® were comparable to IVP, the device might be too fragile for IAP measurements in the clinical setting. Local ethical committee trial registration: EK2024 PMID:19383161

  18. Effects of a Belt on Intra-Abdominal Pressure during Weight Lifting

    DTIC Science & Technology

    1989-01-01

    effective for increasing lAP, reducing to reduce potentially injurious compressive forces on spinal discs during lifting. To investigate the effects of a...earlier with than without the belt. When the belt was worn, IAP rose significantly earlier than did GRF. Both with and possibly reducing spinal disc ... spinal disc com- plates at either end of the bar rested on surfaces adjacent pressive forces by up to 40% (6,10,12,14). to and level with the top of the

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

    2012-01-01

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

  1. Effect of mechanical ventilation on intra-abdominal pressure in critically ill patients without other risk factors for abdominal hypertension: an observational multicenter epidemiological study

    PubMed Central

    2012-01-01

    Background Mechanical ventilation (MV) is considered a predisposing factor for increased intra-abdominal pressure (IAP), especially when positive end-expiratory pressure (PEEP) is applied or in the presence of auto-PEEP. So far, no prospective data exists on the effect of MV on IAP. The study aims to look on the effects of MV on IAP in a group of critically ill patients with no other risk factors for intra-abdominal hypertension (IAH). Methods An observational multicenter study was conducted on a total of 100 patients divided into two groups: 50 patients without MV and 50 patients with MV. All patients were admitted to the intensive care units of the Medical and Surgical Research Centre, the Carlos J. Finlay Hospital, the Julio Trigo University Hospital, and the Calixto García Hospital, in Havana, Cuba between July 2000 and December 2004. The IAP was measured twice daily on admission using a standard transurethral technique. IAH was considered if IAP was greater than 12 mmHg. Correlations were made between IAP and body mass index (BMI), diagnostic category, gender, age, and ventilatory parameters. Results The mean IAP in patients on MV was 6.7 ± 4.1 mmHg and significantly higher than in patients without MV (3.6 ± 2.4 mmHg, p < 0.0001). This difference was maintained regardless of gender, age, BMI, and diagnosis. The use of MV and BMI were independent predictors for IAH for the whole population, while male gender, assisted ventilation mode, and the use of PEEP were independent factors associated with IAH in patients on MV. Conclusions In this study, MV was identified as an independent predisposing factor for the development of IAH. Critically ill patients, which are on MV, present with higher IAP values on admission and should be monitored very closely, especially if PEEP is applied, even when they have no other apparent risk factors for IAH. PMID:23281625

  2. The effect of aqueous extract of gross and commercial yerba mate (Ilex paraguariensis) on intra-abdominal and epididymal fat and glucose levels in male Wistar rats.

    PubMed

    Silva, Raquel D'Agostini; Bueno, Audrin Loss Scopel; Gallon, Carin Weirich; Gomes, Luana Ferreira; Kaiser, Samuel; Pavei, Cabral; Ortega, George González; Kucharski, Luiz Carlos; Jahn, Matheus Parmegiani

    2011-09-01

    This study analyzed the plasma lipid profile, glucose levels and fat deposits in male rats treated with aqueous extract of gross yerba mate, commercial yerba mate or water. Yerba mate treatment did not change body weight gain and lipid profile. The consumption of gross yerba mate significantly increased blood glucose (6.6 mmol/L) as compared to the water (4.8 mmol/L) and commercial group (5.2 mmol/L) and decreased epididymal and intra-abdominal deposits (10.1mg/g and 23.7 mg/g of weight) as compared to the water (15.4 mg/g and 36.9 mg/g of weight) and commercial group (12.5mg/g and 28 mg/g of weight). The results suggest that gross yerba mate reduces fat more efficiently but produces a greater increase in blood glucose when compared to commercial yerba mate and water groups.

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

    PubMed

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

    2015-07-01

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

  4. Intra-abdominal fat accumulation is a hypertension risk factor in young adulthood

    PubMed Central

    Takeoka, Atsushi; Tayama, Jun; Yamasaki, Hironori; Kobayashi, Masakazu; Ogawa, Sayaka; Saigo, Tatsuo; Kawano, Hiroaki; Abiru, Norio; Hayashida, Masaki; Maeda, Takahiro; Shirabe, Susumu

    2016-01-01

    Abstract Accumulation of intra-abdominal fat is related to hypertension. Despite this, a relationship between hypertension and intra-abdominal fat in young adulthood is not clear. In this study, we verify whether intra-abdominal fat accumulation increases a hypertension risk in young adult subjects. In a cross-sectional study, intra-abdominal fat area was measured using a dual bioelectrical impedance analysis instrument in 697 university students (20.3 ± 0.7 years, 425 men). Blood pressure and anthropometric factors were measured. Lifestyle variables including smoking, drinking, physical activity, and eating behavior were assessed with questionnaire. High blood pressure risk (systolic blood pressure ≥130 mm Hg and/or diastolic blood pressure ≥85 mm Hg) with increasing intra-abdominal fat area was evaluated. Participants were divided into 5 groups according to their intra-abdominal fat area (≤24.9, 25–49.9, 50–74.9, 75–99.9, and ≥100 cm2). As compared with the values of the smallest intra-abdominal fat area group, the crude and lifestyle-adjusted odds ratios (ORs) were elevated in larger intra-abdominal fat area groups [OR 1.31, 95% confidence interval (CI) 0.66–2.80; OR 3.38, 95% CI 1.60–7.57; OR 7.71, 95% CI 2.75–22.22; OR 18.74, 95% CI 3.93–105.64, respectively). The risk increase was observed only in men. Intra-abdominal fat accumulation is related to high blood pressure in men around 20 years of age. These results indicate the importance of evaluation and reduction of intra-abdominal fat to prevent hypertension. PMID:27828861

  5. Torsion of an intra-abdominal testis.

    PubMed

    Lewis; Roller; Parra; Cotlar

    2000-09-01

    To present a case of torsion of a nonneoplastic intra-abdominal testis with an unusual clinical presentation.A 26-year-old active duty Navy Petty Officer presented to the emergency department on 3 occasions over a 5-day period with lower abdominal pain. Physical examination demonstrated acute tenderness in the left lower quadrant with sugestion of a normal spermatic cord and atrophic testis in the left scrotum. Computed tomography scan demonstrated an intra-abdominal lesion near the internal inguinal ring. The patient underwent surgical exploration through an inguinal incision. Torsion of a nonviable intra-abdominal testis was present. The scrotum contained only the vas deferens and cremasteric muscle. An orchiectomy was performed with removal of the vas deferens and other cord structures.The unusual clinical finding of acute torsion of an intra-abdominal testis, associated with an apparent atrophic scrotal testis, presented a confusing clinical picture. Computed tomography scan did not clarify the issue sufficiently to establish a definite preoperative diagnosis. Clinical suspicion prompted early surgical intervention. Review of the current literature produced 60 reported cases of torsion of an intra-abdominal testis. Two thirds of these involved testicular neoplasm, usually seminoma. Although the clinical presentation varied, most patients had recent onset of lower abdominal pain associated with tenderness and, in half the cases, a mass. Patients almost always presented with an absent scrotal testis on the involved side, and not infrequently reported previous surgery thought to be an orchiectomy.Diagnosis of an intra-abdominal testicular torsion is rare, particularly when no neoplasm is present. A high index of suspicion must be maintained whenever there is abdominal pain and undescended testis. The surgical history and imaging studies may not clarify a confusing clinical picture.

  6. Empyema following intra-abdominal sepsis.

    PubMed

    Ballantyne, K C; Sethia, B; Reece, I J; Davidson, K G

    1984-09-01

    Over the past 9 years, ten patients have presented to the Thoracic Unit, Glasgow Royal Infirmary, with 12 empyemas secondary to intra-abdominal sepsis. In eight patients, the presenting signs and symptoms were wrongly attributed to primary intra-thoracic pathology. All were subsequently found to have intra-abdominal sepsis. The presence of empyema after recent abdominal surgery or abdominal pain strongly suggests a diagnosis of ipsilateral subphrenic abscess. Adequate surgical drainage is essential. In our experience, limited thoracotomy with subdiaphragmatic extension offers the best access to both pleural and subphrenic spaces and provides the greatest chance of eradicating infection on both sides of the diaphragm.

  7. Management of intra-abdominal hypertension and abdominal compartment syndrome: a review

    PubMed Central

    2014-01-01

    Patients in the intensive care unit (ICU) are at risk of developing of intra abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). Aim: This review seeks to define IAH and ACS, identify the aetiology and presentation of IAH and ACS, identify IAP measurement techniques, identify current management and discuss the implications of IAH and ACS for nursing practice. A search of the electronic databases was supervised by a health librarian. The electronic data bases Cumulative Index of Nursing and Allied Health Literature (CINAHL); Medline, EMBASE, and the World Wide Web was undertaken from 1996- January 2011 using MeSH and key words which included but not limited to: abdominal compartment syndrome, intra -abdominal hypertension, intra-abdominal pressure in adult populations met the search criteria and were reviewed by three authors using a critical appraisal tool. Data derived from the retrieved material are discussed under the following themes: (1) etiology of intra-abdominal hypertension; (2) strategies for measuring intra-abdominal pressure (3) the manifestation of abdominal compartment syndrome; and (4) the importance of nursing assessment, observation and interventions. Intra-abdominal pressure (IAP) and abdominal compartment syndrome (ACS) have the potential to alter organ perfusion and compromise organ function. PMID:24499574

  8. Intra-abdominal fat accumulation is a hypertension risk factor in young adulthood: A cross-sectional study.

    PubMed

    Takeoka, Atsushi; Tayama, Jun; Yamasaki, Hironori; Kobayashi, Masakazu; Ogawa, Sayaka; Saigo, Tatsuo; Kawano, Hiroaki; Abiru, Norio; Hayashida, Masaki; Maeda, Takahiro; Shirabe, Susumu

    2016-11-01

    Accumulation of intra-abdominal fat is related to hypertension. Despite this, a relationship between hypertension and intra-abdominal fat in young adulthood is not clear. In this study, we verify whether intra-abdominal fat accumulation increases a hypertension risk in young adult subjects.In a cross-sectional study, intra-abdominal fat area was measured using a dual bioelectrical impedance analysis instrument in 697 university students (20.3 ± 0.7 years, 425 men). Blood pressure and anthropometric factors were measured. Lifestyle variables including smoking, drinking, physical activity, and eating behavior were assessed with questionnaire. High blood pressure risk (systolic blood pressure ≥130 mm Hg and/or diastolic blood pressure ≥85 mm Hg) with increasing intra-abdominal fat area was evaluated.Participants were divided into 5 groups according to their intra-abdominal fat area (≤24.9, 25-49.9, 50-74.9, 75-99.9, and ≥100 cm). As compared with the values of the smallest intra-abdominal fat area group, the crude and lifestyle-adjusted odds ratios (ORs) were elevated in larger intra-abdominal fat area groups [OR 1.31, 95% confidence interval (CI) 0.66-2.80; OR 3.38, 95% CI 1.60-7.57; OR 7.71, 95% CI 2.75-22.22; OR 18.74, 95% CI 3.93-105.64, respectively). The risk increase was observed only in men.Intra-abdominal fat accumulation is related to high blood pressure in men around 20 years of age. These results indicate the importance of evaluation and reduction of intra-abdominal fat to prevent hypertension.

  9. [INFLUENCE OF THE INTRA-ABDOMINAL HYPERTENSION ON THE BLOOD COAGULATION SYSTEM (EXPERIMENTAL STUDY)].

    PubMed

    Turgunov, Y; Matyushko, D; Nurbekov, A; Kaliyeva, D; Alibekov, A

    2016-07-01

    The analysis of the influence of the intra-abdominal hypertension on the blood coagulation system by carrying out an experimental research with laboratory animals is presented in article. After simulating intra-abdominal hypertension with different degree and exposition we made the laboratory research of blood coagulation system (fibrinogen, PTI, SFMC, APTT) and ELISA research on the concentration of the modern marker of thrombozis - D-dimer. The results in article clearly demonstrate that there is a direct linear dependence of level of fibrinogen and SFMC on degree of intra-abdominal hypertension, and the multidirectional changes of indicators with increase of intra-abdominal hypertension duration - towards hypercoagulation for 3-12 hours, and then by 24 o'clock - in the opposite direction towards hypocoagulation. Perhaps, it is explained with development of organ dysfunction and a coagulopathy of consumption. Indicator D-dimer has also direct linear dependence on the intra-abdominal hypertension level with contents peak at 3 hour exposition, and at all intra-abdominal hypertension levels, more than 2-fold rise of D-dimer level is statistically significant.

  10. 2013 WSES guidelines for management of intra-abdominal infections

    PubMed Central

    2013-01-01

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

  11. Erysipelothrix rhusiopathiae intra-abdominal abscess.

    PubMed

    Feasi, Marcello; Bacigalupo, Lorenzo; Cappato, Stefano; Pontali, Emanuele; Usiglio, David; Rollandi, Gian Andrea; Filauro, Marco; Mori, Marco; Cassola, Giovanni

    2010-01-01

    Erysipelothrix rhusiopathiae is a Gram-positive bacillus that is infrequently responsible for infections in humans. Most human cases present as localized or generalized cutaneous infections. An invasive septic form, usually associated with endocarditis, has rarely been described. We report here an invasive infection caused by E. rhusiopathiae without endocardium involvement. To our knowledge, this is the first report of an intra-abdominal abscess due to this pathogen.

  12. Clinical evaluation of an air-capsule technique for the direct measurement of intra-abdominal pressure after elective abdominal surgery

    PubMed Central

    Otto, Jens; Kaemmer, Daniel; Biermann, Andreas; Jansen, Marc; Dembinski, Rolf; Schumpelick, Volker; Schachtrupp, Alexander

    2008-01-01

    Background The gold standard for assessment of intraabdominal pressure (IAP) is via intravesicular pressure measurement (IVP). This accepted technique has some inherent problems, e.g. indirectness. Aim of this clinical study was to assess direct IAP measurement using an air-capsule method (ACM) regarding complications risks and agreement with IVP in patients undergoing abdominal surgery. Methods A prospective cohort study was performed in 30 patients undergoing elective colonic, hepatic, pancreatic and esophageal resection. For ACM a Probe 3 (Spiegelberg®, Germany) was placed on the greater omentum. It was passed through the abdominal wall paralleling routine drainages. To compare ACM with IVP t-testing was performed and mean difference as well as limits of agreement were calculated. Results ACM did not lead to complications particularly with regard to organ lesion or surgical site infection. Mean insertion time of ACM was 4.4 days (min-max: 1–5 days). 168 pairwise measurements were made. Mean ACM value was 7.9 ± 2.7 mmHg while mean IVP was 8.4 ± 3.0 mmHg (n.s). Mean difference was 0.4 mmHg ± 2.2 mmHg. Limits of agreement were -4.1 mmHg to 5.1 mmHg. Conclusion Using ACM, direct IAP measurement is feasible and uncomplicated. Associated with relatively low pressure ranges (<17 mmHg), results are comparable to bladder pressure measurement. PMID:18925973

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

    PubMed Central

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

    2016-01-01

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

  14. The effects of intra-abdominal hypertension on the secretory function of canine adrenal glands.

    PubMed

    Yu, Jian; Fu, XiaoJuan; Chang, MingTao; Zhang, LiangChao; Chen, ZhiQiang; Zhang, LianYang

    2013-01-01

    Intra-abdominal hypertension (IAH) can damage multiple organ systems, but the explicit impact on the adrenal gland is unclear. To evaluate the effects of intra-abdominal pressure (IAP) on the secretory function of the adrenal glands, we established canine models of IAH. By comparing morphology; hemodynamics; plasma cortisol, aldosterone, epinephrine, and norepinephrine concentrations; and the expression of IL-1, IL-6, and TNF-α in adrenal gland tissue from these dogs, we found that hemodynamic instability occurred after IAH and that IAH increased the plasma cortisol, aldosterone, epinephrine, and norepinephrine concentrations. Higher IAPs resulted in more significant changes, and the above indicators gradually returned to normal 2 h after decompression. Compared with the sham-operated group, IAH significantly increased IL-1, IL-6, and TNF-α levels in adrenal tissue, with larger increases in the presence of higher IAPs. However, the concentrations of these markers remained higher than those in the sham-operated group despite their decrease after 2 h of decompression. Histopathological examination revealed congestion, red blood cell exudation, and neutrophil infiltration in the adrenal glands when IAP was elevated; these conditions became more significant with more severe IAH. These results suggest that the secretion of adrenal hormones and adrenal gland inflammation are positively correlated with IAP and that abdominal decompression effectively corrects adrenal gland function.

  15. Xanthogranulomatous panniculitis after spillage of gallstones during laparoscopic cholecystectomy mimics intra-abdominal malignancy.

    PubMed

    Lin, Chien-Hua; Chu, Heng-Cheng; Hsieh, Huan-Fa; Jin, Jong-Shiaw; Yu, Jyh-Cherng; Cheng, Ming-Fang; Hsu, Sheng-Der; Chan, De-Chuan

    2006-08-01

    Spillage of gallstones into the peritoneal cavity during laparoscopic cholecystectomy (LC) occurs frequently and may be associated with complications. Most of these complications present late after the original procedure, and many have clinical pictures that are not related to biliary etiology, which can confound and delay adequate management. Our patient presented with an intra-abdominal firm heterogeneous mass lesion. Imaging studies showed obvious abdominal wall invasion, and CA-125 level was elevated. Thus, malignancy could not be excluded. Final operative pathology revealed xanthogranulomatous inflammation. Complications of LC should be considered for patients with intra-abdominal abscess or mass lesion if there is a history of LC, regardless of time interval.

  16. Unique Presentation of Intra-Abdominal Testis: Small Bowel Obstruction

    PubMed Central

    Bassiouny, Ibrahim E.; Abbas, Tariq O.; Alansari, Amani N.; Ali, Mansour A.

    2011-01-01

    We describe here a two-year-old male who required urgent laparotomy to relieve a strangulated small bowel caused by internal herniation around an intra-abdominal testis. This clinical presentation has not been reported previously. PMID:22084802

  17. Fournier's gangrene secondary to intra-abdominal processes.

    PubMed

    Gerber, G S; Guss, S P; Pielet, R W

    1994-11-01

    We report 2 cases of necrotizing fasciitis of the perineum, perianal area, and male genitalia (Fournier's gangrene) that arose secondary to intra-abdominal infectious processes (ruptured appendicitis and diverticulitis). Management consisted of immediate debridement of necrotic tissue, exploratory laparotomy, and diverting colostomy. The presence of an acute abdominal process was not immediately evident on initial evaluation of either patient. This demonstrates the critical importance of considering intra-abdominal infection in patients with Fournier's gangrene when the more commonly seen urinary tract, perirectal, and traumatic causes are not readily apparent.

  18. The Effect of Intra-Abdominal Hypertension Incorporating Severe Acute Pancreatitis in a Porcine Model

    PubMed Central

    Ke, Lu; Tong, Zhi-hui; Ni, Hai-bin; Ding, Wei-wei; Sun, Jia-kui; Li, Wei-qin; Li, Ning; Li, Jie-shou

    2012-01-01

    Introduction Abdominal compartment syndrome (ACS) and intra abdominal hypertension(IAH) are common clinical findings in patients with severe acute pancreatitis(SAP). It is thought that an increased intra abdominal pressure(IAP) is associated with poor prognosis in SAP patients. But the detailed effect of IAH/ACS on different organ system is not clear. The aim of this study was to assess the effect of SAP combined with IAH on hemodynamics, systemic oxygenation, and organ damage in a 12 h lasting porcine model. Measurements and Methods Following baseline registrations, a total of 30 animals were divided into 5 groups (6 animals in each group): SAP+IAP30 group, SAP+IAP20 group, SAP group, IAP30 group(sham-operated but without SAP) and sham-operated group. We used a N2 pneumoperitoneum to induce different levels of IAH and retrograde intra-ductal infusion of sodium taurocholate to induce SAP. The investigation period was 12 h. Hemodynamic parameters (CO, HR, MAP, CVP), urine output, oxygenation parameters(e.g., SvO2, PO2, PaCO2), peak inspiratory pressure, as well as serum parameters (e.g., ALT, amylase, lactate, creatinine) were recorded. Histological examination of liver, intestine, pancreas, and lung was performed. Main Results Cardiac output significantly decreased in the SAP+IAH animals compared with other groups. Furthermore, AST, creatinine, SUN and lactate showed similar increasing tendency paralleled with profoundly decrease in SvO2. The histopathological analyses also revealed higher grade injury of liver, intestine, pancreas and lung in the SAP+IAH groups. However, few differences were found between the two SAP+IAH groups with different levels of IAP. Conclusions Our newly developed porcine SAP+IAH model demonstrated that there were remarkable effects on global hemodynamics, oxygenation and organ function in response to sustained IAH of 12 h combined with SAP. Moreover, our model should be helpful to study the mechanisms of IAH/ACS-induced exacerbation and

  19. Do Polymicrobial Intra-Abdominal Infections Have Worse Outcomes than Monomicrobial Intra-Abdominal Infections?

    PubMed Central

    Edwards, Brandy L.; Dietch, Zachary C.; Guidry, Christopher A.; Davies, Stephen W.; Hennessy, Sara A.; Duane, Therese M.; O'Neill, Patrick J.; Coimbra, Raul; Cook, Charles H.; Askari, Reza; Popovsky, Kimberly; Sawyer, Robert G.

    2016-01-01

    Abstract Background: Numerous studies have demonstrated microorganism interaction through signaling molecules, some of which are recognized by other bacterial species. This interspecies synergy can prove detrimental to the human host in polymicrobial infections. We hypothesized that polymicrobial intra-abdominal infections (IAI) have worse outcomes than monomicrobial infections. Methods: Data from the Study to Optimize Peritoneal Infection Therapy (STOP-IT), a prospective, multicenter, randomized controlled trial, were reviewed for all occurrences of IAI having culture results available. Patients in STOP-IT had been randomized to receive four days of antibiotics vs. antibiotics until two days after clinical symptom resolution. Patients with polymicrobial and monomicrobial infections were compared by univariable analysis using the Wilcoxon rank sum, χ2, and Fisher exact tests. Results: Culture results were available for 336 of 518 patients (65%). The durations of antibiotic therapy in polymicrobial (n = 225) and monomicrobial IAI (n = 111) were equal (p = 0.78). Univariable analysis demonstrated similar demographics in the two populations. The 37 patients (11%) with inflammatory bowel disease were more likely to have polymicrobial IAI (p = 0.05). Polymicrobial infections were not associated with a higher risk of surgical site infection, recurrent IAI, or death. Conclusion: Contrary to our hypothesis, polymicrobial IAI do not have worse outcomes than monomicrobial infections. These results suggest polymicrobial IAI can be treated the same as monomicrobial IAI. PMID:26397376

  20. Epidemiology and antimicrobial susceptibility of Gram-negative aerobic bacteria causing intra-abdominal infections during 2010-2011.

    PubMed

    Hawser, Stephen; Hoban, Daryl J; Badal, Robert E; Bouchillon, Samuel K; Biedenbach, Douglas; Hackel, Meredith; Morrissey, Ian

    2015-02-01

    The study for monitoring antimicrobial resistance trends (SMART) surveillance program monitors the epidemiology and trends in antibiotic resistance of intra-abdominal pathogens to currently used therapies. The current report describes such trends during 2010-2011. A total of 25,746 Gram-negative clinical isolates from intra-abdominal infections were collected and classified as hospital-associated (HA) if the hospital length of stay (LOS) at the time of specimen collection was ≥48 hours, community-associated (CA) if LOS at the time of specimen collection was <48 hours, or unknown (no designation given by participating centre). A total of 92 different species were collected of which the most common was Escherichia coli: 39% of all isolates in North America to 55% in Africa. Klebsiella pneumoniae was the second most common pathogen: 11% of all isolates from Europe to 19% of all isolates from Asia. Isolates were from multiple intra-abdominal sources of which 32% were peritoneal fluid, 20% were intra-abdominal abscesses, and 16.5% were gall bladder infections. Isolates were further classified as HA (55% of all isolates), CA (39% of all isolates), or unknown (6% of all isolates). The most active antibiotics tested were imipenem, ertapenem, amikacin, and piperacillin-tazobactam. Resistance rates to all other antibiotics tested were high. Considering the current data set and high-level resistance of intra-abdominal pathogens to various antibiotics, further monitoring of the epidemiology of intra-abdominal infections and their susceptibility to antibiotics through SMART is warranted.

  1. Keratinocyte Growth Factor Combined with a Sodium Hyaluronate Gel Inhibits Postoperative Intra-Abdominal Adhesions

    PubMed Central

    Wei, Guangbing; Zhou, Cancan; Wang, Guanghui; Fan, Lin; Wang, Kang; Li, Xuqi

    2016-01-01

    Postoperative intra-abdominal adhesion is a very common complication after abdominal surgery. One clinical problem that remains to be solved is to identify an ideal strategy to prevent abdominal adhesions. Keratinocyte growth factor (KGF) has been proven to improve the proliferation of mesothelial cells, which may enhance fibrinolytic activity to suppress postoperative adhesions. This study investigated whether the combined administration of KGF and a sodium hyaluronate (HA) gel can prevent intra-abdominal adhesions by improving the orderly repair of the peritoneal mesothelial cells. The possible prevention mechanism was also explored. The cecum wall and its opposite parietal peritoneum were abraded after laparotomy to induce intra-abdominal adhesion formation. Animals were randomly allocated to receive topical application of HA, KGF, KGF + HA, or normal saline (Control). On postoperative day 7, the adhesion score was assessed with a visual scoring system. Masson’s trichrome staining, picrosirius red staining and hydroxyproline assays were used to assess the magnitude of adhesion and tissue fibrosis. Cytokeratin, a marker of the mesothelial cells, was detected by immunohistochemistry. The levels of tissue plasminogen activator (tPA), interleukin-6 (IL-6), and transforming growth factor β1 (TGF-β1) in the abdominal fluid were determined using enzyme-linked immunosorbent assays (ELISAs). Western blotting was performed to examine the expression of the TGF-β1, fibrinogen and α-smooth muscle actin (α-SMA) proteins in the rat peritoneal adhesion tissue. The combined administration of KGF and HA significantly reduced intra-abdominal adhesion formation and fibrin deposition and improved the orderly repair of the peritoneal mesothelial cells in the rat model. Furthermore, the combined administration of KGF and HA significantly increased the tPA levels but reduced the levels of IL-6, tumor necrosis factor α (TNF-α) and TGF-β1 in the abdominal fluid. The expression

  2. Clinical review: Intra-abdominal hypertension: does it influence the physiology of prone ventilation?

    PubMed

    Kirkpatrick, Andrew W; Pelosi, Paolo; De Waele, Jan J; Malbrain, Manu Lng; Ball, Chad G; Meade, Maureen O; Stelfox, Henry T; Laupland, Kevin B

    2010-01-01

    Prone ventilation (PV) is a ventilatory strategy that frequently improves oxygenation and lung mechanics in critical illness, yet does not consistently improve survival. While the exact physiologic mechanisms related to these benefits remain unproven, one major theoretical mechanism relates to reducing the abdominal encroachment upon the lungs. Concurrent to this experience is increasing recognition of the ubiquitous role of intra-abdominal hypertension (IAH) in critical illness, of the relationship between IAH and intra-abdominal volume or thus the compliance of the abdominal wall, and of the potential difference in the abdominal influences between the extrapulmonary and pulmonary forms of acute respiratory distress syndrome. The present paper reviews reported data concerning intra-abdominal pressure (IAP) in association with the use of PV to explore the potential influence of IAH. While early authors stressed the importance of gravitationally unloading the abdominal cavity to unencumber the lung bases, this admonition has not been consistently acknowledged when PV has been utilized. Basic data required to understand the role of IAP/IAH in the physiology of PV have generally not been collected and/or reported. No randomized controlled trials or meta-analyses considered IAH in design or outcome. While the act of proning itself has a variable reported effect on IAP, abundant clinical and laboratory data confirm that the thoracoabdominal cavities are intimately linked and that IAH is consistently transmitted across the diaphragm--although the transmission ratio is variable and is possibly related to the compliance of the abdominal wall. Any proning-related intervention that secondarily influences IAP/IAH is likely to greatly influence respiratory mechanics and outcomes. Further study of the role of IAP/IAH in the physiology and outcomes of PV in hypoxemic respiratory failure is thus required. Theories relating inter-relations between prone positioning and the

  3. Intra-abdominal drainage following pancreatic resection: A systematic review

    PubMed Central

    Čečka, Filip; Loveček, Martin; Jon, Bohumil; Skalický, Pavel; Šubrt, Zdeněk; Neoral, Čestmír; Ferko, Alexander

    2015-01-01

    AIM: To study all the aspects of drain management in pancreatic surgery. METHODS: We conducted a systematic review according to the PRISMA guidelines. We searched the Cochrane Central Registry of Controlled Trials, EMBASE, Web of Science, and PubMed (MEDLINE) for relevant articles on drain management in pancreatic surgery. The reference lists of relevant studies were screened to retrieve any further studies. We included all articles that reported clinical studies on human subjects with elective pancreatic resection and that compared various strategies of intra-abdominal drain management, such as drain vs no drain, selective drain use, early vs late drain extraction, and the use of different types of drains. RESULTS: A total of 19 studies concerned with drain management in pancreatic surgery involving 4194 patients were selected for this systematic review. We included studies analyzing the outcomes of pancreatic resection with and without intra-abdominal drains, studies comparing early vs late drain removal and studies analyzing different types of drains. The majority of the studies reporting equal or superior results for pancreatic resection without drains were retrospective and observational with significant selection bias. One recent randomized trial reported higher postoperative morbidity and mortality with routine omission of intra-abdominal drains. With respect to the timing of drain removal, all of the included studies reported superior results with early drain removal. Regarding the various types of drains, there is insufficient evidence to determine which type of drain is more suitable following pancreatic resection. CONCLUSION: The prophylactic use of drains remains controversial. When drains are used, early removal is recommended. Further trials comparing types of drains are ongoing. PMID:26523110

  4. Hypothermia Increases Tissue Plasminogen Activator Expression and Decreases Post-Operative Intra-Abdominal Adhesion

    PubMed Central

    Lee, Chien-Chang; Wang, Hsuan-Mao; Chou, Tzung-Hsin; Wu, Meng-Che; Hsueh, Kuang-Lung; Chen, Shyr-Chyr

    2016-01-01

    Background Therapeutic hypothermia during operation decreases postoperative intra-abdominal adhesion formation. We sought to determine the most appropriate duration of hypothermia, and whether hypothermia affects the expression of tissue plasminogen activator (tPA). Methods 80 male BALB/c mice weighing 25–30 g are randomized into one of five groups: adhesion model with infusion of 15°C saline for 15 minutes (A); 30 minutes (B); 45 minute (C); adhesion model without infusion of cold saline (D); and sham operation without infusion of cold saline (E). Adhesion scores and tPA levels in the peritoneum fluid levels were analyzed on postoperative days 1, 7, and 14. Results On day 14, the cold saline infusion groups (A, B, and C) had lower adhesion scores than the without infusion of cold saline group (D). However, only group B (cold saline infusion for 30 minutes) had a significantly lower adhesion scores than group D. Also, group B was found to have 3.4 fold, 2.3 fold, and 2.2 fold higher levels of tPA than group D on days 1, 7, and 14 respectively. Conclusions Our results suggest that cold saline infusion for 30 minutes was the optimum duration to decrease postoperative intra-abdominal adhesion formation. The decrease in the adhesion formations could be partly due to an increase in the level of tPA. PMID:27583464

  5. Toxicity from intra-abdominal injection of chlorfenapyr.

    PubMed

    Lee, Jina; Lee, Jun Hyun; Baek, Jong Min; Lee, Do Sang; Park, Il Young; Won, Jong Man; Sung, Ki Young

    2013-01-01

    Introduction. Chlorfenapyr is commonly used for food crops in Korea. However, chlorfenapyr toxicity in humans has not yet been studied. Case. A 74-year-old man was admitted to the emergency room after he intra-abdominally injected 20 mL of chlorfenapyr in an attempt to commit suicide. Emergency surgery was performed and accumulation of approximately 500 mL of reactive fluid in the abdomen was observed. The entire small intestine showed congestion. After surgery, additional surgery to drain the fluid was performed on POD 12. But immediately after administration of general anesthesia, flat rhythm was observed by electrocardiogram (ECG) monitoring, requiring cardiopulmonary resuscitation (CPR). Discussion. The color of the bowel was purple, indicating ischemic injury. This could be attributed to direct absorption of the substance through the peritoneum, leading to chemical injury to the small intestine serosa, unlike in the case of oral ingestion. This resulted in an ischemic change in the small intestine, eventually leading to sepsis. Conclusion. Only a few cases of chlorfenapyr toxicity have been reported in the literature, and death occurred in all cases, including our case. Therefore, careful and aggressive treatments are necessary. This is the first reported case of intra-abdominal injection of chlorfenapyr.

  6. Toxicity from Intra-Abdominal Injection of Chlorfenapyr

    PubMed Central

    Lee, Jina; Lee, Jun Hyun; Baek, Jong Min; Lee, Do Sang; Park, Il Young; Won, Jong Man; Sung, Ki Young

    2013-01-01

    Introduction. Chlorfenapyr is commonly used for food crops in Korea. However, chlorfenapyr toxicity in humans has not yet been studied. Case. A 74-year-old man was admitted to the emergency room after he intra-abdominally injected 20 mL of chlorfenapyr in an attempt to commit suicide. Emergency surgery was performed and accumulation of approximately 500 mL of reactive fluid in the abdomen was observed. The entire small intestine showed congestion. After surgery, additional surgery to drain the fluid was performed on POD 12. But immediately after administration of general anesthesia, flat rhythm was observed by electrocardiogram (ECG) monitoring, requiring cardiopulmonary resuscitation (CPR). Discussion. The color of the bowel was purple, indicating ischemic injury. This could be attributed to direct absorption of the substance through the peritoneum, leading to chemical injury to the small intestine serosa, unlike in the case of oral ingestion. This resulted in an ischemic change in the small intestine, eventually leading to sepsis. Conclusion. Only a few cases of chlorfenapyr toxicity have been reported in the literature, and death occurred in all cases, including our case. Therefore, careful and aggressive treatments are necessary. This is the first reported case of intra-abdominal injection of chlorfenapyr. PMID:23691373

  7. Estrogen improved metabolic syndrome through down-regulation of VEGF and HIF-1α to inhibit hypoxia of periaortic and intra-abdominal fat in ovariectomized female rats.

    PubMed

    Xu, Jinwen; Xiang, Qiuling; Lin, Guiping; Fu, Xiaodong; Zhou, Kewen; Jiang, Ping; Zheng, Shuhui; Wang, Tinghuai

    2012-08-01

    Metabolic syndrome (MBS), a cluster of metabolic abnormalities and visceral fat accumulation, increases cardiovascular risks in postmenopausal women. In addition to visceral fat, perivascular adipose tissue has been recently found to play an important role in vascular pathophysiology. Hence, the present study investigates the effects of estrogen on both intra-abdominal fat (visceral fat) and periaortic fat (perivascular fat) accumulation as well as hypoxia in ovariectomized female rats. Female rats were divided into sham operation, ovariectomy and ovariectomy with 17β-estradiol supplementation groups. Twelve weeks later, we found that estrogen improved MBS via reducing body weight gain, the weight of periaortic and intra-abdominal fat, hepatic triglyceride, and total serum cholesterol levels. Estrogen also increased insulin sensitivity through restoring glucose and serum leptin levels. For periaortic fat, western blot showed estrogen inhibited hypoxia by reducing the levels of VEGF and HIF-1α, which is consistent with the results from immunohistochemical staining. The correlation analysis indicated that perivascular fat had a positive correlation with body weight, intra-abdominal fat or serum total cholesterol, but a negative correlation with insulin sensitivity index. For intra-abdominal fat, real-time fluorescent RT-PCR showed estrogen improved fat dysfunction via reducing the levels of relative leptin, MCP-1 but increasing adiponectin mRNA. Estrogen reduced the levels of VEGF and HIF-1α to inhibit hypoxia but restored the levels of PPARγ and Srebp-1c, which are important for lipid capacity function of intra-abdominal fat. These results demonstrated estrogen improved MBS through down-regulating VEGF and HIF-1α to inhibit hypoxia of periaortic and intra-abdominal fat in ovariectomized female rats.

  8. Recommendations for intra-abdominal infections consensus report

    PubMed Central

    Avkan-Oğuz, Vildan; Baykam, Nurcan; Sökmen, Selman; Güner, Rahmet; Agalar, Fatih; Alp, Emine; Doğrul, Ahmet; Turhan, Özge; Ağalar, Canan; Kurtaran, Behice; Geçim, İbrahim Ethem; Özaras, Reşat; Yılmaz, Gürdal; Akbulut, Ayhan; Koksal, İftihar

    2016-01-01

    Guidelines include the recommendations of experts from various specialties within a topic in consideration of data specific to each country. However, to date there has not been a guideline standardizing the nomenclature and offering recommendations for intra-abdominal infections (IAIs) in Turkey. This is mainly due to the paucity of laboratory studies regarding the clinical diagnosis and treatment of IAIs or the sensitivity of microorganisms isolated from patients with IAIs. However, due to the diversification of host characteristics and advancements in technological treatment methods, it has become imperative to ‘speak a common language’. For this purpose May 2015, a group of 15 experts in intra-abdominal infections, under the leadership of the Infectious Diseases and Clinical Microbiology Specialty Society of Turkey (EKMUD) and with representatives from the Turkish Surgical Association, Turkish Society of Colon and Rectal Surgery, Hernia Society, Turkish Society of Hepato-pancreato-biliary Surgery, and the Turkish Society of Hospital Infections and Control, was formed to analyze relevant studies in the literature. Ultimately, the suggestions for adults found in this consensus report were developed using available data from Turkey, referring predominantly to the 2010 guidelines for diagnosing and managing complicated IAIs in adults and children by the Infectious Diseases Society of America (IDSA) and the Surgical Infection Society. The recommendations are presented in two sections, from the initial diagnostic evaluation of patients to the treatment approach for IAI. This Consensus Report was presented at the EKMUD 2016 Congress in Antalya and was subsequently opened for suggestions on the official websites of the Infectious Diseases and Clinical Microbiology Specialty Society of Turkey and Turkish Surgical Association for one month. The manuscript was revised according to the feedback received. PMID:28149134

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

    PubMed

    Otomaru, Konosuke; Fujikawa, Takuro; Saito, Yasuo; Ando, Takaaki; Obi, Takeshi; Miura, Naoki; Kubota, Chikara

    2015-09-01

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

  10. Factors associated with surgery in patients with intra-abdominal fistulizing Crohn's disease

    PubMed Central

    Yaari, Shaul; Benson, Ariel; Aviran, Eyal; Lev Cohain, Naama; Oren, Ran; Sosna, Jacob; Israeli, Eran

    2016-01-01

    AIM To characterize radiological and clinical factors associated with subsequent surgical intervention in Crohn’s disease (CD) patients with intra-abdominal fistulae. METHODS From a cohort of 1244 CD patients seen over an eight year period (2006 to 2014), 126 patients were identified as having intra-abdominal fistulae, and included in the study. Baseline patient information was collected from the medical records. Imaging studies were assessed for: anatomic type and number of fistulae; diameter of the inflammatory conglomerate; length of diseased bowel; presence of a stricture with pre-stenotic dilatation; presence of an abscess; lymphadenopathy; and the degree of bowel enhancement. Multivariate analysis for the prediction of abdominal surgery was calculated via Generalized Linear Models. RESULTS In total, there were 193 fistulae in 132 patients, the majority (52%) being entero-enteric. Fifty-nine (47%) patients underwent surgery within one year of the imaging study, of which 36 (29%) underwent surgery within one month. Radiologic features that were associated with subsequent surgery included: multiple fistulae (P = 0.009), presence of stricture (P = 0.02), and an entero-vesical fistula (P = 0.01). Evidence of an abscess, lymphadenopathy, or intense bowel enhancement as well as C-reactive protein levels was not associated with an increased rate of surgery. Patients who were treated after the imaging study with combination immunomodulatory and anti-TNF therapy had significantly lower rates of surgery (P = 0.01). In the multivariate analysis, presence of a stricture [RR 4.5 (1.23-16.3), P = 0.02] was the only factor that increased surgery rate. CONCLUSION A bowel stricture is the only factor predicting an increased rate of surgery. Radiological parameters may guide in selecting treatment options in patients with fistulizing CD. PMID:28058018

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

    NASA Technical Reports Server (NTRS)

    Kravik, S.; Landmark, K.

    1980-01-01

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

  12. Percutaneous Sclerotherapy Using Acetic Acid After Failure of Alcohol Ablation in an Intra-abdominal Lymphangioma

    SciTech Connect

    Park, Sang Woo Cha, In Ho; Kim, Kyeong Ah; Hong, Suk Joo; Park, Cheol Min; Chung, Hwan Hoon

    2004-09-15

    We report a case of percutaneous sclerotherapy using acetic acid in a 22-year-old woman with an intra-abdominal cystic lymphangioma who was not successfully treated with ethanol despite multiple trials.

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

    PubMed Central

    2013-01-01

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

  14. Risk Factors and Outcome for Massive Intra-Abdominal Bleeding Among Patients With Infected Necrotizing Pancreatitis.

    PubMed

    Shen, Xiao; Sun, Jing; Zhang, Jingzhu; Ke, Lu; Tong, Zhihui; Li, Gang; Jiang, Wei; Li, Weiqin; Li, Jieshou

    2015-07-01

    The incidence of acute bleeding is reported to be 13.5% in patients with acute necrotizing pancreatitis. However, of all the bleeding events, intra-abdominal bleeding was less studied in the literature and its risk factors have not been well defined yet. The purpose of the present study was to investigate the risk factors for massive intra-abdominal bleeding among the patients with infected necrotizing pancreatitis and assessed the outcome of these patients. Both univariate and multivariate logistic regression models were applied for evaluating risk factors for intra-abdominal bleeding using 33 indices, including age, sex, etiology of acute pancreatitis (AP), APACHE II score, etc. Outcome assessments such as mortality, hospital and intensive care unit (ICU) durations, and cost were also compared between patients with or without intra-abdominal bleeding. Acute kidney injury (AKI) (odds ratio [OR]: 7.54, 95% confidence interval [CI]: 2.53-22.52, P < 0.001) and number of operation (OR: 8.84, 95% CI: 2.01-38.86, P = 0.004) were 2 predictors for massive intra-abdominal bleeding in the patients with infected necrotizing pancreatitis. In addition, AP patients with intra-abdominal bleeding also showed significantly higher mortality rate, prolonged hospital and ICU durations, more complications and invasive treatments, as well as increased cost. Our study revealed that AKI and multiple operations were 2 critical factors increasing the risk of intra-abdominal bleeding among patients with infected necrotizing pancreatitis. Additionally, massive intra-abdominal bleeding was also associated with poor prognosis.

  15. Risk Factors and Outcome for Massive Intra-Abdominal Bleeding Among Patients With Infected Necrotizing Pancreatitis

    PubMed Central

    Shen, Xiao; Sun, Jing; Zhang, Jingzhu; Ke, Lu; Tong, Zhihui; Li, Gang; Jiang, Wei; Li, Weiqin; Li, Jieshou

    2015-01-01

    Abstract The incidence of acute bleeding is reported to be 13.5% in patients with acute necrotizing pancreatitis. However, of all the bleeding events, intra-abdominal bleeding was less studied in the literature and its risk factors have not been well defined yet. The purpose of the present study was to investigate the risk factors for massive intra-abdominal bleeding among the patients with infected necrotizing pancreatitis and assessed the outcome of these patients. Both univariate and multivariate logistic regression models were applied for evaluating risk factors for intra-abdominal bleeding using 33 indices, including age, sex, etiology of acute pancreatitis (AP), APACHE II score, etc. Outcome assessments such as mortality, hospital and intensive care unit (ICU) durations, and cost were also compared between patients with or without intra-abdominal bleeding. Acute kidney injury (AKI) (odds ratio [OR]: 7.54, 95% confidence interval [CI]: 2.53–22.52, P < 0.001) and number of operation (OR: 8.84, 95% CI: 2.01–38.86, P = 0.004) were 2 predictors for massive intra-abdominal bleeding in the patients with infected necrotizing pancreatitis. In addition, AP patients with intra-abdominal bleeding also showed significantly higher mortality rate, prolonged hospital and ICU durations, more complications and invasive treatments, as well as increased cost. Our study revealed that AKI and multiple operations were 2 critical factors increasing the risk of intra-abdominal bleeding among patients with infected necrotizing pancreatitis. Additionally, massive intra-abdominal bleeding was also associated with poor prognosis. PMID:26181564

  16. Successful medical management of intra-abdominal abscesses in 4 adult horses.

    PubMed

    Berlin, Dalia; Kelmer, Gal; Steinman, Amir; Sutton, Gail A

    2013-02-01

    Four adult horses with large intra-abdominal abscesses, suspected to be complications of strangles, were treated with systemic antibiotics alone and made a full recovery. The 100% survival rate is significantly better than other reported survival rates. The median duration of treatment (35 days) was shorter than in most previous reports. This study suggests that penicillin G can be used for successful treatment of strangles associated intra-abdominal abscesses in horses.

  17. Dynamics of Albumin Synthetic Response to Intra-Abdominal Abscess in Patients with Gastrointestinal Fistula

    PubMed Central

    Zhou, Bo; Han, Gang; Chen, Yu; A, Jiye; Gu, Guosheng; Chen, Jun; Wang, Gefei; Li, Jieshou

    2014-01-01

    Abstract Background: Low serum albumin concentration is a predictor of failure of source control for intra-abdominal infection. However, data on dynamics of albumin synthesis in these patients and to what extent these changes contribute to hypoalbuminemia are relatively scarce. We investigated in a group of patients with gastrointestinal fistula the dynamic response of liver albumin synthesis to intra-abdominal abscess and how these related to hypoalbuminemia and circulating endocrine hormone profiles. Methods: Eight gastrointestinal fistula patients scheduled to undergo percutaneous abscess sump drainage were enrolled prospectively to measure albumin synthesis rates at different stages of the inflammatory response (immediately after diagnosis and 7 d following sump drainage when clinical signs of intra-abdominal sepsis had been eradicated). Eight age-, sex-, and body mass index–matched intestinal fistula patients were studied as control patients. Consecutive arterial blood samples were drawn during a primed-constant infusion (priming dose: 4 micromol·kg−1, infusion rate: 6 micromol·kg−1·min−1) to determine the incorporation rate of L-[ring-2H5]-phenylalanine directly into plasma albumin using gas chromatography/mass spectrometry analysis. Results: Patients suffering from intra-abdominal infection had reduced plasma albumin and total plasma protein concentrations, compared with control patients. Albumin fractional synthesis rates in patients with intra-abdominal abscess were decreased, compared with those in the control group. When the source of infection was removed, albumin synthesis rates returned to control values, whereas albumin concentrations did not differ significantly from the corresponding concentrations in control subjects and patients with intra-abdominal abscess. Conclusion: Despite nutritional intervention, albumin synthesis rate is decreased in intestinal fistula patients with intra-abdominal abscess; albumin synthesis returns to

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

    PubMed Central

    2014-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  20. Extensive characterization of feline intra-abdominal adipose-derived mesenchymal stem cells.

    PubMed

    Kim, Hee-Ryang; Lee, Jienny; Byeon, Jeong Su; Gu, Na-Yeon; Lee, Jiyun; Cho, In-Soo; Cha, Sang-Ho

    2016-07-25

    Mesenchymal stem cells (MSCs) have been isolated from various tissues and well characterized for therapeutic application to clinical diseases. However, in contrast to MSCs from other animal species, the characteristics of feline MSCs have not been well documented. In this study, we attempted to conduct extensive characterization of feline adipose tissue-derived MSCs (fAD-MSCs). fAD-MSCs were individually isolated from the intra-abdominal adipose tissues of six felines. The expression levels of cell surface markers and pluripotent markers were evaluated. Next, the proliferation capacity was analyzed by cumulative population doubling level (CPDL) and doubling time (DT) calculation assays. Differentiation potentials into mesodermal cell lineages of fAD-MSCs were further analyzed by specific staining and molecular markers. All of fAD-MSCs positively expressed cell surface markers such as CD29, CD44, CD90, CD105, CD166, and MHC-I, while CD14, CD34, CD45, and CD73 were negatively expressed. The CPDL of the fAD-MSCs was maintained until passage 5 to 6 (P5 to P6) and DT increased after P5 to P6. Also, stem cell specific pluripotent markers (Oct3/4, Nanog, and SSEA-4) were detected. Importantly, all of the fAD-MSCs demonstrated mesodermal differentiation capacity. These results suggest that well characterized fAD-MSCs could be beneficial, when considering these cells for researches of feline diseases.

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

    PubMed Central

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

    2013-01-01

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

  2. Safety and Effectiveness of Meropenem in Infants With Suspected or Complicated Intra-abdominal Infections

    PubMed Central

    Cohen-Wolkowiez, Michael; Poindexter, Brenda; Bidegain, Margarita; Weitkamp, Joern-Hendrik; Schelonka, Robert L.; Randolph, David A.; Ward, Robert M.; Wade, Kelly; Valencia, Gloria; Burchfield, David; Arrieta, Antonio; Mehta, Varsha; Walsh, Michele; Kantak, Anand; Rasmussen, Maynard; Sullivan, Janice E.; Finer, Neil; Rich, Wade; Brozanski, Beverly S.; van den Anker, John; Blumer, Jeffrey; Laughon, Matthew; Watt, Kevin M.; Kearns, Gregory L.; Capparelli, Edmund V.; Martz, Karen; Berezny, Katherine; Benjamin, Daniel K.; Smith, P. Brian

    2012-01-01

    Background. Intra-abdominal infections are common in young infants and lead to significant morbidity and mortality. Meropenem is a broad-spectrum antimicrobial with excellent activity against pathogens associated with intra-abdominal infections. The purpose of this study was to determine the safety and effectiveness of meropenem in young infants with suspected or complicated intra-abdominal infections. Methods. Preterm and term infants <91 days of age with suspected or confirmed intra-abdominal infections hospitalized in 24 neonatal intensive care units were studied in an open-label, multiple-dose study. Adverse events and serious adverse events were collected through 3 and 30 days following the last meropenem dose, respectively. Effectiveness was assessed by 3 criteria: death, bacterial cultures, and presumptive clinical cure score. Results. Of 200 subjects enrolled in the study, 99 (50%) experienced an adverse event, and 34 (17%) had serious adverse events; no adverse events were probably or definitely related to meropenem. The most commonly reported adverse events were sepsis (6%), seizures (5%), elevated conjugated bilirubin (5%), and hypokalemia (5%). Only 2 of the serious adverse events were determined to be possibly related to meropenem (isolated ileal perforation and an episode of fungal sepsis). Effectiveness was evaluable in 192 (96%) subjects, and overall treatment success was 84%. Conclusions. Meropenem was well tolerated in this cohort of critically ill infants, and the majority of infants treated with meropenem met the definition of therapeutic success. Clinical Trials Registration. NCT00621192. PMID:22955430

  3. Intra-abdominal desmoplastic small round-cell tumor: expansion of the pathologic profile.

    PubMed

    Dorsey, B V; Benjamin, L E; Rauscher, F; Klencke, B; Venook, A P; Warren, R S; Weidner, N

    1996-06-01

    This report describes an intra-abdominal desmoplastic small round-cell tumor in a 29-year-old man that significantly differed from the classically described appearances of this unique tumor. It showed extensive papillary areas, no necrosis, and very little desmoplasia. The latter was limited, paucicellular, and present in areas separate from the papillary structures. Also, areas of back-to-back, single-cell infiltration, which mimicked lobular breast carcinoma, were present. These epithelial features suggested the diagnosis of adenocarcinoma or peculiar mesothelioma. But, the immunohistochemical features (tumor cells positive for keratin, desmin, and vimentin) were more consistent with an intra-abdominal desmoplastic small round-cell tumor. The diagnosis became clear after application of reverse transcriptase-polymerase chain reaction techniques to formalin-fixed, paraffin-embedded tissue, which showed the presence of a 100-base pair product containing the fusion junction of Ewing's sarcoma-1 exon 7 to Wilms' tumor-1 exon 8. This feature is considered unique to intra-abdominal desmoplastic small round-cell tumors. This case illustrates the less common histologic findings that can be found in intra-abdominal desmoplastic small round-cell tumor. This deviation from the classic histologic findings may be an expression of an uncommon morphologic variant and/or partially produced by the effects of prior chemotherapy. In either event, only by illustrating the various histologic appearances of intra-abdominal desmoplastic small round-cell tumor are the chances increased for the accurate diagnosis of this aggressive neoplasm with a poor prognosis.

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

    PubMed Central

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

    2011-01-01

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

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

    PubMed Central

    Kołaczyk, Katarzyna; Bernatowicz, Elżbieta

    2015-01-01

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

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

    PubMed

    Smereczyński, Andrzej; Kołaczyk, Katarzyna; Bernatowicz, Elżbieta

    2015-09-01

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

  7. Preventive Effects of the Intestine Function Recovery Decoction, a Traditional Chinese Medicine, on Postoperative Intra-Abdominal Adhesion Formation in a Rat Model

    PubMed Central

    Zhou, Cancan; Jia, Pengbo; Jiang, Zhengdong; Chen, Ke; Wang, Guanghui; Wang, Kang; Wei, Guangbing

    2016-01-01

    The intestine function recovery decoction (IFRD) is a traditional Chinese medicine that has been used for the treatment of adhesive intestinal obstruction. In this study, the preventative effects and probable mechanism of the IFRD were investigated in a rat model. We randomly assigned rats to five groups: normal, model, control, low dose IFRD, and high dose IFRD. In the animal model, the caecum wall and parietal peritoneum were abraded to induce intra-abdominal adhesion formation. Seven days after surgery, adhesion scores were assessed using a visual scoring system, and histopathological samples were examined. The levels of serum interleukin-6 (IL-6) and transforming growth factor beta-1 (TGF-β1) were analysed by an enzyme-linked immunosorbent assay (ELISA). The results showed that a high dose of IFRD reduced the grade of intra-abdominal adhesion in rats. Furthermore, the grades of inflammation, fibrosis, and neovascularization in the high dose IFRD group were significantly lower than those in the control group. The results indicate that the IFRD can prevent intra-abdominal adhesion formation in a rat model. These data suggest that the IFRD may be an effective antiadhesion agent. PMID:28105058

  8. Synergistic Effect of Combined Hollow Viscus Injuries on Intra-Abdominal Abscess Formation.

    PubMed

    Paulus, Elena M; Croce, Martin A; Shahan, Charles P; Zarzaur, Ben L; Sharpe, John P; Dileepan, Amirtha; Boyd, Brandon S; Fabian, Timothy C

    2015-07-01

    The strong association between penetrating colon injuries and intra-abdominal abscess (IAA) formation is well established and attributed to high colon bacterial counts. Since trauma patients are rarely fasting at injury, stomach and small bowel colony counts are also elevated. We hypothesized that there is a synergistic effect of increased IAA formation with concomitant stomach and/or colon injuries when compared to small bowel injuries alone. Consecutive patients at a level one trauma center with penetrating small bowel (SB), stomach (S), and/or colon (C) injuries from 1996 to 2012 were reviewed. Logistic regression determined associations with IAA, adjusting for age, gender, Injury Severity Score (ISS), admission Glasgow Coma Score, transfusions, and concurrent pancreas or liver injury. A total of 1518 patients (91% male, ISS = 15.9 ± 8.4) were identified: 496 (33%) SB, 231 (15%) S, 288 (19%) C, 40 (3%) S + SB, 69 (5%) S + C, 338 (22%) C + SB, and 56 (4%) S + C + SB. 148 (10%) patients developed IAA: 4 per cent SB, 9 per cent S, 10 per cent C, 5 per cent S + SB, 22 per cent S + C, 13 per cent C + SB, and 25 per cent S + C + SB. Multiple logistic regression demonstrated that ISS, 24 hour blood transfusions, and concomitant pancreatic or liver injuries were associated with IAA. Compared with reference SB, S or S + SB injuries were no more likely to develop IAA. However, S + C, SB + C, and S + C + SB injuries were significantly more likely to have IAA. In conclusion, combined stomach + colon, small bowel + colon, and stomach, colon, + small bowel injuries have a synergistic effect leading to increased IAA formation after penetrating injuries. Heightened clinical suspicion for IAA formation is necessary in these combined hollow viscus injury patients.

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

    PubMed Central

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

    1994-01-01

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

  10. Adult metastatic yolk sac tumor descending from an intra-abdominal testis: A case report and review of the literature.

    PubMed

    Wang, Zhao; Yan, Bin; Wei, Yong-Bao; Yin, Zhuo; Zhou, Ke-Qin; Yang, Jin-Rui

    2015-12-01

    Pure yolk sac tumors are extremely rare in adults; to the best of our knowledge, <20 cases have been reported. Multiple metastases originating from a pure yolk sac testicular tumor, descending from an intra-abdominal testis, are additionally extremely rare. In the present case, a man exhibiting a 30-year history of cryptorchidism and indirect inguinal hernia, was admitted to the Department of Urology (The Second Xiangya Hospital, Changsha, China) due to a mass that had descended from the abdominal cavity 7 months previously. Elevated levels of specific serum marker (α-fetoprotein, lactate dehydrogenase and human chorionic gonadotropin) did not indicate potential testicular germ cell types prior to surgery and pathological examination. Pathological results and immunohistochemistry revealed a testicular pure yolk sac tumor subsequent to surgery. The present case report and literature review describes the typical characteristics of an adult testicular yolk sac tumor, as well as the diagnosis and management of the disease.

  11. Adult metastatic yolk sac tumor descending from an intra-abdominal testis: A case report and review of the literature

    PubMed Central

    WANG, ZHAO; YAN, BIN; WEI, YONG-BAO; YIN, ZHUO; ZHOU, KE-QIN; YANG, JIN-RUI

    2015-01-01

    Pure yolk sac tumors are extremely rare in adults; to the best of our knowledge, <20 cases have been reported. Multiple metastases originating from a pure yolk sac testicular tumor, descending from an intra-abdominal testis, are additionally extremely rare. In the present case, a man exhibiting a 30-year history of cryptorchidism and indirect inguinal hernia, was admitted to the Department of Urology (The Second Xiangya Hospital, Changsha, China) due to a mass that had descended from the abdominal cavity 7 months previously. Elevated levels of specific serum marker (α-fetoprotein, lactate dehydrogenase and human chorionic gonadotropin) did not indicate potential testicular germ cell types prior to surgery and pathological examination. Pathological results and immunohistochemistry revealed a testicular pure yolk sac tumor subsequent to surgery. The present case report and literature review describes the typical characteristics of an adult testicular yolk sac tumor, as well as the diagnosis and management of the disease. PMID:26788184

  12. Fatal intra-abdominal hemorrhage as a result of avulsion of the gallbladder: a postmortem case report

    PubMed Central

    Usui, Akihito; Kawasumi, Yusuke; Hosokai, Yoshiyuki; Saito, Haruo; Igari, Yui; Funayama, Masato

    2013-01-01

    Gallbladder injuries are extremely rare in blunt trauma, with a reported incidence of <2%. We report an autopsy case of fatal hemorrhagic shock due to intra-abdominal bleeding resulting from complete avulsion of the gallbladder associated with liver cirrhosis. Multiplanar images derived from multislice computed tomography (MSCT) performed as part of pre-autopsy screening showed complete avulsion of the gallbladder without any other associated intra-abdominal injuries, facilitating forensic autopsy planning. In this report, we discuss the role of MSCT in cases of fatal intra-abdominal bleeding caused by avulsion of the gallbladder and discuss the mechanism of this injury. PMID:23986858

  13. In vitro activity of moxifloxacin against 923 anaerobes isolated from human intra-abdominal infections.

    PubMed

    Goldstein, Ellie J C; Citron, Diane M; Warren, Yumi A; Tyrrell, Kerin L; Merriam, C Vreni; Fernandez, Helen

    2006-01-01

    The in vitro activity of moxifloxacin against 923 recent anaerobic isolates obtained from pretreatment cultures in patients with complicated intra-abdominal infections was studied using the CLSI M11-A-6 agar dilution method. Moxifloxacin was active against 87% (96 of 110) Bacteroides fragilis strains at < or = 1 microg/ml and 87% (79 of 90) B. thetaiotaomicron strains at < or = 2 microg/ml. Species variation was seen, with B. uniformis, B. vulgatus, Clostridium clostridioforme, and C. symbiosum being least susceptible and accounting for most of the resistant isolates; excluding the aforementioned four resistant species, 86% (303 of 363) of Bacteroides species isolates and 94% (417 of 450) of all other genera and species were susceptible to < or = 2 microg/ml of moxifloxacin. Overall, moxifloxacin was active against 763 of 923 (83%) of strains at < or = 2 microg/ml, supporting its use as a monotherapy for some community-acquired intra-abdominal infections.

  14. Free intra-abdominal hemorrhage after open-heart surgery: an unusual gastrointestinal complication.

    PubMed

    Iriz, Erkan; Ereren, Emrah; Yuksel, Osman; Kalaycioglu, Sedat

    2006-01-01

    Gastrointestinal complications after open-heart surgery are rare. Many preoperative, intraoperative, and postoperative factors may predispose patients to these complications or cause them. Our patient was a 64-year-old woman who underwent aortic valve replacement due to aortic stenosis. Free intra-abdominal hemorrhage occurred on the 2nd postoperative day. During exploratory laparotomy, it was determined that the hemorrhage was from a vein near the falciform ligament of the liver and from a bleeding laceration of the splenic capsule. The complication was repaired surgically. To our knowledge, intra-abdominal hemorrhage of both liver and spleen after open-heart surgery has never been reported before, even in large patient series. We report the case and present our ideas regarding the cause of the bleeding.

  15. Intra-abdominal inflammatory myofibroblastic pseudotumor: case report and review of the literature.

    PubMed

    Bronzino, P; Abbo, L; Bagnasco, F; Barisone, P; Dezzani, C; Genovese, A M; Iannucci, P; Ippoliti, M; Sacchi, M; Aimo, I

    2005-10-01

    Inflammatory myofibroblastic pseudotumors (IPM) are very rare tumor characterized by unpredictable clinical behaviour. They arise in soft tissues of almost every organ and the most common site is the lung. Over 200 cases of inflammatory myofibroblastic pseudotumor of the lung have been described in literature. Intra-abdominal IMP are very rare. We describe a case of intra-abdominal IMP in a boy of 15 years old who presented symptoms and signs of acute appendicitis. Exploratory laparotomy revealed a mass in the peritoneal cavity. The mass was removed. The histologic examination showed that it was an IMP. Surgical treatment was the only therapy. Six months after the surgical operation the patient has no sign of illness.

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

    PubMed Central

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

    2011-01-01

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

  17. A Torted Ruptured Intra-abdominal Testicular Seminoma Presenting As An Acute Abdomen.

    PubMed

    Nickalls, Oliver James; Tan, Char Loo; Thian, Yee Liang

    2015-12-01

    The susceptibility of the undescended testis to malignant transformation is well documented. The most common location of the undescended testis is within the inguinal canal, with only a minority located within the abdominal cavity. When a testicular mass develops, the risk of torsion increases. We describe a large intra-abdominal testicular seminoma that had undergone torsion, rupture and haemorrhage, presenting as an acute abdomen. A 30 year old man presented to the emergency department with right iliac fossa pain. Computed tomography in the emergency department showed haemoperitoneum and a torted large left testicular mass, likely malignant. The patient underwent laparotomy and excision of the mass. Histologic examination revealed a grossly enlarged seminomatous testis which had torted and ruptured. While pre-operative imaging diagnosis of an intra-abdominal testicular seminoma has been published, reports are few. To the best of the author's knowledge pre-operative imaging diagnosis of a malignant testicular mass with torsion and intra-abdominal haemorrhage presenting as an acute abdomen has not been described before.

  18. Low-dose dacarbazine-doxorubicin therapy against intra-abdominal desmoid tumors.

    PubMed

    Yamamoto, Hirofumi; Oshiro, Ryota; Nishimura, Junichi; Uemura, Mamoru; Haraguchi, Naotsugu; Hata, Taishi; Takemasa, Ichiro; Mizushima, Tsunekazu; Sekimoto, Mitsugu; Doki, Yuichiro; Mori, Masaki

    2013-05-01

    Intra-abdominal desmoid tumor is a life-threatening disease. Studies have shown that dacarbazine (DTIC)-doxorubicin (DOX) (D-D) therapy is the most effective treatment. However, myelosuppression is a major problem, and cardiac muscle disorders due to DOX limit the number of administration cycles, whereas it usually requires a long time to achieve tumor shrinkage. To resolve these issues, we introduced low-dose D-D therapy to 3 patients employing 50 mg/m² DOX and 600-700 mg/m² DTIC per cycle, which permits repeated administration cycles up to 10-11 times. Case 1 was a 23-year-old female with a sporadic recurrent mesenterium desmoid tumor located in the pelvis (maximum diameter, 8 cm). Cases 2 and 3 were a 33-year-old female and a 36-year-old male. Both patients had intra-abdominal mesenterium desmoid tumors (maximum diameter 9.6 and 9.0 cm, respectively) that were generated after proctocolectomy due to familial adenomatous polyposis. No severe adverse events occurred during the therapy. With the aid of sulindac and tamoxifen after low-dose D-D therapy, the first two patients achieved a complete response, and the third patient achieved a partial response and awaits further tumor shrinkage. Our experience indicates that low-dose DT-D therapy is a safe and effective regimen for patients with intra-abdominal desmoid tumors.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2016-01-01

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

  1. [Evaluation of Intra-abdominal fat distribution using X-ray CT data for detection of rectal cancer].

    PubMed

    Ogura, Toshihiro; Takatsu, Kazuaki; Negishi, Ryoichi; Koizumi, Kouichi; Satou, Masanori; Yanai, Kazuya; Sasaki, Isamu; Fukuda, Kazuya; Nagashima, Hiroyuki; Kouno, Atsushi; Shimomura, Younosuke

    2005-06-20

    To develop a novel method of detecting rectal cancer, we assessed relationships between intra-abdominal fat distribution and rectal cancer in Japanese patients. Subjects comprised 38 patients with rectal cancer apparent on CT-colonography and 110 other cases. The intra-abdominal fat area was determined by calculating pixel distribution with attenuation values from -140 HU to -40 HU. The area of intra-abdominal fat was measured on axial images using an interslice gap of 10 mm. Profile curves of intra-abdominal fat were in the plane direction from diaphragm to anus. Of note is the fact that Ogura's peak, a secondary small peak around the rectal cancer, was apparent on the profile of intra-abdominal fat, with 73.7% of rectal cancers displaying Ogura's peak. In comparison, only 19.1% of other cases displayed Ogura's peak on this profile. The relationship between fat and rectal cancer is difficult to explain. However, making good use of these results showing intra-abdominal fat distribution, a computer-aided diagnosis (CAD) system for detecting rectal cancer according to the presence of Ogura's peak has potential as a method of mass screening. As only 148 cases were investigated in the present study, the accumulation of additional data is needed. More detailed studies with larger patient populations are warranted.

  2. Sporadic Intra-Abdominal Desmoid: A Rare Presentation as a Hepatic Mass

    PubMed Central

    Gupta, Shahana; Ray, Udipta; Chatterjee, Souvik; Kumar, Sanjeev; Satapathy, Ayusman; Chatterjee, Shamita; Choudhury, Tamal Kanti

    2012-01-01

    We report an unusual presentation of a sporadic intra-abdominal desmoid tumour, possibly arising from the diaphragm, masquerading as a hepatic mass in a young female without any history of surgery or trauma. Histopathology ruled out a hepatic origin of the tumour as was inferred from pre- and intraoperative evaluation. Immunohistochemistry showed positivity of lesional fibroblastic cells for β-catenin and negativity for CD34, CD117, EMA, SMA, desmin, vimentin, cytokeratin, and ALK1 thereby confirming the diagnosis of a desmoid tumour. There exist only a few reports in the literature on desmoids related to the diaphragm, but only one on a diaphragmatic desmoid that is possibly primary. PMID:23091764

  3. Spinal epidural abscess presenting as intra-abdominal pathology: a case report and literature review.

    PubMed

    Bremer, Andrew A; Darouiche, Rabih O

    2004-01-01

    Spinal epidural abscess is a rare infectious disease. However, if left unrecognized and untreated, the clinical outcome of spinal epidural abscess can be devastating. Correctly diagnosing a spinal epidural abscess in a timely fashion is often difficult, particularly if the clinician does not actively consider the diagnosis. The most common presenting symptoms of spinal epidural abscess include backache, radicular pain, weakness, and sensory deficits. However, early in its course, spinal epidural abscess can also present with vague and nondescript manifestations. In this report, we describe a case of spinal epidural abscess presenting as abdominal pain, and review the literature describing other cases of spinal epidural abscess presenting as intra-abdominal pathology.

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

    PubMed Central

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

    2016-01-01

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

  5. Incidence and prognosis of intra-abdominal hypertension in critically ill medical patients: a prospective epidemiological study

    PubMed Central

    2012-01-01

    Introduction The aim of this study was to determine the incidence of intra-abdominal hypertension (IAH) in patients with two or more categorized risk factors (CRF) for IAH, and their morbidity and mortality during their intensive care unit (ICU) stay. Methods Prospective cohort study carried out at a medical ICU. A total of 151 medical patients were enrolled during a period of 3 months. After ICU whole staff training, we conducted daily screening of the four CRF for IAH based on the World Society of Abdominal Compartment Syndrome (WSACS) guidelines (namely, diminished abdominal wall compliance, increased intraluminal content, increased abdominal content, and capillary leak syndrome or fluid resuscitation). In those patients with risk factors of at least two different categories (≥2 CRF), intra-abdominal pressure (IAP) was measured every 8 h during ICU stay. Data included demographics, main diagnosis on admission, severity scores, cumulative fluid balance, daily mean IAP, resolution of IAH, days of ICU and hospital stay, and mortality. Results Eighty-seven patients (57.6%) had ≥2 CRF for IAH, 59 (67.8%) out of whom developed IAH. Patients with ≥2 CRF had a significantly higher mortality rate (41.4 vs. 14.3%, p < 0.001). Patients with IAH had higher body mass index, severity scores, organ dysfunctions/failures, number of CRF for IAH, days of ICU/hospital stay and hospital mortality rate (45.8 vs. 32.1%, p = 0.22). Non-resolution of IAH was associated with a higher mortality rate (64.7 vs. 35.3%, p = 0.001). None of the cohort patients developed abdominal compartment syndrome. The multivariate analysis showed that IAH development (odds ratio (OR) 4.09; 95% confidence interval (CI) 0.83-20.12) was a non-independent risk factor for mortality, and its non-resolution (OR 13.15; 95% CI 22.13-81.92) was an independent risk factor for mortality. Conclusions Critically ill medical patients admitted to ICU with ≥2 CRF have high morbidity, mortality rate, and incidence

  6. Expression of Bacteroides fragilis hemolysins in vivo and role of HlyBA in an intra-abdominal infection model.

    PubMed

    Lobo, Leandro A; Jenkins, Audrey L; Jeffrey Smith, C; Rocha, Edson R

    2013-04-01

    Bacteroides fragilis is the most frequent opportunistic pathogen isolated from anaerobic infections. However, there is a paucity of information regarding the genetic and molecular aspects of gene expression of its virulence factors during extra-intestinal infections. A potential virulence factor that has received little attention is the ability of B. fragilis to produce hemolysins. In this study, an implanted perforated table tennis "ping-pong" ball was used as an intra-abdominal artificial abscess model in the rat. This procedure provided sufficient infected exudate for gene expression studies in vivo. Real-time reverse transcription polymerase chain reaction (RT-PCR) was used to quantify the relative expression of hlyA, hlyB, hlyC, hlyD, hlyE, hlyF, hlyG, and hlyIII mRNAs. The hlyA mRNA was induced approximately sixfold after 4 days postinfection compared with the mRNA levels in the inoculum culture prior to infection. The hlyB mRNA increased approximately sixfold after 4 days and 12-fold after 8 days postinfection. Expression of hlyC mRNA increased sixfold after 1 day, 45-fold after 4 days, and 16-fold after 8 days postinfection, respectively. The hlyD and hlyE mRNAs were induced approximately 40-fold and 30-fold, respectively, after 4-days postinfection. The hlyF expression increased approximately threefold after 4-days postinfection. hlyG was induced approximately fivefold after 4 and 8 days postinfection. The hlyIII mRNA levels had a steady increase of approximately four-, eight-, and 12-fold following 1, 4, and 8 days postinfection, respectively. These findings suggest that B. fragilis hemolysins are induced and differentially regulated in vivo. Both parent and hlyBA mutant strains reached levels of approximately 3-8 × 10(9) cfu/mL after 1 day postinfection. However, the hlyBA mutant strain lost 2 logs in viable cell counts compared with the parent strain after 8 days postinfection. This is the first study showing HlyBA is a virulence factor which plays a

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

    PubMed Central

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

    2015-01-01

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

  8. Adrenal gland volume, intra-abdominal and pericardial adipose tissue in major depressive disorder.

    PubMed

    Kahl, Kai G; Schweiger, Ulrich; Pars, Kaweh; Kunikowska, Alicja; Deuschle, Michael; Gutberlet, Marcel; Lichtinghagen, Ralf; Bleich, Stefan; Hüper, Katja; Hartung, Dagmar

    2015-08-01

    Major depressive disorder (MDD) is associated with an increased risk for the development of cardio-metabolic diseases. Increased intra-abdominal (IAT) and pericardial adipose tissue (PAT) have been found in depression, and are discussed as potential mediating factors. IAT and PAT are thought to be the result of a dysregulation of the hypothalamus-pituitary-adrenal axis (HPAA) with subsequent hypercortisolism. Therefore we examined adrenal gland volume as proxy marker for HPAA activation, and IAT and PAT in depressed patients. Twenty-seven depressed patients and 19 comparison subjects were included in this case-control study. Adrenal gland volume, pericardial, intraabdominal and subcutaneous adipose tissue were measured by magnetic resonance imaging. Further parameters included factors of the metabolic syndrome, fasting cortisol, fasting insulin, and proinflammatory cytokines. Adrenal gland and pericardial adipose tissue volumes, serum concentrations of cortisol and insulin, and serum concentrations tumor-necrosis factor-α were increased in depressed patients. Adrenal gland volume was positively correlated with intra-abdominal and pericardial adipose tissue, but not with subcutaneous adipose tissue. Our findings point to the role of HPAA dysregulation and hypercortisolism as potential mediators of IAT and PAT enlargement. Further studies are warranted to examine whether certain subtypes of depression are more prone to cardio-metabolic diseases.

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

    PubMed Central

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

    2014-01-01

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

  10. Piperacillin-tazobactam versus imipenem-cilastatin for treatment of intra-abdominal infections.

    PubMed Central

    Brismar, B; Malmborg, A S; Tunevall, G; Wretlind, B; Bergman, L; Mentzing, L O; Nyström, P O; Kihlström, E; Bäckstrand, B; Skau, T

    1992-01-01

    In order to compare the clinical and microbiological efficacies and safety of piperacillin plus tazobactam with those of imipenem plus cilastatin, 134 patients with intra-abdominal infections (73 patients with appendicitis) participated in an open randomized comparative multicenter trial. A total of 40 men and 29 women (mean age, 53 years; age range, 18 to 92 years) were enrolled in the piperacillin-tazobactam group and 40 men and 25 women (mean age, 54 years; age range, 16 to 91 years) were enrolled in the imipenem-cilastatin group. The patients received either piperacillin (4 g) and tazobactam (500 mg) every 8 h or imipenem and cilastatin (500 mg each) every 8 h. Both regimens were given by intravenous infusion. A total of 113 patients were clinically evaluable. Of 55 patients who received piperacillin-tazobactam, 50 were clinically cured, while 40 of 58 patients in the imipenem-cilastatin group were clinically cured. The differences were significant (Wilcoxon test; P = 0.005). There were 4 failures or relapses in the piperacillin-tazobactam group and 18 failures or relapses in the imipenem-cilastatin group. The microorganisms isolated were eradicated in similar proportions in the two patient groups. Adverse reactions, mainly gastrointestinal disturbances and nausea, were noted in 13 patients who received piperacillin-tazobactam and in 14 patients who received imipenem-cilastatin. Results of the present study show that piperacillin-tazobactam is effective and safe for the treatment of intra-abdominal infections. PMID:1336347

  11. Cytoreductive strategy for multiple intra-abdominal and abdominal wall desmoid tumors in familial adenomatous polyposis: report of three cases.

    PubMed

    Tanaka, Koji; Toiyama, Yuji; Okugawa, Yoshinaga; Hiro, Junichiro; Kawamoto, Aya; Inoue, Yasuhiro; Uchida, Keiichi; Araki, Toshimitsu; Mohri, Yasuhiko; Kusunoki, Masato

    2012-10-01

    Desmoid tumors (DTs) are benign myofibroblastic neoplasms originating from the fascia or muscle aponeurosis, which occur in one-third of patients with familial adenomatous polyposis (FAP). Most FAP-associated DTs occur in the intra-abdominal or abdominal wall region, thus, their infiltrative or expansive growth causes life-threatening organ damage, such as intestinal obstruction, urethral obstruction, and mesenteric infiltration with the involvement of mesenteric vessels. Treatments including surgical resection, cytotoxic chemotherapy, nonsteroidal anti-inflammatory drugs and anti-estrogen therapy have all been tried with variable success. Here, we report on three patients with FAP who developed multiple intra-abdominal and abdominal wall DTs after total proctocolectomy and ileal pouch-anal anastomosis. Two cases underwent surgical resection of uncontrolled abdominal wall DTs after successful control of intra-abdominal DTs by systemic chemotherapy. The remaining case underwent repeated surgical resections of multiple intra-abdominal and abdominal wall DTs, and consequently had recurrent intra-abdominal DTs, with involvement of the small bowel and ureter. Surgical intervention as tumor volume reduction (cytoreduction) may be useful for cases with medical treatment-refractory or symptomatic FAP-associated abdominal DTs.

  12. Segmental arterial mediolysis of varying phases affecting both the intra-abdominal and intracranial vertebral arteries: an autopsy case report.

    PubMed

    Ro, Ayako; Kageyama, Norimasa; Takatsu, Akihiro; Fukunaga, Tatsushige

    2010-01-01

    We report an autopsy case of segmental arterial mediolysis (SAM) of various phases occurring in both the intracranial vertebral artery (IVA) and intra-abdominal arteries. The patient was a 70-year-old male found dead in his house. The cause of death was massive intra-abdominal hemorrhage owing to a ruptured right gastroepiploic artery. Histopathological examination revealed that there was a broad arterial dissection as long as 20 cm in the right gastroepiploic artery associated with SAM in the injurious phase. In addition, SAM in the reparative phase was observed as organized arterial dissections in the left gastric artery. Furthermore, SAM in the reparative phase was detected as an arterial dissection in the right IVA undergoing an organizing process. These three lesions were considered to have developed at different times. SAM occurring in both the intra-abdominal and intracranial vertebral arteries is extremely rare. This coincidence may provide a clue to the relationship between SAM and spontaneous IVA dissection.

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

    PubMed Central

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

    2015-01-01

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

  14. Intra-abdominal 'angiosarcomatosis' report of two cases after pelvic irradiation

    SciTech Connect

    Wolov, R.B.; Sato, N.; Azumi, N.; Lack, E.E. )

    1991-05-01

    Angiosarcomas account for only 1% to 2% of all soft tissue sarcomas with the most common site of origin being skin and subcutaneous tissue particularly on the face and scalp of elderly patients. These neoplasms rarely arise in the small or large bowel with presentation as diffuse abdominal 'angiosarcomatosis.' Two patients are reported who were treated with adjuvant pelvic irradiation for gynecologic malignancies (squamous cell carcinoma of the cervix and adenocarcinoma of the endometrium) in whom diffuse abdominal angiosarcoma of intestinal origin developed 7 and 18 years later. Both patients were treated with standard megavoltage irradiation. The clinical course was rapid in both cases with death due to intra-abdominal hemorrhage and bowel obstruction. The pertinent literature relating to the association between radiation therapy and subsequent development of angiosarcomas of soft tissues and other sites is briefly reviewed.20 references.

  15. Intra-abdominal abscess and intractable sinus - a rare late complication after splenectomy

    PubMed Central

    Shrestha, Badri; Hampton, James

    2017-01-01

    Intra-abdominal abscess and an intractable abdominal wall sinus forty years after splenectomy is rare, which has not been described previously in the surgical literature. We report the management of a patient who had presented with an intractable sinus on his left hypochondrium forty years after having undergone splenectomy and cholecystectomy, which persisted for more than two years despite repeated surgery and courses of antibiotics and compromised quality of life significantly from pain. A sinogram and computerised tomographic scan followed by exploration and laying open of the sinus delivered multiple silk sutures used for ligation of splenic pedicle, led to complete resolution of the sinus. It is important to avoid using non-absorbable silk sutures during splenectomy when splenectomy is undertaken in a contaminated field. Appropriate imaging and exploration is mandatory for its resolution. PMID:28138442

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

    PubMed Central

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

    2013-01-01

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

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

    USGS Publications Warehouse

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

    1996-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  19. Is intra-abdominal hypertension a missing factor that drives multiple organ dysfunction syndrome?

    PubMed

    Kirkpatrick, Andrew W; Roberts, Derek J; De Waele, Jan; Laupland, Kevin

    2014-03-19

    In a recent issue of Critical Care, Cheng and colleagues conducted a rabbit model study that demonstrated that intra-abdominal hypertension (IAH) may damage both gut anatomy and function. With only 6 hours of IAH at 25 mmHg, these authors observed an 80% reduction in mucosal blood flow, an exponential increase in mucosal permeability, and erosion and necrosis of the jejunal villi. Such dramatic findings should remind all caring for the critically ill that IAH may severely damage the normal gut barrier functions and thus may be reasonably expected to facilitate bacterial and mediator translocation. The potential contribution of IAH as a confounding factor in the efficacy of selective decontamination of the digestive tract should be considered.

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

    PubMed

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

    2016-01-01

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

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

    PubMed Central

    Liu, Dong; Li, Yang; Zhang, Lianyang

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

    Introduction The Streptococcus anginosus group of bacteria are low-virulence bacteria existing as commensals in the oral flora and gastrointestinal tracts of humans. S. anginosus may spread to the blood in individuals with poor oral hygiene in cases of oral infections, such as gingivitis and tooth abscesses, that develop following the loss of mucosal unity. This may lead to infections in the whole body, primarily as brain and liver abscesses. Case Presentation A 32-year-old male patient presented with complaints of nausea, vomiting, and diffuse abdominal pain. Diffuse abdominal tenderness and rebound tenderness were detected particularly in the epigastrium and right upper quadrant. Laboratory assessment revealed a leukocyte count of 20,500/mm3. Free fluid around the liver and heterogeneous areas of abscess formation in the right lateral gallbladder were revealed on abdominal computed tomography. Diffuse adhesions between the bowel and seropurulent free liquid in the abdomen were detected on surgical exploration, and a sample was taken for cultures. The patient was discharged without complications on the sixth postoperative day and his antibiotic course was completed with 4 weeks of oral treatment. We reviewed the literature for similar cases of disseminated pyogenic infections caused by the S. anginosus group. Conclusions It should be kept in mind that the oral flora bacterium S. anginosus may cause transient bacteremia and deep-seated organ abscesses in immunodeficient patients with poor oral hygiene. Such patients with intra-abdominal abscesses should be treated with antibiotics and surgery. PMID:27630763

  3. Intra-Abdominal Hypertension Causes Bacterial Growth in Lungs: An Animal Study

    PubMed Central

    Papakrivou, Eleni; Manoulakas, Efstratios; Mitroudi, Magda; Tepetes, Konstantinos; Papazoglou, Konstantinos; Zakynthinos, Epaminondas

    2017-01-01

    To study the effect of intra-abdominal hypertension (IAH) on the frequency of pneumonia with an experimental study, thirteen Sprague-Dawley rats were included. Eight out of thirteen animals were randomly assigned to receive 10 ml of benzalkonium chloride 0.2% (megacolon group) and five animals received 10 ml NaCl 0.9% (controls). Animals were anaesthetized by intramuscular delivery of ketamine. The incidence of positivity for bacteria lung tissue cultures and mesenteric lymph node cultures was assessed at the 21st day after animals' sacrification, or before in case of death. All megacolon group animals presented progressive increase of the abdomen and increased IAP (≥10 mmHg) whereas the frequency of their evacuations was almost eliminated. Controls presented normal evacuations, no sign of abdominal distention, and normal IAP. In megacolon group animals, there was evidence of significant amount of bacteria in lung cultures. In contrast, no bacteria were found in control animals. PMID:28357400

  4. IMAGING DIAGNOSIS - ECTOPIC SPLEEN MIMICKING HEPATIC TUMOR WITH INTRA-ABDOMINAL METASTASES INVESTIGATED VIA TRIPLE-PHASE HELICAL COMPUTED TOMOGRAPHY IN A DOG.

    PubMed

    Kutara, Kenji; Konno, Toshiaki; Kondo, Hirotaka; Aoki, Kotoyo; Yamazoe, Hinako; Matsunaga, Satoru

    2016-07-05

    A 10-year-old castrated male miniature dachshund was presented with an abdominal mass. The dog had a history of splenectomy. Triple-phase helical computed tomography was utilized, revealing a hepatic mass and multiple intra-abdominal solid masses. In triple-phase helical computed tomography the images, hepatic mass and two of four intra-abdominal masses were heterogenous in all phases. Therefore, we diagnosed a malignant hepatic tumor and presumed intra-abdominal metastases. The masses were surgically removed and were histologically composed of normal spleen tissues, findings which were consistent with ectopic spleen.

  5. Ceftazidime-avibactam for the treatment of complicated urinary tract infections and complicated intra-abdominal infections.

    PubMed

    Mawal, Yogesh; Critchley, Ian A; Riccobene, Todd A; Talley, Angela K

    2015-01-01

    Treatment of complicated urinary tract infections and complicated intra-abdominal infections is increasingly difficult due to the rising prevalence of multidrug-resistant Gram-negative bacteria. Ceftazidime-avibactam is a combination of the established third-generation cephalosporin ceftazidime with avibactam, a novel non-β-lactam β-lactamase inhibitor, which restores the activity of ceftazidime against many β-lactamase-producing Gram-negative bacteria, including extended-spectrum β-lactamases and Klebsiella pneumoniae carbapenemases. Clinical and nonclinical studies supporting the safety and efficacy of ceftazidime-avibactam include microbiological surveillance studies of clinically relevant pathogens, in vivo animal models of infection, pharmacokinetic/pharmacodynamic target attainment analyses, Phase I clinical pharmacology studies, and Phase II/III studies in the treatment of complicated intra-abdominal infections and complicated urinary tract infections, including patients with ceftazidime-nonsusceptible Gram-negative infections.

  6. [Intra-abdominal pressure as a surgery predictor in patients with acute abdominal pain].

    PubMed

    Campos-Muñoz, Manuel Alejandro; Villarreal-Ríos, Enrique; Chimal-Torres, Mariano; Pozas-Medina, Josué Atila

    2016-01-01

    Introducción: la presión intraabdominal es el estado de equilibrio de la presión de la cavidad abdominal en reposo y puede presentar cambios durante la ventilación mecánica o espontánea. El objetivo fue determinar la presión intraabdominal como predictor de cirugía en el paciente con dolor abdominal agudo. Métodos: se llevó a cabo un estudio de casos y controles anidado en una cohorte de pacientes con dolor abdominal agudo en el servicio de urgencias de un hospital de segundo nivel, en el periodo comprendido entre abril y diciembre de 2013. Se incluyeron 37 pacientes, todos fueron intervenidos quirúrgicamente con previa toma de la presión intraabdominal. Se formaron los grupos con el resultado del estudio anatomopatológico: con evidencia de proceso inflamatorio abdominal agudo (n = 28) y sin evidencia de proceso inflamatorio abdominal agudo (n = 9). Resultados: en los casos el 100 % presentó presión intraabdominal alta con una p = 0.01, RM: 5 (IC 95 %: 2.578-9.699). En los casos la media de la presión intraabdominal fue de 11.46 y en los controles de 9.2 (p = 0.183). Conclusiones: el dolor abdominal que requiere cirugía para su resolución tiene relación directa con una presión intraabdominal > 5 mmHg.

  7. Ceftolozane/Tazobactam: A Review in Complicated Intra-Abdominal and Urinary Tract Infections.

    PubMed

    Scott, Lesley J

    2016-02-01

    Globally, the increasing prevalence of multidrug-resistant pathogens continues to pose major problems in healthcare systems and, at least in part, is driving an initiative to develop new antibacterials, such as ceftolozane (a cephalosporin β-lactam). Adding a β-lactamase inhibitor (e.g. tazobactam) to a β-lactam extends its spectrum of activity against β-lactamase-producing microorganisms (a key mechanism of resistance to β-lactams). Ceftolozane/tazobactam (Zerbaxa™), a β-lactam/β-lactamase inhibitor combination, is indicated for the treatment of adults with complicated intra-abdominal infections (cIAI) or complicated urinary tract infections (cUTI), including pyelonephritis. In multinational, phase 3 noninferiority trials, intravenous ceftolozane/tazobactam was an effective and generally well tolerated treatment in patients with cIAI or cUTI. In the ASPECT-cIAI trial, ceftolozane/tazobactam plus metronidazole was noninferior to meropenem in terms of clinical cure rates at the test-of-cure (TOC) visit, with clinical cure rates in subgroup analyses consistent with those in the primary analysis. In the ASPECT-cUTI trial, ceftolozane/tazobactam was superior to levofloxacin in terms of composite cure rates (clinical cure plus microbiological eradiation) at the TOC visit. Further clinical experience should help to more definitively position ceftolozane/tazobactam in the treatment of cIAI and cUTI, including in patients with renal impairment. In the meantime, given its very good in vitro activity against extended-spectrum β-lactamase-producing Enterobacteriaceae and drug-resistant Pseudomonas aeruginosa isolates, ceftolozane/tazobactam provides a potential alternative to currently approved antibacterials for empirical treatment of cIAI and cUTI in adults.

  8. Intra-abdominal Infections: The Role of Anaerobes, Enterococci, Fungi, and Multidrug-Resistant Organisms

    PubMed Central

    Marcus, Gil; Levy, Samuel; Salhab, Ghaleb; Mengesha, Bethlehem; Tzuman, Oran; Shur, Shira; Burke, Erica; Mayeda, Rebecca Cruz; Cochavi, Lior; Perluk, Idan; Zaidenstein, Ronit; Lazarovitch, Tsilia; Dadon, Mor

    2016-01-01

    Background. Intra-abdominal infections (IAI) constitute a common reason for hospitalization. However, there is lack of standardization in empiric management of (1) anaerobes, (2) enterococci, (3) fungi, and (4) multidrug-resistant organisms (MDRO). The recommendation is to institute empiric coverage for some of these organisms in “high-risk community-acquired” or in “healthcare-associated” infections (HCAI), but exact definitions are not provided. Methods. Epidemiological study of IAI was conducted at Assaf Harofeh Medical Center (May–November 2013). Logistic and Cox regressions were used to analyze predictors and outcomes of IAI, respectively. The performances of established HCAI definitions to predict MDRO-IAI upon admission were calculated by receiver operating characteristic (ROC) curve analyses. Results. After reviewing 8219 discharge notes, 253 consecutive patients were enrolled (43 [17%] children). There were 116 patients with appendicitis, 93 biliary infections, and 17 with diverticulitis. Cultures were obtained from 88 patients (35%), and 44 of them (50%) yielded a microbiologically confirmed IAI: 9% fungal, 11% enterococcal, 25% anaerobic, and 34% MDRO. Eighty percent of MDRO-IAIs were present upon admission, but the area under the ROC curve of predicting MDRO-IAI upon admission by the commonly used HCAI definitions were low (0.73 and 0.69). Independent predictors for MDRO-IAI were advanced age and active malignancy. Conclusions. Multidrug-resistant organism-IAIs are common, and empiric broad-spectrum coverage is important among elderly patients with active malignancy, even if the infection onset was outside the hospital setting, regardless of current HCAI definitions. Outcomes analyses suggest that empiric regimens should routinely contain antianaerobes (except for biliary IAI); however, empiric antienterococcal or antifungals regimens are seldom needed. PMID:28018930

  9. Decreased Risk of Ventilator-Associated Pneumonia in Sepsis Due to Intra-Abdominal Infection

    PubMed Central

    Philippart, François; Bouroche, Gaëlle; Timsit, Jean-François; Garrouste-Orgeas, Maité; Azoulay, Elie; Darmon, Michael; Adrie, Christophe; Allaouchiche, Bernard; Ara-Somohano, Claire; Ruckly, Stéphane; Dumenil, Anne-Sylvie; Souweine, Bertrand; Goldgran-Toledano, Dany; Bouadma, Lila; Misset, Benoît

    2015-01-01

    Rationale Experimental studies suggest that intra-abdominal infection (IAI) induces biological alterations that may affect the risk of lung infection. Objectives To investigate the potential effect of IAI at ICU admission on the subsequent occurrence of ventilator-associated pneumonia (VAP). Methods We used data entered into the French prospective multicenter Outcomerea database in 1997–2011. Consecutive patients who had severe sepsis and/or septic shock at ICU admission and required mechanical ventilation for more than 3 days were included. Patients with acute pancreatitis were not included. Measurements and Main Results Of 2623 database patients meeting the inclusion criteria, 290 (11.1%) had IAI and 2333 (88.9%) had other infections. The IAI group had fewer patients with VAP (56 [19.3%] vs. 806 [34.5%], P<0.01) and longer time to VAP (5.0 vs.10.5 days; P<0.01). After adjustment on independent risk factors for VAP and previous antimicrobial use, IAI was associated with a decreased risk of VAP (hazard ratio, 0.62; 95% confidence interval, 0.46–0.83; P<0.0017). The pathogens responsible for VAP were not different between the groups with and without IAI (Pseudomonas aeruginosa, 345 [42.8%] and 24 [42.8%]; Enterobacteriaceae, 264 [32.8%] and 19 [34.0%]; and Staphylococcus aureus, 215 [26.7%] and 17 [30.4%], respectively). Crude ICU mortality was not different between the groups with and without IAI (81 [27.9%] and 747 [32.0%], P = 0.16). Conclusions In our observational study of mechanically ventilated ICU patients with severe sepsis and/or septic shock, VAP occurred less often and later in the group with IAIs compared to the group with infections at other sites. PMID:26339904

  10. Ceftolozane/tazobactam and ceftazidime/avibactam for the treatment of complicated intra-abdominal infections

    PubMed Central

    Goodlet, Kellie J; Nicolau, David P; Nailor, Michael D

    2016-01-01

    Complicated intra-abdominal infections (cIAI) represent a large proportion of all hospital admissions and are a major cause of morbidity and mortality in the intensive care unit. Rising rates of multidrug resistant organisms (MDRO), including extended-spectrum β-lactamase producing Enterobacteriaceae and carbapenem-nonsusceptible Pseudomonas spp., for which there are few remaining active antimicrobial agents, pose an increased challenge to clinicians. Patients with frequent exposures to the health care system or multiple recurrent IAIs are at increased risk for MDRO; however, treatment options have traditionally been limited, in some cases necessitating the utilization of last-line agents with unfavorable side-effect profiles. Ceftolozane/tazobactam and ceftazidime/avibactam are two new cephalosporin and β-lactamase inhibitor combinations with recent US Food and Drug Administration approvals for the treatment of cIAI in combination with metronidazole. Ceftolozane/tazobactam has demonstrated excellent in vitro activity against MDR and extensively drug-resistant Pseudomonas spp., including carbapenem-nonsusceptible strains, while ceftazidime/avibactam effectively inhibits a broad range of β-lactamases, making it an excellent option for the treatment of carbapenem-resistant Enterobacteriaceae. Both agents were shown to be noninferior to meropenem for treatment of cIAI in Phase III trials; however, reduced responses in patients with renal impairment at baseline highlight the importance of routine serum creatinine monitoring and ongoing dose adjustments. This review highlights in vitro and in vivo data of these two agents and suggests their proper place in cIAI treatment to ensure adequate therapy in our most at-risk patients while sparing unnecessary use in patients without MDRO risk factors. PMID:27942218

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

    PubMed Central

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

    2016-01-01

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

  12. Radiological features of primitive neuroectodermal tumors in intra-abdominal and retroperitoneal regions: A series of 18 cases

    PubMed Central

    Zhang, Youming; Xiao, Desheng; Yin, Hongling; Long, Xueying; Li, Li; Zai, Hongyan; Chen, Minfeng; Li, Wenzheng; Sun, Lunquan

    2017-01-01

    Objectives To characterize the imaging and clinicopathological features of primitive neuroectodermal tumors (PNETs) arising in intra-abdominal and retroperitoneal regions. Methods Eighteen patients with histopathologically proven intra-abdominal and retroperitoneal PNET were enrolled; computed tomography was performed for all cases, and magnetic resonance imaging was performed for a single case. Typical computed tomography and magnetic resonance imaging findings, including morphology, texture and enhancement features, as well as clinicopathological characteristics and prognosis data were retrospectively analyzed. Results Of eighteen PNET patients, fifteen were male and three were female, with a median age of 36 years (range, 2–65 years). The onset of symptoms was most often nonspecific and insidious. The mean tumor diameter was 7.2 cm (range, 3.0–12.1 cm), with necrosis in fifteen cases, cystic changes in eight, partition structure in five, calcification in five, hemorrhage in two, and mural nodules in one. Contrast enhanced computed tomography showed multiple tiny feeding arteries within the masses in six cases, resulting in a crab-like appearance, and mild ring enhancement pattern in five cases. Eleven cases showed surrounding invasion and metastasis. Of the eighteen PNET cases, nine cases showed smooth, well-defined margins, and nine cases had irregular, ill-defined margins. A median survival was 10.0±1.6 months. However, chemotherapy had efficacy on patients even those with advanced disease. Conclusions Primary intra-abdominal and retroperitoneal PNETs are rare, and imaging features documented here may help the diagnosis of this severe disease. Notably, two signs present in retroperitoneal PNET tumors, including a mild ring enhancement pattern and a crab-like appearance of the tiny feeding arteries, may have the potential to help us improve the ability to make a relatively reliable diagnosis. PMID:28319177

  13. Spectrally selective UV bactericidal effect for curative treatment of post-surgical intra-abdominal abscesses and other infections

    NASA Astrophysics Data System (ADS)

    Dudelzak, Alexander E.; Miller, Mark A.; Babichenko, Sergey M.

    2004-07-01

    Results of in-vitro studies of bactericidal effects of ultraviolet (UV) irradiation on strains causing drug-resistant endo-cavital infections (Enterococcus, Staphylococcus aureus, Pseudomonas aeruginosa, and others) are presented. An original technique to measure effects of UV-irradiation on bacterial growth at different wavelengths has been developed. Spectral dependences of the bactericidal effect have been observed, and spectral maxima of bactericidal efficiency have been found. Applications to curative treatments of wounds, post-surgical intra-abdominal abscesses and other diseases are discussed.

  14. The Cause of Unexpected Acute Abdomen and Intra-Abdominal Hemorrhage in 24-Week Pregnant Woman: Bochdalek Hernia

    PubMed Central

    Barut, Ibrahim; Yazkan, Rasih

    2016-01-01

    Bochdalek hernia (BH) is the most common type of congenital diaphragm hernia and is rarely seen in adults. In adult patients, BH often remains asymptomatic or presents with nondiagnostic symptoms and may lead to complications, though rarely. The necrosis and perforations occurring in the hernia may lead to mortality. In this report, we present a 34-year-old pregnant woman at 24 gestational weeks who presented with Bochdalek hernia causing gastric volvulus associated with perforation and intra-abdominal hemorrhage associated with splenic rupture. PMID:28018700

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

    PubMed

    Chen, Jingjing; Wu, Zengjie; Sun, Binbin; Li, Dacheng; Wang, Zhenguang; Liu, Fangjun; Hua, Hui

    2016-05-01

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

  16. Severe retroperitoneal and intra-abdominal bleeding after stapling procedure for prolapsed haemorrhoids (PPH); diagnosis, treatment and 6-year follow-up of the case.

    PubMed

    Safadi, Wajdi; Altshuler, Alexander; Kiv, Sakal; Waksman, Igor

    2014-10-30

    Procedure for prolapsed haemorrhoids (PPH) is a popular treatment of haemorrhoids. PPH has the advantages of a shorter operation time, minor degree of postoperative pain, shorter hospital stay and quicker recovery but may be followed by several postoperative complications. Rectal bleeding, acute pain, chronic pain, rectovaginal fistula, complete rectal obliteration, rectal stenosis, rectal pocket, tenesmus, faecal urgency, faecal incontinence, rectal perforation, pelvic sepsis and rectal haematoma have all been reported as postoperative complications of PPH. Additionally, one rare complication of the procedure is intra-abdominal bleeding. There are a few case reports describing intra-abdominal bleeding after the procedure. We report a case of a 26-year-old man who developed severe intra-abdominal and retroperitoneal haemorrhage after PPH. The diagnosis was made on the second postoperative day by CT of the abdomen and pelvis. The patient was treated conservatively and had an uneventful recovery.

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

    PubMed Central

    Muniyappa, Bharathi

    2015-01-01

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

  18. Endoscopic Ultrasound-Guided Drainage of Intra-Abdominal Abscess after Gastric Perforation in a Patient Receiving Ramucirumab and Paclitaxel for Advanced Gastric Cancer.

    PubMed

    Mandai, Koichiro; Shirakawa, Atsushi; Uno, Koji; Yasuda, Kenjiro

    2017-01-01

    Gastrointestinal perforation is a serious adverse event that occurs in approximately 1% of patients receiving ramucirumab and paclitaxel. A 67-year-old man with unresectable advanced gastric cancer was admitted to our hospital and treated with ramucirumab and paclitaxel. Gastric perforation occurred during the second cycle of chemotherapy. Although the patient's condition improved without surgery, an abscess developed in the intra-abdominal fluid collection resulting from the perforation. We performed endoscopic ultrasound-guided abscess drainage. The patient improved and was discharged in satisfactory condition. Endoscopic ultrasound-guided drainage is a treatment option for patients with intra-abdominal abscess following gastric perforation due to ramucirumab.

  19. Endoscopic Ultrasound-Guided Drainage of Intra-Abdominal Abscess after Gastric Perforation in a Patient Receiving Ramucirumab and Paclitaxel for Advanced Gastric Cancer

    PubMed Central

    Mandai, Koichiro; Shirakawa, Atsushi; Uno, Koji; Yasuda, Kenjiro

    2017-01-01

    Gastrointestinal perforation is a serious adverse event that occurs in approximately 1% of patients receiving ramucirumab and paclitaxel. A 67-year-old man with unresectable advanced gastric cancer was admitted to our hospital and treated with ramucirumab and paclitaxel. Gastric perforation occurred during the second cycle of chemotherapy. Although the patient's condition improved without surgery, an abscess developed in the intra-abdominal fluid collection resulting from the perforation. We performed endoscopic ultrasound-guided abscess drainage. The patient improved and was discharged in satisfactory condition. Endoscopic ultrasound-guided drainage is a treatment option for patients with intra-abdominal abscess following gastric perforation due to ramucirumab. PMID:28203161

  20. New drugs for the treatment of complicated intra-abdominal infections in the era of increasing antimicrobial resistance.

    PubMed

    Syue, Ling-Shan; Chen, Yen-Hsu; Ko, Wen-Chien; Hsueh, Po-Ren

    2016-04-01

    The continuing increase in multidrug-resistant organisms (MDROs) worldwide has created new challenges in treating complicated intra-abdominal infections (cIAIs). A number of novel antimicrobial agents have been developed against resistant pathogens. To target extended-spectrum β-lactamase (ESBL)-producing pathogens, novel β-lactam antibiotics, such as ceftolozane/tazobactam, ceftazidime/avibactam, aztreonam/avibactam, imipenem/relebactam and S-649266, are antimicrobial alternatives for cIAIs. Two new drugs, eravacycline and plazomicin, have activity against Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae, carbapenem-resistant Acinetobacter baumannii and ESBL-producers. New lipoglycopeptides and oxazolidinones provide feasible options against resistant Gram-positive pathogens. These novel antimicrobials may play a role in improving the clinical outcomes of cIAIs caused by MDROs.

  1. Prospective observational study of the frequency and features of intra-abdominal abscesses in patients with melioidosis in northeast Thailand.

    PubMed

    Maude, Rapeephan R; Vatcharapreechasakul, Teerapon; Ariyaprasert, Pitchayanant; Maude, Richard J; Hongsuwan, Maliwan; Yuentrakul, Prayoon; Limmathurotsakul, Direk; Koh, Gavin C K W; Chaowagul, Wipada; Day, Nicholas P J; Peacock, Sharon J

    2012-10-01

    Retrospective case series from Thailand have reported the presence of intra-abdominal abscesses in around half of patients with melioidosis, a much higher rate than our clinical experience would suggest. We performed a prospective, observational study of 230 adult patients with culture-confirmed melioidosis in which all patients underwent abdominal ultrasound. One or more abscesses were detected in the liver and/or spleen in 77 (33%) cases. These were often multiple (70%, 31/44 in hepatic abscesses and 88%, 50/57 in splenic abscesses) and clinically silent (27% of cases with abscesses presenting with abdominal pain). The mortality rate at 4 weeks post-discharge was lower in patients who were abscess-positive vs abscess-negative (10%, 8/77 vs 20%, 31/153).

  2. Unexpected natural death secondary to intra-abdominal bleeding: report of one idiopathic spontaneous intraperitoneal hemorrhage case.

    PubMed

    Dedouit, Fabrice; Piercecchi-Marti, Marie-Dominique; Leonetti, Georges; Rougé, Daniel; Telmon, Norbert

    2012-01-10

    A 39-year-old woman was found dead at home. She was single, foreign national, chronic alcoholic, and had given shelter to a compatriot for three days. This man found the deceased in her bed, after a night of heavy drinking. The emergency medical team observed numerous recent blue ecchymoses of the upper limbs. Because of the unclear circumstances, a medicolegal autopsy was ordered by the public prosecutor. Massive hemoperitoneum was diagnosed with no visible internal traumatic injury. Autopsy revealed hepatic and pancreatic abnormalities secondary to chronic alcoholism, which were confirmed by pathological study. The source of the hemoperitoneum was not identified despite careful visceral and vascular examination. The authors concluded that death was secondary to idiopathic spontaneous hemoperitoneum or abdominal apoplexy. The forensic literature on unexpected death due to massive nontraumatic intra-abdominal hemorrhage in association with liver cirrhosis is sparse, with only five cases reported, including the present case.

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

    PubMed Central

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

    2011-01-01

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

  4. [Influence of mydocalm on the degree of intra-abdominal hypertension and local blood circulation in the intestinal wall in experiment].

    PubMed

    Sapegin, V I; Sapegin, I D; Il'chenko, F N

    2014-01-01

    The effect of mydocalm (tolperison, 5 mg/kg single dose) on the dynamics of intra-abdominal hypertension (IAH), blood circulation regulation, and oxygen balance in the tissues of intestinal wall were studied in acute experiments on rabbits. Using a special stand of original design, the initial IAH level was modeled at 200 mm H2O with the subsequent stopping of further receipt of liquid during 3 hours in an elastic container in the abdominal cavity. During 3-h observation without drug administration, no changes in IAH due to the tone of muscles of the frontal abdominal wall takes place, but there is progressive deceleration of local blood flow (-35.33 + 0.99%, p < 0.01), suppressed dilation (-20.02 + 0.54%, p < 0.01) and constriction (-60.45 + 1.17%, p < 0.01) reactivity of vessels, and decreased oxygen tension (-47.18 + 0.75%, p < 0.01) in the intestinal wall at the end of experiment. The introduction of mydocalm reduces the tone of muscles of the frontal abdominal wall, which leads to a decrease in IAH (maximum effect after 1.5 hours, -20.81 + 0.84%, p < 0.01) and prevents decrease in the local blood flow (-26.77 + 0.41%, p < 0.01), suppression of dilation (-16.51 + 0.34%, p < 0.01) and constriction (-37.85 + 0.61%, p < 0.01) reactivity of vessels, and reduction in oxygen tension (-36.60 + 1.18%, p < 0.01) at the end of experiment. The administration of mydocalm can extend the limits of application of a conservative therapy for patients with IAH and to improve the results.

  5. Acute abdomen as a consequence of an unusual suicide attempt: intra-abdominal injection of sulfuric acid

    PubMed Central

    Lepore, Anna; D’Antini, Davide; Raimondo, Pasquale; Mirabella, Lucia; Pennisi, Leonardo; Carrillo, Giuseppe; Cotoia, Antonella; Dambrosio, Michele; Cinnella, Gilda

    2016-01-01

    Caustic ingestion is a common cause of life-threatening upper gastrointestinal tract injuries. It mostly happens in children as accidental exposure, but may occur in adults as a result of suicide attempt. We present a case of an acute abdomen that occurred after a peculiar way of self-administration of sulfuric acid as a suicide attempt in an adult psychiatric male patient, already known for self-harm with caustic agents in the previous years. In a few hours, the patient developed diffuse peritonitis, pneumoperitoneum, and a rapid hemodynamic deterioration, as a consequence of ileum and sigmoid necrosis, requiring an emergency surgery with the application of a damage control strategy. The patient was then transferred to intensive care unit for hemodynamic stabilization, and definitive surgical correction of the abdominal lesions was performed after 3 days with Hartmann procedure. Thirty-nine days after hospital admission, the patient was discharged. In conclusion, to our knowledge, never has been reported in the literature a case of intra-abdominal self-administration of caustic substance causing a rapid evolution of clinical conditions and requiring the application of damage control strategy. PMID:27853393

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

    PubMed

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

    2016-03-01

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

  7. T helper type 2-polarized invariant natural killer T cells reduce disease severity in acute intra-abdominal sepsis.

    PubMed

    Anantha, R V; Mazzuca, D M; Xu, S X; Porcelli, S A; Fraser, D D; Martin, C M; Welch, I; Mele, T; Haeryfar, S M M; McCormick, J K

    2014-11-01

    Sepsis is characterized by a severe systemic inflammatory response to infection that is associated with high morbidity and mortality despite optimal care. Invariant natural killer T (iNK T) cells are potent regulatory lymphocytes that can produce pro- and/or anti-inflammatory cytokines, thus shaping the course and nature of immune responses; however, little is known about their role in sepsis. We demonstrate here that patients with sepsis/severe sepsis have significantly elevated proportions of iNK T cells in their peripheral blood (as a percentage of their circulating T cells) compared to non-septic patients. We therefore investigated the role of iNK T cells in a mouse model of intra-abdominal sepsis (IAS). Our data show that iNK T cells are pathogenic in IAS, and that T helper type 2 (Th2) polarization of iNK T cells using the synthetic glycolipid OCH significantly reduces mortality from IAS. This reduction in mortality is associated with the systemic elevation of the anti-inflammatory cytokine interleukin (IL)-13 and reduction of several proinflammatory cytokines within the spleen, notably interleukin (IL)-17. Finally, we show that treatment of sepsis with OCH in mice is accompanied by significantly reduced apoptosis of splenic T and B lymphocytes and macrophages, but not natural killer cells. We propose that modulation of iNK T cell responses towards a Th2 phenotype may be an effective therapeutic strategy in early sepsis.

  8. Intra-Abdominal Complications after Curative Gastrectomies Worsen Prognoses of Patients with Stage II–III Gastric Cancer

    PubMed Central

    A.T.M. Abdul, Kader; Murakami, Yuki; Yoshimoto, Miwa; Onishi, Kazunari; Kuroda, Hirohiko; Matsunaga, Tomoyuki; Fukumoto, Yoji; Takano, Shuichi; Tokuyasu, Naruo; Osaki, Tomohiro; Saito, Hiroaki; Ikeguchi, Masahide

    2016-01-01

    Background Postoperative complications have been shown to worsen prognoses of various cancer types. Methods We retrospectively analyzed 265 patients with stage II-III gastric cancer who underwent curative gastrectomies between 1991 and 2010 at Tottori University Hospital to determine the effect of postoperative intra-abdominal complication (IAC) on prognosis. Results Of the 265 patients, 38 (14.3%) developed postoperative IACs of grade ≥ 2, of whom significantly more patients were male. Patients in the IAC group were significantly older than patients in the non-complication (NC) group. The NC group had significantly better survival than did the IAC group (P < 0.0001). Within the IAC group, 5-year survival rates did not significantly differ between patients with infectious complication subgroup (24.6%) and the non-infectious subgroup (46.2%). Grade of complication was not related to prognosis. Lengths of time before starting adjuvant chemotherapy (AC) after surgery were significantly longer for the IAC group (55.3 ± 34.7 days) than for the NC group: (26.6 ± 11.9 days; P = 0.0023). Prognosis of patients who took AC within 6 weeks after surgery tended to be better than that of patients who took AC > 6 weeks after surgery (P = 0.071). In multivariate analysis, IAC was an independent predictor of prognosis, as were age, invasion depth, and lymph node metastasis. Conclusion Postoperative IACs were related to poorer survival for patients with stage II–III gastric cancer. PMID:27708536

  9. Level indicator for pressure vessels

    DOEpatents

    Not Available

    1982-04-28

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

  10. Patterns of intra-abdominal relapse (IAR) in patients with Wilms' tumor who received radiation: analysis by histopathology. A report of National Wilms' tumor studies 1 and 2 (NWTS-1 and 2)

    SciTech Connect

    Tefft, M.; D'Angio, G.J.; Beckwith, B.; Farewell, V.; Meyer, J.A.

    1980-06-01

    336 non-metastatic patients who received radiation in national Wilms' Tumor Study-1 and 2 have been reviewed. Follow-up was minimum of two years. 15/273 (6%) of the favorable history patients had intra-abdominal relapse as compared to 8/44 unfavorable histology (18%) (P = 0.003). Developing intra-abdominal relapse does not seem related to low radiation therapy doses or small volumes. However, a delay of greater than ten days to start radiation therapy from nephrectomy was related to the occurrence of intra-abdominal relapse in unfavorable histology patients (P < 0.001).

  11. Phase 2, Dose-Ranging Study of Relebactam with Imipenem-Cilastatin in Subjects with Complicated Intra-abdominal Infection

    PubMed Central

    Lucasti, Christopher; Vasile, Liviu; Sandesc, Dorel; Venskutonis, Donatas; McLeroth, Patrick; Lala, Mallika; Rizk, Matthew L.; Brown, Michelle L.; Losada, Maria C.; Pedley, Alison; Kartsonis, Nicholas A.

    2016-01-01

    Relebactam (REL [MK-7655]) is a novel class A/C β-lactamase inhibitor intended for use with imipenem for the treatment of Gram-negative bacterial infections. REL restores imipenem activity against some resistant strains of Klebsiella and Pseudomonas. In this multicenter, double-blind, controlled trial (NCT01506271), subjects who were ≥18 years of age with complicated intra-abdominal infection were randomly assigned (1:1:1) to receive 250 mg REL, 125 mg REL, or placebo, each given intravenously (i.v.) with 500 mg imipenem-cilastatin (IMI) every 6 h (q6h) for 4 to 14 days. The primary efficacy endpoint was the proportion of microbiologically evaluable (ME) subjects with a favorable clinical response at discontinuation of i.v. therapy (DCIV). A total of 351 subjects were randomized, 347 (99%) were treated, and 255 (73%) were ME at DCIV (55% male; mean age, 49 years). The most common diagnoses were complicated appendicitis (53%) and complicated cholecystitis (17%). Thirty-six subjects (13%) had imipenem-resistant Gram-negative infections at baseline. Both REL doses plus IMI were generally well tolerated and demonstrated safety profiles similar to that of IMI alone. Clinical response rates at DCIV were similar in subjects who received 250 mg REL plus IMI (96.3%) or 125 mg REL plus IMI (98.8%), and both were noninferior to IMI alone (95.2%; one-sided P < 0.001). The treatment groups were also similar with respect to clinical response at early and late follow-up and microbiological response at all visits. Pharmacokinetic/pharmacodynamic simulations show that imipenem exposure at the proposed dose of 500 mg IMI with 250 mg REL q6h provides coverage of >90% of carbapenem-resistant bacterial strains. PMID:27503659

  12. Reliability of continuous cardiac output measurement during intra-abdominal hypertension relies on repeated calibrations: an experimental animal study

    PubMed Central

    Gruenewald, Matthias; Renner, Jochen; Meybohm, Patrick; Höcker, Jan; Scholz, Jens; Bein, Berthold

    2008-01-01

    Introduction Monitoring cardiac output (CO) may allow early detection of haemodynamic instability, aiming to reduce morbidity and mortality in critically ill patients. Continuous cardiac output (CCO) monitoring is recommended in septic or postoperative patients with high incidences of intra-abdominal hypertension (IAH). The aim of the present study was to compare the agreement between three CCO methods and a bolus thermodilution CO technique during acute IAH and volume loading. Methods Ten pigs were anaesthetised and instrumented for haemodynamic measurements. Cardiac output was obtained using CCO by pulse power analysis (PulseCO; LiDCO monitor), using CCO by pulse contour analysis (PCCO; PiCCO monitor) and using CCO by pulmonary artery catheter thermodilution (CCOPAC), and was compared with bolus transcardiopulmonary thermodilution CO (COTCP) at baseline, after fluid loading, at IAH and after an additional fluid loading at IAH. Whereas PulseCO was only calibrated at baseline, PCCO was calibrated at each experimental step. Results PulseCO and PCCO underestimated CO, as the overall bias ± standard deviation was 1.0 ± 1.5 l/min and 1.0 ± 1.1 l/min compared with COTCP. A clinically accepted agreement between all of the CCO methods and COTCP was observed only at baseline. Whereas IAH did not influence the CO, increased CO following fluid loading at IAH was only reflected by CCOPAC and COTCP, not by uncalibrated PulseCO and PCCO. After recalibration, PCCO was comparable with COTCP. Conclusions The CO obtained by uncalibrated PulseCO and PCCO failed to agree with COTCP during IAH and fluid loading. In the critically ill patient, recalibration of continuous arterial waveform CO methods should be performed after fluid loading or before a major change in therapy is initiated. PMID:18957114

  13. MICU1 may be a promising intervention target for gut-derived sepsis induced by intra-abdominal hypertension

    PubMed Central

    Leng, Yuxin; Ge, Qinggang; Zhao, Zhiling; Wang, Kun; Yao, Gaiqi

    2016-01-01

    Intra-abdominal hypertension (IAH) is a common and serious complication in critically ill patients, for which there is no targeted therapy. IAH-induced dysfunction of intestinal barriers is closely associated with oxidative imbalances, which are considered to provide a pathophysiological basis for subsequent gut-derived sepsis. However, the upstream mechanism that produces oxidative damage during IAH remains unknown. It is not clear whether ‘mitochondrial Ca2+ uptake 1’ (MICU1, the key protein regulating the oxidative process) is involved in preventing Ca2+m (mitochondrial Ca2+) overload. Here, we detected changes in the expression of MICU1 during the development of increased intestinal permeability in rats with IAH, and we explored the related mechanism regulating epithelial-barrier functions by knocking-down micu1 in Caco-2 cells. Our results demonstrated that, to combat IAH-induced dysfunction of intestinal barriers, MICU1 undergoes a compensatory increase in expression, whereas ‘mitochondrial calcium uniporter’ (MCU) – a conserved Ca2+ transporter – becomes transcriptionally suppressed. Silencing the expression of MICU1 destroyed Caco-2 cell barrier integrity, promoted paracellular permeability, and impaired the expression of tight junction proteins (occludin, ZO-1, and claudin 1). Meanwhile, oxidative imbalances were induced; malondialdehyde (MDA), a product of oxidation, was increased and antioxidant products (GSH-Px, CAT, and SOD) were decreased. In MICU1-deficient Caco-2 cells, proliferation was inhibited and apoptosis was promoted. Collectively, our results indicate that MICU1-related oxidation/antioxidation disequilibrium is strongly involved in IAH-induced damage to intestinal barriers. MICU1-targeted treatment may hold promise for preventing the progression of IAH to gut-derived sepsis. PMID:27924224

  14. Clinical characteristics of patients with community-acquired complicated intra-abdominal infections: a prospective, multicentre, observational study.

    PubMed

    Jean, Shio-Shin; Ko, Wen-Chien; Xie, Yang; Pawar, Vaishali; Zhang, Dongmu; Prajapati, Girish; Mendoza, Myrna; Kiratisin, Pattarachai; Ramalheira, Elmano; Castro, Ana Paula; Rosso, Fernando; Hsueh, Po-Ren

    2014-09-01

    In this prospective, observational, multicentre study using data from five countries (Columbia, The Philippines, Portugal, Taiwan and Thailand), the clinical impact of extended-spectrum β-lactamase (ESBL)-producing organisms on hospitalised patients with community-acquired complicated intra-abdominal infections (CA-cIAIs) was compared with that of non-ESBL-producing organisms during the period April 2010 to December 2011. Adult patients (aged ≥18 years) requiring surgery or percutaneous drainage were enrolled and were followed during the first hospitalisation course. An unadjusted statistical comparison of risk factors for ESBL-positive and ESBL-negative patients was performed. Multivariate regression analyses were performed to assess whether length of stay (LOS) in hospital, clinical cure rate and some important clinical characteristics were associated with ESBL positivity. During the study period, a total of 105 adult patients from five countries were enrolled, of whom 17 (16.2%) had CA-cIAI due to ESBL-positive organisms and 88 (83.8%) had CA-cIAI due to ESBL-negative organisms. Escherichia coli was isolated in 73.3% of all samples. Infections were cured in 8 (47.1%) of the patients with CA-cIAI due to ESBL-positive organisms and in 59 (67.0%) of the patients with CA-cIAI due to ESBL-negative organisms (P=0.285). The median LOS was 11.6 days for patients with infections due to ESBL-negative organisms and 17.6 days for patients with infections due to ESBL-positive organisms (P=0.011). Multivariate logistic regression analysis revealed that pre-existing co-morbidities, but not ESBL positivity, were adversely associated with clinical cure of CA-cIAIs. In contrast, duration of hospitalisation was longer for patients with CA-cIAI due to ESBL-positive organisms.

  15. [Intra-abdominal mycoses].

    PubMed

    Boos, C; Kujath, P; Bruch, H-P

    2005-01-01

    The incidence of invasive mycoses in patients undergoing abdominal surgery amounts to approximately 8% and shows an upward trend in epidemiological studies. The lethality of these systemic mycoses, which are mostly based on Candida infections constitutes up to 60%. The development of a sytemic mycosis is marked by exogenic, endogenic and iatrogenic risk factors and typically displays tissue invasion after an initial fungal contamination or systemic dissemination via fungal sepsis. Fungal peritonitis is generally a monoinfection with Candida spp., where Candida albicans outweighs in 70% of cases. Aspergillus spp. are only detected abdominally in rare cases. The histological verification of a fungal invasion is regarded as proof of the existence of an invasive mycosis, but typical macroscopic findings with corresponding cultural findings can also confirm the diagnosis. Systemic mycosis requires an early initiation of a consistent antimycotic therapy as well as definitive surgical eradication of the focus in order to reduce high lethal rate. Resistances or incorrect dosages can be validated objectively by means of histological monitoring of the antimycotic therapy, thus affording early recognition of the need to change the substance class.

  16. Evaluation of surgical anti-adhesion products to reduce postsurgical intra-abdominal adhesion formation in a rat model

    PubMed Central

    Zhang, Hui-Hui; Liao, Ni-Na; Luo, Jing-Wan; Sun, Yu-Long

    2017-01-01

    postsurgical intra-abdominal adhesion formation is Seprafilm > PLA >> HA > Chitosan > PEG. PMID:28207824

  17. Distinct populations of metastases-enabling myeloid cells expand in the liver of mice harboring invasive and preinvasive intra-abdominal tumor.

    PubMed

    Connolly, Michael K; Mallen-St Clair, Jon; Bedrosian, Andrea S; Malhotra, Ashim; Vera, Valery; Ibrahim, Junaid; Henning, Justin; Pachter, H Leon; Bar-Sagi, Dafna; Frey, Alan B; Miller, George

    2010-04-01

    The liver is the most common site of adenocarcinoma metastases, even in patients who initially present with early disease. We postulated that immune-suppressive cells in the liver of tumor-bearing hosts inhibit anti-tumor T cells, thereby accelerating the growth of liver metastases. Using models of early preinvasive pancreatic neoplasia and advanced colorectal cancer, aims of this study were to determine immune phenotype, stimulus for recruitment, inhibitory effects, and tumor-enabling function of immune-suppressive cells in the liver of tumor-bearing hosts. We found that in mice with intra-abdominal malignancies, two distinct CD11b(+)Gr1(+) populations with divergent phenotypic and functional properties accumulate in the liver, becoming the dominant hepatic leukocytes. Their expansion is contingent on tumor expression of KC. These cells are distinct from CD11b(+)Gr1(+) populations in other tissues of tumor-bearing hosts in terms of cellular phenotype and cytokine and chemokine profile. Liver CD11b(+)Gr1(+) cells are highly suppressive of T cell activation, proliferation, and cytotoxicity and induce the development of Tregs. Moreover, liver myeloid-derived suppressor cells accelerate the development of hepatic metastases by inactivation of cytotoxic T cells. These findings may explain the propensity of patients with intra-abdominal cancers to develop liver metastases and suggest a promising target for experimental therapeutics.

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

    PubMed

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

    2016-05-01

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

  19. Persistent Müllerian duct syndrome of mixed anatomical variant (combined male and female type) with mixed germ cell tumor of left intra-abdominal testis.

    PubMed

    Mohapatra, Manisha; Subramanya, Yerraguntla Sarma

    2016-01-01

    Persistent Müllerian duct syndrome (PMDS) is a rare form of internal male pseudohermaphroditism characterized by retention of Müllerian duct derivatives in a phenotypically and karyotypically male patient. Deficiency of anti-Müllerian hormone (AMH) secretion or resistance to AMH action due to defective AMH-II receptor is presumed to cause such syndrome in the majority of cases. About 158 PMDS cases have been reported so far, out of which 31 cases are associated with testicular neoplasms. Herein, we describe an interesting case of young male initially diagnosed and treated for inguinal hernia, but finally diagnosed as "PMDS of mixed anatomical variant (combined male and female type) with mixed germ cell tumor of left intra-abdominal testis" comprising components of seminoma and yolk sac tumor and treated successfully.

  20. Unusual continuous intra-abdominal spread of primary testicular lymphoma along the spermatic cord and gonadal vessels: Report of 2 cases

    PubMed Central

    Sabale, Avinash; Prahladan, Anil; Kalidos, Kalirajan; Koshy, Sumod Mathew; Ramachandran, Krishnankutty

    2015-01-01

    Primary testicular lymphoma (PTL) is an uncommon neoplasm (<5% of all testicular tumors). Testicular lymphoma presents with homogeneous mass, hyperintense on T1-weighted images, and iso-to-hypointense on T2-weighted images with strong diffusion restriction and homogeneous contrast enhancement. Seminoma testis, a close differential due to T2 hypointensity and homogeneousity, can be differentiated by its lower diffusion restriction and younger age group. Involvement of spermatic cord and epididymis is rare with seminoma. Intra-abdominal extension along the gonadal vein is not reported. PTL disseminates to extranodal sites. However, extension of PTL along the spermatic cord and gonadal vein up to the inferior vena cava is a rare phenomenon. We report 2 cases of PTL with involvement of epididymis and spermatic cord and further continuous extension along the gonadal vein up to the inferior vena cava. These findings are very rare and when present may help to differentiate testicular lymphoma from other testicular tumors. PMID:26649126

  1. Hyaline globules and papillary fragments in cytologic smears from two intra-abdominal tumors (ovarian and hepatic) in female patients: A diagnostic pitfall with histologic correlation.

    PubMed

    Machado, Isidro; López-Soto, María Victoria; Pérez-López, Albadio Samir; Domínguez-Álvarez, Carlos; Llombart-Bosch, Antonio

    2016-11-01

    Hyaline globules and papillary fragments in cytologic samples from two intra-abdominal tumors in young females are presented including the cytological features and the correlation with the histopathologic and immunohistochemical findings. In the first case a cytologic study from an ovarian mass showed papillary structures and isolated tumor cells with epithelioid morphology, irregular reniform-like nuclear contour, pale or vacuolated cytoplasm, abundant hyaline globules and occasional glomeruloid structures resembling Schiller-Duval bodies. Yolk sac tumor (YST) was the diagnosis on the histological slides. Tumor cells showed positivity for cytokeratin (AE1/AE3), epithelial membrane antigen (EMA), alpha-fetoprotein (AFP) and Sal-like protein 4 (SALL4). In case number two the cytologic study from a liver metastasis displayed papillary and rosette-like clusters composed of uniform and bland cells showing occasional long cytoplasmic tails, hyaline globules and nuclear grooves. A diagnosis of hepatic metastasis from solid pseudopapillary neoplasm of the pancreas (SPNP) was rendered from the histology. Tumor cells revealed immunoreactivity for cytokeratin (AE1/AE3), Vimentin, Galectin-1 (GAL-1), Neuron specific-enolase, CD10, progesterone and β-catenin (nuclear stain). Regarding differential diagnosis, in the patient with the ovarian mass an ovarian clear cell carcinoma was considered, as well as other germ cell tumors or metastatic carcinoma, while in the patient with a liver metastasis a neuroendocrine carcinoma was taken into account. YST and SPNP share some cytological findings, including hyaline globules, papillary structures, clear cells and intercellular eosinophilic basement membrane deposits. Thus, a detailed study and careful interpretation of the cytological, histological and immunohistochemical findings may be worthwhile to avoid a potential misdiagnosis, particularly in the cytologic specimens of the ovarian and/or intra-abdominal mass, when involving young

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  4. Ruptured subcapsular hematoma of the liver due to pre-eclampsia presenting as interstitial pregnancy and the role of intra-abdominal packing.

    PubMed

    Ngene, N C; Amin, N; Moodley, J

    2015-01-01

    Ruptured subcapsular hematoma of the liver (RSHL) can mimic ruptured interstitial pregnancy because each of these conditions occasionally presents at the same gestational period and both do manifest hemodynamic instability. The similarities between the two conditions pose a diagnostic challenge, especially in an un-booked patient. We report a case of an un-booked primigravida, at 21 weeks of gestation, who arrived at a regional hospital with evidence of intra-abdominal bleeding and hypovolemic shock. She was diagnosed as potentially having a ruptured interstitial pregnancy. During the ensuing emergency laparotomy, RSHL was discovered, the area around the ruptured liver capsule was packed with large abdominal swabs, and the patient recovered. This case report illustrates the need to consider RSHL in patients presenting with features of ruptured interstitial pregnancy, as this will assist in the planning of intraoperative care. We also describe abdominal packing and highlight the need for this essential surgical intervention to be taught to doctors practising in low-resource settings.

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

    NASA Technical Reports Server (NTRS)

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

    2012-01-01

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

  6. Correlation between carbapenem consumption and resistance to carbapenems among Enterobacteriaceae isolates collected from patients with intra-abdominal infections at five medical centers in Taiwan, 2006-2010.

    PubMed

    Ho, Cheng-Mao; Ho, Mao-Wang; Liu, Yung-Ching; Toh, Han-Siong; Lee, Yu-Lin; Liu, Yuag-Meng; Huang, Chi-Chang; Lu, Po-Liang; Liu, Chun-Eng; Chen, Yen-Hsu; Ko, Wen-Chien; Tang, Hung-Jen; Yu, Kwok-Woon; Chen, Yao-Shen; Chuang, Yin-Ching; Wang, Jen-Hsien; Hsueh, Po-Ren

    2012-06-01

    We investigated the trend in resistance to carbapenems among isolates of Enterobacteriaceae that had been collected from patients with intra-abdominal infections at five medical centers in Taiwan from 2006 to 2010 and evaluated the correlation between resistance to carbapenems and consumption of said agents as part of the Study for Monitoring Antimicrobial Resistance Trends (SMART). During the study period, the usage of ertapenem and that of total carbapenems (ertapenem, imipenem, and meropenem) increased significantly from 6.13 to 13.38 defined daily doses per 1000 patient-days for ertapenem and from 20.43 to 34.25 defined daily doses per 1000 patient-days for total carbapenems. The most common species were Escherichia coli (n = 1095), Klebsiella spp. (n = 663), and Enterobacter spp. (n = 202). The susceptibility of all isolates to ertapenem and to imipenem varied during the study period. For ertapenem, the rates of nonsusceptibility ranged from 3.5% to 10.3% and those for imipenem ranged from 3.5% to 10.7%. Although the use of carbapenems increased during the study period, there was no marked increase in resistance to carbapenems. Continuous monitoring of resistance trends is necessary so that antimicrobial prescription policies can be adjusted and infection control intervention programs can be implemented.

  7. Antibiotic optimization in the difficult-to-treat patient with complicated intra-abdominal or complicated skin and skin structure infections: focus on tigecycline

    PubMed Central

    Reygaert, Wanda C

    2010-01-01

    Complicated intra-abdominal and skin and skin structure infections are widely varied in presentation. These infections very often lead to an increase in length of hospital stay, with a resulting increase in costs and mortality. In addition, these infections may be caused by a wide variety of bacteria and are often polymicrobial with the possibility of the presence of antimicrobial-resistant strains, such as methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum β-lactamase strains (Escherichia coli, Klebsiella pneumoniae), and K. pneumoniae carbapenemase-producing strains. In combination with patients’ immunosuppression or comorbidities, the treatment and management options for initial therapy success are few. Tigecycline, a new glycylcyline antimicrobial from the tetracycline drug class, represents a viable option for the successful treatment of these infections. It has been shown to have activity against a wide variety of bacteria, including the antimicrobial-resistant strains. As with all tetracycline drugs, it is not recommended for pregnant or nursing women. The potential side effects are those typical of tetracycline drugs: nausea, vomiting, and headaches. Drug–drug interactions are not expected, and renal function monitoring is not necessary. PMID:20856688

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

    PubMed Central

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

    2010-01-01

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

  9. Pressure studies of deep levels in semiconductors

    SciTech Connect

    Samara, G.A.

    1989-01-01

    The effects of pressure on the energetics and kinetics of electron emission and capture processes by several important deep levels in Si are discussed. The results yield the first quantitative measures of the breathing mode lattice relaxations accompanying these processes. 2 refs., 1 fig.

  10. Liquid-Level Monitor for Pressurized Vessels

    NASA Technical Reports Server (NTRS)

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

    1986-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2015-10-19

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

  14. Association between source control and mortality in 258 patients with intra-abdominal candidiasis: a retrospective multi-centric analysis comparing intensive care versus surgical wards in Spain.

    PubMed

    Lagunes, L; Rey-Pérez, A; Martín-Gómez, M T; Vena, A; de Egea, V; Muñoz, P; Bouza, E; Díaz-Martín, A; Palacios-García, I; Garnacho-Montero, J; Campins, M; Bassetti, M; Rello, J

    2017-01-01

    Early empiric therapy and adequate resuscitation have been identified as main predictors of outcome in patients with candidemia or bacteremia. Moreover, source control is a major determinant in infectious sites when feasible, as a main technique to reduce microbiological burden. A retrospective, multicenter, cohort study was performed at surgical wards and intensive care units (ICU) of three University Hospitals in Spain between 2010 and 2014, with the aim of improving understanding of the interaction between source control, early antifungal therapy, and use of vasoactives in patients with intra-abdominal candidiasis (IAC). Source control was defined as all physical actions taken to control a focus of infection and reduce the favorable conditions that promote microorganism growth or that maintain the impairment of host defenses. Two hundred and fifty-eight patients with IAC were identified. Sixty-one patients were at ICU for diagnosis. Mortality was higher in the ICU group compared to what was documented for the non-ICU group (35 % vs 19.5 %, p = 0011). Adequate source control within 48 h of diagnosis was achieved in 60 % of the cohort. In multivariate analysis, inadequate source control was identified as the only common risk factor for 30-day mortality in both groups (ICU group OR: 13.78 (95% CI: 2.60-72.9, p = 0.002) and non-ICU group OR: 6.53 (95% CI: 2.56-16.61, p = <0.001). The population receiving both adequate source control and adequate antifungal treatment was the one associated with a higher survival rate, in both the ICU and surgical groups. Source control remains a key element in IAC, inside and outside the intensive care unit. Early antifungal treatment among ICU patients was associated with lower mortality.

  15. Preoperative Intra-abdominal Sepsis, Not Penetrating Behavior Itself, Is Associated With Worse Postoperative Outcome After Bowel Resection for Crohn Disease

    PubMed Central

    Zhang, Tenghui; Yang, Jianbo; Ding, Chao; Li, Yi; Gu, Lili; Wei, Yao; Cao, Lei; Gong, Jianfeng; Zhu, Weiming; Li, Ning; Li, Jieshou

    2015-01-01

    Abstract It is generally believed that penetrating behavior is associated with worse surgical outcomes in Crohn disease (CD). We hypothesized that intra-abdominal sepsis (IAS), but not penetrating behavior itself, contributes to postoperative morbidity in patients undergoing bowel resection for CD. Patients who underwent surgery from April 2010 to April 2014 were retrospectively identified from a prospectively maintained database. Demographic information and preoperative and operative data were collected. The outcomes following surgery in patients who had penetrating disease with or without IAS versus nonpenetrating CD were compared. Of 288 patients, 180 had penetrating CD, including 54 who had IAS. Preoperative characteristics were similar between the groups, except for serum albumin, abdominal drainage, and prior bowel resection. Patients with penetrating CD with IAS were more likely to have a stoma, surgical site complications, postoperative IAS complications, and major complications than patients with penetrating CD without IAS or nonpenetrating CD. There were no significant differences between patients with penetrating CD without IAS and nonpenetrating CD. The postoperative outcome was strengthened after propensity-score matching analysis. Moreover, penetrating CD with IAS (odds ratio [OR], 13.034; P = 0.004) is a risk predictor for major postoperative complications, and preoperative serum albumin (OR, 0.095; P = 0.002) and preoperative enteral nutrition (OR, 0.203, P = 0.049) are protective. Penetrating CD without IAS did not adversely affect postoperative outcome after bowel resection compared with penetrating CD with IAS. These results may revise the notion that all patients with penetrating CD have worse postoperative complications. PMID:26559283

  16. Genetic variations in toll-like receptor 4 in Mexican-Mestizo patients with intra-abdominal infection and/or pneumonia.

    PubMed

    Rodriguez-Osorio, Carlos A; Lima, Guadalupe; Herrera-Caceres, Jaime O; Villegas-Torres, Beatriz E; Zuñiga, Joaquin; Ponce-de-Leon, Sergio; Llorente, Luis; Sifuentes-Osornio, Jose

    2013-06-01

    Sepsis is a leading cause of death around the world, and 73-83% of all sepsis cases requiring attention in intensive care units are linked to intra-abdominal infection (IAI) or pneumonia. The activation of innate immunity is central to the manifestation of sepsis, and toll-like receptor (TLR) 4 plays an important role in this activation process. The 299G and 399I alleles of TLR4 have been linked with an increased risk of Gram-negative bacteria (GNB) infections and septic shock in some populations. This case-control study evaluated the prevalence of D299G/T399I polymorphisms in Mexican patients with IAI and/or pneumonia and in healthy controls. Genotyping revealed that 1 in 44 patients (2.3%; CI 95%: 0.05-12.0%) and 4 in 126 controls (3.2%; CI 95%: 0.9-7.9%) were heterozygous for both the D299G and T399l polymorphisms (OR: 0.71, CI 95%: 0.01-7.44, p = NS), confirming the co-segregation of these alleles in this population. Furthermore, the patients with a GNB infection and severe sepsis were not carriers of the risk alleles. In summary, this report shows that the frequency of the D299G and T399I polymorphisms in Mexican-Mestizos is lower than anticipated in comparison with other ethnic groups, emphasizing the variable distribution of TLR4 polymorphisms among different populations. Consequently, this study was not able to detect associations between TLR4 polymorphisms and sepsis in this population.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    SciTech Connect

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

    2012-08-01

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

  20. Validation of a fast method for quantification of intra-abdominal and subcutaneous adipose tissue for large-scale human studies.

    PubMed

    Borga, Magnus; Thomas, E Louise; Romu, Thobias; Rosander, Johannes; Fitzpatrick, Julie; Dahlqvist Leinhard, Olof; Bell, Jimmy D

    2015-12-01

    Central obesity is the hallmark of a number of non-inheritable disorders. The advent of imaging techniques such as MRI has allowed for a fast and accurate assessment of body fat content and distribution. However, image analysis continues to be one of the major obstacles to the use of MRI in large-scale studies. In this study we assess the validity of the recently proposed fat-muscle quantitation system (AMRA(TM) Profiler) for the quantification of intra-abdominal adipose tissue (IAAT) and abdominal subcutaneous adipose tissue (ASAT) from abdominal MR images. Abdominal MR images were acquired from 23 volunteers with a broad range of BMIs and analysed using sliceOmatic, the current gold-standard, and the AMRA(TM) Profiler based on a non-rigid image registration of a library of segmented atlases. The results show that there was a highly significant correlation between the fat volumes generated by the two analysis methods, (Pearson correlation r = 0.97, p < 0.001), with the AMRA(TM) Profiler analysis being significantly faster (~3 min) than the conventional sliceOmatic approach (~40 min). There was also excellent agreement between the methods for the quantification of IAAT (AMRA 4.73 ± 1.99 versus sliceOmatic 4.73 ± 1.75 l, p = 0.97). For the AMRA(TM) Profiler analysis, the intra-observer coefficient of variation was 1.6% for IAAT and 1.1% for ASAT, the inter-observer coefficient of variation was 1.4% for IAAT and 1.2% for ASAT, the intra-observer correlation was 0.998 for IAAT and 0.999 for ASAT, and the inter-observer correlation was 0.999 for both IAAT and ASAT. These results indicate that precise and accurate measures of body fat content and distribution can be obtained in a fast and reliable form by the AMRA(TM) Profiler, opening up the possibility of large-scale human phenotypic studies.

  1. Sound pressure level in a municipal preschool

    PubMed Central

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

    2013-01-01

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

  2. [Intra-abdominal hypertension as a consequence of plasty in the abdominal wall defects, the methods of its determination and prophylaxis].

    PubMed

    Vorovs'kyĭ, O O

    2013-09-01

    The results of various methods of investigation of intraabdominal hypertension (IAH) in 186 patients were analyzed. In 134 (27.1%) patients IAH was measured via bladder, in 46 (8.9%)--the investigation using nasogastric probe was added and in 8 (1.6%), in whom the abdominal wall defect coincided with adhesive disease, the measurement was performed immediately via drainages. In 44 (8.9%) patients the IAH measurement while abdominal wall defect closure was performed, using Stryker Intra Compartmental Pressure Monitor apparatus. The data obtained using this apparatus were considered the most informative. For the IAH prophylaxis it is mandatory to prognosticate the intraabdominal pressure raising, so on the stage of the hernia gates edges approximation it must not be bigger than a second degree level.

  3. In Vitro Activity of Ceftazidime-Avibactam against Isolates in a Phase 3 Open-Label Clinical Trial for Complicated Intra-Abdominal and Urinary Tract Infections Caused by Ceftazidime-Nonsusceptible Gram-Negative Pathogens.

    PubMed

    Stone, Gregory G; Bradford, Patricia A; Newell, Paul; Wardman, Angela

    2017-02-01

    The in vitro activity of ceftazidime-avibactam was evaluated against 341 Gram-negative isolates from 333 patients in a randomized, phase 3 clinical trial of patients with complicated urinary tract or intra-abdominal infections caused by ceftazidime-nonsusceptible pathogens (NCT01644643). Ceftazidime-avibactam MIC90 values against Enterobacteriaceae and Pseudomonas aeruginosa (including several class B or D enzyme producers that avibactam does not inhibit) were 1 and 64 μg/ml, respectively. Overall, the ceftazidime-avibactam activity against ceftazidime-nonsusceptible isolates was comparable to the activity of ceftazidime-avibactam previously reported against ceftazidime-susceptible isolates. (This study has been registered at ClinicalTrials.gov under identifier NCT01644643.).

  4. Incidence and antimicrobial susceptibility of Escherichia coli and Klebsiella pneumoniae with extended-spectrum beta-lactamases in community- and hospital-associated intra-abdominal infections in Europe: results of the 2008 Study for Monitoring Antimicrobial Resistance Trends (SMART).

    PubMed

    Hawser, Stephen P; Bouchillon, Samuel K; Hoban, Daryl J; Badal, Robert E; Cantón, Rafael; Baquero, Fernando

    2010-07-01

    From 2002 to 2008, there was a significant increase in extended-spectrum beta-lactamase (ESBL)-positive Escherichia coli isolates in European intra-abdominal infections, from 4.3% in 2002 to 11.8% in 2008 (P < 0.001), but not for ESBL-positive Klebsiella pneumoniae isolates (16.4% to 17.9% [P > 0.05]). Hospital-associated isolates were more common than community-associated isolates, at 14.0% versus 6.5%, respectively, for E. coli (P < 0.001) and 20.9% versus 5.3%, respectively, for K. pneumoniae (P < 0.01). Carbapenems were consistently the most active drugs tested.

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

    NASA Technical Reports Server (NTRS)

    Deardorff, J. W.

    1982-01-01

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

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

    ERIC Educational Resources Information Center

    Walsh, Anthony; Walsh, Patricia Ann

    1987-01-01

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

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

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

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

  8. A Sound Pressure-level Meter Without Amplification

    NASA Technical Reports Server (NTRS)

    Stowell, E Z

    1937-01-01

    The N.A.C.A. has developed a simple pressure-level meter for the measurement of sound-pressure levels above 70 db. The instrument employs a carbon microphone but has no amplification. The source of power is five flashlight batteries. Measurements may be made up to the threshold of feeling with an accuracy of plus or minus 2 db; band analysis of complex spectra may be made if desired.

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

    PubMed

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

    2015-07-01

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

  10. Dairy Foods in a Moderate Energy Restricted Diet Do Not Enhance Central Fat, Weight, and Intra-Abdominal Adipose Tissue Losses nor Reduce Adipocyte Size or Inflammatory Markers in Overweight and Obese Adults: A Controlled Feeding Study

    PubMed Central

    Van Loan, Marta D.; Keim, Nancy L.; Adams, Sean H.; Souza, Elaine; Woodhouse, Leslie R.; Thomas, Anthony; Witbracht, Megan; Gertz, Erik R.; Piccolo, Brian; Bremer, Andrew A.; Spurlock, Michael

    2011-01-01

    Background. Research on dairy foods to enhance weight and fat loss when incorporated into a modest weight loss diet has had mixed results. Objective. A 15-week controlled feeding study to determine if dairy foods enhance central fat and weight loss when incorporated in a modest energy restricted diet of overweight and obese adults. Design. A 3-week run-in to establish energy needs; a 12-week 500 kcal/d energy reduction with 71 low-dairy-consuming overweight and obese adults randomly assigned to diets: ≤1 serving dairy/d (low dairy, LD) or ≤4 servings dairy/d (adequate dairy, AD). All foods were weighed and provided by the metabolic kitchen. Weight, fat, intra-abdominal adipose tissue (IAAT), subcutaneous adipose tissue (SAT) macrophage number, SAT inflammatory gene expression, and circulating cytokines were measured. Results. No diet differences were observed in weight, fat, or IAAT loss; nor SAT mRNA expression of inflammation, circulating cytokines, fasting lipids, glucose, or insulin. There was a significant increase (P = 0.02) in serum 25-hydroxyvitamin D in the AD group. Conclusion. Whether increased dairy intake during weight loss results in greater weight and fat loss for individuals with metabolic syndrome deserves investigation. Assessment of appetite, hunger, and satiety with followup on weight regain should be considered. PMID:21941636

  11. Dairy Foods in a Moderate Energy Restricted Diet Do Not Enhance Central Fat, Weight, and Intra-Abdominal Adipose Tissue Losses nor Reduce Adipocyte Size or Inflammatory Markers in Overweight and Obese Adults: A Controlled Feeding Study.

    PubMed

    Van Loan, Marta D; Keim, Nancy L; Adams, Sean H; Souza, Elaine; Woodhouse, Leslie R; Thomas, Anthony; Witbracht, Megan; Gertz, Erik R; Piccolo, Brian; Bremer, Andrew A; Spurlock, Michael

    2011-01-01

    Background. Research on dairy foods to enhance weight and fat loss when incorporated into a modest weight loss diet has had mixed results. Objective. A 15-week controlled feeding study to determine if dairy foods enhance central fat and weight loss when incorporated in a modest energy restricted diet of overweight and obese adults. Design. A 3-week run-in to establish energy needs; a 12-week 500 kcal/d energy reduction with 71 low-dairy-consuming overweight and obese adults randomly assigned to diets: ≤1 serving dairy/d (low dairy, LD) or ≤4 servings dairy/d (adequate dairy, AD). All foods were weighed and provided by the metabolic kitchen. Weight, fat, intra-abdominal adipose tissue (IAAT), subcutaneous adipose tissue (SAT) macrophage number, SAT inflammatory gene expression, and circulating cytokines were measured. Results. No diet differences were observed in weight, fat, or IAAT loss; nor SAT mRNA expression of inflammation, circulating cytokines, fasting lipids, glucose, or insulin. There was a significant increase (P = 0.02) in serum 25-hydroxyvitamin D in the AD group. Conclusion. Whether increased dairy intake during weight loss results in greater weight and fat loss for individuals with metabolic syndrome deserves investigation. Assessment of appetite, hunger, and satiety with followup on weight regain should be considered.

  12. Early life stress and blood pressure levels in late adulthood.

    PubMed

    Alastalo, H; Räikkönen, K; Pesonen, A-K; Osmond, C; Barker, D J P; Heinonen, K; Kajantie, E; Eriksson, J G

    2013-02-01

    Severe stress experienced in early life may have long-term consequences on adult physiological functions. We studied the long-term effects of separation on blood pressure levels in non-obese subjects who were separated temporarily in childhood from their parents during World War II (WWII). The original clinical study cohort consists of people born during 1934-1944 in Helsinki, Finland. This substudy includes 1361 non-obese subjects (body mass index <30 kg m(-2)). Of these, 192 (14.1%) had been evacuated abroad during WWII. The remaining subjects served as controls. Blood pressure levels and use of blood pressure medication were studied. The separated subjects had significantly higher systolic blood pressure values than the non-separated (148.6+21.5 vs 142.2+19.6 mm Hg, P<0.0001) in adult life. Those subjects separated in early childhood had markedly higher systolic and diastolic blood pressure values in adult life compared with the non-separated (154.6 vs 142.5 mm Hg; 95% confidence interval (CI) 2.6-14.7; P<0.005 and 90.8 vs 87.7 mm Hg; 95% CI 1.0-7.3; P<0.02, respectively). Systolic blood pressure was also higher in the group separated for a duration of <1 year (151.7 vs 142.2 mm Hg; 95% CI 0.0-12.4; P<0.05) compared with the non-separated. Besides being separated, age at separation and duration of separation also influenced blood pressure levels in adult life. This could be due to early hormonal and metabolic programming, during plastic periods in early life, influencing blood pressure levels in adult life.

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

    PubMed

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

    1986-01-01

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

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

    NASA Technical Reports Server (NTRS)

    Hoar, Timothy J.; Wilson, Clark R.

    1994-01-01

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

  15. The Comparison of the Effects of Ellagic Acid and Diclofenac Sodium on Intra-Abdominal Adhesion: An In Vivo Study in the Rat Model

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2014-01-01

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

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

    PubMed

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

    2013-07-01

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

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

    PubMed

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

    2010-12-01

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

  19. Antimicrobial susceptibility and extended-spectrum beta-lactamase rates in aerobic gram-negative bacteria causing intra-abdominal infections in Vietnam: report from the Study for Monitoring Antimicrobial Resistance Trends (SMART 2009-2011).

    PubMed

    Biedenbach, Douglas J; Bouchillon, Samuel K; Hoban, Daryl J; Hackel, Meredith; Phuong, Doan Mai; Nga, Tran Thi Thanh; Phuong, Nguyen Tran My; Phuong, Tran Thi Lan; Badal, Robert E

    2014-08-01

    Treatment options for multidrug-resistant pathogens remain problematic in many regions and individual countries, warranting ongoing surveillance and analysis. Limited antimicrobial susceptibility information is available for pathogens from Vietnam. This study determined the bacterial susceptibility of aerobic gram-negative pathogens of intra-abdominal infections among patients in Vietnam during 2009-2011. A total of 905 isolates were collected from 4 medical centers in this investigation as part of the Study for Monitoring Antimicrobial Resistance Trends. Antimicrobial susceptibility and extended-spectrum beta-lactamase (ESBL) rates among the appropriate species were determined by a central laboratory using Clinical and Laboratory Standards Institute methods. Among the species collected, Escherichia coli (48.1% ESBL-positive) and Klebsiella pneumoniae (39.5% ESBL-positive) represented the majority (46.4%) of the isolates submitted for this study. Ertapenem MIC90 values were lowest for these 2 species at 0.12 and 0.25μg/mL and remained unchanged for ESBL-positive isolates. Imipenem MIC90 values were also the same for all isolates and ESBL-positive strains at 0.25 and 0.5μg/mL, respectively. Ertapenem MIC90 values for additional species with sufficient numbers for analysis, including Enterobacter cloacae, Proteus mirabilis, Acinetobacter baumannii, and Pseudomonas aeruginosa, were 1, 0.06, >4, and >4μg/mL, respectively. Analysis of beta-lactamases in a subset of 132 phenotypically ESBL-positive Enterobacteriaceae demonstrated that CTX-M variants, particularly CTX-M-27 and CTX-M-15, were the predominant enzymes. High resistance rates in Vietnam hospitals dictate continuous monitoring as antimicrobial inactivating enzymes continue to spread throughout Asia and globally.

  20. Objective sea level pressure analysis for sparse data areas

    NASA Technical Reports Server (NTRS)

    Druyan, L. M.

    1972-01-01

    A computer procedure was used to analyze the pressure distribution over the North Pacific Ocean for eleven synoptic times in February, 1967. Independent knowledge of the central pressures of lows is shown to reduce the analysis errors for very sparse data coverage. The application of planned remote sensing of sea-level wind speeds is shown to make a significant contribution to the quality of the analysis especially in the high gradient mid-latitudes and for sparse coverage of conventional observations (such as over Southern Hemisphere oceans). Uniform distribution of the available observations of sea-level pressure and wind velocity yields results far superior to those derived from a random distribution. A generalization of the results indicates that the average lower limit for analysis errors is between 2 and 2.5 mb based on the perfect specification of the magnitude of the sea-level pressure gradient from a known verification analysis. A less than perfect specification will derive from wind-pressure relationships applied to satellite observed wind speeds.

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

    ERIC Educational Resources Information Center

    Haber, David

    1986-01-01

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

  2. Intra-abdominal bleeding in appendicitis.

    PubMed

    Thongprayoon, C; Pasa-Arj, S

    1991-08-01

    A 34-year-old woman, gravida 6 with 10 weeks of gestation was admitted because of abdominal pain and fainting. On physical examination she had hypotension, was pale with abdominal tenderness and guarding. Culdocentesis yielded unclotted blood. Immediate laparotomy was performed, because a diagnosis of ectopic pregnancy was made. About 2,500 ml of fresh blood was found in the abdominal cavity. Appendicular artery tear caused active arterial bleeding. The torn appendicular artery was observed to be the consequence of perforated appendicitis, which, in turn, was caused by a faecalith. Appendectomy was performed and she made a good recovery.

  3. System for water level measurement based on pressure transducer

    NASA Astrophysics Data System (ADS)

    Paczesny, Daniel; Marzecki, Michał; Woyke, Michał; Tarapata, Grzegorz

    2016-09-01

    The paper reports system for water level measurement, which is designed to be used for measuring liquid levels in the tanks of an autonomous industrial cleaning robot. The selected method of measurement utilized by the designed system is based on pressure measurement. Such system is insensitive on vibrations, foams presence and liquid impurities. The influences of variable pressure on the measurements were eliminated by utilizing the differential method and as well as the system design. The system is capable of measuring water level in tanks up to 400 mm of height with accuracy of about 2,5%. The system was tested in a container during filling and emptying with various liquids. Performed tests exhibited the linearity of the sensor characteristic and the lack of hysteresis. Obtained sensitivity of the sensor prototype was approximately 6,2 mV/mm H2O.

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

    NASA Astrophysics Data System (ADS)

    Watry, Derek

    2005-09-01

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

  5. Abdominal compartment syndrome and acute kidney injury due to excessive auto-positive end-expiratory pressure.

    PubMed

    Matthew, Dwight; Oxman, David; Djekidel, Karim; Ahmed, Ziauddin; Sherman, Michael

    2013-02-01

    Abdominal compartment syndrome is an under-recognized cause of acute kidney injury in critically ill patients. We report a case of a patient with severe obstructive lung disease who, while intubated for respiratory failure, developed abdominal compartment syndrome and oliguric acute kidney injury due to air-trapping and excessive auto-positive end-expiratory pressure (auto-PEEP; also known as intrinsic PEEP). When chemical paralysis was initiated and the auto-PEEP resolved, the patient's intra-abdominal hypertension rapidly improved and kidney function recovered immediately. Abdominal compartment syndrome secondary to excessive auto-PEEP appears to be unreported in the literature; however, any process that significantly increases intrathoracic pressure conceivably could cause increased pressure to be transmitted to the abdominal compartment, resulting in organ failure. Patients undergoing mechanical ventilation, which puts them at risk of airflow obstruction and the development of intra-abdominal hypertension, should be evaluated for air-trapping and excessive auto-PEEP.

  6. Multicenter, double-blind, randomized, phase II trial to assess the safety and efficacy of ceftolozane-tazobactam plus metronidazole compared with meropenem in adult patients with complicated intra-abdominal infections.

    PubMed

    Lucasti, Christopher; Hershberger, Ellie; Miller, Benjamin; Yankelev, Sara; Steenbergen, Judith; Friedland, Ian; Solomkin, Joseph

    2014-09-01

    Ceftolozane-tazobactam (TOL-TAZ) is a novel antibacterial with activity against Pseudomonas aeruginosa and other common Gram-negative pathogens, including extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae, that are associated with complicated intra-abdominal infections (cIAIs). This prospective, double-blind, randomized, multicenter, phase II trial assessed patient clinical and microbiological responses to and the safety of TOL-TAZ plus metronidazole compared with those of meropenem. Hospitalized adults with cIAIs that required surgical intervention were randomized (2:1) to receive intravenous (i.v.) TOL-TAZ (1.5 g [containing 1,000 mg TOL and 500 mg TAZ] every 8 h [q8h]) with or without i.v. metronidazole (500 mg q8h) or i.v. meropenem (1 g q8h) for 4 to 7 days. The primary endpoint was the clinical response at the test-of-cure visit in the microbiologically modified intent-to-treat (mMITT) and microbiologically evaluable (ME) populations. Secondary measures included the patients' microbiological response and safety. In total, 82 patients received TOL-TAZ (90.2% with metronidazole), and 39 received meropenem. For the mMITT population, clinical cure was seen in 83.6% of the patients (51/61; 95% confidence interval [CI], 71.9 to 91.8) who received TOL-TAZ and 96.0% of the patients (24/25; 95% CI, 79.6 to 99.9) who received meropenem (difference, -12.4%; 95% CI, -34.9% to 11.1%); in the ME population, clinical cure was seen in 88.7% and 95.8% of the patients (difference, -7.1%; 95% CI, -30.7% to 16.9%) who received TOL-TAZ and meropenem, respectively. TOL-TAZ demonstrated microbiological success against Escherichia coli (89.5%), Klebsiella pneumoniae (100%), and P. aeruginosa (100%). The adverse event rates were similar in the groups (50.0% with TOL-TAZ and 48.8% with meropenem). TOL-TAZ in combination with metronidazole was well tolerated and resulted in clinical and microbiological success rates supportive of further clinical development in

  7. Antimicrobial susceptibility of Gram-negative ESKAPE pathogens isolated from hospitalized patients with intra-abdominal and urinary tract infections in Asia-Pacific countries: SMART 2013-2015.

    PubMed

    Karlowsky, James A; Hoban, Daryl J; Hackel, Meredith A; Lob, Sibylle H; Sahm, Daniel F

    2017-01-01

    Gram-negative ESKAPE pathogens (Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp.) are responsible for increases in antimicrobial-resistant infections worldwide. We determined in vitro susceptibilities to eight parenteral antimicrobial agents using Clinical and Laboratory Standards Institute broth microdilution methodology for Gram-negative ESKAPE pathogens isolated from hospitalized patients with intra-abdominal infections (IAIs) (n=3052) and urinary tract infections (UTIs) (n=1088) in 11 Asia-Pacific countries/regions from 2013 to 2015. Amikacin (98.3, 96.4 %), imipenem (97.1, 95.5 %) and ertapenem (95.3, 93.2 %) demonstrated the highest rates of susceptibility for isolates of K. pneumoniae from IAI and UTI, respectively, whereas susceptibility to advanced-generation cephalosporins was <84 and <71 %, respectively. K. pneumoniae with an extended-spectrum β-lactamase-positive phenotype were more common in UTI (27.1 %) than IAI (16.2 %). Imipenem and amikacin were the most active agents against extended-spectrum β-lactamase-positive K. pneumoniae from IAI (95.1, 91.8 %) and UTI (94.9, 92.3 %), respectively, whereas <54 % were susceptible to piperacillin-tazobactam. Against Enterobacter spp. and P. aeruginosa, amikacin demonstrated the highest rates of susceptibility for isolates from IAI (99.7, 95.5 %) and UTI (90.9, 91.5 %), respectively. K. pneumoniae, Enterobacter spp. and P. aeruginosa from urine demonstrated lower susceptibility to levofloxacin (74.1, 81.8 and 73.8 %) than from IAI (87.6, 91.8 and 85.4 %). For A. baumannii, rates of susceptibility to all agents tested were <43 %. We conclude that the studied Gram-negative ESKAPE pathogens demonstrated reduced susceptibility to commonly prescribed advanced-generation cephalosporins, piperacillin-tazobactam and levofloxacin, while amikacin and carbapenems were the most active. Ongoing surveillance to monitor evolving resistance trends and

  8. Wind turbine sound pressure level calculations at dwellings.

    PubMed

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

    2016-03-01

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

  9. Plantar pressures during level walking compared with other ambulatory activities.

    PubMed

    Lundeen, S; Lundquist, K; Cornwall, M W; McPoil, T G

    1994-06-01

    This study was designed to determine the magnitude of plantar pressures during level walking in comparison to other activities. These activities included climbing up stairs, going down stairs, a simple pivot while walking, and a crossover pivot while walking in normal individuals. Twelve volunteers, six men and six women, mean age 28 years, served as subjects. Data were collected on the dominant foot with an EMED-SF pressure sensor platform as each subject walked barefoot and did each of the five activities. Maximum plantar pressure (MPP) and pressure-time integral (PTI) was found in the metatarsal and heel regions. The results of repeated-measures analysis of variance tests showed that the five experimental conditions were statistically different for both MPP and PTI in the metatarsal and heel regions. Post hoc analysis indicated that MPP and PTI were decreased during the going down stairs condition in the heel and increased during the crossover pivot while walking and pivot while walking conditions for the metatarsal region.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2014-12-11

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

  12. Sound Pressure Level Gain in an Acoustic Metamaterial Cavity

    NASA Astrophysics Data System (ADS)

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

    2014-12-01

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

  13. Loudness discomfort level for speech: comparison of two instructional sets for saturation sound pressure level selection.

    PubMed

    Beattie, R C; Svihovec, D A; Carmen, R E; Kunkel, H A

    1980-01-01

    This study was undertaken to compare the speech loudness discomfort levels (LDL's) with two instructional sets which have been proposed for saturation sound pressure level selection of hearing aids. The phraseology recommended by McCandless and by Berger was presented to normal-hearing and hearing-impaired listeners. The normal-hearing subjects obtained mean LDL's of 94.6 and 111.9 dB SPL for these respective instructions, which was statistically significant. The hearing-impaired listeners also showed LDL's with Berger's instructions (114.7 dB SPL) to be significantly higher than with McCandless' instructional set (109.3 dB SPL). Consequently, this investigation suggests that these two instructional sets may lead to substantially different saturation sound pressure levels. Further studies are needed to determine the most appropriate phraseology for LDL measurement, including the assessment of speech intelligibility at various saturation sound pressure levels. Another instructional set was constructed which (1) includes an explanation to patients of the purpose and importance of the test, (2) requests listeners to indicate the upper level they are "willing" to listen as opposed to the level they are "able" to listen, (3) instructs patients to search thoroughly around their LDL before making a final judgment, and (4) contains a statement that the LDL should be made with the understanding that the speech could be listened to for a period of time. Whatever instructions are used, clinicians are advised to interpret their LDL's very cautiously until validational studies are available.

  14. System-level challenges in pressure-operated soft robotics

    NASA Astrophysics Data System (ADS)

    Onal, Cagdas D.

    2016-05-01

    Last decade witnessed the revival of fluidic soft actuation. As pressure-operated soft robotics becomes more popular with promising recent results, system integration remains an outstanding challenge. Inspired greatly by biology, we envision future robotic systems to embrace mechanical compliance with bodies composed of soft and hard components as well as electronic and sensing sub-systems, such that robot maintenance starts to resemble surgery. In this vision, portable energy sources and driving infrastructure plays a key role to offer autonomous many-DoF soft actuation. On the other hand, while offering many advantages in safety and adaptability to interact with unstructured environments, objects, and human bodies, mechanical compliance also violates many inherent assumptions in traditional rigid-body robotics. Thus, a complete soft robotic system requires new approaches to utilize proprioception that provides rich sensory information while remaining flexible, and motion control under significant time delay. This paper discusses our proposed solutions for each of these system-level challenges in soft robotics research.

  15. Pressure levels and pulsation frequencies can be varied on high pressure/frequency testing device

    NASA Technical Reports Server (NTRS)

    Routson, J. W.

    1967-01-01

    Hydraulic system components test device obtains a pulsating pressure from a hydraulic actuator that is being driven by a vibration exciter of sufficient force and displacement. Input to the exciter controls the frequency of pressure variation.

  16. Pneumoperitoneum pressures during pelvic laparoscopic surgery: a systematic review and meta-analysis.

    PubMed

    Bogani, Giorgio; Martinelli, Fabio; Ditto, Antonino; Chiappa, Valentina; Lorusso, Domenica; Ghezzi, Fabio; Raspagliesi, Francesco

    2015-12-01

    Growing evidence suggests that the level of pneumoperitoneal pressure is directly correlated with postoperative pain in patients undergoing laparoscopic procedures. However, only limited evidence is available in the field of gynaecologic surgery. Therefore, this study aimed to compare the effects of low (8mmHg), standard (12mmHg) and high (15mmHg) pneumoperitoneal pressures (LPPpressure influence postoperative pain. The study also sought to determine the safety of LPP during gynaecologic procedures. A literature search revealed two randomized controlled trials that evaluated the effects of different pneumoperitoneal pressures. Overall, 230 patients who underwent gynaecologic procedures via laparoscopy using different pneumoperitoneal pressures (LPP: n=74, 32%; SPP: n=67, 29%; HPP: n=89, 39%) were evaluated. Pooled results suggested that the use of LPP does not increase operative time compared with SPP [mean difference (MD) 6.78min] and HPP (MD 5.52min). Similarly, no differences in operative time were recorded between procedures using SPP and HPP (MD 0.34min). Estimated blood loss was not influenced by CO2 intra-abdominal pressure (LPP vs SPP: MD 10.05ml; LPP vs HPP: MD -4.03ml; SPP vs HPP: MD 6.75ml). Twenty-four hours after surgery, HPP was found to be correlated with higher levels of pain compared with LPP and SPP. However, CO2 pressure did not influence the length of hospital stay. These results suggest that in comparison with SPP and HPP, LPP provides a slight benefit in terms of postoperative pain among patients undergoing gynaecologic laparoscopy, with no increase in operative time, blood loss or surgery-related morbidity.

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

    USGS Publications Warehouse

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

    1992-01-01

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

  18. 16 CFR 1500.47 - Method for determining the sound pressure level produced by toy caps.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

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

  19. Contact Pressure Level Indication Using Stepped Output Tactile Sensors

    PubMed Central

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

    2016-01-01

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

  20. Level of Mercury Manometer With Respect to Heart: Does it Affect Blood Pressure Measurement?

    PubMed

    Kapoor, Raj; Roy, V K; Manna, S; Bhattacharjee, M

    2015-01-01

    Measurement of blood pressure is an integral part of clinical examination. Over the years various types of instruments have been used to measure blood pressure but till date the mercury sphygmomanometer is regarded as the gold standard. However, there is a myth prevalent among health professionals regarding the level of the manometer in relation to heart at the time of measuring of blood pressure. Many professionals insist that it has to be placed at the level of the heart. We argue that the limb from which pressure is measured must be at the heart level rather than the manometer. We conducted a study in which we measured the blood pressure in adults by placing the manometer at three different levels with respect to the heart. The values of blood pressure obtained at all levels were similar and did not show any statistically significant difference. We therefore conclude that the level of sphygmomanometer per se does not affect blood pressure measurement.

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

    USGS Publications Warehouse

    Carnley, Mark V.

    2015-01-01

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

  2. Long-term AICAR administration reduces metabolic disturbances and lowers blood pressure in rats displaying features of the insulin resistance syndrome.

    PubMed

    Buhl, Esben S; Jessen, Niels; Pold, Rasmus; Ledet, Thomas; Flyvbjerg, Allan; Pedersen, Steen B; Pedersen, Oluf; Schmitz, Ole; Lund, Sten

    2002-07-01

    The insulin resistance syndrome is characterized by several risk factors for cardiovascular disease. Chronic chemical activation of AMP-activated protein kinase by the adenosine analog 5-aminoimidazole-4-carboxamide-1-beta -D-ribofuranoside (AICAR) has been shown to augment insulin action, upregulate mitochondrial enzymes in skeletal muscles, and decrease the content of intra-abdominal fat. Furthermore, acute AICAR exposure has been found to reduce sterol and fatty acid synthesis in rat hepatocytes incubated in vitro as well as suppress endogenous glucose production in rats under euglycemic clamp conditions. To investigate whether chronic AICAR administration, in addition to the beneficial effects on insulin sensitivity, is capable of improving other phenotypes associated with the insulin resistance syndrome, obese Zucker (fa/fa) rats (n = 6) exhibiting insulin resistance, hyperlipidemia, and hypertension were subcutaneously injected with AICAR (0.5 mg/g body wt) daily for 7 weeks. Obese control rats were either pair-fed (PF) (n = 6) or ad libitum-fed (AL) (n = 6). Lean Zucker rats (fa/-) (n = 8) served as a reference group. AICAR administration significantly reduced plasma triglyceride levels (P < 0.01 for AICAR vs. AL, and P = 0.05 for AICAR vs. PF) and free fatty acids (P < 0.01 for AICAR vs. AL, and P < 0.05 for AICAR vs. PF) and increased HDL cholesterol levels (P < 0.01 for AICAR vs. AL and PF). AICAR treatment also lowered systolic blood pressure by 14.6 +/- 4.3 mmHg (P < 0.05), and AICAR-treated animals exhibited a tendency toward decreased intra-abdominal fat content. Furthermore, AICAR administration normalized the oral glucose tolerance test and decreased fasting concentrations of glucose and insulin close to the level of the lean animals. Finally, in line with previous findings, AICAR treatment was also found to enhance GLUT4 protein expression and to increase maximally insulin-stimulated glucose transport in primarily white fast-twitch muscles. Our

  3. Low-pressure pneumoperitoneum during laparoscopic donor nephrectomy to optimize live donors' comfort.

    PubMed

    Warlé, M C; Berkers, A W; Langenhuijsen, J F; van der Jagt, M F; Dooper, Ph M; Kloke, H J; Pilzecker, D; Renes, S H; Wever, K E; Hoitsma, A J; van der Vliet, J A; D'Ancona, F C H

    2013-01-01

    Nowadays, laparoscopic donor nephrectomy (LDN) has become the gold standard to procure live donor kidneys. As the relationship between donor and recipient loosens, it becomes of even greater importance to optimize safety and comfort of the surgical procedure. Low-pressure pneumoperitoneum has been shown to reduce pain scores after laparoscopic cholecystectomy. Live kidney donors may also benefit from the use of low pressure during LDN. To evaluate feasibility and efficacy to reduce post-operative pain, we performed a randomized blinded study. Twenty donors were randomly assigned to standard (14 mmHg) or low (7 mmHg) pressure during LDN. One conversion from low to standard pressure was indicated by protocol due to lack of progression. Intention-to-treat analysis showed that low pressure resulted in a significantly longer skin-to-skin time (149 ± 86 vs. 111 ± 19 min), higher urine output during pneumoperitoneum (23 ± 35 vs. 11 ± 20 mL/h), lower cumulative overall pain score after 72 h (9.4 ± 3.2 vs. 13.5 ± 4.5), lower deep intra-abdominal pain score (11 ± 3.3 vs. 7.5 ± 3.1), and a lower cumulative overall referred pain score (1.8 ± 1.9 vs. 4.2 ± 3). Donor serum creatinine levels, complications, and quality of life dimensions were not significantly different. Our data show that low-pressure pneumoperitoneum during LDN is feasible and may contribute to increase live donors' comfort during the early post-operative phase.

  4. HEADCO: a program for converting observed water levels and pressure measurements to formation pressure and standard hydraulic head

    SciTech Connect

    Spane, F.A. Jr.; Mercer, R.B.

    1985-10-01

    Static water-level and fluid pressure measurements are commonly converted in hydrologic studies to formation pressure and hydraulic head, which are used to determine groundwater flow characteristics of aquifer systems. While the direct use of field measurements is usually adequate for determining formation pressure and hydraulic head for shallow flow systems (i.e., <1000 ft), corrections and conversion parameters must be used to properly account for fluid-column density effects, which commonly occur with deep systems. This report presents a program, HEADCO, for converting static water-level and pressure measurements to formation pressure and standard hydraulic head. The HEADCO program corrects field measurements for the effects of fluid-density variation and selected external stresses. Factors that affect density of the fluid column, in which field measurements are made, include temperature, pressure, salinity, suspended solids, and multiphase conditions. External stresses examined in HEADCO include barometric and earth tide fluctuations, and gravitational acceleration variation. A program description and procedures for converting field measurements obtained using field test arrangements commonly employed in the Basalt Waste Isolation Project field program are provided in this report. The report includes user instructions and an illustrative test example. Results of a field example comparison are also provided. This comparison examines observed and HEADCO-calculated pressures for 30 pressure probes recently calibrated in a laboratory and tested under field conditions at borehole DC-8. The test case and field example comparisons indicate that HEADCO provides accurate estimates of formation pressure and standard hydraulic head that are well within the accuracy range of downhole pressure-measuring instrumentation. 44 refs., 14 figs., 8 tabs.

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

    SciTech Connect

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

    1992-12-31

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

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

    NASA Technical Reports Server (NTRS)

    Ponte, Rui M.

    1994-01-01

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

  7. [Combination surgery (ECCE+IOL+TE) and intraocular pressure levels].

    PubMed

    Hornová, J

    1997-08-01

    The authors investigated the effect of a combined operation, ECCE + TE + IOL, on reduction of intraocular pressure (IOP), changes in antiglaucomatous treatment and on vision six months after operation. In 1994 36 eyes were operated, 16 eyes with primary open angle glaucoma (POAG), 8 eyes with angular glaucoma (PACG) and 12 eyes with marked exfoliative syndrome (CG). Six months after operation the IOP declined from 26.4 mm Hg to 13.3 mm Hg (P 0.05), antiglaucomatous treatment was reduced from 2.55 to 1.11 (P 0.05), vision improved by 0.39, i.e. by 2-3 lines of optotypes (P 0.05). 89% of the operated patients have a vision better than 0.5. Comparison of values before and after operation revealed a more marked drop of IOP in CG (P 0.05) than in POAG.

  8. Relationship between IL-17 serum level and ambulatory blood pressure in women with polycystic ovary syndrome

    PubMed Central

    Foroozanfard, Fatemeh; Soleimani, Alireza; Arbab, Elham; Samimi, Mansooreh; Tamadon, Mohammad Reza

    2017-01-01

    Background Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders with an inflammatory basis. It is associated with hyperandrogenism in women and can be also associated with increased activity of the renin-angiotensin system (RAS). Approximately 5% to 10% of women of reproductive age are affected by this disease. This syndrome is the main cause of infertility. Blood pressure may be one of the complications of the syndrome. Objectives In this study, we sought to assess the role of the IL-17 inflammatory cytokine in increasing blood pressure in patients with PCOS. Patients and Methods In this cross-sectional study, after obtaining informed consent, we evaluated 85 patients with PCOS. IL-17 serum level was measured after separating the serum via ELISA method. The results obtained for the two groups of patients with high blood pressure and normal blood pressure were compared with each other. Results The daytime blood pressure was abnormal in eight patients, while it was normal in 72 patients. The blood pressure during the day had a direct correlation with the IL-17serum level; as a result, the mean IL-17 serum level in patients with high blood pressure was 77.10 ± 17.94 ρ g/ml while in those with normal blood pressure it was 55.20 ± 13.71 ρ g/ml (P = 0.001). High blood pressure during the night also showed a direct relation with theIL-17 serum level (P = 0.001). In addition, increasing of ambulatory 24-hourblood pressure was significantly related with IL-17 serum level, in such a way that the IL-17 serum level of people with high blood pressure rose by almost 22 ρg/ml during 24 hours (P = 0.001). Conclusions Our results showed an association between PCO syndrome and inflammatory factors. The IL-17 serum level was directly associated with the increase in blood pressure. PMID:28042549

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

    NASA Technical Reports Server (NTRS)

    Atwal, M.; Bernhard, R.

    1984-01-01

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

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

    SciTech Connect

    Xuan Shi, Dali Wang

    2014-05-05

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-02-01

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

  12. DEPENDENCE OF THE SATURATION LEVEL OF MAGNETOROTATIONAL INSTABILITY ON GAS PRESSURE AND MAGNETIC PRANDTL NUMBER

    SciTech Connect

    Minoshima, Takashi; Hirose, Shigenobu; Sano, Takayoshi

    2015-07-20

    A large set of numerical simulations of MHD turbulence induced by the magnetorotational instability is presented. Revisiting the previous survey conducted by Sano et al., we investigate the gas pressure dependence of the saturation level. In ideal MHD simulations, the gas pressure dependence is found to be very sensitive to the choice of numerical scheme. This is because the numerical magnetic Prandtl number varies according to the scheme as well as the pressure, which considerably affects the results. The saturation level is more sensitive to the numerical magnetic Prandtl number than the pressure. In MHD simulations with explicit viscosity and resistivity, the saturation level increases with the physical magnetic Prandtl number, and it is almost independent of the gas pressure when the magnetic Prandtl number is constant. This is indicative of the incompressible turbulence saturated by the secondary tearing instability.

  13. Association between individual-level and community-level socio-economic status and blood pressure among Inuit in Greenland

    PubMed Central

    Riva, Mylène; Larsen, Christina Viskum Lytken; Bjerregaard, Peter

    2016-01-01

    Background Despite abundant evidence that socio-economic status (SES) is a fundamental determinant of health, there is a dearth of research examining association between SES, measured at the individual and community levels, and cardiovascular risk factors and morbidity among indigenous populations. Objectives To examine the influence of individual-level and community-level SES on systolic and diastolic blood pressure among Greenlandic Inuit. Methods Multilevel analysis of cross-sectional data from the Inuit Health in Transition – Greenland Survey, to which 3,108 Greenlandic Inuit aged 18 years and older participated. Blood pressure is measured using an automatic device, according to standardized protocol. Individual SES is measured by education. Community socio-economic conditions are measured using combined information on average disposable household income and settlement type. Results Education was not significantly associated with blood pressure. There was an inverse U-shape association between community socio-economic conditions and blood pressure with significantly lower SBP and DBP among participants living in remote traditional villages characterized by lower average disposable household income and in affluent more urbanized towns. Sex-stratified analyses demonstrate the salience of community conditions for men. Conclusions The association observed between blood pressure and community-level socio-economic conditions suggests that public health and social policies, programmes and interventions aiming to improve living conditions might improve cardiovascular health in Greenland. Studies are required to further examine social gradients in cardiovascular risk factors and morbidity among indigenous populations using different measures of SES. PMID:27938632

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

    NASA Technical Reports Server (NTRS)

    Edwards, Lawrence G.; Haberbusch, Mark

    1993-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Liu, Z.; Higgins, C. W.

    2015-03-01

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

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

    PubMed Central

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

    2015-01-01

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

  17. 14 CFR 29.979 - Pressure refueling and fueling provisions below fuel level.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... below fuel level. 29.979 Section 29.979 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... System § 29.979 Pressure refueling and fueling provisions below fuel level. (a) Each fueling connection below the fuel level in each tank must have means to prevent the escape of hazardous quantities of...

  18. 14 CFR 29.979 - Pressure refueling and fueling provisions below fuel level.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... below fuel level. 29.979 Section 29.979 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... System § 29.979 Pressure refueling and fueling provisions below fuel level. (a) Each fueling connection below the fuel level in each tank must have means to prevent the escape of hazardous quantities of...

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

    NASA Technical Reports Server (NTRS)

    Vonglahn, U. H.

    1978-01-01

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

  20. Resonant and deep impurity levels under hydrostatic pressure in pure n-type InAs

    NASA Astrophysics Data System (ADS)

    Kadri, A.; Aulombard, R. L.; Zitouni, K.; Konczewicz, L.

    1986-05-01

    Hall coefficient ( RH) and electrical resistivity (ϱ 0) were measured as a function of hydrostatic pressure up to 18 kbar, in the 4.2 K-120 K temperature range, on nominally undopted n-type InAs with free carrier concentration ∼2 × 10 16 cm -3. In the 4.2-30 K range, RH and ϱ 0 versus pressure variations indicate the deionization of impurity states which are resonant in the Γ 1c band at normal pressure. The position and the pressure variation of the resonant impurity level are discussed. At T>30 K, evidence is made for the existence of a donor-like impurity level lying ∼10 meV below the Γ 1c band minimum and moving with pressure at the rate of -1.8 meV/kbar with respect to this band.

  1. Incremental bias in Finapres estimation of baseline blood pressure levels over time.

    PubMed

    Ristuccia, H L; Grossman, P; Watkins, L L; Lown, B

    1997-04-01

    Finapres finger blood pressure monitoring appears to provide a reliable alternative to intra-arterial blood pressure measurement under many circumstances. However, few studies have focused on the limitations of Finapres assessment. In a previous pilot investigation, we observed that Finapres pressure following mental stressors failed to return to initial resting levels. Our objectives in the present study were to (1) replicate earlier findings, (2) examine whether local changes in the measured finger were responsible for the observed drift, and (3) test a method to facilitate the return of pressure to systemic baseline levels. We studied two groups of healthy subjects who underwent a protocol consisting of two mental stressors preceded and followed by baseline periods. In the control group, the Finapres continuously monitored pressure on a single finger for the entire protocol. The intervention group periodically had the Finapres cuff removed and the measured finger exercised to prevent local changes that might influence Finapres estimation of blood pressure. Comparisons indicated a group x baseline interaction effect for systolic and diastolic pressures (P < .0004 and P < .003, respectively). The group with the exercise intervention showed much greater recover during the final baseline than the control group. Recovery of pressures in the control group but not the intervention group was inversely related to the stress level of blood pressure (r = .86, P < .0002), indicating a relationship between blood pressure rise and the degree of distortion of subsequent baseline values. On the basis of our results, we propose that in prolonged protocols, the measurement finger be exercised to facilitate accurate measurements of finger pressure with the Finapres.

  2. High Pressure Germination of Bacillus subtilis Spores with Alterations in Levels and Types of Germination Proteins

    DTIC Science & Technology

    2014-01-01

    1ITLE AND SUBTITLE 5a CONTRACTNUMBER High pressure germination of Bacillus subtilis spores with W911NF-09-l-0286 alterations in levels and types of...A moderate high pressure (mHP) of 150 megaPascals (MPa) triggers germination of Bacillus subtilis spores via germinant receptors (GRs), while...germination by a very high pressure (vHP) of550 MPa is GR-independent. The mHP and vHP germination of Bacillus subtilis spores with different levels ofGRs

  3. MP3 player listening sound pressure levels among 10 to 17 year old students.

    PubMed

    Keith, Stephen E; Michaud, David S; Feder, Katya; Haider, Ifaz; Marro, Leonora; Thompson, Emma; Marcoux, Andre M

    2011-11-01

    Using a manikin, equivalent free-field sound pressure level measurements were made from the portable digital audio players of 219 subjects, aged 10 to 17 years (93 males) at their typical and "worst-case" volume levels. Measurements were made in different classrooms with background sound pressure levels between 40 and 52 dBA. After correction for the transfer function of the ear, the median equivalent free field sound pressure levels and interquartile ranges (IQR) at typical and worst-case volume settings were 68 dBA (IQR = 15) and 76 dBA (IQR = 19), respectively. Self-reported mean daily use ranged from 0.014 to 12 h. When typical sound pressure levels were considered in combination with the average daily duration of use, the median noise exposure level, Lex, was 56 dBA (IQR = 18) and 3.2% of subjects were estimated to exceed the most protective occupational noise exposure level limit in Canada, i.e., 85 dBA Lex. Under worst-case listening conditions, 77.6% of the sample was estimated to listen to their device at combinations of sound pressure levels and average daily durations for which there is no known risk of permanent noise-induced hearing loss, i.e., ≤  75 dBA Lex. Sources and magnitudes of measurement uncertainties are also discussed.

  4. Empirical prediction of peak pressure levels in anthropogenic impulsive noise. Part I: Airgun arrays signals.

    PubMed

    Galindo-Romero, Marta; Lippert, Tristan; Gavrilov, Alexander

    2015-12-01

    This paper presents an empirical linear equation to predict peak pressure level of anthropogenic impulsive signals based on its correlation with the sound exposure level. The regression coefficients are shown to be weakly dependent on the environmental characteristics but governed by the source type and parameters. The equation can be applied to values of the sound exposure level predicted with a numerical model, which provides a significant improvement in the prediction of the peak pressure level. Part I presents the analysis for airgun arrays signals, and Part II considers the application of the empirical equation to offshore impact piling noise.

  5. Temperature and pressure coefficients of iron resonant impurity level in PbTe

    NASA Astrophysics Data System (ADS)

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

    2017-01-01

    We investigate temperature dependences of galvanomagnetic parameters in weak magnetic fields (4.2 ≤ T ≤ 300 K, B ≤ 0.07 T) in the p-Pb1-yFeyTe alloy from the middle part of the single-crystal ingot, where the Fermi level is pinned by the resonant impurity level lying under the top of the valence band. Experiments are performed under hydrostatic compression up to 10 kbar. Using scanning electron microscopy, we find microscopic inclusions of the secondary phase enriched with iron and show that the main phase is characterized by a good uniformity of the spatial distribution of impurities. A monotonous increase of the free hole concentration at liquid-helium temperature under pressure and anomalous temperature dependences of the Hall coefficient in the whole investigated pressure range are revealed. Experimental results are explained by a model assuming pinning of the Fermi level by the impurity level and a redistribution of electrons between the valence band and impurity states with increasing temperature and under pressure. In the framework of the two-band Kane dispersion law, theoretical temperature dependences of the Hall coefficient under pressure, which are in satisfactory agreement with the experimental ones at low temperatures, are calculated and temperature and pressure coefficients of the iron deep level are determined. Diagrams of the electronic structure rearrangement with increasing temperature for Pb1-yFeyTe at pressures up to 10 kbar are proposed.

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

    SciTech Connect

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

    1992-07-01

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

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

    SciTech Connect

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

    1992-07-01

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

  8. Non-invasive liquid level and density gauge for nuclear power reactor pressure vessels

    SciTech Connect

    Baratta, A.J.; Jester, W.A.; Kenney, E.S.; Mc Master, I.B.; Schultz, M.A.

    1987-01-27

    A method is described of non-invasively determining the liquid coolant level and density in a nuclear power reactor pressure vessel comprising the steps: positioning at least three neutron detector fission chambers externally of the reactor pressure vessel at multiple spaced positions along the side of the fuel core. One of the neutron detectors is positioned at the side near the bottom of the fuel core. The multiple spaced positions along the side remove any ambiguity as to whether the liquid level is decreasing or increasing: shielding the neutron detector fission chamber from thermal neutrons to avoid the noise associated therewith, and eliminating the effects of gamma radiation from the detected signals; monitoring the detected neutron level signals to determine to coolant liquid level and density in the nuclear power reactor pressure vessel.

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

    DOEpatents

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

    1981-10-26

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

  10. 14 CFR 29.979 - Pressure refueling and fueling provisions below fuel level.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... below fuel level. 29.979 Section 29.979 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Fuel System § 29.979 Pressure refueling and fueling provisions below fuel level. (a) Each fueling...

  11. 14 CFR 29.979 - Pressure refueling and fueling provisions below fuel level.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... below fuel level. 29.979 Section 29.979 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Fuel System § 29.979 Pressure refueling and fueling provisions below fuel level. (a) Each fueling...

  12. 14 CFR 29.979 - Pressure refueling and fueling provisions below fuel level.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... below fuel level. 29.979 Section 29.979 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: TRANSPORT CATEGORY ROTORCRAFT Powerplant Fuel System § 29.979 Pressure refueling and fueling provisions below fuel level. (a) Each fueling...

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

    NASA Astrophysics Data System (ADS)

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

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

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

    NASA Technical Reports Server (NTRS)

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

    2000-01-01

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

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

    NASA Technical Reports Server (NTRS)

    Fu, Lee-Lueng; Pihos, Greg

    1994-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Roebuck, Nikole Moore

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

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

    SciTech Connect

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

    1994-06-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2000-06-01

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

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

    NASA Technical Reports Server (NTRS)

    Bishu, Ram R.; Klute, Glenn K.

    1993-01-01

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

  20. Impacts of static pressure set level on HVAC energy consumption and indoor conditions

    SciTech Connect

    Liu, M.; Zhu, Y.; Claridge, D.E.; White, E.

    1997-12-31

    Air static pressure must be maintained at a certain level leaving the air-handling unit (AHU) to force a suitable amount of air through the terminal boxes. However, an excessive static pressure level is often used due to (1) lack of a control device in a constant-volume (CV) system, (2) a malfunctioning control device in a variable-air-volume (VAV) system, and (3) fear of failure to maintain room temperature. High static pressure often develops excessive damper leakage in older mixing boxes. This results in an appropriate mixing of hot and cold air for dual-duct systems, excessive reheat in single-duct systems, and an excessive amount of air entering the space. Consequently, the actual fan power and heating and cooling energy consumption all become significantly higher than the design values. Even worse, the system may not be able to maintain room conditions due to unwanted simultaneous heating and cooling and may be noisy due to the excessive static pressure. This paper proposed to control the hot duct pressure and the variable-frequency drives (VFDs) to control the fan static, i.e., the cold duct pressure for dual-duct air-handling units. Both a theoretical analysis and results from a case study are presented in this paper.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-09-21

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

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

    PubMed

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

    2015-06-01

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

  4. Exaggerated blood pressure response to exercise is not associated with masked hypertension in patients with high normal blood pressure levels.

    PubMed

    Grossman, Alon; Cohen, Noa; Shemesh, Joseph; Koren-Morag, Nira; Leibowitz, Avshalom; Grossman, Ehud

    2014-04-01

    The association between exaggerated blood pressure (BP) response to exercise (ExBPR) and "masked hypertension" is unclear. Medical records of patients with high-normal BP who were evaluated in the Chaim Sheba Screening Institute Ramat Gan, Israel, during the years 2002-2007 and referred for 24-hour ambulatory BP monitoring (ABPM) and exercise test were reviewed. Data on exercise tests performed in the preceding 5 years were retrieved. Reproducible ExBPR was defined when it was recorded at least twice. BP levels on 24-hour ABPM were compared between patients with a normal BP response and those with an ExBPR (systolic BP ≥200 mm Hg). Sixty-nine normotensive patients with high normal BP levels were identified. ExBPR was recorded in 43 patients and was reproducible in 28. BP levels on 24-hour ABPM were similar in patients with and without ExBPR. In patients with high-normal BP levels, ExBPR is not associated with masked hypertension.

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

    SciTech Connect

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

    2013-04-10

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

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

    NASA Astrophysics Data System (ADS)

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

    2016-06-01

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

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

    NASA Technical Reports Server (NTRS)

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

    1974-01-01

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

  8. Relationship between androgen levels and blood pressure in young women with polycystic ovary syndrome.

    PubMed

    Chen, Mei-Jou; Yang, Wei-Shiung; Yang, Jehn-Hsiahn; Chen, Chi-Ling; Ho, Hong-Nerng; Yang, Yu-Shih

    2007-06-01

    The role of testosterone on the development of hypertension is controversial, especially in women with polycystic ovary syndrome (PCOS) who have higher prevalence of obesity and insulin resistance than women without PCOS. Little is known about the association between serum testosterone level and blood pressure in young women with PCOS. In the 151 young Taiwanese women with PCOS enrolled in this cross-sectional study, we measured the body mass index, waist circumference, blood pressure, fasting glucose, fasting insulin, lipid profile, and hormone profiles. The free androgen index, total testosterone, and sex hormone-binding globulin, but not the level of dehydroepiandrosterone sulfate, significantly correlated with both systolic blood pressure (SBP) and diastolic blood pressure (DBP). In multiple linear regression models adjusted for age, body mass index, and other anthropometric, metabolic, and hormonal variables, the level of serum free androgen index or total testosterone, but not the sex hormone-binding globulin, were independently related to SBP and DBP. The age- and body mass index-adjusted least-square mean of serum-free androgen index levels were significantly different between the highest quartile and other quartiles of the SBP and DBP levels. The high bioavailable testosterone levels (free androgen index: >or=19%) in women with PCOS increased the risk of elevated blood pressure (SBP >or=130 mm Hg and/or DBP >or=85 mm Hg) with an odds ratio of 3.817 (P=0.029; 95% CI: 1.14 to 12.74) after adjustment for age, anthropometric measures, and metabolic profiles. Our results suggest that the characteristic hyperandrogenemia in young women with PCOS was associated with an elevated SBP and DBP independent of age, insulin resistance, obesity, or dyslipidemia.

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

    PubMed

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

    2016-01-01

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

  10. Intra-Abdominal Actinomycosis Mimicking Malignant Abdominal Disease

    PubMed Central

    Oguejiofor, Njideka; Al-Abayechi, Sarah; Njoku, Emmanuel

    2017-01-01

    Abdominal actinomycosis is a rare infectious disease, caused by gram positive anaerobic bacteria, that may appear as an abdominal mass and/or abscess (Wagenlehner et al. 2003). This paper presents an unusual case of a hemodynamically stable 80-year-old man who presented to the emergency department with 4 weeks of worsening abdominal pain and swelling. He also complains of a 20-bound weight loss in 2 months. A large tender palpable mass in the right upper quadrant was noted on physical exam. Laboratory studies showed a normal white blood cell count, slightly decreased hemoglobin and hematocrit, and mildly elevated total bilirubin and alkaline phosphatase. A CT with contrast was done and showed a liver mass. Radiology and general surgery suspected malignancy and recommended CT guided biopsy. The sample revealed abundant neutrophils and gram positive rods. Cytology was negative for malignancy and cultures eventually grew actinomyces. High dose IV penicillin therapy was given for 4 weeks and with appropriate response transitioned to oral antibiotic for 9 months with complete resolution of symptoms. PMID:28299215

  11. Primary intra-abdominal synovial sarcoma: a case report.

    PubMed

    Travaglini, Grazia; Biagetti, Simona; Alfonsi, Simona; Bearzi, Italo; Marmorale, Cristina

    2013-09-03

    Il caso clinico che vi presentiamo riguarda la straordinaria localizzazione intra-addominale di un sinovial-sarcoma. Questo tumore dei tessuti molli generalmente interessa le piccole e grandi articolazioni. Sono state descritte altre localizzazioni a livello intra-addominale e retroperitoneale. La nostra paziente si ricovera per una tumefazione dolente dell’addome, alla TC addome si evidenzia una voluminosa massa intra-addominale che comprime e disloca i parenchimi e visceri circostanti e che affiora ai tessuti più superficiali della parete addominale. La biopsia eco-guidata della lesione, insieme allo studio immunoistochimico, permette di porre la diagnosi di sinovial-sarcoma. La paziente viene candidata ad un trattamento chemioterapico a scopo neoadiuvante. Per il sopraggiungere di anemizzazione da sanguinamento della neoplasia, valutata anche la risposta parziale al trattamento sistemico, si pone indicazione all’intervento chirurgico. La massa con peduncolo vascolare maggiore costituito dai vasi gastroepiploici di destra, viene completamente asportata. L’esame definitivo conferma la diagnosi di Sinovial-Sarcoma bifasico. L’indagine genetica condotta sul campione conservato in formalina non ha permesso, a causa della difficoltà di estrarre ed amplificare un quantitativo adeguato di RNA, di identificare la traslocazione (X; 18) (p 11.2; q 11.2) specifica del Sinovial-Sarcoma. La paziente è stata dimessa dopo un decorso clinico regolare. Il follow-up ad un anno non ha mostrato ripresa di malattia ma dopo 18 mesi alla TC torace-addome di rivalutazione si evidenzia la ripresa di malattia a livello intra-addominale e la presenza di metastasi polmonari bilaterali.

  12. [Procalcitonin as a marker of intra-abdominal infection].

    PubMed

    Domínguez-Comesaña, Elías; Ballinas-Miranda, Julio Roberto

    2014-01-01

    Antecedentes: la procalcitonina es un marcador bastante específico de infección y en los últimos años se ha demostrado su superioridad, con respecto a otros marcadores de inflamación como la proteína C reactiva, para el diagnóstico y vigilancia de una gran variedad de infecciones. Objetivo: resumir los datos actualmente existentes y discutir la utilidad de la procalcitonina en diversas infecciones intrabdominales, incluidas las postoperatorias. Conclusiones: los resultados de estudios hasta ahora publicados son variables, lo que genera controversia en relación con su utilidad.

  13. Cystic Echinococcosis: A Case of Extrahepatic Intra-Abdominal Involvement

    PubMed Central

    Carvalho, André; Fernandes, Teresa; Gonçalves, José

    2017-01-01

    Hydatid disease, or echinococcal disease, is a parasitic infestation caused by the larval stage of the Echinococcus tapeworm and it primarily affects the liver and lung but involvement of other organs is also possible secondary to peritoneal seeding or hematogeneous dissemination. We describe a rare case of extensive abdominal disease, with lesions affecting the liver, peritoneum, and lesser omentum, requiring aggressive surgical intervention. Complementary diagnostic exams were crucial to reach the diagnosis and evaluate the extension of the disease. PMID:28194292

  14. Intra-abdominal sepsis--epidemiology, aetiology and management.

    PubMed

    Hadley, G P

    2014-12-01

    Peritonitis is a progressive disease leading inexorably from local peritoneal irritation to overwhelming sepsis and death unless this trajectory is interrupted by timely and effective therapy. In children peritonitis is usually secondary to intraperitoneal disease, the nature of which varies around the world. In rich countries, appendicitis is the principal cause whilst in poor countries diseases such as typhoid must be considered in the differential diagnosis. Where resources are limited, the clinical diagnosis of peritonitis mandates laparotomy for diagnosis and source control. In regions with unlimited resources, radiological investigation, ultrasound, CT scan or MRI may be used to select patients for non-operative management. For patients with appendicitis, laparoscopic surgery has achieved results comparable to open operation; however, in many centres open operation remains the standard. In complicated peritonitis "damage control surgery" may be appropriate wherein source control is undertaken as an emergency with definitive repair or reconstruction awaiting improvement in the patient's general condition. Awareness of abdominal compartment syndrome is essential. Primary peritonitis in rich countries is seen in high-risk groups, such as steroid-dependent nephrotic syndrome patients, whilst in poor countries the at-risk population is less well defined and the diagnosis is often made at surgery.

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

    Technology Transfer Automated Retrieval System (TEKTRAN)

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

  16. Load influence on gear noise. [mathematical model for determining acoustic pressure level as function of load

    NASA Technical Reports Server (NTRS)

    Merticaru, V.

    1974-01-01

    An original mathematical model is proposed to derive equations for calculation of gear noise. These equations permit the acoustic pressure level to be determined as a function of load. Application of this method to three parallel gears is reported. The logical calculation scheme is given, as well as the results obtained.

  17. Relations among subglottal pressure, breathing, and acoustic parameters of sentence-level prominence in German.

    PubMed

    Petrone, Caterina; Fuchs, Susanne; Koenig, Laura L

    2017-03-01

    This study investigates whether acoustic correlates of prominence are related to actions of the respiratory system resulting in local changes of subglottal pressure (Psub). Simultaneous recordings were made of acoustics; intraoral pressure (Pio), as an estimate of Psub; and thoracic and abdominal volume changes. Ten German speakers read sentences containing a verb ending with /t/ followed by a noun starting with /t/. These /t#t/ sequences were typically realized as one /t:/ with a long intraoral pressure plateau. Sentence-level prominence was manipulated by shifting the position of contrastive focus within the sentences. The slope and peak values of Pio within the /t#t/ sequence were used to estimate differences in Psub across focus positions. Results show that prominence production is related to changes in the slope and maximum value of the pressure plateau. While pressure increases led to higher intensity, the increases did not relate to f0, hence, suggesting that local f0 changes primarily reflect laryngeal activity. Finally, strong individual differences were observed in the respiratory data. These findings confirm past reports of local Psub increases corresponding to sentence-level prominence. Speaker-specific activations of the respiratory system are interpreted in terms of motor equivalence, with laryngeal mechanisms also appearing to contribute to Psub changes.

  18. Blood Pressure Responses and Mineral Ocorticoid Levels in the Suspended Rat Model for Weightlessness

    NASA Technical Reports Server (NTRS)

    Musacchia, X. J.; Steffen, J. M.

    1985-01-01

    Cardiovascular responses and fluid/electrolyte shifts seen during space flight are attributed to cephalad redistribution of vascular fluid. The antiorthostatic (AO) rat (suspended head down tilted, 15-20 deg) is used to model these responses. Current studies show that elevated blood pressures in A0 rats are sustained for periods up to seven days. Comparisons are made with presuspension rats. Increased blood pressure in head down tilted subjects suggests a specific response to A0 positioning, potentially relatable to cephalad fluid shift. To assess a role for hormonal regulation of sodium excretion, serum aldosterone levels were measured.

  19. Absolute pressure dependence of the second ionization level of EL2 in GaAs

    SciTech Connect

    Bliss, D.E.; Walukiewicz, W.; Nolte, D.D.; Haller, E.E.

    1989-11-01

    We report the results of DLTS experiments under uniaxial stress on the second ionization level of EL2(++/+) in p-type GaAs. We measured the shift in the hole emission rate as a function of stress applied in the (100) and (110) directions. By modeling the valence band with two independently displacing bands and appropriately derived effective masses, we obtain a small absolute hydrostatic pressure derivative for the defect, 39 {plus minus} 15 MeV GPa{sup {minus}1}. The shear contribution is negligible. This result is very different than for the first ionization level, EL2(+/o) with a emission energy pressure derivative of 90 {plus minus} 15 MeV GPa{sup {minus}1}. The difference can be accounted for by the pressure dependence of the electron capture barrier of EL2(+/o), 49 {plus minus} 15 MeV GPa{sup {minus}1}. The absolute pressure derivatives of the two levels are then comparable and in good agreement with simple theory for Ga site point defects. 20 refs., 2 figs.

  20. Absolute pressure dependence of the second ionization level of EL2 in GaAs

    SciTech Connect

    Bliss, D.E.; Nolte, D.D.; Walukiewicz, W.; Haller, E.E. Department of Materials Science and Mineral Engineering, University of California at Berkeley, Berkeley, California 94720 ); Lagowski, J. )

    1990-03-19

    We report the results of deep level transient spectroscopy experiments with the second ionization level of the double donor defect (EL2) under uniaxial stress in {ital p}-type GaAs. We measure the shift in the hole emission rate as a function of stress applied in the (100) and (110) directions. By modeling the valence band with two independently displacing bands and appropriately derived effective masses, we determine the absolute hydrostatic pressure derivative of the defect to be 39{plus minus}15 meV GPa{sup {minus}1}. The shear contribution is negligible. These results are very different from those obtained for the first ionization level, which has a much higher absolute pressure derivative of 90 meV GPa{sup {minus}1}.

  1. Evidence for unloading arterial baroreceptors during low levels of lower body negative pressure in humans

    PubMed Central

    Fu, Qi; Shibata, Shigeki; Hastings, Jeffrey L.; Prasad, Anand; Palmer, M. Dean; Levine, Benjamin D.

    2009-01-01

    Low levels (i.e., ≤20 mmHg) of lower body negative pressure (LBNP) have been utilized to unload “selectively” cardiopulmonary baroreceptors in humans, since steady-state mean arterial pressure and heart rate (HR) have been found unchanged at such levels. However, transient reductions in blood pressure (BP), followed by reflex compensation, may occur without detection, which could unload arterial baroreceptors. The purposes of this study were to test the hypothesis that the arterial baroreflex is engaged even during low levels of LBNP and to determine the time course of changes in hemodynamics. Fourteen healthy individuals (age range 20–54 yr) were studied. BP (Portapres and Suntech), HR (ECG), pulmonary capillary wedge pressure (PCWP) or pulmonary artery diastolic pressure (PDP) and right atrial pressure (RAP) (Swan-Ganz catheter) and hemodynamics (Modelflow) were recorded continuously at baseline and −15- and −30-mmHg LBNP for 6 min each. Application of −15-mmHg LBNP resulted in rapid and sustained falls in RAP and PCWP or PDP, progressive decreases in cardiac output and stroke volume, followed subsequently by transient reductions in both systolic and diastolic BP, which were then restored through the arterial baroreflex feedback mechanism after ∼15 heartbeats. Additional studies were performed in five subjects using even lower levels of LBNP, and this transient reduction in BP was observed in three at −5- and in all at −10-mmHg LBNP. The delay for left ventricular stroke volume to fall at −15-mmHg LBNP was about 10 cardiac cycles. An increase in systemic vascular resistance was detectable after 20 heartbeats during −15-mmHg LBNP. Steady-state BP and HR remained unchanged during mild LBNP. However, BP decreased, while HR increased, at −30-mmHg LBNP. These results suggest that arterial baroreceptors are consistently unloaded during low levels (i.e., −10 and −15 mmHg) of LBNP in humans. Thus “selective” unloading of cardiopulmonary

  2. Relationship between blood lead levels and blood pressure and its cardiovascular risk implications

    SciTech Connect

    Pirkle, J.L.; Schwartz, J.; Landis, J.R.; Harlan, W.R.

    1985-02-01

    The relationship between blood pressure and blood lead levels in the second National Health and Nutrition Examination Survey (1976-1980) has been examined for white males aged 40-59 years. After adjustment for age, body mass index, nutritional factors, and blood biochemistries in a multiple linear regression model, the relationship of systolic and diastolic blood pressures to blood lead levels was statistically significant (p < 0.01). There was no evidence of a threshold blood lead level for this relationship. Although these data alone do not prove a causal relationship between low blood lead levels and blood pressure, the findings are consistent with current epidemiologic and animal studies, indicating that a causal reationship is probable. To examine the potential health risks, the multiple logistic risk factor coefficients from the Pooling Project and Framingham studies were used to predict the impact of the 37% decrease in mean blood lead levels which occurred in adult white males from 1976 to 1980. As a result of this blood lead decrease, the calculations predicted a 4.7% decrease in the incidence of fatal and nonfatal myocardial infarction over 10 years, a 6.7% decrease in the incidence of fatal and nonfatal strokes over 10 years, and a 5.5% decrease in the incidence of death from all causes over 11.5 years. In addition, as a result of this blood lead decrease, the predicted number of white males in this age group with hypertension (diastolic blood pressure greater than or equal to 90 mmHg) decreased by 17.5%.

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

    SciTech Connect

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

    2014-07-14

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

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

    SciTech Connect

    Alammar, M.A.

    1986-01-01

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

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

    USGS Publications Warehouse

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

    2015-01-01

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

  6. The influence of solar variability and the quasi-biennial oscillation on sea level pressure

    NASA Astrophysics Data System (ADS)

    Roy, I.; Haigh, J. D.

    2010-12-01

    We investigate an apparent inconsistency between two published results concerning the temperature of the winter polar stratosphere and its dependence on the state of the Sun and the phase of the Quasi-Biennial Oscillation (QBO). We find that the differences can be explained by the use of the authors of different pressure levels to define the phase of the QBO. We identify QBO and solar cycle signals in sea level pressure (SLP) data using a multiple linear regression approach. First we used a standard QBO time series dating back to 1953. In the SLP observations dating back to that time we find at high latitudes that individually the solar and QBO signals are weak but that a temporal index representing the combined effects of the Sun and the QBO shows a significant signal. This is such that combinations of low solar activity with westerly QBO and high solar activity with easterly QBO are both associated with a strengthening in the polar modes; while the opposite combinations coincide with a weakening. This result is true irrespective of the choice of QBO pressure level. By employing a QBO dataset reconstructed back to 1900, we extended the analysis and also find a robust signal in the surface SAM; though weaker for surface NAM. Our results suggest that solar variability, modulated by the phase of QBO, influences zonal mean temperatures at high latitudes in the lower stratosphere and subsequently affect sea level pressure near the poles. Thus a knowledge of the state of the Sun, and the phase of the QBO might be useful in surface climate prediction.

  7. Absolute pressure derivatives of deep level defects in III-V semiconductors

    SciTech Connect

    Nolte, D.D.; Walukiewicz, W.; Haller, E.E.

    1987-11-01

    Based on transition metal reference levels, we present absolute pressure derivatives for band-edges in GaAs and InP and defects in GaAs. The defect deformation potentials are directly related to the electron-lattice coupling which drives lattice relaxation around the defects. We find an exceedingly large inward lattice relaxation of the EL2 defect in GaAs upon electron emission. 12 refs., 1 fig.

  8. Numerical simulation of the processes in the normal incidence tube for high acoustic pressure levels

    NASA Astrophysics Data System (ADS)

    Fedotov, E. S.; Khramtsov, I. V.; Kustov, O. Yu.

    2016-10-01

    Numerical simulation of the acoustic processes in an impedance tube at high levels of acoustic pressure is a way to solve a problem of noise suppressing by liners. These studies used liner specimen that is one cylindrical Helmholtz resonator. The evaluation of the real and imaginary parts of the liner acoustic impedance and sound absorption coefficient was performed for sound pressure levels of 130, 140 and 150 dB. The numerical simulation used experimental data having been obtained on the impedance tube with normal incidence waves. At the first stage of the numerical simulation it was used the linearized Navier-Stokes equations, which describe well the imaginary part of the liner impedance whatever the sound pressure level. These equations were solved by finite element method in COMSOL Multiphysics program in axisymmetric formulation. At the second stage, the complete Navier-Stokes equations were solved by direct numerical simulation in ANSYS CFX in axisymmetric formulation. As the result, the acceptable agreement between numerical simulation and experiment was obtained.

  9. Relationship between Food Security with Sugar Level and Blood Pressure in Diabetes Type 2 in Tehran

    PubMed Central

    Moghadam, Seyed Amir Hossein Zehni; Javadi, Maryam; Mohammadpooral, Asghar

    2016-01-01

    Introduction Food security has been defined as the “availability, stability, access and utilization of safe foods”. Diabetes has been known as one of the biggest health and medical problems throughout the world and is clearly related to lifestyle, and particularly, improper food consumption. The aim of this study was to determine the relationship between food security with sugar and blood pressure in patients suffering from type 2 diabetes who refer to diabetes centers in Tehran. Methods This cross-sectional study was conducted in 2015 on type 2 diabetes patients in Tehran, Iran. From two diabetes centers in the eastern and southern parts of Tehran, 243 type 2 diabetes patients were selected. Necessary information (demographic and food security information) about all the studied persons was collected using the standard questionnaire verified by US Department of Agriculture (USDA). The data was analyzed by SPSS version 16, statistical comparisons were made using analysis of variance (ANOVA) and Chi-square and Tukey tests and a significant level of <0.05. Results Most subjects were female (68.7%). There was no significant relationship between gender and food security (p=0.372). No significant relation was observed between food security and fasting blood pressure, HbA1C, and systolic blood pressure (p>0.05), but there was a significant relationship between food security and diastolic blood pressure (p= 0.030). Conclusions According to the relationship between diastolic blood pressure and food security and the role of blood pressure in the irreparable diabetic complications, it is recommended to perform appropriate food advice. PMID:28163854

  10. Use of inexpensive pressure transducers for measuring water levels in wells

    USGS Publications Warehouse

    Keeland, B.D.; Dowd, J.F.; Hardegree, W.S.

    1997-01-01

    Frequent measurement of below ground water levels at multiple locations is an important component of many wetland ecosystem studies. These measurements, however, are usually time consuming, labor intensive, and expensive. This paper describes a water-level sensor that is inexpensive and easy to construct. The sensor is placed below the expected low water level in a shallow well and, when connected to a datalogger, uses a pressure transducer to detect groundwater or surface water elevations. Details of pressure transducer theory, sensor construction, calibration, and examples of field installations are presented. Although the transducers must be individually calibrated, the sensors have a linear response to changing water levels (r2 ??? .999). Measurement errors resulting from temperature fluctuations are shown to be about 4 cm over a 35??C temperature range, but are minimal when the sensors are installed in groundwater wells where temperatures are less variable. Greater accuracy may be obtained by incorporating water temperature data into the initial calibration (0.14 cm error over a 35??C temperature range). Examples of the utility of these sensors in studies of groundwater/surface water interactions and the effects of water level fluctuations on tree growth are provided. ?? 1997 Kluwer Academic Publishers.

  11. Measurement and analysis of 8-hour time-weighted average sound pressure levels in a vivarium decontamination facility.

    PubMed

    Pate, William; Charlton, Michael; Wellington, Carl

    2013-01-01

    Occupational noise exposure is a recognized hazard for employees working near equipment and processes that generate high levels of sound pressure. High sound pressure levels have the potential to result in temporary or permanent alteration in hearing perception. The cleaning of cages used to house laboratory research animals is a process that uses equipment capable of generating high sound pressure levels. The purpose of this research study was to assess occupational exposure to sound pressure levels for employees operating cage decontamination equipment. This study reveals the potential for overexposure to hazardous noise as defined by the Occupational Safety and Health Administration (OSHA) permissible exposure limit and consistent surpassing of the OSHA action level. These results emphasize the importance of evaluating equipment and room design when acquiring new cage decontamination equipment in order to minimize employee exposure to potentially hazardous noise pressure levels.

  12. Pressure-induced crossing of the core levels in 5 d metals

    NASA Astrophysics Data System (ADS)

    Tal, Alexey A.; Katsnelson, Mikhail I.; Ekholm, Marcus; Jönsson, H. Johan M.; Dubrovinsky, Leonid; Dubrovinskaia, Natalia; Abrikosov, Igor A.

    2016-05-01

    A pressure-induced interaction between core electrons, the core-level crossing (CLC) transition, has been observed in hcp Os at P ≈400 GPa [L. Dubrovinsky et al., Nature (London) 525, 226 (2015)], 10.1038/nature14681. By carrying out a systematic theoretical study for all metals of the 5 d series (Hf, Ta, W, Re, Os, Ir, Pt, Au) we have found that the CLC transition is a general effect for this series of metals. While in Pt it occurs at ≈1500 GPa , at a pressure substantially higher than in Os, in Ir it occurs already at 80 GPa. Moreover, we predict that in Re the CLC transition may take place already at ambient pressure. We explain the effect of the CLC and analyze the shift of the transition pressure across the series within the Thomas-Fermi model. In particular, we show that the effect has many common features with the atomic collapse in rare-earth elements.

  13. Low-level blasts raise intracranial pressure and impair cognitive function in rats.

    PubMed

    Säljö, Annette; Svensson, Berndt; Mayorga, Maria; Hamberger, Anders; Bolouri, Hayde

    2009-08-01

    Brain injury after high-level blast has been established both clinically and experimentally. Less is known about the effects on the brain of exposure to low to moderate blast levels, such as those encountered by military personnel during the firing of weapons. This study investigates if exposure to occupational levels of low-level blasts affect intracranial pressure and cognitive performance. Rats were exposed to blast overpressure in a shock tube at peak levels of 10, 30, and 60 kPa. Intracranial pressure (ICP) was measured after 0.5, 3, 6, and 10 h and 1, 2, 3, 5, and 7 days. We found two features of the response: a dose-dependent rise in ICP in rats exposed to blast, and an increasing time delay in elevation with decreasing intensity of exposure. The ICP increased in a dose-dependent fashion, up to 15.7 mm Hg after exposure to a 60-kPa blast from a control level of 6 mm Hg. While the initial elevation took place within 30 min after exposure to 60 kPa, it did not appear until after 2 and 6 h for 30 and 10 kPa, respectively. In all cases, the ICP returned to control levels after 7 days. The cognitive function of the blast-exposed rats was assessed with the Morris water maze. After exposure to 10 or 30 kPa and re-testing 2 days later, the latency was increased by over 100%. The results show that exposure of rats to blast levels as low as 10 kPa affects both ICP and cognitive function. Though species differences do not allow direct extrapolation to humans, these findings do pose the question as to whether the thresholds for brain injury might be lower than those of other organs used to set training standards for blast exposure.

  14. Role of borehole pressure containment on surface ground vibration levels at close scaled distances

    SciTech Connect

    Taqieddin, S.A.

    1982-01-01

    A total of 84 reduced-scale single-hole test blasts were conducted to study the effects of collar stemming length, primer location, geophone orientation, and indirectly the borehole and detonation pressures on the generation of ground vibrations. Extra 60% dynamite and black powder explosives were tested. Charges of 144.5 and 276.5 gm having diameters of 0.5-, 0.75-, and 1.00-inch were confined within holes drilled in Jefferson City dolomite rock. Three collar stemming lengths, bottom and collar priming and two different orientation of joints were employed. Particle velocity measured by a recording seismograph, with its geophone placed at constant 15 feet, was used throughout this study. It was found at the close scaled-distances employed in this study that collar stemming length has a reciprocal relationship with the levels of ground vibration up to an optimum value beyond which it has minimal effect. Also, the length of collar stemming needed to suppress ground vibration is less than that needed to contain air blast and was dependent on charge diameter. It was also found that collar-primed charges produced higher levels of ground vibration than did the bottom-primed charges, and ground vibrations attenuated more rapidly parallel to the geologic jointing direction. Lastly it was found that the primary cause of ground vibrations was the explosive borehole pressure with little or no effect produced by detonation pressure.

  15. Association of low-level blood lead and blood pressure in NHANES 1999-2006

    SciTech Connect

    Scinicariello, Franco; Abadin, Henry G.; Edward Murray, H.

    2011-11-15

    This study investigated whether low blood-lead levels ({<=}10 {mu}g/dL) were associated with blood pressure (BP) outcomes. The authors analyzed data from National Health and Nutrition Examination Survey 1999-2006 and participants aged 20 years or older. Outcome variables were systolic and diastolic BP measurements, pulse pressure, and hypertension status. Multivariable linear and logistic regressions stratified by race/ethnicity and gender were performed. Blood lead levels (BLL) were significantly correlated with higher systolic BP among black men and women, but not white or Mexican-American participants. BLLs were significantly associated with higher diastolic BPs among white men and women and black men, whereas, a negative association was observed in Mexican-American men that had, also, a wider pulse pressure. Black men in the 90th percentile of blood lead distribution (BLL{>=}3.50 {mu}g/dL) compared to black men in the 10th percentile of blood lead distribution (BLL{<=}0.7 {mu}g/dL) had a significant increase of risk of having hypertension (adjusted POR=2.69; 95% CI: 1.08-6.72). In addition, blood cadmium was significantly associated with hypertension and systolic and diastolic blood. This study found that, despite the continuous decline in blood lead in the U.S. population, lead exposure disparities among race and gender still exist.

  16. [Physical activity level and home blood pressure measurement: Pilot study "Acti-HTA"].

    PubMed

    Sosner, P; Ott, J; Steichen, O; Bally, S; Krummel, T; Brucker, M; Lequeux, B; Dourmap, C; Llaty, P; Le Coz, S; Baguet, S; Miranne, A; Labrunée, M; Gremeaux, V; Lopez-Sublet, M

    2015-06-01

    While physical activity (PA) is recommended for high blood pressure management, the level of PA practice of hypertensive patients remains unclear. We aimed to assess the association between the level of both PA and blood pressure of individuals consulting in 9 hypertension specialist centres. Eighty-five hypertensive patients were included (59 ± 14 years, 61% men, 12% smokers, 29% with diabetes). Following their consultation, they performed home blood pressure measurement (HBPM) over 7 days (2 in the morning+2 in the evening), they wrote in a dedicated form their daily activities to estimate the additional caloric expenditure using Acti-MET device (built from International physical Activity Questionnaire [IPAQ]). Thus, patients completed a self-administered questionnaire "score of Dijon" (distinguishing active subjects with a score>20/30, from sedentary<10/30). Subjects with normal HBPM value (<135/85 mm Hg) (55% of them) compared to those with high HBPM were older, had a non-significant trend towards higher weekly caloric expenditure (4959 ± 5045 kcal/week vs. 4048 ± 4199 kcal/week, P=0.3755) and score of Dijon (19.44 ± 5.81 vs. 18.00 ± 4.32, P=0.2094) with a higher proportion of "active" subjects (48.9% vs. 34.2%, P=0.1773). In conclusion, our results demonstrate a "tendency" to a higher level of reported PA for subjects whose hypertension was controlled. This encourages us to continue with a study that would include more subjects, which would assess PA level using an objective method such as wearing an accelerometer sensor.

  17. The association of blood pressure levels and change in renal function in hypertensive and nonhypertensive subjects.

    PubMed

    Rosansky, S J; Hoover, D R; King, L; Gibson, J

    1990-10-01

    We compared the changes in serum creatinine levels over time after a mean follow-up of 9.8 years in essential hypertensive (EH, n = 56) and control (n = 59) male veteran subjects. All subjects had normal serum creatinine levels (62 to 124 mumol/L) and "normal" urinalysis results on entry into the study. Subjects with comorbid renal diagnoses and diabetes mellitus were eliminated from the analysis. Although not statistically significant, the rate of change in the serum creatinine concentration over time was greater in the EH cohort compared with the control cohort (1.08 +/- 4.8 vs 0.027 +/- 3.5 mumol/L per year). The difference was especially marked in black EH subjects vs black control subjects (1.60 +/- 6.2 mumol/L per year vs -0.21 +/- 3.3 mumol/L per year). When age, race, body mass index, and a diagnosis of EH were entered into a logistic regression analysis, EH subjects had a statistically significantly greater rate of decline in renal function than did control subjects (1.5 +/- 8.3 mumol/L per year). When mean time-averaged systolic blood pressure for each subject was also included in the logistic regression analysis, only systolic time-averaged blood pressure was statistically significant (0.063 +/- 0.029 mumol/L per year). We conclude that in the absence of clinically detected parenchymal renal disease, EH subjects have a greater rate of decline in renal function than do nonhypertensive subjects. Time-averaged blood pressure is predictive of the change in serum creatinine concentration not only in EH subjects but also in nonhypertensive subjects. Thus, preservation of renal function may require a blood pressure lower than the currently accepted normotensive range.

  18. Intragastric pressure: Useful indicator in the management of congenital diaphragmatic hernia

    PubMed Central

    Mandal, Kartik Chandra; Halder, Pankaj; Barman, Shibsankar; Kumar, Rajarshi; Mukhopadhyay, Biswanath; Shukla, Ram Mohan

    2016-01-01

    Aims: To assess the role of measuring of intragastric pressure (IGP) during closure of congenital diaphragmatic hernia. Materials and Methods: Thirty-two cases were included in the study (August 2008 to February 2014), and IGP has been measured intraoperatively during closure. Result: Patients were categorized in group A (15 patients), group B (14 patients) and group C (3 patients). In group C, IGP was more than 30 cm of water pressure and all of tehm required creation of ventral hernia and ventilator support. Conclusion: Measurement of IGP as an objective, noninvasive and simple method to evaluate intra-abdominal pressure and prevention of abdominal compartment syndrome and intraoperative IGP value determines the types of abdominal closure. PMID:27695209

  19. Effect of external pressure environment on the internal noise level due to a source inside a cylindrical tank

    NASA Technical Reports Server (NTRS)

    Clevenson, S. A.; Roussos, L. A.

    1984-01-01

    A small cylindrical tank was used to study the effect on the noise environment within a tank of conditions of atmospheric (sea level) pressure or vacuum environments on the exterior. Experimentally determined absorption coefficients were used to calculate transmission loss, transmissibility coefficients and the sound pressure (noise) level differences in the interior. The noise level differences were also measured directly for the two exterior environments and compared to various analytical approximations with limited agreement. Trend study curves indicated that if the tank transmission loss is above 25 dB, the difference in interior noise level between the vacuum and ambient pressure conditions are less than 2 dB.

  20. An algorithm based on sea level pressure fluctuations to identify major Baltic inflow events

    NASA Astrophysics Data System (ADS)

    Schimanke, Semjon; Dieterich, Christian; Markus Meier, H. E.

    2014-05-01

    The Baltic Sea is one of world largest brackish water areas with an estuarine like circulation. It is connected to the world ocean through the narrow Danish straits limiting the exchange of water masses. The deep water of the Baltic Sea is mainly renewed by so called major Baltic inflows which are an important feature to sustain the sensitive steady state of the Baltic Sea. We introduce an algorithm to identify atmospheric variability favourable for major Baltic inflows. The algorithm is based on sea level pressure fields as the only parameter. Characteristic sea level pressure pattern fluctuations include a precursory phase of 30 days and 10 days of inflow period. The algorithm identifies successfully the majority of observed major Baltic inflows between 1961--2010. In addition, the algorithm finds some occurrences which cannot be related to observed inflows. In these cases with favourable atmospheric conditions inflows were precluded by contemporaneously existing saline water masses or strong freshwater supply. No event is registered during the stagnation period 1983-1993 indicating that the lack of inflows is a consequence of missing favourable atmospheric variability. The only striking inflow which is not identified by the algorithm is the event in January 2003. We demonstrate that this is due to the special evolution of sea level pressure fields which are not comparable with any other event. Finally, the algorithm is applied to an ensemble of scenario simulations. The result indicates that the number of atmospheric events favourable for major Baltic inflows increases slightly in all scenarios. Possible explanations as for instance more frequent atmospheric blockings or changes in the NAO will be discussed.

  1. Disproportional decrease in office blood pressure compared with 24-hour ambulatory blood pressure with antihypertensive treatment: dependency on pretreatment blood pressure levels.

    PubMed

    Schmieder, Roland E; Schmidt, Stephanie T; Riemer, Thomas; Dechend, Ralf; Hagedorn, Ina; Senges, Jochen; Messerli, Franz H; Zeymer, Uwe

    2014-11-01

    The long-term relationship between 24-hour ambulatory blood pressure (ABP) and office BP in patients on therapy is not well documented. From a registry we included all patients in whom antihypertensive therapy needed to be uptitrated. Drug treatment included the direct renin inhibitor aliskiren or an angiotensin-converting enzyme inhibitor/angiotensin receptor blocker or drugs not blocking the renin-angiotensin system, alone or on top of an existing drug regimen. In all patients, office BP and 24-hour ABP were obtained at baseline and after 1 year with validated devices. In the study population of 2722 patients, there was a good correlation between the change in office BP and 24-hour ABP (systolic: r=0.39; P<0.001; diastolic: r=0.34; P<0.001). However, the numeric decrease in office BP did not correspond to the decrease in ABP in a 1:1 fashion, for example, a decrease of 10, 20, and 30 mm Hg corresponded to a decrease of ≈7.2, 10.5, and 13.9 mm Hg in systolic ABP, respectively. The disproportionally greater decrease in systolic office BP compared with ABP was dependent on the level of the pretreatment BP, which was consistently higher for office BP than ABP. The white coat effect (difference between office BP and ABP) was on average 10/5 mm Hg lower 1 year after intensifying treatment and the magnitude of that was also dependent on pretreatment BP. There was a disproportionally greater decrease in systolic office BP than in ABP, which for both office BP and ABP seemed to depend on the pretreatment BP level.

  2. Development of a nuclear technique for monitoring water levels in pressurized vehicles

    NASA Technical Reports Server (NTRS)

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

    1983-01-01

    A new technique for monitoring water levels in pressurized stainless steel cylinders was developed. It is based on differences in attenuation coefficients of water and air for Cs137 (662 keV) gamma rays. Experimentally observed gamma ray counting rates with and without water in model reservoir cylinder were compared with corresponding calculated values for two different gamma ray detection theshold energies. Calculated values include the effects of multiple scattering and attendant gamma ray energy reductions. The agreement between the measured and calculated values is reasonably good. Computer programs for calculating angular and spectral distributions of scattered radition in various media are included.

  3. Development of an improved-contact liquid-level probe for pressurized reactor vessels

    NASA Astrophysics Data System (ADS)

    Kelsey, P. V., Jr.

    1982-09-01

    Electrical-conductivity-based probes for liquid level sensing show promise for pressurized water reactor environments, but have exhibited frequent bond failures at the ceramic/metal interfaces. A program to characterize and improve the interface behavior was completed successfully, and provided data for optimizing fabrication parameters, as well as general information on glass-to-metal bonding in a superalloy/silicate-glass system. The materials studied were Inconel X-750 and a barium silicate glass containing minor amounts of TiO2, CeO2, As2O3, Bi2O3, and Al2O3.

  4. Effects of Pressure on Optically Active Deep Levels in Phosphorus Doped ZnSe

    NASA Astrophysics Data System (ADS)

    Weinstein, B. A.; Iota, V.

    1998-03-01

    We report high pressure photoluminescence (PL) and PL-excitation (PLE) studies at 8K of the 'midgap' emission in P-doped ZnSe using a diamond-cell with He medium. The dominant emission at low pressure is due to donor-acceptor-pair (DAP) transitions between shallow donors and deep trigonally relaxed P_Se acceptors.(J. Davies, et al., J. Luminescence 18/19, 322 (1979)) Its PL and PLE peaks shift by 8.2meV/kbar and 5.9meV/kbar, respectively -- Stokes shift decreasing with pressure. At 35kbar a new PL band, shifting to lower energy (-5.4meV/kbar), emerges from above the absorption edge, and concurrently the original DAP PL quenches. This shows that a resonant level, a deep donor or possibly a P_Se antibonding state,(R. Watts, et al., Phys. Rev. B3), 404 (1971) crosses the conduction edge into the gap. A third PL band is seen only with internse UV excitation. It occurs initially as a high energy shoulder of the original DAP peak, but shifts more rapidly upward (9.4meV/kbar) until it crosses the edge and quenches at 40kbar. We discuss candidates for this band, including donor-P_Se complexes, and we compare our results to similar work on the Zn vacancy in ZnSe. (figures)

  5. Point prevalence of pressure ulcers in three second-level hospitals in Mexico.

    PubMed

    Galván-Martínez, Iris L; Narro-Llorente, Roberto; Lezama-de-Luna, Favio; Arredondo-Sandoval, Jesus; Fabian-Victoriano, Ma Rosy; Garrido-Espindola, Ximena; Lozano-Platonoff, Adriana; Contreras-Ruiz, Jose

    2014-12-01

    Pressure ulcers (PU) are the source of multiple complications and even death. To our knowledge, there is no available data about PU prevalence in Mexico. The objective of this study was to determine the point prevalence of PU in three second-level hospitals in Mexico. Every adult hospitalised patient was included in each hospital. Age, gender, hospitalisation ward, Braden score, and the number, location and stage of the ulcers encountered were recorded, as well as any pressure relief measures. In total, 294 patients were examined (127 were male); of these, 63 were considered to be at risk. The average age was 48·6 years. The overall prevalence of the PU was 17%. The service with the highest prevalence was the ICU. The most frequent stage was II (32%) and they were most commonly found in the sacrum (74%). The average Braden score of the patients with ulcers was 10, and 21·4% of the patients obtained moderate- to high-risk Braden scores. Of them, 60·3% had ulcers and only 46% had any preventive measures. The prevalence of PU in three hospitals in Mexico is 17%. The most common stage is II and the most commonly affected site is the sacrum. Only 46% of patients with PU had at least one pressure release measure.

  6. Association between respiratory muscle strength and reduction of arterial blood pressure levels after aerobic training in hypertensive subjects

    PubMed Central

    Galdino, Giovane; Silva, Andreia Maria; Bogão, José Angelo; Braz de Oliveira, Marcos Paulo; Araújo, Hayslenne Andressa Gonçalves de Oliveira; Oliveira, Maísa Sodoco; Maldonado, Ana Clara Desiderio; Ulisses de Oliveira, Herick; Borges, Juliana Bassalobre Carvalho

    2016-01-01

    [Purpose] The purpose of present study was associate the increase of respiratory muscle strength with blood pressure levels in hypertensive subjects who underwent an aerobic exercise program. [Subjects and Methods] 90 hypertensive subjects were divided in two groups: intervention and control. All participants had an interview with a physiotherapist and were evaluated by 6-minute walk test, maximal inspiratory pressure, maximal expiratory pressure, heart rate, systolic blood pressure and diastolic blood pressure, before and after the 8 weeks. In the intervention group, the subjects underwent aerobic exercise program, 2 times a week for 8 weeks [Results] After the program, the levels of blood pressure were significantly reduced and the distance walked in the 6-minute walk test and the respiratory muscle strength were increased, compared to pre intervention and control group values. However, there was no correlation between the results provided by 6-minute walk test, maximal inspiratory pressure and maximal expiratory pressure with systolic arterial blood pressure levels. Nonetheless, the distance walked correlated with respiratory muscle strength values, in the intervention group. [Conclusion] The present study demonstrated that the aerobic training was effective in reducing the arterial blood pressure in hypertensive subjects associated with an improvement of physical conditioning and respiratory muscle strength. PMID:28174465

  7. Output sound pressure levels of personal music systems and their effect on hearing.

    PubMed

    Kumar, Ajith; Mathew, Kuruvilla; Alexander, Swathy Ann; Kiran, Chitra

    2009-01-01

    This study looked at output levels produced by new generation personal music systems (PMS), at the level of eardrum by placing the probe microphone in the ear canal. Further, the effect of these PMS on hearing was evaluated by comparing the distortion product otoacoustic emissions and high frequency pure tone thresholds (from 3 kHz to 12 kHz) of individuals who use PMS to that of age matched controls who did not use PMS. The relationship between output sound pressure levels and hearing measures was also evaluated. In Phase I output SPLs produced by the PMS were measured in three different conditions - a) at volume control setting that was preferred by the subjects in quiet b) at volume control setting that was preferred by the subject in presence of 65 dB SPL bus noise c) at maximum volume control settings of the instrument. In Phase II pure tone hearing thresholds and DPOAEs were measured. About 30% of individuals in a group of 70 young adults listened to music above the safety limits (80 dBA for 8 hours) prescribed by Ministry of Environment and Forests, India. Addition of bus noise did not increase the preferred volume control settings of the subjects significantly. There were no significant differences between the experimental and control groups for mean pure tone threshold and for mean DPOAE amplitude comparisons. However, a positive correlation between hearing thresholds and music levels and a negative correlation between DPOAE measures and music levels were found.

  8. Comparing two levels of closed system suction pressure in ICU patients: Evaluating the relative safety of higher values of suction pressure

    PubMed Central

    Yazdannik, Ahmad R.; Haghighat, Somayeh; Saghaei, Mahmoud; Eghbali, Maryam

    2013-01-01

    Background: Endotracheal suctioning (ETS) is one of the most common supportive measures in intensive care units (ICU). ETS may be associated with complications including hypoxia and tachycardia. Closed system suctioning (CSS) decreases the rate of cardiorespiratory complication mainly due to continuation of ventilatory support and oxygenation during procedure. CSS has questionable efficacy, therefore higher values of negative pressure has been recommended to enhance the efficacy of CSS. This study was designed to evaluate the effects on gas exchange of 200 mmHg suctioning pressure compared with 100 mmHg in CSS. Materials and Methods: Fifty mechanically ventilated (MV) ICU patients were selected for the study. Two consecutive ten seconds CSS using suction pressures of 100 and 200 mmHg, in random order applied in each subject with the two hours wash out period. Effects of two levels of suction pressure on gas exchange were measured by recording the SPo2 values at 4 times. Results: Repeated measure analysis of variance didn't show any significant difference between two levels of pressure (P = 0.315), but within each groups (100 and 200 mmHg) SPO2 changes was significant (P = 0.000). There was a mild but significant and transient increase in heart rate following both suction pressures, but no significant difference between two groups. Conclusion: The results show that CSS with suction pressure 200 mmHg has no detrimental effect on cardiorespiratory function of MV ICU patients. Since the safety of 200 mmHg suctioning pressure was approved, using 200 mmHg suction pressures is recommended for ETS of MV patients. PMID:23983740

  9. Effects of zero reference position on bladder pressure measurements: an observational study

    PubMed Central

    2012-01-01

    Background Although the World Society for Abdominal Compartment Syndrome in its guidelines recommends midaxillary line (MAL) as zero reference level in intra-abdominal pressure (IAP) measurements in aiming at standardizing the technique, evidence supporting this suggestion is scarce. The aim of this study is to study if the zero reference position influences bladder pressure measurements as estimate for IAP. Methods The IAP of 100 surgical patients was measured during the first 24 h of admission to the surgical intensive care unit of General Calixto Garcia Hospital in Havana (Cuba) following laparotomy. The period was January 2009 to January 2010. The IAP was measured twice with a six-hour interval using the transurethral technique with a priming volume of 25 ml. IAP was first measured with the zero reference level placed at MAL (IAPMAL), followed by a second measurement at the level of the symphysis pubis (SP) after 3 minutes (IAPSP). Correlations were made between IAP and body mass index (BMI), type of surgery, gender, and age. Results Mean IAPMAL was 8.5 ± 2.8 mmHg vs. IAPSP 6.5 ± 2.8 mmHg (p < 0.0001). The bias between measurements was 2.0 ± 1.5, 95% confidence interval of 1.4 to 3.0, upper limit of 4.9, lower limit of -0.9, and a percentage error of 35.1%. IAPMAL was consistently higher than IAPSP regardless of the type of surgery. The BMI correlated with IAP values regardless of the zero reference level (R2 = 0.4 and 0.3 with IAPMAL and IAPSP respectively, p < 0.0001). Conclusions The zero reference level has an important impact on IAP measurement in surgical patients after laparotomy and can potentially lead to over or underestimation. Further anthropometric studies are needed with regard to the relative MAL and SP zero reference position in relation to the theoretical ideal reference level at midpoint of the abdomen. Until better evidence is available, MAL remains the recommended zero reference position due to its best anatomical localization at iliac

  10. Intraocular pressure (IOP) in relation to four levels of daily geomagnetic and extreme yearly solar activity

    NASA Astrophysics Data System (ADS)

    Stoupel, E.; Goldenfeld, M.; Shimshoni, M.; Siegel, R.

    1993-03-01

    The link between geomagnetic field activity (GMA), solar activity and intraocular pressure (IOP) in healthy individuals was investigated. The IOP of 485 patients (970 eyes) was recorded over three nonconsecutive years (1979, 1986, 1989) which were characterized by maximal solar activity (1979, 1989) or minimal solar activity (1986). The measurements were also correlated with four categories of GMA activity: quiet (level I0), unsettled (II0), active (III0), and stormy (IV0). Participants were also differentiated by age and sex. We found that IOP was lowest on days of level IV0 (stormy) GMA. The drop in IOP concomitant with a decrease in GMA level was more significant during periods of low solar activity and in persons over 65 years of age. There was a trend towards higher IOP values on days of levels II0 and IV0 GMA in years of high solar activity. Differences between the sexes and among individuals younger than 65 years were not significant. Our results show an interesting aspect of environmental influence on the healthy population.

  11. COMPARISON OF VENTED AND ABSOLUTE PRESSURE TRANSDUCERS FOR WATER-LEVEL MONITORING IN HANFORD SITE CENTRAL PLATEAU WELLS

    SciTech Connect

    MCDONALD JP

    2011-09-08

    Automated water-level data collected using vented pressure transducers deployed in Hanford Site Central Plateau wells commonly display more variability than manual tape measurements in response to barometric pressure fluctuations. To explain this difference, it was hypothesized that vented pressure transducers installed in some wells are subject to barometric pressure effects that reduce water-level measurement accuracy. Vented pressure transducers use a vent tube, which is open to the atmosphere at land surface, to supply air pressure to the transducer housing for barometric compensation so the transducer measurements will represent only the water pressure. When using vented transducers, the assumption is made that the air pressure between land surface and the well bore is in equilibrium. By comparison, absolute pressure transducers directly measure the air pressure within the wellbore. Barometric compensation is achieved by subtracting the well bore air pressure measurement from the total pressure measured by a second transducer submerged in the water. Thus, no assumption of air pressure equilibrium is needed. In this study, water-level measurements were collected from the same Central Plateau wells using both vented and absolute pressure transducers to evaluate the different methods of barometric compensation. Manual tape measurements were also collected to evaluate the transducers. Measurements collected during this study demonstrated that the vented pressure transducers over-responded to barometric pressure fluctuations due to a pressure disequilibrium between the air within the wellbores and the atmosphere at land surface. The disequilibrium is thought to be caused by the relatively long time required for barometric pressure changes to equilibrate between land surface and the deep vadose zone and may be exacerbated by the restriction of air flow between the well bore and the atmosphere due to the presence of sample pump landing plates and well caps. The

  12. Deep electronic levels at growth interrupted interfaces in low-temperature-grown GaAs and the pressure dependence of these levels

    SciTech Connect

    Samara, G.A. ); Vook, D.W.; Gibbons, J.F. )

    1992-02-15

    Deep electronic energy levels associated with defects confined to interrupted growth interfaces of thin GaAs layers grown by low-temperature (720 K) metalorganic chemical vapor deposition using tertiarybutylarsine and subsequently annealed at 920 K for about 2 min were investigated by transient capacitance spectroscopy at both atmospheric pressure (1 bar) and hydrostatic pressures to 8 kbar. Samples grown under widely different As/Ga ratios in the gas phase were compared, and this ratio was found to have a strong influence on the levels observed. Most of these levels are characteristic of levels seen in GaAs grown from the vapor phase. Analysis of the pressure dependencies of the electron emission rates and capture cross sections shows that most of the levels move higher in energy with pressure and yields the activation volume which accompanies electron emission or capture. These features are unique signatures of the levels and provide new insights into the physics involved. One of the levels is identified as the midgap donor EL2. Its energy exhibits a relatively large increase with pressure, and a large inward (outward) volume relaxation accompanies electron emission (capture) of electrons from (by) it.

  13. Cuff Pressure Pain Detection Is Associated with Both Sex and Physical Activity Level in Nonathletic Healthy Subjects.

    PubMed

    Lemming, Dag; Börsbo, Björn; Sjörs, Anna; Lind, Eva-Britt; Arendt-Nielsen, Lars; Graven-Nielsen, Thomas; Gerdle, Björn

    2017-01-04

    PURPOSE : The aim of this study was to evaluate pressure pain sensitivity on leg and arm in 98 healthy persons (50 women) using cuff algometry. Furthermore, associations with sex and physical activity level were investigated.

  14. Pressure ulcer prevention in nursing homes: nurse descriptions of individual and organization level factors.

    PubMed

    Dellefield, Mary Ellen; Magnabosco, Jennifer L

    2014-01-01

    Sustaining pressure ulcer prevention (PUP) in nursing homes has been difficult to achieve. Implementation science researchers suggest that identification of individual staff and organizational factors influencing current practices is essential to the development of an effective and customized plan to implement practice changes in a specific setting. A mixed methods approach was used to describe nurses' perceptions of individual and organization-level factors influencing performance of PUP in two Veterans Health Administration (VHA) nursing homes prior to implementation of a national VHA initiative on Hospital Acquired Pressure Ulcers (HAPUs). Individual interviews of 16 nursing staff were conducted. Individual factors influencing practice were a personal sense of responsibility to Veterans and belief in the effectiveness and importance of preventive measures. Organizational factors were existence of cooperative practices between nursing assistants and licensed nurses in assessing risk; teamwork, communication, and a commitment to Veterans' well-being. Integration and reinforcement of such factors in the development and maintenance of customized plans of PUP initiatives is recommended.

  15. Active Negative Pressure Peritoneal Therapy After Abbreviated Laparotomy

    PubMed Central

    Roberts, Derek J.; Faris, Peter D.; Ball, Chad G.; Kubes, Paul; Tiruta, Corina; Xiao, Zhengwen; Holodinsky, Jessalyn K.; McBeth, Paul B.; Doig, Christopher J.; Jenne, Craig N.

    2015-01-01

    Objective: To determine whether active negative pressure peritoneal therapy with the ABThera temporary abdominal closure device reduces systemic inflammation after abbreviated laparotomy. Background: Excessive systemic inflammation after abdominal injury or intra-abdominal sepsis is associated with poor outcomes. Methods: We conducted a single-center, randomized controlled trial. Forty-five adults with abdominal injury (46.7%) or intra-abdominal sepsis (52.3%) were randomly allocated to the ABThera (n = 23) or Barker's vacuum pack (n = 22). On study days 1, 2, 3, 7, and 28, blood and peritoneal fluid were collected. The primary endpoint was the difference in the plasma concentration of interleukin-6 (IL-6) 24 and 48 hours after temporary abdominal closure application. Results: There was a significantly lower peritoneal fluid drainage from the ABThera at 48 hours after randomization. Despite this, there was no difference in plasma concentration of IL-6 at baseline versus 24 (P = 0.52) or 48 hours (P = 0.82) between the groups. There was also no significant intergroup difference in the plasma concentrations of IL-1β, −8, −10, or −12 p70 or tumor necrosis factor α between these time points. The cumulative incidence of primary fascial closure at 90 days was similar between groups (hazard ratio, 1.6; 95% confidence interval, 0.82–3.0; P = 0.17). However, 90-day mortality was improved in the ABThera group (hazard ratio, 0.32; 95% confidence interval, 0.11–0.93; P = 0.04). Conclusions: This trial observed a survival difference between patients randomized to the ABThera versus Barker's vacuum pack that did not seem to be mediated by an improvement in peritoneal fluid drainage, fascial closure rates, or markers of systemic inflammation. Trial Registration: ClinicalTrials.gov identifier NCT01355094. PMID:25536308

  16. Fuzzy logic control of steam generator water level in pressurized water reactors

    SciTech Connect

    Kuan, C.C.; Lin, C.; Hsu, C.C. . Dept. of Nuclear Engineering)

    1992-10-01

    In this paper a fuzzy logic controller is applied to control the steam generator water level in a pressurized water reactor. The method does not require a detailed mathematical mode of the object to be controlled. The design is based on a set of linguistic rules that were adopted from the human operator's experience. After off-line fuzzy computation, the controller is a lookup table, and thus, real-time control is achieved. Shrink-and-swell phenomena are considered in the linguistic rules, and the simulation results show that their effect is dramatically reduced. The performance of the control system can also be improved by changing the input and output scaling factors, which is convenient for on-line tuning.

  17. Diversity in sound pressure levels and estimated active space of resident killer whale vocalizations.

    PubMed

    Miller, Patrick J O

    2006-05-01

    Signal source intensity and detection range, which integrates source intensity with propagation loss, background noise and receiver hearing abilities, are important characteristics of communication signals. Apparent source levels were calculated for 819 pulsed calls and 24 whistles produced by free-ranging resident killer whales by triangulating the angles-of-arrival of sounds on two beamforming arrays towed in series. Levels in the 1-20 kHz band ranged from 131 to 168 dB re 1 microPa at 1 m, with differences in the means of different sound classes (whistles: 140.2+/-4.1 dB; variable calls: 146.6+/-6.6 dB; stereotyped calls: 152.6+/-5.9 dB), and among stereotyped call types. Repertoire diversity carried through to estimates of active space, with "long-range" stereotyped calls all containing overlapping, independently-modulated high-frequency components (mean estimated active space of 10-16 km in sea state zero) and "short-range" sounds (5-9 km) included all stereotyped calls without a high-frequency component, whistles, and variable calls. Short-range sounds are reported to be more common during social and resting behaviors, while long-range stereotyped calls predominate in dispersed travel and foraging behaviors. These results suggest that variability in sound pressure levels may reflect diverse social and ecological functions of the acoustic repertoire of killer whales.

  18. Blood pressure (BP) assessment-from BP level to BP variability.

    PubMed

    Feber, Janusz; Litwin, Mieczyslaw

    2016-07-01

    The assessment of blood pressure (BP) can be challenging in children, especially in very young individuals, due to their variable body size and lack of cooperation. In the absence of data relating BP with cardiovascular outcomes in children, there is a need to convert absolute BP values (in mmHg) into age-, gender- and height appropriate BP percentiles or Z-scores in order to compare a patient's BP with the BP of healthy children of the same age, but also of children of different ages. Traditionally, the interpretation of BP has been based mainly on the assessment of the BP level obtained by office, home or 24-h BP monitoring. Recent studies suggest that it is not only BP level (i.e. average BP) but also BP variability that is clinically important for the development of target organ damage, including the progression of chronic kidney disease. In this review we describe current methods to evaluate of BP level, outline available methods for BP variability assessment and discuss the clinical consequences of BP variability, including its potential role in the management of hypertension.

  19. Stress in the wild: chronic predator pressure and acute restraint affect plasma DHEA and corticosterone levels in a songbird.

    PubMed

    Newman, A E M; Zanette, L Y; Clinchy, M; Goodenough, N; Soma, K K

    2013-05-01

    The effects of chronic stressors on glucocorticoid levels are well described in laboratory rodents, but far less is known about the effects of chronic stressors on wild animals or on dehydroepiandrosterone (DHEA) levels. DHEA can be produced by the adrenal cortex and has prominent antiglucocorticoid properties. Here, we examined wild songbirds to elucidate the relationship between chronic predator pressure and plasma DHEA and corticosterone levels. We measured circulating steroid levels at baseline and after acute restraint in the breeding and nonbreeding seasons. During the breeding season, males in low predator pressure (LPP) environments had higher baseline DHEA levels than males in high predator pressure (HPP) environments. Also, acute restraint decreased DHEA levels in LPP males only but increased corticosterone levels in HPP and LPP males similarly. During the nonbreeding season, DHEA and corticosterone levels were lower than during the breeding season, and acute restraint decreased DHEA levels in both HPP and LPP males. Unlike males, breeding females showed no effect of predator pressure on baseline DHEA or corticosterone levels. These data suggest that naturalistic chronic and acute stressors affect circulating DHEA and corticosterone levels in wild animals and highlight the importance of using multiple endpoints when studying the physiological effects of chronic stress.

  20. Calpain-5 gene variants are associated with diastolic blood pressure and cholesterol levels

    PubMed Central

    Sáez, María E; Martínez-Larrad, María T; Ramírez-Lorca, Reposo; González-Sánchez, José L; Zabena, Carina; Martinez-Calatrava, María J; González, Alejandro; Morón, Francisco J; Ruiz, Agustín; Serrano-Ríos, Manuel

    2007-01-01

    Background Genes implicated in common complex disorders such as obesity, type 2 diabetes mellitus (T2DM) or cardiovascular diseases are not disease specific, since clinically related disorders also share genetic components. Cysteine protease Calpain 10 (CAPN10) has been associated with T2DM, hypertension, hypercholesterolemia, increased body mass index (BMI) and polycystic ovary syndrome (PCOS), a reproductive disorder of women in which isunlin resistance seems to play a pathogenic role. The calpain 5 gene (CAPN5) encodes a protein homologue of CAPN10. CAPN5 has been previously associated with PCOS by our group. In this new study, we have analysed the association of four CAPN5 gene variants(rs948976A>G, rs4945140G>A, rs2233546C>T and rs2233549G>A) with several cardiovascular risk factors related to metabolic syndrome in general population. Methods Anthropometric measurements, blood pressure, insulin, glucose and lipid profiles were determined in 606 individuals randomly chosen from a cross-sectional population-based epidemiological survey in the province of Segovia in Central Spain (Castille), recruited to investigate the prevalence of anthropometric and physiological parameters related to obesity and other components of the metabolic syndrome. Genotypes at the four polymorphic loci in CAPN5 gene were detected by polymerase chain reaction (PCR). Results Genotype association analysis was significant for BMI (p ≤ 0.041), diastolic blood pressure (p = 0.015) and HDL-cholesterol levels (p = 0.025). Different CAPN5 haplotypes were also associated with diastolic blood pressure (DBP) (0.0005 ≤ p ≤ 0.006) and total cholesterol levels (0.001 ≤ p ≤ 0.029). In addition, the AACA haplotype, over-represented in obese individuals, is also more frequent in individuals with metabolic syndrome defined by ATPIII criteria (p = 0.029). Conclusion As its homologue CAPN10, CAPN5 seems to influence traits related to increased risk for cardiovascular diseases. Our results also

  1. Identifying Individuals at Risk for Cardiovascular Events Across the Spectrum of Blood Pressure Levels

    PubMed Central

    Karmali, Kunal N; Ning, Hongyan; Goff, David C; Lloyd-Jones, Donald M

    2015-01-01

    Background We determined the proportion of atherosclerotic cardiovascular disease (ASCVD) events that occur across the spectrum of systolic blood pressure (SBP) and assessed whether multivariable risk assessment can identify persons who experience ASCVD events at all levels of SBP, including those with goal levels. Methods and Results Participants aged 45 to 64 years from the Framingham Offspring and Atherosclerosis Risk in Communities studies were stratified based on treated and untreated SBP levels (<120, 120 to 129, 130 to 139, 140 to 149, 150 to 159, ≥160 mm Hg). We determined the number of excess ASCVD events in each SBP stratum by calculating the difference between observed and expected events (ASCVD event rate in untreated SBP <120 mm Hg was used as the reference). We categorized participants into 10-year ASCVD risk groups using the Pooled Cohort risk equations. There were 18 898 participants (78% white; 22% black) who were followed for 10 years. We estimated 427 excess ASCVD events, of which 56% (109 of 197) and 50% (115 of 230), respectively, occurred among untreated and treated participants with elevated SBP who were not recommended for antihypertensive therapy. Among untreated participants, 10-year ASCVD risk ≥7.5% identified 64% of those who experienced an ASCVD at 10 years and 30% of those who did not. Multivariable risk assessment was less useful in baseline-treated participants. Conclusions Half of excess ASCVD events occurred in persons with elevated SBP who were not currently recommended for antihypertensive therapy. Multivariable risk assessment may help identify those likely to benefit from further risk-reducing therapies. These findings support consideration of multivariable risk in guiding prevention across the spectrum of SBP. PMID:26391134

  2. Sound Pressure Levels Measured in a University Concert Band: A Risk of Noise-Induced Hearing Loss?

    ERIC Educational Resources Information Center

    Holland, Nicholas V., III

    2008-01-01

    Researchers have reported public school band directors as experiencing noise-induced hearing loss. Little research has focused on collegiate band directors and university student musicians. The present study measures the sound pressure levels generated within a university concert band and compares sound levels with the criteria set by the…

  3. Peak Sound Pressure Levels and Associated Auditory Risk from an H[subscript 2]-Air "Egg-Splosion"

    ERIC Educational Resources Information Center

    Dolhun, John J.

    2016-01-01

    The noise level from exploding chemical demonstrations and the effect they could have on audiences, especially young children, needs attention. Auditory risk from H[subscript 2]- O2 balloon explosions have been studied, but no studies have been done on H[subscript 2]-air "eggsplosions." The peak sound pressure level (SPL) was measured…

  4. High-circulating leptin levels are associated with increased blood pressure in uncontrolled resistant hypertension.

    PubMed

    de Haro Moraes, C; Figueiredo, V N; de Faria, A P C; Barbaro, N R; Sabbatini, A R; Quinaglia, T; Ferreira-Melo, S E; Martins, L C; Demacq, C; Júnior, H M

    2013-04-01

    Leptin and aldosterone have been associated with the pathophysiological mechanisms of hypertension. However, despite studies showing the association of leptin with intima-media thickness, arterial distensibility and sympathetic nerve activation, the relationship between leptin and blood pressure (BP) in resistant hypertension (RHTN) is unknown. We aimed to assess the correlation of plasma leptin and aldosterone levels with BP in uncontrolled controlled RHTN (UCRHTN) and CRHTN patients. Plasma leptin and aldosterone levels, office BP, ambulatory BP monitoring and heart rate were measured in 41 UCRHTN, 39 CRHTN and 31 well-controlled HTN patients. No differences were observed between the three groups regarding gender, body mass index and age. The UCRHTN group had increased leptin when compared with CRHTN and well-controlled HTN patients (38.2±21.4, 19.6±8.7 and 20.94±13.9 ng ml(-1), respectively; P<0.05). Aldosterone levels values were also statistically different when comparing RHTN, CRHTN and well-controlled HTN patients (9.6±3.8, 8.1±5.0 and 8.0±4.7 ng dl(-1), respectively; P<0.05). As expected, UCRHTN patients had higher heart rate values compared with CRHTN and well-controlled HTN patients (86.2±7.2, 83.5±6.7 and 83.4±8.5, respectively; P<0.05). Plasma leptin positively correlated with systolic (SBP) and diastolic BP (DBP), and aldosterone (r=0.43, 0.35 and 0.47, respectively; all P<0.05) in UCRHTN, but neither in the CRHTN nor in the HTN group. Simple linear regression showed that SBP, DBP and aldosterone may be predicted by leptin (r(2)=0.16, 0.15 and 0.19, respectively; all P<0.05) only in the UCRHTN subgroup. In conclusion, UCRHTN patients have higher circulating leptin levels associated with increased plasma aldosterone and BP levels when compared with CRHTN and HTN subjects.

  5. [Cardiac preload and central venous pressure].

    PubMed

    Weyland, A; Grüne, F

    2009-05-01

    The force of cardiac contraction is strongly influenced by myocardial fibre length at the beginning of systole. Because the length of cardiac sarcomers and muscle fibres primarily depends on the end-diastolic ventricular volume, filling pressures a priori can only act as indirect parameters of cardiac preload. Central venous pressure (CVP) gives information on right ventricular end-diastolic pressure, which parallels changes in left ventricular end-diastolic pressure as long as ventricular function is not impaired. Since the pressure-volume relationship of cardiac ventricles is not linear and shows great variability, filling of the ventricles cannot be directly derived from end-diastolic pressure. Further limitations of CVP as a surrogate variable of preload are caused by the influence of intrathoracic and intra-abdominal pressures. A valid parameter of preload should describe the relationship between preload and stroke volume as given by the Frank-Starling law. Furthermore, estimates of cardiac preload should enable prediction of fluid responsiveness. Many studies have demonstrated that under clinical conditions CVP cannot meet these demands and thus does not appear to be a useful predictor of cardiac preload. Variables which more directly represent end-diastolic ventricular volume (e.g. intrathoracic blood volume or end-diastolic ventricular area) offer a higher validity as estimates of cardiac preload. Furthermore, dynamic parameters of ventricular preload, such as pulse pressure variation or stroke volume variation, seem to be more predictive of volume responsiveness in ventilated patients than CVP. These limitations, however, do not impair the importance of CVP as the downstream pressure of the systemic venous system.

  6. A tissue-level electromechanical model of the left ventricle: application to the analysis of intraventricular pressure.

    PubMed

    Le Rolle, Virginie; Carrault, Guy; Richard, Pierre-Yves; Pibarot, Philippe; Durand, Louis-Gilles; Hernández, Alfredo I

    2009-12-01

    The ventricular pressure profile is characteristic of the cardiac contraction progress and is useful to evaluate the cardiac performance. In this contribution, a tissue-level electromechanical model of the left ventricle is proposed, to assist the interpretation of left ventricular pressure waveforms. The left ventricle has been modeled as an ellipsoid composed of twelve mechano-hydraulic sub-systems. The asynchronous contraction of these twelve myocardial segments has been represented in order to reproduce a realistic pressure profiles. To take into account the different energy domains involved, the tissue-level scale and to facilitate the building of a modular model, multiple formalisms have been used: Bond Graph formalism for the mechano-hydraulic aspects and cellular automata for the electrical activation. An experimental protocol has been defined to acquire ventricular pressure signals from three pigs, with different afterload conditions. Evolutionary Algorithms have been used to identify the model parameters in order to minimize the error between experimental and simulated ventricular pressure signals. Simulation results show that the model is able to reproduce experimental ventricular pressure. In addition, electro-mechanical activation times have been determined in the identification process. For example, the maximum electrical activation time is reached, respectively, 96.5, 139.3 and 131.5 ms for the first, second, and third pigs. These preliminary results are encouraging for the application of the model on non-invasive data like ECG, arterial pressure or myocardial strain.

  7. Comparison of Mid-latitude Cyclones in Sea Level Pressure, Gepotential Height and Vorticity Fields

    NASA Astrophysics Data System (ADS)

    Raible, Christoph C.; Blender, Richard; Fraedrich, Klaus

    2013-04-01

    The mid-latitudes are dominated by diurnal variability, which is related to traveling high- and low-pressure systems. The lows or cyclones are a major source of natural hazards. This has led to growing interest in the scientific community to develop Eulerian and Lagrangian measures and to analyze the atmospheric high-frequency variability. One important issue is that there is no straight forward definition of cyclones resulting in a large variety of so-called cyclone detection and tracking methods. Each of these methods relies on different input fields which are related to specific features of a cyclone, e.g., sea level pressure (SLP), which specifically focuses on the mass aspect of the velocity field. Recently, the available methods have been compared with respect to climatology and life cycles using the ERA interim data set (Neu et al. 2013). Based on this study we investigate different fields as input for one specific method. We focus on the three mostly used input data, sea level pressure (SLP), 1000-hPa gepotential height (Z1000) and 850-hPa vorticity (850VOR). The cyclone detection and tracking method developed by Blender et al. (1997) is used and we apply it to ERA interim data in the 1.5 x 1.5 resolution. The method was mainly applied for Z1000 and the Northern Hemisphere (e.g., Blender et al. 1997; Raible et al. 2008). To compare the tracks and cyclone characteristics obtained from the different input data we need to adapt critical parameters of the method in such a way that comparable numbers of cyclone centers are identified in either field. The target is set to the number of cyclone centers in northern hemispheric winter. This enables us to assess the seasonal and hemispheric dependence. Preliminary results show that the agreement between cyclones based on SLP and Z1000 varies between roughly 70 to 80% depending on the season and the hemisphere. Spatially, most of the differences are found around orographic features like Greenland. An interesting

  8. Photoluminescence from the (5)D(0) level of Eu(3+) ions in a phosphate glass under pressure.

    PubMed

    Surendra Babu, S; Babu, P; Jayasankar, C K; Tröster, Th; Sievers, W; Wortmann, G

    2006-02-15

    The pressure dependence of the luminescence from [Formula: see text] transitions of Eu(3+) ions in 58.5P(2)O(5)-9Al(2)O(3)-14.5BaO-17K(2)O-1Eu(2)O(3) glass has been investigated up to 38.3 GPa at room temperature. The relative luminescence intensity ratio of [Formula: see text] to [Formula: see text] transitions of the Eu(3+) ions is found to decrease with increasing pressure, indicating a lowering of the asymmetry around the Eu(3+) ions with pressure. The [Formula: see text] transitions exhibit pressure-induced red shifts of different magnitude, which suggests a decrease in Slater parameters (F(k)) and in the spin-orbit coupling parameters (ζ) for the Eu(3+) ions. Stark components of the (7)F(1) level have been used to evaluate the crystal-field (CF) parameters B(20) and B(22), which are in turn used to estimate the CF strength experienced by the Eu(3+) ions in the glass. The observed increase in the CF strength parameter is found to have an almost cubic dependence on pressure. Luminescence decay curves for the [Formula: see text] transition are found to be single exponential over the entire pressure range studied. The lifetime did not change under pressure up to 5 GPa, although a significant change in the CF strength is noticed in this pressure range. The reduction of lifetime observed at pressures above 5 GPa could be partially due to an increase of pressure-induced defect centres. Such a process can then explain the hysteresis observed in the variation of lifetime and crystal-field strength on the release of pressure.

  9. Effect of Nickel Levels on Hydrogen Partial Pressure and Methane Production in Methanogens

    PubMed Central

    2016-01-01

    Hydrogen (H2) consumption and methane (CH4) production in pure cultures of three different methanogens were investigated during cultivation with 0, 0.2 and 4.21 μM added nickel (Ni). The results showed that the level of dissolved Ni in the anaerobic growth medium did not notably affect CH4 production in the cytochrome-free methanogenic species Methanobacterium bryantii and Methanoculleus bourgensis MAB1, but affected CH4 formation rate in the cytochrome-containing Methanosarcina barkeri grown on H2 and CO2. Methanosarcina barkeri also had the highest amounts of Ni in its cells, indicating that more Ni is needed by cytochrome-containing than by cytochrome-free methanogenic species. The concentration of Ni affected threshold values of H2 partial pressure (pH2) for all three methanogen species studied, with M. bourgensis MAB1 reaching pH2 values as low as 0.1 Pa when Ni was available in amounts used in normal anaerobic growth medium. To our knowledge, this is the lowest pH2 threshold recorded to date in pure methanogen culture, which suggests that M.bourgensis MAB1 have a competitive advantage over other species through its ability to grow at low H2 concentrations. Our study has implications for research on the H2-driven deep subsurface biosphere and biogas reactor performance. PMID:27992585

  10. Beneficial Effects of Dietary Nitrate on Endothelial Function and Blood Pressure Levels

    PubMed Central

    d'El-Rei, Jenifer; Cunha, Ana Rosa; Trindade, Michelle; Neves, Mario Fritsch

    2016-01-01

    Poor eating habits may represent cardiovascular risk factors since high intake of fat and saturated fatty acids contributes to dyslipidemia, obesity, diabetes mellitus, and hypertension. Thus, nutritional interventions are recognized as important strategies for primary prevention of hypertension and as adjuvants to pharmacological therapies to reduce cardiovascular risk. The DASH (Dietary Approach to Stop Hypertension) plan is one of the most effective strategies for the prevention and nonpharmacological management of hypertension. The beneficial effects of DASH diet on blood pressure might be related to the high inorganic nitrate content of some food products included in this meal plan. The beetroot and other food plants considered as nitrate sources account for approximately 60–80% of the daily nitrate exposure in the western population. The increased levels of nitrite by nitrate intake seem to have beneficial effects in many of the physiological and clinical settings. Several clinical trials are being conducted to determine the broad therapeutic potential of increasing the bioavailability of nitrite in human health and disease, including studies related to vascular aging. In conclusion, the dietary inorganic nitrate seems to represent a promising complementary therapy to support hypertension treatment with benefits for cardiovascular health. PMID:27088010

  11. Quasi-periodic, global oscillations in sea level pressure on intraseasonal timescales

    NASA Astrophysics Data System (ADS)

    Kiranmayi, L.; Bhat, G. S.

    2009-06-01

    The sea level pressure (SLP) variability in 30-60 day intraseasonal timescales is investigated using 25 years of reanalysis data addressing two issues. The first concerns the non-zero zonal mean component of SLP near the equator and its meridional connections, and the second concerns the fast eastward propagation (EP) speed of SLP compared to that of zonal wind. It is shown that the entire globe resonates with high amplitude wave activity during some periods which may last for few to several months, followed by lull periods of varying duration. SLP variations in the tropical belt are highly coherent from 25°S to 25°N, uncorrelated with variations in mid latitudes and again significantly correlated but with opposite phase around 60°S and 65°N. Near the equator (8°S-8°N), the zonal mean contributes significantly to the total variance in SLP, and after its removal, SLP shows a dominant zonal wavenumber one structure having a periodicity of 40 days and EP speeds comparable to that of zonal winds in the Indian Ocean. SLP from many of the atmospheric and coupled general circulation models show similar behaviour in the meridional direction although their propagation characteristics in the tropical belt differ widely.

  12. Investigation of the relationship between electroglottogram waveform, fundamental frequency, and sound pressure level using clustering.

    PubMed

    Selamtzis, Andreas; Ternström, Sten

    2016-12-08

    Although it has been shown in previous research (Orlikoff, 1991; Henrich et al, 2005; Kuang et al, 2014; Awan, 2015) that there exists a relationship between the electroglottogram (EGG) waveform and the acoustic signal, this relationship is still not fully understood. To investigate this relationship, the EGG and acoustic signals were measured for four male amateur choir singers who each produced eight consecutive tones of increasing and decreasing vocal intensity. The EGG signals were processed cycle-synchronously to obtain the discrete Fourier transform, and the data were used as an input to a clustering algorithm. The acoustic signal was analyzed in terms of sound pressure level (dB SPL) and fundamental frequency (fo) of vibration, and the results of both EGG and acoustic analysis were depicted on a two-dimensional plane with fo on the x-axis and SPL on the y-axis. All the subjects were seen to have a weak, near-sinusoidal EGG waveform in their lowest SPL range, whereas increase in SPL coincided with progressive enrichment in harmonic content of the EGG waveforms. The results of the clustering were additionally used to classify waveforms across subjects to enable inter-subject comparisons and assessment of individual strategies of exploring the fo-SPL dimensions. In these male subjects, the EGG waveform shape appeared to vary with SPL and to remain essentially constant with fo over one octave.

  13. Is there any association between blood pressure and education level? The CroHort study.

    PubMed

    Erceg, Marijan; Ivicević-Uhernik, Ana; Kern, Josipa; Vuletić, Silvije

    2012-01-01

    The aim of this study was to explore how the association of 5-year cumulative incidence of arterial hypertension (further 5-CIAH) and education varies according to body weight, age and sex. The study was conducted on cohort of 1383 subjects aged 18+ with initially normal blood pressure (systolic < 140 mmHg and diastolic < 90 mmHg, and not taking medication). Data were collected in 2003 and repeated in 2008. Methods of descriptive statistics, chi2 test and logistic regression were used. No association between education level and hypertension development was recorded in the group of men and in the group of woman aged 65+. In the group of women with normal body weight, younger than 65 years, significantly higher 5-CIAH values were recorded in those with less than 12 years of education (32.5% [22.0 to 42.9]) compared to those with 12 or more years of education (9.6% [6.1 to 13.1]).

  14. Effect of Nickel Levels on Hydrogen Partial Pressure and Methane Production in Methanogens.

    PubMed

    Neubeck, Anna; Sjöberg, Susanne; Price, Alex; Callac, Nolwenn; Schnürer, Anna

    2016-01-01

    Hydrogen (H2) consumption and methane (CH4) production in pure cultures of three different methanogens were investigated during cultivation with 0, 0.2 and 4.21 μM added nickel (Ni). The results showed that the level of dissolved Ni in the anaerobic growth medium did not notably affect CH4 production in the cytochrome-free methanogenic species Methanobacterium bryantii and Methanoculleus bourgensis MAB1, but affected CH4 formation rate in the cytochrome-containing Methanosarcina barkeri grown on H2 and CO2. Methanosarcina barkeri also had the highest amounts of Ni in its cells, indicating that more Ni is needed by cytochrome-containing than by cytochrome-free methanogenic species. The concentration of Ni affected threshold values of H2 partial pressure (pH2) for all three methanogen species studied, with M. bourgensis MAB1 reaching pH2 values as low as 0.1 Pa when Ni was available in amounts used in normal anaerobic growth medium. To our knowledge, this is the lowest pH2 threshold recorded to date in pure methanogen culture, which suggests that M.bourgensis MAB1 have a competitive advantage over other species through its ability to grow at low H2 concentrations. Our study has implications for research on the H2-driven deep subsurface biosphere and biogas reactor performance.

  15. Sound power and pressure level measurements in the inlet and outlet of an HRSG duct

    NASA Astrophysics Data System (ADS)

    Jungbauer, D. E.; Unruh, J. F.; Rose, S.; Pantermuehl, P. J.

    1995-04-01

    The ever-increasing size of cogeneration facilities has mandated the need for noise abatement in the design stage. Many noise projection models are available to the industry for predicting noise levels in and adjacent to new installations. However, the models all require accurate source noise information if valid noise predictions are to be expected. As a consequence of designing one of the world's largest cogeneration installations involving eight Model W-701 turbine units and their Heat Recovery Steam Generators (HRSGs), it became apparent that the attention between the exhaust of the turbine and the outlet of the HRSGs was not well known. Not having this information posed potentially expensive noise abatement modifications during the design and construction phases. In order to verify the adequacy of scaling studies from a W-501 turbine and HRSG to the W-701 system, a comprehensive field test of an existing W-501 installation was conducted. This paper describes the design of an acoustic intensity and sound pressure probe to operate inside the high-temperature ductwork, the access engineering required, data acquisition, and final results concerning noise attenuation across the HRSG.

  16. Beneficial Effects of Dietary Nitrate on Endothelial Function and Blood Pressure Levels.

    PubMed

    d'El-Rei, Jenifer; Cunha, Ana Rosa; Trindade, Michelle; Neves, Mario Fritsch

    2016-01-01

    Poor eating habits may represent cardiovascular risk factors since high intake of fat and saturated fatty acids contributes to dyslipidemia, obesity, diabetes mellitus, and hypertension. Thus, nutritional interventions are recognized as important strategies for primary prevention of hypertension and as adjuvants to pharmacological therapies to reduce cardiovascular risk. The DASH (Dietary Approach to Stop Hypertension) plan is one of the most effective strategies for the prevention and nonpharmacological management of hypertension. The beneficial effects of DASH diet on blood pressure might be related to the high inorganic nitrate content of some food products included in this meal plan. The beetroot and other food plants considered as nitrate sources account for approximately 60-80% of the daily nitrate exposure in the western population. The increased levels of nitrite by nitrate intake seem to have beneficial effects in many of the physiological and clinical settings. Several clinical trials are being conducted to determine the broad therapeutic potential of increasing the bioavailability of nitrite in human health and disease, including studies related to vascular aging. In conclusion, the dietary inorganic nitrate seems to represent a promising complementary therapy to support hypertension treatment with benefits for cardiovascular health.

  17. Document authentication at molecular levels using desorption atmospheric pressure chemical ionization mass spectrometry imaging.

    PubMed

    Li, Ming; Jia, Bin; Ding, Liying; Hong, Feng; Ouyang, Yongzhong; Chen, Rui; Zhou, Shumin; Chen, Huanwen; Fang, Xiang

    2013-09-01

    Molecular images of documents were obtained by sequentially scanning the surface of the document using desorption atmospheric pressure chemical ionization mass spectrometry (DAPCI-MS), which was operated in either a gasless, solvent-free or methanol vapor-assisted mode. The decay process of the ink used for handwriting was monitored by following the signal intensities recorded by DAPCI-MS. Handwritings made using four types of inks on four kinds of paper surfaces were tested. By studying the dynamic decay of the inks, DAPCI-MS imaging differentiated a 10-min old from two 4 h old samples. Non-destructive forensic analysis of forged signatures either handwritten or computer-assisted was achieved according to the difference of the contour in DAPCI images, which was attributed to the strength personalized by different writers. Distinction of the order of writing/stamping on documents and detection of illegal printings were accomplished with a spatial resolution of about 140 µm. A Matlab® written program was developed to facilitate the visualization of the similarity between signature images obtained by DAPCI-MS. The experimental results show that DAPCI-MS imaging provides rich information at the molecular level and thus can be used for the reliable document analysis in forensic applications.

  18. Temperature Humidity and Sea Level Pressure Increments Induced by 1DVAR Analysis of GPS Refractivity

    NASA Technical Reports Server (NTRS)

    Poli, Paul; Joiner, Joanna; Kursinski, Emil Robert; Einaudi, Franco (Technical Monitor)

    2001-01-01

    The Global Positioning System (GPS) transmitted signals are affected by the atmosphere. Using the radio occultation technique, where a receiver is placed on a low-Earth-orbiting platform. it is possible to perform soundings. by measuring the bending angles of the rays. The information can be converted into atmospheric refractivity. We have developed a one dimensional variational (1DVAR) analysis that uses GPS/MET 1995 refractivity and 6-hour FVDAS (Finite Volume Data Assimilation System) forecasts as background information to constrain the retrievals. The analysis increments are defined as 1DVAR minus background temperature, humidity and sea level pressure. Before assimilating the 1DVAR profiles into the FVDAS. the increments need to be understood. First, some bias could be induced in the retrievals when confronted with actual biased data: second. bias in the back-round could create undesired bias in the retrievals. Anv bias in the analyses will ultimately change the climatology of the model the retrievals will be assimilated into. We relate the increments to the reduction of the difference between observed minus computed refractivity profiles. We also point out the difference in the mean increments using backgrounds which have assimilated either NESDIS TIROS Operational Vertical Sounder (TOVS) operational retrievals or Data Assimilation Office (DAO) TOVS interactive retrievals. The climatology of the model in terms of refractivity is significantly different and this impacts the GPS 1DVAR increments. This testifies that changing the basic load of assimilated data has an influence on the impact the GPS data may have in a DAS.

  19. Earth's air pressure 2.7 billion years ago constrained to less than half of modern levels

    NASA Astrophysics Data System (ADS)

    Som, Sanjoy M.; Buick, Roger; Hagadorn, James W.; Blake, Tim S.; Perreault, John M.; Harnmeijer, Jelte P.; Catling, David C.

    2016-06-01

    How the Earth stayed warm several billion years ago when the Sun was considerably fainter is the long-standing problem of the `faint young Sun paradox'. Because of negligible O2 and only moderate CO2 levels in the Archaean atmosphere, methane has been invoked as an auxiliary greenhouse gas. Alternatively, pressure broadening in a thicker atmosphere with a N2 partial pressure around 1.6-2.4 bar could have enhanced the greenhouse effect. But fossilized raindrop imprints indicate that air pressure 2.7 billion years ago (Gyr) was below twice modern levels and probably below 1.1 bar, precluding such pressure enhancement. This result is supported by nitrogen and argon isotope studies of fluid inclusions in 3.0-3.5 Gyr rocks. Here, we calculate absolute Archaean barometric pressure using the size distribution of gas bubbles in basaltic lava flows that solidified at sea level ~2.7 Gyr in the Pilbara Craton, Australia. Our data indicate a surprisingly low surface atmospheric pressure of Patm = 0.23 +/- 0.23 (2σ) bar, and combined with previous studies suggests ~0.5 bar as an upper limit to late Archaean Patm. The result implies that the thin atmosphere was rich in auxiliary greenhouse gases and that Patm fluctuated over geologic time to a previously unrecognized extent.

  20. Self-pressurization of a flightweight liquid hydrogen tank: Effects of fill level at low wall heat flux

    NASA Technical Reports Server (NTRS)

    Vandresar, N. T.; Hasan, M. M.; Lin, C.-S.

    1991-01-01

    Experimental results are presented for the self pressurization and thermal stratification of a 4.89 cu m liquid hydrogen storage tank subjected to low heat flux (2.0 and 3.5 W/sq m) in normal gravity. The test tank was representative of future spacecraft tankage, having a low mass to volume ratio and high performance multilayer thermal insulation. Tests were performed at fill levels of 29 and 49 pcts. (by volume) and complement previous tests at 83 pct. fill. As the heat flux increases, the pressure rise rate at each fill level exceeds the homogeneous rate by an increasing ratio. Herein, this ratio did not exceed a value of 2. The slowest pressure rise rate was observed for the 49 pct. fill level at both heat fluxes. This result is attributed to the oblate spheroidal tank geometry which introduces the variables of wetted wall area, liquid-vapor interfacial area, and ratio of side wall to bottom heating as a function of fill level or liquid depth. Initial tank thermal conditions were found to affect the initial pressure rise rate. Quasi steady pressure rise rates are independent of starting conditions.

  1. Functional magnetic resonance imaging of sound pressure level encoding in the rat central auditory system.

    PubMed

    Zhang, Jevin W; Lau, Condon; Cheng, Joe S; Xing, Kyle K; Zhou, Iris Y; Cheung, Matthew M; Wu, Ed X

    2013-01-15

    Intensity is an important physical property of a sound wave and is customarily reported as sound pressure level (SPL). Invasive techniques such as electrical recordings, which typically examine one brain region at a time, have been used to study neuronal encoding of SPL throughout the central auditory system. Non-invasive functional magnetic resonance imaging (fMRI) with large field of view can simultaneously examine multiple auditory structures. We applied fMRI to measure the hemodynamic responses in the rat brain during sound stimulation at seven SPLs over a 72 dB range. This study used a sparse temporal sampling paradigm to reduce the adverse effects of scanner noise. Hemodynamic responses were measured from the central nucleus of the inferior colliculus (CIC), external cortex of the inferior colliculus (ECIC), lateral lemniscus (LL), medial geniculate body (MGB), and auditory cortex (AC). BOLD signal changes generally increase significantly (p<0.001) with SPL and the dependence is monotonic in CIC, ECIC, and LL. The ECIC has higher BOLD signal change than CIC and LL at high SPLs. The difference between BOLD signal changes at high and low SPLs is less in the MGB and AC. This suggests that the SPL dependences of the LL and IC are different from those in the MGB and AC and the SPL dependence of the CIC is different from that of the ECIC. These observations are likely related to earlier observations that neurons with firing rates that increase monotonically with SPL are dominant in the CIC, ECIC, and LL while non-monotonic neurons are dominant in the MGB and AC. Further, the IC's SPL dependence measured in this study is very similar to that measured in our earlier study using the continuous imaging method. Therefore, sparse temporal sampling may not be a prerequisite in auditory fMRI studies of the IC.

  2. Air pressure effects on sea level changes during the twentieth century

    NASA Astrophysics Data System (ADS)

    Piecuch, Christopher G.; Thompson, Philip R.; Donohue, Kathleen A.

    2016-10-01

    Interpretation of tide gauge data in terms sea level (η) and ocean dynamics requires estimates of air pressure (pa) to determine the ocean's isostatic response—the inverted barometer effect (ηib). Three gridded pa products (HadSLP2, NOAA-20CRv2, and ERA-20C) are used alongside meteorological station pa and tide gauge η records to evaluate the contribution of ηib to η changes over the twentieth century. Agreement between gridded products is better during more recent periods and over regions with good historical data coverage, whereas it is worse for earlier time periods or in ocean areas with poor observational data coverage. Comparison against station data reveals the presence of systematic errors in the gridded products, for example, such that uncertainties estimated through differencing the gridded products underestimate the true errors by roughly 40% on interannual and decadal time scales. Notwithstanding such correlated errors, gridded products are still useful for interpretation of tide gauge data. Removing gridded estimates of ηib from η records reduces spatial variance in centennial trends across tide gauges by 10-30%, formal errors in centennial trends from individual gauges by ˜5%, and the temporal variance in detrended records by 10-15% on average (depending on choice of gridded product). Results here advocate for making the ηib correction to tide gauge records in studies of ocean circulation and global η over long, multidecadal, and centennial time scales using an ensemble mean taken across several gridded ηib products.

  3. Effects of sound pressure level and visual perceptual load on the auditory mismatch negativity.

    PubMed

    Szychowska, Malina; Eklund, Rasmus; Nilsson, Mats E; Wiens, Stefan

    2017-02-15

    Auditory change detection has been studied extensively with mismatch negativity (MMN), an event-related potential. Because it is unresolved if the duration MMN depends on sound pressure level (SPL), we studied effects of different SPLs (56, 66, and 76dB) on the duration MMN. Further, previous research suggests that the MMN is reduced by a concurrent visual task. Because a recent behavioral study found that high visual perceptual load strongly reduced detection sensitivity to irrelevant sounds, we studied if the duration MMN is reduced by load, and if this reduction is stronger at low SPLs. Although a duration MMN was observed for all SPLs, the MMN was apparently not moderated strongly by SPL, perceptual load, or their interaction, because all 95% CIs overlapped zero. In a contrast analysis of the MMN (across loads) between the 56-dB and 76-dB groups, evidence (BF=0.31) favored the null hypothesis that duration MMN is unaffected by a 20-dB increase in SPL. Similarly, evidence (BF=0.19) favored the null hypothesis that effects of perceptual load on the duration MMN do not change with a 20-dB increase in SPL. However, evidence (BF=3.12) favored the alternative hypothesis that the effect of perceptual load in the present study resembled the overall effect in a recent meta-analysis. When the present findings were combined with the meta-analysis, the effect of load (low minus high) was -0.43μV, 95% CI [-0.64, -0.22] suggesting that the duration MMN decreases with load. These findings provide support for a sensitive monitoring system of the auditory environment.

  4. The functional c.-2G>C variant of the mineralocorticoid receptor modulates blood pressure, renin, and aldosterone levels.

    PubMed

    van Leeuwen, Nienke; Caprio, Massimiliano; Blaya, Carolina; Fumeron, Frédéric; Sartorato, Paola; Ronconi, Vanessa; Giacchetti, Gilberta; Mantero, Franco; Fernandes-Rosa, Fabio L; Simian, Christophe; Peyrard, Sévrine; Zitman, Frans G; Penninx, Brenda W J H; de Kloet, E Ron; Azizi, Michel; Jeunemaitre, Xavier; Derijk, Roel H; Zennaro, Maria-Christina

    2010-11-01

    The mineralocorticoid receptor (MR) is essential in the regulation of volemia and blood pressure. Rare mutations in the MR gene cause type 1 pseudohypoaldosteronism and hypertension. In this study we characterized the common MR polymorphism c.-2G>C (rs2070951) in vitro and tested its influence on parameters related to blood pressure regulation and the renin-angiotensin system. In vitro studies showed that the G allele was associated with decreased MR protein levels and reduced transcriptional activation compared with the C allele. Association studies were performed with several outcome variables in 3 independent cohorts: a mild hypertensive group subjected to a salt-sensitivity test, a healthy normotensive group included in a crossover study to receive both a high and low Na/K diet, and a large cohort (The Netherlands Study of Depression and Anxiety), in which blood pressure was measured. Subjects with the GG genotype had significantly higher plasma renin levels both in the mild hypertensive group and in normal volunteers compared with homozygous C carriers. The GG genotype was also correlated with higher plasma aldosterone levels in healthy subjects. In both the mild hypertensive group and The Netherlands Study of Depression and Anxiety cohort the genotype GG was associated with higher systolic blood pressure in males. In conclusion, the G allele of the common functional genetic polymorphism c.-2G>C in the MR gene associates with increased activation of the renin-angiotensin-aldosterone axis and with increased blood pressure, probably related to decreased MR expression.

  5. Argon laser trabeculoplasty as a means of decreasing intraocular pressure from ''normal'' levels in glaucomatous eyes

    SciTech Connect

    Sharpe, E.D.; Simmons, R.J.

    1985-06-15

    The authors conducted a retrospective study of 67 patients (85 eyes) with severe glaucoma to determine whether argon laser trabeculoplasty could reduce intraocular pressures below the ''normal'' range. All patients had initial intraocular pressures of less than or equal to 19 mm Hg. Success was defined as a decrease in intraocular pressure of at least 20%, no increase in medications, stable visual field, and no subsequent glaucoma surgery. After an average follow-up period of 30 months, treatment was successful in 31 cases. One half of the failures occurred by six months and 11 failures (30%) occurred after 12 months. Sixteen patients were able to decrease their medications. Two patients achieved intraocular pressures between 6 and 9 mm Hg and 20 between 10 and 12 mm Hg.

  6. Pressure-dependent DLTS (Deep Level Transient Spectroscopy) experiments on Si-doped AlGaAs

    NASA Astrophysics Data System (ADS)

    Farmer, J. W.; Hjalmarson, H. P.; Samara, G. A.

    Pressure dependent Deep Level Transient Spectroscopy (DLTS) experiments are used to measure the properties of the deep donors (DX-centers) responsible for the persistent photoconductivity effect in Si-doped AlGaAs. The sample dependence of the DLTS spectra shows evidence for a defect complex involved in the DX-center.

  7. The Influence of Fundamental Frequency and Sound Pressure Level Range on Breathing Patterns in Female Classical Singing

    ERIC Educational Resources Information Center

    Collyer, Sally; Thorpe, C. William; Callaghan, Jean; Davis, Pamela J.

    2008-01-01

    Purpose: This study investigated the influence of fundamental frequency (F0) and sound pressure level (SPL) range on respiratory behavior in classical singing. Method: Five trained female singers performed an 8-s messa di voce (a crescendo and decrescendo on one F0) across their musical F0 range. Lung volume (LV) change was estimated, and…

  8. HEALTH LITERACY, MEDICATION ADHERENCE, AND BLOOD PRESSURE LEVEL AMONG HYPERTENSIVE OLDER ADULTS TREATED AT PRIMARY HEALTH CARE CENTERS.

    PubMed

    Wannasirikul, Phitchayaphat; Termsirikulchai, Lakkhana; Sujirarat, Dusit; Benjakul, Sarunya; Tanasugarn, Chanuantong

    2016-01-01

    We conducted this study to explore the causal relationships between health literacy, individual characteristics, literacy, culture and society, cognitive ability, medication adherence, and the blood pressure levels of hypertensive older adults receiving health care services at Primary Health Care Centers in Sa Kaeo Province, Thailand. Six hundred hypertensive older adults had their blood pressure level recorded and were interviewed using questionnaires. Structural Equation Modeling (SEM) was used to determine the effect size, both direct and indirect, among factors. Almost half (48.7%) of studied subjects had inadequate health literacy, 98.3% had good medication adherence, and 80% had good blood pressure levels. The highest effect size on health literacy was literacy, followed by cognitive ability, and culture and society. Medication adherence was affected directly and indirectly by cognitive ability, literacy, and culture and society. Health literacy had not only a direct effect on medication adherence but was also the mediator. Finally, the highest effect size on blood pressure level was critical and communicative health literacy. These findings suggest that health literacy should be considered in the Health Literacy Program of the National Public Health Policy and Plan, Ministry of Public Health.

  9. Association of blood pressure and metabolic syndrome components with magnesium levels in drinking water in some Serbian municipalities.

    PubMed

    Rasic-Milutinovic, Zorica; Perunicic-Pekovic, Gordana; Jovanovic, Dragana; Gluvic, Zoran; Cankovic-Kadijevic, Milce

    2012-03-01

    Chronic exposure to insufficient levels of magnesium (Mg) in drinking water increases the risk of magnesium deficiency and its association with hypertension, dyslipidemia and type 2 diabetes mellitus. The aim of the study was to assess the potential association of mineral contents in drinking water with blood pressure and other components of metabolic syndrome (MetS) (BMI as measure of obesity, triglycerides, glucose, and insulin resistance, index-HOMA IR), in a healthy population. This study was conducted in three randomly selected municipalities (Pozarevac, Grocka and Banovci), and recruited 90 healthy blood donors, aged 20-50 years. The Pozarevac area had a four times higher mean Mg level in drinking water (42 mg L(-1)) than Grocka (11 mg L(-1)). Diastolic blood pressure was lowest in subjects from Pozarevac. Serum Mg (sMg) was highest, and serum Ca(2+)/Mg (sCa/Mg) lowest in subjects from Pozarevac, and after adjustment for confounders (age, gender, BMI), only total cholesterol and sMg levels were independent predictors of diastolic blood pressure, sMg levels were independent predictors of triglycerides, and sCa/Mg predicted glucose levels. These results suggest that Mg supplementation in areas of lower magnesium levels in drinking water may be an important measure in the prevention of hypertension and MetS in general.

  10. Evidence for Skill Level Differences in the Thought Processes of Golfers During High and Low Pressure Situations

    PubMed Central

    Whitehead, Amy E.; Taylor, Jamie A.; Polman, Remco C. J.

    2016-01-01

    Two studies examined differences in the cognition of golfers with differing levels of expertise in high and low pressure situations. In study 1, six high skill and six low skill golfers performed six holes of golf, while verbalizing their thoughts using Think Aloud (TA) protocol. Higher skilled golfers’ cognitive processes centered more on planning in comparison to lower skilled golfers. Study 2 investigated whether thought processes of golfers changed in response to competitive pressure. Eight high skill and eight moderate skilled golfers, completed a practice round and a competition round whilst verbalizing thoughts using TA. To create pressure in the competition condition, participants were instructed that monetary prizes would be awarded to the top three performers and scores of all golfers would be published in a league table in the club house. When performing under competitive pressure, it was found that higher skilled golfers were more likely to verbalize technical rules compared to practice conditions, especially during putting performance. This shift in cognition toward more technical aspects of motor performance was strongly related to scores on the Decision Specific Reinvestment Scale, suggesting individuals with a higher propensity for reinvestment show the largest changes in cognition under pressure. From a practical perspective, TA can aid a player, coach or sport psychologist by allowing thought processes to be identified and investigate a performer’s thoughts when faced with the pressure of a competition. PMID:26779085

  11. Plasma steroid hormone levels in female flounder Platichthys flesus and the influence of fluctuating hydrostatic pressure.

    PubMed

    Damasceno-Oliveira, A; Fernández-Durán, B; Gonçalves, J; Couto, E; Canário, A V M; Coimbra, J

    2012-11-01

    The reproductive cycle in teleosts is timed to guarantee that eggs hatch in the right place at the right time, with environmental factors playing important roles in entraining and controlling the entire process. The effects of some environmental factors, like temperature and photoperiod, are now well understood. There are only a few studies regarding the effects of hydrostatic pressure (HP) on the reproductive cycle, in spite of its importance as a ubiquitous factor in all biological environments and affecting all living organisms. Hydrostatic pressure is of particular importance in fish because they can also experience rapid and cyclic changes in HP due to vertical movements in the water column. The aim of the present research was to investigate the effects of vertical migrations on the reproductive steroids of maturing female flounder. After a 14 day exposure to cyclic hydrostatic pressure (with a period of 12.4h and with a maximum peak of 800 kPa of absolute hydrostatic pressure), fish showed significantly lower plasmatic concentrations of "5β,3α" steroids, metabolites of the putative maturation-inducing steroid in flounder (17α,20β-dihydroxy-4-pregnen-3-one). Results indicate that environmentally realistic cyclic changes of hydrostatic pressure can influence the metabolism of reproductive steroids. This suggests a physiological role of tidally-associated vertical migrations, affecting oocyte maturation and retarding the reproductive cycle in this species until the spawning ground is attained.

  12. Laboratory evaluation of the Level TROLL 100 manufactured by In-Situ Inc.: results of pressure and temperature tests

    USGS Publications Warehouse

    Carnley, Mark V.; Fulford, Janice M.; Brooks, Myron H.

    2013-01-01

    The Level TROLL 100 manufactured by In-Situ Inc. was evaluated by the U.S. Geological Survey (USGS) Hydrologic Instrumentation Facility (HIF) for conformance to the manufacturer’s accuracy specifications for measuring pressure throughout the device’s operating temperature range. The Level TROLL 100 is a submersible, sealed, water-level sensing device with an operating pressure range equivalent to 0 to 30 feet of water over a temperature range of −20 to 50 degrees Celsius (°C). The device met the manufacturer’s stated accuracy specifications for pressure within its temperature-compensated operating range of 0 to 50 °C. The device’s accuracy specifications did not meet established USGS requirements for primary water-stage sensors used in the operation of streamgages, but the Level TROLL 100 may be suitable for other hydrologic data-collection applications. As a note, the Level TROLL 100 is not designed to meet USGS accuracy requirements. Manufacturer accuracy specifications were evaluated, and the procedures followed and the results obtained are described in this report. USGS accuracy requirements are routinely examined and reported when instruments are evaluated at the HIF.

  13. Cortisol, blood pressure, and heart rate responses to food intake were independent of physical fitness levels in women.

    PubMed

    Jayasinghe, Sisitha U; Torres, Susan J; Fraser, Steve F; Turner, Anne I

    2015-11-01

    This research tested the hypothesis that women who had higher levels of physical fitness will have lower hypothalamo-pituitary-adrenal axis (cortisol) and sympatho-adrenal medullary system (blood pressure and heart rate) responses to food intake compared with women who had low levels of physical fitness. Lower fitness (n = 22; maximal oxygen consumption = 27.4 ± 1.0 mL∙kg(-1)·min(-1)) and higher fitness (n = 22; maximal oxygen consumption = 41.9 ± 1.6 mL∙kg(-1)·min(-1)) women (aged 30-50 years; in the follicular phase of the menstrual cycle) who participated in levels of physical activity that met (lower fitness = 2.7 ± 0.5 h/week) or considerably exceeded (higher fitness = 7.1 ± 1.4 h/week) physical activity guidelines made their own lunch using standardised ingredients at 1200 h. Concentrations of cortisol were measured in blood samples collected every 15 min from 1145-1400 h. Blood pressures and heart rate were also measured every 15 min between 1145 h and 1400 h. The meal consumed by the participants consisted of 20% protein, 61% carbohydrates, and 19% fat. There was a significant overall response to lunch in all of the parameters measured (time effect for all, p < 0.01). The cortisol response to lunch was not significantly different between the groups (time × treatment, p = 0.882). Overall, both groups showed the same pattern of cortisol secretion (treatment p = 0.839). Systolic blood pressure, diastolic blood pressure, mean arterial pressure, or heart rate responses (time × treatment, p = 0.726, 0.898, 0.713, and 0.620, respectively) were also similar between higher and lower fitness women. Results suggest that the physiological response to food intake in women is quite resistant to modification by elevated physical fitness levels.

  14. Cardiac Reactivity and Elevated Blood Pressure Levels among Young African Americans: The Importance of Stress.

    ERIC Educational Resources Information Center

    Livingston, Ivor Lensworth; Marshall, Ronald J.

    1990-01-01

    Explores the racial differences in elevated arterial blood pressure between African American youth, especially adolescents, and their White counterparts. Argues that African American adolescents' perception of day-to-day stress is an important contributor to this condition. Considers a conceptual model of the sociopsychophysiological stress…

  15. 16 CFR 1500.47 - Method for determining the sound pressure level produced by toy caps.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... used at normal or at grazing incidence, whichever gives the most uniform free-field response. The... accurate to within ±1 decibel. If the calibration is of the pressure type or of the piston-phone plus electrostatic actuator type, it shall be corrected to free-field conditions in accordance with the...

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

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... used at normal or at grazing incidence, whichever gives the most uniform free-field response. The... accurate to within ±1 decibel. If the calibration is of the pressure type or of the piston-phone plus electrostatic actuator type, it shall be corrected to free-field conditions in accordance with the...

  17. 16 CFR 1500.47 - Method for determining the sound pressure level produced by toy caps.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... used at normal or at grazing incidence, whichever gives the most uniform free-field response. The... accurate to within ±1 decibel. If the calibration is of the pressure type or of the piston-phone plus electrostatic actuator type, it shall be corrected to free-field conditions in accordance with the...

  18. Changes in Central Aortic Pressure Levels, Wave Components and Determinants Associated with High Peripheral Blood Pressure States in Childhood: Analysis of Hypertensive Phenotype.

    PubMed

    García-Espinosa, Victoria; Curcio, Santiago; Marotta, Marco; Castro, Juan M; Arana, Maite; Peluso, Gonzalo; Chiesa, Pedro; Giachetto, Gustavo; Bia, Daniel; Zócalo, Yanina

    2016-10-01

    The aims were to determine whether children's high peripheral blood pressure states (HBP) are associated with increased central aortic blood pressure (BP) and to characterize hemodynamic and vascular changes associated with HBP in terms of changes in cardiac output (stroke volume, SV), arterial stiffness (aortic pulse wave velocity, PWV), peripheral vascular resistances (PVR) and net and relative contributions of reflected waves to the aortic pulse amplitude. We included 154 subjects (mean age 11; range 4-16 years) assigned to one of two groups: normal peripheral BP (NBP, n = 101), defined as systolic and diastolic BP < 90th percentile, or high BP (HBP, n = 53), defined as average systolic and/or diastolic BP levels ≥90th percentile (curves for sex, age and body height). The HBP group included children with hypertensive and pre-hypertensive BP levels. After a first analysis, groups were compared excluding obese and dyslipidemic children. Peripheral and central aortic BP, PWV and pulse wave-derived parameters (augmentation index, forward and backward wave components' amplitude) were measured using gold-standard techniques, applanation tonometry (SphygmoCor) and oscillometry (Mobil-O-Graph). Independent of the presence of dyslipidemia and/or obesity, aortic systolic and pulse BP were higher in HBP than in NBP children. The increase in central BP could not be explained by an increase in the relative contribution of reflections to the aortic pressure wave, higher PVR or by an augmented peripheral reflection coefficient. Instead, the rise in central BP would be explained by an increase in the amplitude of both incident and reflected wave components.

  19. Pressure as a probe of deep levels and defects in semiconductors: GaAs, GaP and their alloys

    SciTech Connect

    Samara, G.A.

    1992-01-01

    Measurements of the effects of pressure on the thermal electron emission rate and capture cross section for a variety of deep electronic levels in GaAs, GaP and their alloys have yielded the pressure dependences of the energies of these levels in the bandgaps, allowed evaluation of the breathing mode lattice relaxations accompanying carrier emission or capture by these levels and revealed trends which lead to new insights into the nature of the responsible defects. Emphasis is on deep levels believed to be associated with simple defects. Specifically, results will be summarized for the donor levels of the dominant native defect known as EL2 in CAM, which is believed to be associated with the arsenic antisite, and on the radiation-induced El and E2 levels in GaAs, GaP and their alloys, which are believed to be due to arsenic (or phosphorous) vacancies. The results are discussed in terms of models for the defects responsible for these deep levels.

  20. Pressure as a probe of deep levels and defects in semiconductors: GaAs, GaP and their alloys

    SciTech Connect

    Samara, G.A.

    1992-10-01

    Measurements of the effects of pressure on the thermal electron emission rate and capture cross section for a variety of deep electronic levels in GaAs, GaP and their alloys have yielded the pressure dependences of the energies of these levels in the bandgaps, allowed evaluation of the breathing mode lattice relaxations accompanying carrier emission or capture by these levels and revealed trends which lead to new insights into the nature of the responsible defects. Emphasis is on deep levels believed to be associated with simple defects. Specifically, results will be summarized for the donor levels of the dominant native defect known as EL2 in CAM, which is believed to be associated with the arsenic antisite, and on the radiation-induced El and E2 levels in GaAs, GaP and their alloys, which are believed to be due to arsenic (or phosphorous) vacancies. The results are discussed in terms of models for the defects responsible for these deep levels.

  1. The importance of the level of the lip line and resting lip pressure in Class II, Division 2 malocclusion.

    PubMed

    Lapatki, B G; Mager, A S; Schulte-Moenting, J; Jonas, I E

    2002-05-01

    Many clinicians hypothesize that retroclination of the maxillary central incisors in Class II, Division 2 malocclusion is caused by increased resting lip pressure against these teeth. The purpose of this study was (1) to verify this assumption by means of simultaneous lip-pressure measurements at two different levels on the maxillary central incisor crowns, and (2) to examine factors that could possibly contribute to the increased resting lip pressure. This is the first study to prove that individuals with Class II, Division 2 malocclusion (n = 21) have the upper central incisors exposed to significantly higher lip pressure than those with Class I malocclusion (n = 21). Our statistical evaluation revealed that this is primarily attributed to a high lip line and not to a hypertonic peri-oral musculature. We concluded that orthodontic treatment of Class II, Division 2 cases should include intrusion of the maxillary incisors, to eliminate the non-physiologically high pressure exerted by the lower lip on these teeth and, consequently, to reduce the high risk of a post-orthodontic relapse.

  2. Fructose containing sugars do not raise blood pressure or uric acid at normal levels of human consumption.

    PubMed

    Angelopoulos, Theodore J; Lowndes, Joshua; Sinnett, Stephanie; Rippe, James M

    2015-02-01

    The impact of fructose, commonly consumed with sugars by humans, on blood pressure and uric acid has yet to be defined. A total of 267 weight-stable participants drank sugar-sweetened milk every day for 10 weeks as part of their usual, mixed-nutrient diet. Groups 1 and 2 had 9% estimated caloric intake from fructose or glucose, respectively, added to milk. Groups 3 and 4 had 18% of estimated caloric intake from high fructose corn syrup or sucrose, respectively, added to the milk. Blood pressure and uric acid were determined prior to and after the 10-week intervention. There was no effect of sugar type on either blood pressure or uric acid (interaction P>.05), and a significant time effect for blood pressure was noted (P<.05). The authors conclude that 10 weeks of consumption of fructose at the 50th percentile level, whether consumed as pure fructose or with fructose-glucose-containing sugars, does not promote hyperuricemia or increase blood pressure.

  3. Nanocube Superlattices of Cesium Lead Bromide Perovskites and Pressure-Induced Phase Transformations at Atomic and Mesoscale Levels.

    PubMed

    Nagaoka, Yasutaka; Hills-Kimball, Katie; Tan, Rui; Li, Ruipeng; Wang, Zhongwu; Chen, Ou

    2017-03-10

    Lead halide perovskites are promising materials for a range of applications owing to their unique crystal structure and optoelectronic properties. Understanding the relationship between the atomic/mesostructures and the associated properties of perovskite materials is crucial to their application performances. Herein, the detailed pressure processing of CsPbBr3 perovskite nanocube superlattices (NC-SLs) is reported for the first time. By using in situ synchrotron-based small/wide angle X-ray scattering and photoluminescence (PL) probes, the NC-SL structural transformations are correlated at both atomic and mesoscale levels with the band-gap evolution through a pressure cycle of 0 ↔ 17.5 GPa. After the pressurization, the individual CsPbBr3 NCs fuse into 2D nanoplatelets (NPLs) with a uniform thickness. The pressure-synthesized perovskite NPLs exhibit a single cubic crystal structure, a 1.6-fold enhanced photoluminescence quantum yield, and a longer emission lifetime than the starting NCs. This study demonstrates that pressure processing can serve as a novel approach for the rapid conversion of lead halide perovskites into structures with enhanced properties.

  4. An objective definition of air mass types affecting Athens, Greece; the corresponding atmospheric pressure patterns and air pollution levels.

    PubMed

    Sindosi, O A; Katsoulis, B D; Bartzokas, A

    2003-08-01

    This work aims at defining characteristic air mass types that dominate in the region of Athens, Greece during the cold (November-March) and the warm (May-September) period of the year and also at evaluating the corresponding concentration levels of the main air pollutants. For each air mass type, the mean atmospheric pressure distribution (composite maps) over Europe and the Mediterranean is estimated in order to reveal the association of atmospheric circulation with air pollution levels in Athens. The data basis for this work consists of daily values of thirteen meteorological and six pollutant parameters covering the period 1993-97. The definition of the characteristic air mass types is attempted objectively by using the methods of Factor Analysis and Cluster Analysis. The results show that during the cold period of the year there are six prevailing air mass types (at least 3% of the total number of days) and six infrequent ones. The examination of the corresponding air pollution concentration levels shows that the primary air pollutants appear with increased concentrations when light or southerly winds prevail. This is usually the case when a high pressure system is located over the central Mediterranean or a low pressure system lays over south Italy, respectively. Low levels of the primary pollutants are recorded under northeasterly winds, mainly caused by a high pressure system over Ukraine. During the warm period of the year, the southwestern Asia thermal low and the subtropical anticyclone of the Atlantic Ocean affect Greece. Though these synoptic systems cause almost stagnant conditions, four main air mass types are dominant and ten others, associated with extreme weather, are infrequent. Despite the large amounts of total solar radiation characterizing this period, ozone concentrations remain at low levels in central Athens because of its destruction by nitric oxide.

  5. Evaluation and correlation of stress scores with blood pressure, endogenous cortisol levels, and homocysteine levels in patients with central serous chorioretinopathy and comparison with age-matched controls

    PubMed Central

    Agarwal, Abhishek; Garg, Monika; Dixit, Nikhil; Godara, Rohini

    2016-01-01

    Context: Stress had been associated with the development of central serous chorioretinopathy (CSC). The study was designed to evaluate the effect of stress on other risk factors of CSC such as serum cortisol levels, serum homocysteine levels, and blood pressure (BP) in CSC patients. Aims: To compare stress scores, serum cortisol and serum homocysteine levels, and BP of CSC patients with that of control population and to correlate stress scores of CSC patients with BP, serum cortisol levels, and serum homocysteine levels. Materials and Methods: Stress scores, serum morning and evening cortisol levels, serum homocysteine levels, systolic and diastolic BP of 54 CSC patients were measured and compared with that of 54 age- and sex-related controls using Student's t-test. Stress scores of CSC patients were correlated with systolic and diastolic BP, serum morning and evening cortisol levels and serum homocysteine levels and Pearson correlation coefficient (r) were calculated. Results: Stress scores, serum homocysteine levels, serum morning and evening cortisol levels, and systolic and diastolic BP were all elevated in CSC patients as compared with age- and sex-related controls (P < 0.05). Stress scores of CSC patients were found to correlate strongly with serum homocysteine levels, serum morning and evening cortisol levels, and systolic and diastolic BP, with r values 0.82, 0.8, 0.8, 0.8, and 0.81, respectively (P < 0.0001). Conclusions: Stress scores were elevated in CSC patients and were strongly correlated with serum homocysteine and cortisol levels and BP. PMID:27958201

  6. [Factors affecting the control of blood pressure and lipid levels in patients with cardiovascular disease: the PREseAP Study].

    PubMed

    Orozco-Beltrán, Domingo; Brotons, Carlos; Moral, Irene; Soriano, Nuria; Del Valle, María A; Rodríguez, Ana I; Pepió, Josep M; Pastor, Ana

    2008-03-01

    The aim of this observational study was to identify factors influencing the control of blood pressure (i.e., <140/90 mmHg, or <130/80 mmHg in diabetic patients) and low-density lipoprotein (LDL) cholesterol level (<100 mg/dL) in 1223 patients with cardiovascular disease. Overall, 70.2% of patients were men, and their mean age was 66.4 years. Blood pressure was poorly controlled in 50.9% (95% confidence interval [CI], 46.9%-54.8%) and the LDL cholesterol level was poorly controlled in 60.1% (95% CI, 56.3%-63.9%). Determinants of poor blood pressure control were diabetes, hypertension, no previous diagnosis of heart failure, previous diagnosis of peripheral artery disease or stroke, obesity, and no lipid-lowering treatment. Determinants of poor LDL cholesterol control were no lipid-lowering treatment, no previous diagnosis of ischemic heart disease, no antihypertensive treatment, and dyslipidemia. The factors affecting blood pressure control were different from those affecting LDL cholesterol control, an observation that should be taken into account when implementing treatment recommendations for achieving therapeutic objectives in secondary prevention.

  7. Comparison of measured and calculated sound pressure levels around a large horizontal axis wind turbine generator

    NASA Technical Reports Server (NTRS)

    Shepherd, Kevin P.; Willshire, William L., Jr.; Hubbard, Harvey H.

    1989-01-01

    Results are reported from a large number of simultaneous acoustic measurements around a large horizontal axis downwind configuration wind turbine generator. In addition, comparisons are made between measurements and calculations of both the discrete frequency rotational harmonics and the broad band noise components. Sound pressure time histories and noise radiation patterns as well as narrow band and broadband noise spectra are presented for a range of operating conditions. The data are useful for purposes of environmental impact assessment.

  8. Bolus intravenous injection of obestatin does not change blood pressure level of spontaneously hypertensive rat.

    PubMed

    Li, Zhao-Feng; Song, Shu-Wei; Qin, Yong-Wen; Zhang, Jian-Liang; Zhao, Xian-Xian; Zhang, Bi-Li; Ren, An-Jing; Guo, Zhi-Fu; Zheng, Xing

    2009-10-01

    Ghrelin, an endogenous ligand for the GH secretagogue receptor, has been shown to decrease arterial pressure. Obestatin, a sibling of ghrelin derived from preproghrelin, opposes several physiological actions of ghrelin. The aim of this study was to determine the effects of bolus intravenous injection of obestatin on blood pressure in spontaneously hypertensive rats. Three different dosages of obestatin (10, 50, and 100 microg/kg) and one dosage of ghrelin (10 microg/kg) were applied. The mean arterial pressure and heart period were continuously recorded for 30 min after injection of drugs. Baroreflex sensitivity was also investigated. In this study, we first demonstrated that intravenous injection of obestatin showed no significant effects on mean blood pressure (10 microg/kg: 113.8+/-2.0 mmHg vs. 114.4+/-1.6 mmHg; 50 microg/kg: 110+/-2.4 mmHg vs. 109+/-3.2 mmHg; 100 microg/kg: 115.9+/-1.5 mmHg vs. 115.8+/-2.4 mmHg; all P>0.05), heart period (10 microg/kg: 184.7+/-3.9 ms vs. 185.5+/-4.1ms; 50 microg/kg: 185.9+/-4.1 ms vs. 193.4+/-4.5 ms; 100 microg/kg: 137.7+/-4.5 ms vs. 143.9+/-5.6 ms; all P>0.05), or baroreflex sensitivity (10 microg/kg: 0.414+/-0.03 ms/mmHg vs. 0.442+/-0.02 ms/mmHg; 50 microg/kg: 0.453+/-0.04 ms/mmHg vs. 0.439+/-0.01 ms/mmHg; 100 microg/kg: 0.398+/-0.02 ms/mmHg vs. 0.401+/-0.01 ms/mmHg; all P>0.05), however, intravenous injection of ghrelin could decrease mean arterial pressure (115.9+/-1.5 mmHg vs. 108.6+/-3.6 mmHg, P<0.01) and increase heart period (132.4+/-2.8 ms vs. 152.6+/-7.4 ms, P<0.05), but did not change baroreflex sensitivity (0.36+/-0.009 ms/mmHg, P>0.05) in spontaneously hypertensive rats.

  9. Investigation of the Sound Pressure Level (SPL) of earphones during music listening with the use of physical ear canal models

    NASA Astrophysics Data System (ADS)

    Aying, K. P.; Otadoy, R. E.; Violanda, R.

    2015-06-01

    This study investigates on the sound pressure level (SPL) of insert-type earphones that are commonly used for music listening of the general populace. Measurements of SPL from earphones of different respondents were measured by plugging the earphone to a physical ear canal model. Durations of the earphone used for music listening were also gathered through short interviews. Results show that 21% of the respondents exceed the standard loudness/duration relation recommended by the World Health Organization (WHO).

  10. Relationship of anthropometric indicators with blood pressure levels and the risk of hypertension in Nigerian adults

    PubMed Central

    Adedoyin, Rufus A; Mbada, Chidozie E; Bisiriyu, Luqman A; Adebayo, Rasaaq A; Balogun, Michael O; Akintomide, Anthony O

    2008-01-01

    Background and purpose: Studies on cardiovascular risks in relation to anthropometric factors are limited in Sub-Sahara Africa. The aims of this study were to examine the relationship between anthropometric parameters and blood pressure; and to evaluate body mass index (BMI) across the range of underweight and obesity as a primary risk factor of hypertension in adult Nigerians. Material and methods: 2097 adults aged between 20 and 100 years consented and participated in this door-to-door survey. All participants underwent blood pressure and anthropometric measurements using standard procedures. The population study was separated in normotensive and hypertensive males and females and the possible risk for hypertension were categorized into different classes of value based on BMI definition. Results: The relative risks (odds ratio [OR] and 95% confidence interval [CI]) of developing hypertension among the obese compared with the underweight, normal weight, and overweight persons were (OR 5.75; CI 5.67–5.83), (OR 1.73; CI 1.65–1.81), and (OR 1.54; CI 1.46–1.62) for all the participants, respectively. Among obese (BMI ≥ 30.0 Kg/m2) males, the OR for hypertension was three times (OR 2.78; CI 2.76–2.80) that of normal weight (BMI ≥ 18.5–24.9 Kg/m2) males. Females with obesity had a risk of hypertension three times (OR 3.34; CI 3.33–3.35) that of normal weight females. Conclusion: Our results indicated that the there was a significant positive correlation of obesity indicator with blood pressure. In Nigeria, we found a strong gradient between higher BMI and increased risk of hypertension among all ages. Approaches to reduce the risk of hypertension may include prevention of overweight and obesity. PMID:20428404

  11. Measuring Fluctuating Pressure Levels and Vibration Response in a Jet Plume

    NASA Technical Reports Server (NTRS)

    Osterholt, Douglas J.; Knox, Douglas M.

    2011-01-01

    The characterization of loads due to solid rocket motor plume impingement allows for moreaccurate analyses of components subjected to such an environment. Typically, test verification of predicted loads due to these conditions is widely overlooked or unsuccessful. ATA Engineering, Inc., performed testing during a solid rocket motor firing to obtain acceleration and pressure responses in the hydrodynamic field surrounding the jet plume. The test environment necessitated a robust design to facilitate measurements being made in close proximity to the jet plume. This paper presents the process of designing a test fixture and an instrumentation package that could withstand the solid rocket plume environment and protect the required instrumentation.

  12. Plasma sE-selectin level is positively correlated with neutrophil count and diastolic blood pressure in Japanese men.

    PubMed

    Mochizuki, Kazuki; Inoue, Seiya; Miyauchi, Rie; Misaki, Yasumi; Shimada, Masaya; Kasezawa, Nobuhiko; Tohyama, Kazushige; Goda, Toshinao

    2013-01-01

    Increased levels of circulating soluble type of E-selectin (sE-selectin), neutrophil counts and blood pressure are associated with the development of cardiovascular diseases (CVD). In this study, we conducted a cross-sectional study of men who participated in health check-ups, and selected those who were not diagnosed with or being treated for metabolic diseases such as diabetes, hypertension and lipid abnormality according to the health check-ups. We measured their basic clinical parameters including blood pressure and neutrophil count, plasma sE-selectin concentration and lifestyle factors, and assessed their interrelations by multivariate linear regression (MLR) analysis. A total of 351 subjects aged 47.5±8.41 (range, 30-64) y were recruited. Significantly correlated with sE-selectin concentration were neutrophil count, diastolic blood pressure (DBP), and systolic blood pressure (SBP) (Pearson's correlation coefficient, 0.194, 0.220 and 0.175, respectively). MLR analysis showed that sE-selectin concentration was independently positively related with DBP and neutrophil count, whereas neutrophil count was positively associated with sE-selectin concentration but not DBP. DBP, but not SBP, was independently positively correlated with sE-selectin concentration but not neutrophil count. These results indicate that circulating sE-selectin concentration may be a biomarker for indicating subsequent development of metabolic diseases, in particular CVD, from a healthy state.

  13. Hydrostatic pressure and temperature effects on the electronic energy levels of a spherical quantum dot placed at the center of a nano-wire

    NASA Astrophysics Data System (ADS)

    Safarpour, Gh.; Moradi, M.; Barati, M.

    2012-10-01

    The effect of pressure and temperature on the electronic structure of an InAs spherical quantum dot located at the center of a GaAs cylindrical nano-wire have been determined using finite element method, within the effective mass approximation. The energy levels and transition energies are numerically calculated as a function of the dot radius, pressure and temperature. It is shown that the pressure and temperature effects are significant and should be considered in the study of low-dimensional semiconducting systems. The results show that; energy levels (i) decrease as the dot radius increases (ii) decrease as the pressure increases and (iii) increase as the temperature increases. For very small dot radii, the energy levels show unusual behavior, such that the energy levels increase as the pressure increases. We also found that the transition energy (i) increases as the dot size decreases (ii) increases as the pressure increases and (iii) decreases as the temperature increases.

  14. Effect of Reynolds number, turbulence level and periodic wake flow on heat transfer on low pressure turbine blades.

    PubMed

    Suslov, D; Schulz, A; Wittig, S

    2001-05-01

    The development of effective cooling methods is of major importance for the design of new gas turbines blades. The conception of optimal cooling schemes requires a detailed knowledge of the heat transfer processes on the blade's surfaces. The thermal load of turbine blades is predominantly determined by convective heat transfer which is described by the local heat transfer coefficient. Heat transfer is closely related to the boundary layer development along the blade surface and hence depends on various flow conditions and geometrical parameters. Particularly Reynolds number, pressures gradient and turbulence level have great impact on the boundary layer development and the according heat transfer. Therefore, in the present study, the influence of Reynolds number, turbulence intensity, and periodic unsteady inflow on the local heat transfer of a typical low pressure turbine airfoil is experimentally examined in a plane cascade.

  15. Effect of grip type, wrist motion, and resistance level on pressures within the carpal tunnel of normal wrists.

    PubMed

    McGorry, Raymond W; Fallentin, Nils; Andersen, Johan H; Keir, Peter J; Hansen, Torben B; Pransky, Glenn; Lin, Jia-Hua

    2014-04-01

    Elevated carpal tunnel pressure (CTP) has been associated with carpal tunnel syndrome. This study systematically evaluated the effect of wrist motion resistance and grip type on CTP during wrist motion typical of occupational tasks. CTP during four wrist motion patterns, with and without resistance, and with and without gripping, was measured in vivo in 14 healthy individuals. CTP measured during compound motions fell between that measured in the cardinal planes of wrist flexion/extension and radial/ulnar deviation. Generally, with no active gripping there was little pressure change due to wrist angular displacement or resistance level. However, concurrent active pinch or power grip increased CTP particularly in motions including extension. CTP typically did not increase during wrist flexion, and in fact often decreased. Extension motions against resistance when employing a pinch or power grip increase CTP more than motions with flexion. Results could help inform design or modification of wrist motion intensive occupational tasks. © 2014 The Authors.

  16. A global historical Radiosondes and Tracked Balloons Archive on standard pressure levels back to the 1920s

    NASA Astrophysics Data System (ADS)

    Ramella Pralungo, L.; Haimberger, L.; Stickler, A.; Brönnimann, S.

    2013-12-01

    Long observed time series of climate state quantities are needed to extend our understanding of global weather, climate variability and monitoring not only at the Earths surface but also the free atmosphere, since climate anomalies and climate change have a three-dimensional spatial structure. Radiosonde data before 1958 and tracked balloon (PILOT) data are rarely available at standard times on standard pressure levels, which complicates their use for climate studies. This paper describes an upper air dataset on standard pressure levels at 00:00 GMT and 12:00 GMT for parameters temperature and wind. The input data sources of this dataset are the Comprehensive Historical Upper Air Network (CHUAN version 1.7), the Integrated Global Radiosonde Archive (IGRA) and upper air observations from the reanalysis datasets ERA-40 and ERA-Interim. As such it contains many data that have been digitized and collected in the EU FP7 project ERA-CLIM. Those data, which partly exist at asynoptic times and on altitude levels instead of pressure levels, have been brought to synoptic times and standard pressure levels using state of the art interpolation techniques, employing geopotential information National Oceanic and Atmosphere Administration (NOAA) 20th Century Reanalysis (NOAA 20CR) to aid the interpolation. The standardized time series have been merged if necessary, taking care that the data are traceable back to their original sources. Only time series longer than 300 days have been saved in the merged archive, since the main purpose of this dataset is to aid climatological studies. If possible WMO numbers have been given to the station records. For some records which have never been identified by a WMO number, a local ID above 100 000 has been attached. This paper describes the merging procedure, data count and data quality and how traceability of the data is ensured. It does not describe a homogenization procedure for both temperature and wind data. Homogeneity adjustments for

  17. High potassium intake blunts the effect of elevated sodium intake on blood pressure levels.

    PubMed

    Rodrigues, Sérgio Lamêgo; Baldo, Marcelo Perim; Machado, Rebeca Caldeira; Forechi, Ludimila; Molina, Maria del Carmem Bisi; Mill, José Geraldo

    2014-04-01

    The purpose of this study was to investigate the influence of dietary potassium on the sodium effect on blood pressure (BP) in the general population and the adherence of current recommendations for sodium and potassium intake. An overnight (12-hour) urine sample was collected in a population-based study to investigate cardiovascular risk. A sub-sample of 1285 subjects (age range, 25-64 years) free from any medication interfering with BP or potassium excretion was studied. Of the participants, 86.0% consumed over 6 g of salt/day and 87.7% less than the recommended intake of potassium (4.7 g). Potassium excretion and the sodium to potassium ratio were significantly related to systolic and diastolic BP only in subjects consuming more than 6 g/day of salt. Subjects in the highest sodium to potassium ratio quartile (surrogate of unhealthy diet) presented 8 mm Hg and 7 mm Hg higher values of systolic and diastolic BP, respectively, when compared with the first quartile, while individuals in the fourth quartile of urinary potassium excretion (healthier diet) showed 6 mm Hg and 4 mm Hg lower systolic and diastolic BP, respectively, compared with the first quartile. Our data indicate that when people have an increased intake of potassium, high intake of sodium is not associated with higher BP.

  18. Enterprise-Level Motivations, Regulatory Pressures, and Corporate Environmental Management in Guangzhou, China

    NASA Astrophysics Data System (ADS)

    Tang, Shui-Yan; Li, Pansy Honying; Fryxell, Gerald E.; Lo, Carlos Wing-Hung

    2015-09-01

    This study examines the effects of internal motivations and external pressures on the integration of environmental management (EM) practices within manufacturing operations in China. The moderating role of perceptions toward the regulatory process is also considered along with comparisons between wholly Chinese-owned and foreign-owned enterprises. From a sample of 131 manufacturing companies in the Guangzhou area, it was found that the salience of fees and fines has a strong positive influence on perceptions toward the regulator (the local Environmental Protection Bureau, EPB). This also has a positive effect on perceptions toward regulations themselves for foreign-owned enterprises. Business-case motivations for EM positively shape enterprise perceptions toward regulations, whereas risk-reduction motivations have a negative effect on perceptions toward regulations in foreign-owned enterprises. Enterprise perceptions toward the regulatory process have direct effects on the integration of EM practices in wholly Chinese-owned enterprises, but in opposite directions. While positive perceptions toward regulations have positive influence, positive perceptions toward regulators (i.e., the EPB) negatively affect it. Overall, these results indicated that promoting the adoption of EM practices depends on convincing business leaders that EM practices contribute to profit making. The regulatory process can potentially promote these practices, but measures need to be taken to ensure that the regulator is not co-opted by the regulated, especially in wholly Chinese-owned enterprises.

  19. Enterprise-Level Motivations, Regulatory Pressures, and Corporate Environmental Management in Guangzhou, China.

    PubMed

    Tang, Shui-Yan; Li, Pansy Honying; Fryxell, Gerald E; Lo, Carlos Wing-Hung

    2015-09-01

    This study examines the effects of internal motivations and external pressures on the integration of environmental management (EM) practices within manufacturing operations in China. The moderating role of perceptions toward the regulatory process is also considered along with comparisons between wholly Chinese-owned and foreign-owned enterprises. From a sample of 131 manufacturing companies in the Guangzhou area, it was found that the salience of fees and fines has a strong positive influence on perceptions toward the regulator (the local Environmental Protection Bureau, EPB). This also has a positive effect on perceptions toward regulations themselves for foreign-owned enterprises. Business-case motivations for EM positively shape enterprise perceptions toward regulations, whereas risk-reduction motivations have a negative effect on perceptions toward regulations in foreign-owned enterprises. Enterprise perceptions toward the regulatory process have direct effects on the integration of EM practices in wholly Chinese-owned enterprises, but in opposite directions. While positive perceptions toward regulations have positive influence, positive perceptions toward regulators (i.e., the EPB) negatively affect it. Overall, these results indicated that promoting the adoption of EM practices depends on convincing business leaders that EM practices contribute to profit making. The regulatory process can potentially promote these practices, but measures need to be taken to ensure that the regulator is not co-opted by the regulated, especially in wholly Chinese-owned enterprises.

  20. Screening level assessment of agricultural pesticides as a pressure factor on European waters

    NASA Astrophysics Data System (ADS)

    Pistocchi, A.

    2009-04-01

    Currently about 400 chemical substances are reported in use as agricultural pesticides in Europe. However, little knowledge is available about their actual use patterns, emission rates, and consequently expected concentrations in the environment. In this contribution, we use a simple screening model for the evaluation of pesticide concentrations in soil and water, and we apply it to a number of pesticides, for which some monitored values of concentration are available and used for comparison with computed concentrations. The model relies on practically attainable information such as reported pesticide usage data, land cover, and pan-european soil organic carbon content, runoff rates and temperature-dependent degradation rates. After validating the model, we apply it to compute environmental risk indicators that aim at depicting the cumulative effect of pesticides in Europe. These indicators are in essence weighted sums of concentrations of the different chemicals, where weights are ratios of threshold concentrations such as LC50 or NOEC. The model implies simple and easy-to-track computations, and only exploits widely available information on pesticide emissions and properties. Indicators can be used for the assessment of pesticides in Europe for a generic year. A comparison between different years is discussed, yielding indications on the current trends in pesticide contamination at the continental scale. This type of analysis helps identifying pressure factors in agricultural catchments, and their spatial and temporal trends, and may support the identification of priority hazardous substances for river basin management planning within the Water Framework Directive.

  1. Hydrostatic Pressure Regulates MicroRNA Expression Levels in Osteoarthritic Chondrocyte Cultures via the Wnt/β-Catenin Pathway

    PubMed Central

    Cheleschi, Sara; De Palma, Anna; Pecorelli, Alessandra; Pascarelli, Nicola Antonio; Valacchi, Giuseppe; Belmonte, Giuseppe; Carta, Serafino; Galeazzi, Mauro; Fioravanti, Antonella

    2017-01-01

    Mechanical loading and hydrostatic pressure (HP) regulate chondrocytes’ metabolism; however, how mechanical stimulation acts remain unclear. MicroRNAs (miRNAs) play an important role in cartilage homeostasis, mechanotransduction, and in the pathogenesis of osteoarthritis (OA). This study investigated the effects of a cyclic HP (1–5 MPa), in both normal and OA human chondrocytes, on the expression of miR-27a/b, miR-140, miR-146a/b, and miR-365, and of their target genes (MMP-13, ADAMTS-5, IGFBP-5, and HDAC-4). Furthermore, we assessed the possible involvement of Wnt/β-catenin pathway in response to HP. Chondrocytes were exposed to HP for 3h and the evaluations were performed immediately after pressurization, and following 12, 24, and 48 h. Total RNA was extracted and used for real-time PCR. β-catenin was detected by Western blotting analysis and immunofluorescence. In OA chondrocytes, HP induced a significant increase (p < 0.01) of the expression levels of miR-27a/b, miR-140, and miR-146a, and a significant reduction (p < 0.01) of miR-365 at all analyzed time points. MMP-13, ADAMTS-5, and HDAC-4 were significantly downregulated following HP, while no significant modification was found for IGFBP-5. β-catenin levels were significantly increased (p < 0.001) in OA chondrocytes at basal conditions and significantly reduced (p < 0.01) by HP. Pressurization did not cause any significant modification in normal cells. In conclusion, in OA chondrocytes, HP restores the expression levels of some miRNAs, downregulates MMP-13, ADAMTS-5, and HDAC-4, and modulates the Wnt/β-catenin pathway activation. PMID:28085114

  2. Research on Earth's rotation and the effect of atmospheric pressure on vertical deformation and sea level variability

    NASA Technical Reports Server (NTRS)

    Wahr, John

    1993-01-01

    The work done under NASA grant NAG5-485 included modelling the deformation of the earth caused by variations in atmospheric pressure. The amount of deformation near coasts is sensitive to the nature of the oceanic response to the pressure. The PSMSL (Permanent Service for Mean Sea Level) data suggest the response is inverted barometer at periods greater than a couple months. Green's functions were constructed to describe the perturbation of the geoid caused by atmospheric and oceanic loading and by the accompanying load-induced deformation. It was found that perturbation of up to 2 cm are possible. Ice mass balance data was used for continental glaciers to look at the glacial contributions to time-dependent changes in polar motion, the lod, the earth's gravitational field, the position of the earth's center-of-mass, and global sea level. It was found that there can be lateral, non-hydrostatic structure inside the fluid core caused by gravitational forcing from the mantle, from the inner core, or from topography at the core/mantle or inner core/outer core boundaries. The nutational and tidal response of a non-hydrostatic earth with a solid inner core was modeled. Monthly, global tide gauge data from PSMSL was used to look at the 18.6-year ocean tide, the 14-month pole tide, the oceanic response to pressure, the linear trend and inter-annual variability in the earth's gravity field, the global sea level rise, and the effects of post glacial rebound. The effects of mantle anelasticity on nutations, earth tides, and tidal variation in the lod was modeled. Results of this model can be used with Crustal Dynamics observations to look at the anelastic dissipation and dispersion at tidal periods. The effects of surface topography on various components of crustal deformation was also modeled, and numerical models were developed of post glacial rebound.

  3. Deep electronic levels in high-pressure Bridgman Cd{sub 1-x}Zn{sub x}Te

    SciTech Connect

    Szeles, C.; Shan, Y.Y.; Lynn, K.G.; Eissler, E.E.

    1995-12-01

    The behavior of deep electronic levels was studied as a function of Zn concentration in CdZnTe crystals grown by the high-pressure Bridgman technique using thermoelectric effect spectroscopy. A significant increase of the thermal ionization energies of hole traps was observed with the increasing Zn content of the ternary compound. The effect explains the stronger hole trapping and the resulting much shorter hole lifetime usually observed in CdZnTe as compared to CdTe. The behavior also suggests increased carrier recombination and explains the strong deterioration of electron collection in detectors fabricated from CdZnTe of high Zn concentration.

  4. Comparison of sea-level measurements between microwave radar and subsurface pressure gauge deployed at select locations along the coast of India

    NASA Astrophysics Data System (ADS)

    Mehra, Prakash; Prabhudesai, Ramachandra Gopal; Joseph, Antony; Kumar, Vijay; Agarvadekar, Yogesh; Luis, Ryan; Nadaf, Lalsab

    2013-01-01

    Sea-level data are obtained from several remote and coastal locations using absolute pressure gauges deployed at known level, known as chart datum. However, to yield correct sea-level measurements from absolute pressure measurements, it is necessary to take into account the atmospheric pressure and water density at the measurement locations. We used data collected from microwave radar and an absolute pressure gauge deployed at Verem, Goa (January 2009 to May 2010), Tuticorin, and Mandapam, Tamil Nadu (June 2010 to March 2011) to carry out comparative studies. The root-mean-square difference between the estimated sea level from radar and pressure gauge (incorporating atmospheric pressure correction) is ˜2.69, 2.73, and 1.46 cm at Verem, Tuticorin, and Mandapam, respectively. Harmonic analysis of the two time-series of sea-level data at Verem produces similar residuals and tidal constituents. Our results indicate the importance of concurrent measurement of atmospheric pressure along with subsurface absolute pressure gauge measurements. Internet-based real-/near-real-time tracking and monitoring of sea level, sea state, and surface-meteorological conditions from a network of several island and coastal stations provides considerable information to disaster managers and local administrators during episodic events such as storms, storm surges, and tsunamis.

  5. Mercury vapor pressure of flue gas desulfurization scrubber suspensions: effects of pH level, gypsum, and iron.

    PubMed

    Schuetze, Jan; Kunth, Daniel; Weissbach, Sven; Koeser, Heinz

    2012-03-06

    Calcium-based scrubbers designed to absorb HCl and SO(2) from flue gases can also remove oxidized mercury. Dissolved mercury halides may have an appreciable partial vapor pressure. Chemical reduction of the dissolved mercury may increase the Hg emission, thereby limiting the coremoval of mercury in the wet scrubbing process. In this paper we evaluate the effects of the pH level, different gypsum qualities, and iron in flue gas desulfurization (FGD) scrubber suspensions. The impact of these parameters on mercury vapor pressure was studied under controlled laboratory conditions in model scrubber suspensions. A major influence is exerted by pH values above 7, considerably amplifying the mercury concentration in the vapor phase above the FGD scrubber suspension. Gypsum also increases the mercury re-emission. Fe(III) decreases and Fe(II) increases the vapor pressure significantly. The consequences of the findings for a reliable coremoval of mercury in FGD scrubbers are discussed. It is shown that there is an increased risk of poor mercury capture in lime-based FGD scrubbers in comparison to limestone FGD scrubbers.

  6. Exposure to classroom sound pressure level among dance teachers in Porto Alegre (RS)

    PubMed Central

    Nehring, Cristiane; Bauer, Magda Aline; Teixeira, Adriane Ribeiro

    2013-01-01

    Summary Introduction: Dance teachers are exposed to high sound intensities. Aim: To verify the sound intensity of music used by dance teachers during classes. Method: This was a transversal and prospective study. Dance teachers were evaluated with a sociodemographic questionnaire, and sound intensity level measurements were taken at the beginning, middle, and end of dance classes. Results: The sample comprised 35 teachers (average age, 31.8 years). The duration of their career as dance teachers was 1–37 years; they worked daily for approximately 1–10 h. Among the classes followed, there were 15 (42.85%) classical ballet classes, 4 (11.42%) tap dancing lessons, 5 (14.28%) jazz dance classes, 2 (5.71) Arab dance lessons, 6 (17.14%) street dance classes, and 3 (8.57%) ballroom dancing lessons. The average values observed at the beginning, middle, and end of the classes were 80.91 dB (A), 83.22 dB (A), and 85.19 dB (A), respectively. The music played in the street dance classes exposed teachers to the highest sound intensity. Conclusion: The average level of sound intensity of the dance classes in this study was either below or equal to the limit considered harmful for hearing health. Analysis of different class types showed that the sound densities of street, ballroom, and tap dance classes were above the recommended limits. PMID:25991989

  7. Combustion noise level assessment in direct injection Diesel engines by means of in-cylinder pressure components

    NASA Astrophysics Data System (ADS)

    Torregrosa, A. J.; Broatch, A.; Martín, J.; Monelletta, L.

    2007-07-01

    The low consumption achievable with Diesel engines and the subsequent reduction of CO2 emissions, together with the new technologies allowing to meet present and future legislation for pollutant emission reduction, make them attractive from an environmental viewpoint. However, current and future Diesel concepts are intrinsically noisy, and thus in the past few years, combustion noise was considered as an additional factor in engine development alongside performance, emissions and driveability. Otherwise, due to this negative issue intrinsic to Diesel combustion, end-users could be reluctant to drive Diesel-powered vehicles and their potential for environment preservation could thus be lost or underused. Evaluation procedures are then required, both for noise level and sound quality, that may be integrated into the global engine development process, avoiding the need to resort to long and expensive acoustic tests. In this paper, such a procedure, based on the noise source diagnostic through the definition of suitable components extracted from in-cylinder pressure, is proposed and validated. An innovative decomposition of the in-cylinder pressure signal is used to obtain such components, so that features associated with the excitation inside the cylinder may be properly identified. These combustion components, significant of the rate of heat release in the cylinder and the resonance in the combustion chamber, may be correlated with the overall noise level. A prediction of the radiated engine noise level more accurate than that obtained from the classical 'block attenuation' approach is achieved, while combustion process features related to the resulting noise level can be identified and thus corrective actions may be proposed.

  8. Impact of HLA Selection Pressure on HIV Fitness at a Population Level in Mexico and Barbados

    PubMed Central

    Payne, Rebecca; Soto-Nava, Maribel; Avila-Rios, Santiago; Valenzuela-Ponce, Humberto; Adland, Emily; Leitman, Ellen; Brener, Jacqui; Muenchhoff, Maximilian; Branch, Songee; Landis, Clive; Reyes-Teran, Gustavo; Goulder, Philip

    2014-01-01

    ABSTRACT Previous studies have demonstrated that effective cytotoxic T lymphocyte (CTL) responses drive the selection of escape mutations that reduce viral replication capacity (VRC). Escape mutations, including those with reduced VRC, can be transmitted and accumulate in a population. Here we compared two antiretroviral therapy (ART)-naive HIV clade B-infected cohorts, in Mexico and Barbados, in which the most protective HLA alleles (HLA-B*27/57/58:01/81:01) are differentially expressed, at 8% and 34%, respectively. Viral loads were significantly higher in Mexico than in Barbados (median, 40,774 versus 14,200; P < 0.0001), and absolute CD4+ T-cell counts were somewhat lower (median, 380/mm3 versus 403/mm3; P = 0.007). We tested the hypothesis that the disparate frequencies of these protective HLA alleles would be associated with a higher VRC at the population level in Mexico. Analysis of VRC in subjects in each cohort, matched for CD4+ T-cell count, revealed that the VRC was indeed higher in the Mexican cohort (mean, 1.13 versus 1.03; P = 0.0025). Although CD4 counts were matched, viral loads remained significantly higher in the Mexican subjects (P = 0.04). This VRC difference was reflected by a significantly higher frequency in the Barbados cohort of HLA-B*27/57/58:01/81:01-associated Gag escape mutations previously shown to incur a fitness cost on the virus (P = 0.004), a difference between the two cohorts that remained statistically significant even in subjects not expressing these protective alleles (P = 0.01). These data suggest that viral set points and disease progression rates at the population level may be significantly influenced by the prevalence of protective HLA alleles such as HLA-B*27/57/58:01/81:01 and that CD4 count-based guidelines to initiate antiretroviral therapy may need to be modified accordingly, to optimize the effectiveness of treatment-for-prevention strategies and reduce HIV transmission rates to the absolute minimum. IMPORTANCE Immune

  9. Association of target organ damage with 24-hour systolic and diastolic blood pressure levels and hypertension subtypes in untreated Chinese.

    PubMed

    Wei, Fang-Fei; Li, Yan; Zhang, Lu; Xu, Ting-Yan; Ding, Feng-Hua; Staessen, Jan A; Wang, Ji-Guang

    2014-02-01

    The association of target organ damage with 24-hour systolic and diastolic blood pressure levels and ambulatory hypertension subtypes has not yet been examined in untreated Chinese patients. We measured left ventricular mass index by echocardiography (n=619), the urinary albumin:creatinine ratio (n=1047), and aortic pulse wave velocity by tonometry (n=1013) in 1047 untreated subjects (mean age, 50.6 years; 48.9% women). Normotension was a 24-hour systolic/diastolic blood pressure <130/<80 mm Hg. Hypertension subtypes were isolated diastolic hypertension and mixed systolic plus diastolic hypertension. We assessed associations of interest by multivariable-adjusted linear models. Using normotension as reference, mixed hypertension was associated with higher (P≤0.003) left ventricular mass index (+4.31 g/m(2)), urinary albumin:creatinine ratio (+1.63 mg/mmol), and pulse wave velocity (+0.76 m/s); and isolated diastolic hypertension was associated with similar left ventricular mass index and pulse wave velocity (P≥0.39), but higher urinary albumin:creatinine ratio (+1.24 mg/mmol; P=0.002). In younger participants (<55 years), the mutually independent effect sizes associated with 1 SD increases in 24-hour systolic/diastolic blood pressure were +3.31/-0.36 g/m(2) (P=0.009/0.79) for left ventricular mass index, +1.15/+1.14 mg/mmol (P=0.02/0.04) for the urinary albumin:creatinine ratio, and +0.54/-0.05 m/s (P<0.001/0.54) for pulse wave velocity. In older participants, these estimates were +3.58/+0.30 g/m(2) (P=0.045/0.88), +1.23/+1.05 mg/mmol (P=0.002/0.54), and +0.76/-0.49 m/s (P<0.001/<0.001), respectively. In conclusion, 24-hour systolic blood pressure and mixed hypertension are major determinants of target organ damage irrespective of age and target organ, whereas 24-hour diastolic blood pressure and isolated diastolic hypertension only relate to the urinary albumin:creatinine ratio below middle age.

  10. Differences in Blood Pressure and Vascular Responses Associated with Ambient Fine Particulate Matter Exposures Measured at the Personal Versus Community Level

    EPA Science Inventory

    Background Higher ambient fine particulate matter (PM2.5) levels can be associated with increased blood pressure and vascular dysfunction. Objectives To determine the differential effects on blood pressure and vascular function of daily changes in community ambient-...

  11. The Activation Effects of Low Level Isopropyl Alcohol Exposure on Arterial Blood Pressures Are Associated with Decreased 5-Hydroxyindole Acetic Acid in Urine

    PubMed Central

    Zhao, Zhiqiang; Liu, Xinxia; Xing, Xiumei; Lu, Yao; Sun, Yi; Ou, Xiaoyan; Su, Xiaolin; Jiang, Jun; Yang, Yarui; Chen, Jingli; Shen, Biling; He, Yun

    2016-01-01

    Purposes The objectives of this paper are to study the impact of low level isopropyl alcohol exposure on blood pressure and to explore its potential mechanism. Methods This cross-sectional study was based on a prospective occupational cohort in south China, which focusing on occupational risk factors related cardiovascular health problems. A total of 283 participants (200 low isopropyl alcohol exposed workers and 83 controls) was finally enrolled in this study. Linear regression models were used to analyze the relationship between arterial blood pressures and low level isopropyl alcohol exposure. We used mediation method to explore possible mediated roles of neurogenic factors. Results Systolic blood pressure (SBP, 123±10 vs. 118±11), diastolic blood pressure (DBP, 79±7 vs. 74±7) and mean blood pressure (MBP, 93±8 vs. 89±9) were different between the exposed group and the control group (p < 0.01). After adjusting for covariates, the difference was still significant. Besides, isopropyl alcohol and smoking had an interactive effect on DBP and MBP (p < 0.05). Furthermore, we observed a mediated effect of 5-hydroxyindole acetic acid (5-HIAA) on isopropyl alcohol exposure induced arterial blood pressure increase, which accounted for about 25%. Conclusions Our results suggest that low level isopropyl alcohol exposure is a potential risk factor for the increased arterial blood pressure and 5-HIAA partly mediates the association between low level isopropyl alcohol exposure and arterial blood pressures. PMID:27622502

  12. MS2 Virus Inactivation by Atmospheric-Pressure Cold Plasma Using Different Gas Carriers and Power Levels

    PubMed Central

    Wu, Yan; Liang, Yongdong; Wei, Kai; Li, Wei; Grinshpun, Sergey A.

    2014-01-01

    In this study, airborne MS2 bacteriophages were exposed for subsecond time intervals to atmospheric-pressure cold plasma (APCP) produced using different power levels (20, 24, and 28 W) and gas carriers (ambient air, Ar-O2 [2%, vol/vol], and He-O2 [2%, vol/vol]). In addition, waterborne MS2 viruses were directly subjected to the APCP treatment for up to 3 min. MS2 viruses with and without the APCP exposure were examined by scanning electron microscopy (SEM), reverse transcription-PCR (RT-PCR), and sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Viral inactivation was shown to exhibit linear relationships with the APCP generation power and exposure time (R2 > 0.95 for all energy levels tested) up to 95% inactivation (1.3-log reduction) after a subsecond airborne exposure at 28 W; about the same inactivation level was achieved for waterborne viruses with an exposure time of less than 1 min. A larger amount of reactive oxygen species (ROS), such as atomic oxygen, in APCP was detected for a higher generation power with Ar-O2 and He-O2 gas carriers. SEM images, SDS-PAGE, and agarose gel analysis of exposed waterborne viruses showed various levels of damage to both surface proteins and their related RNA genes after the APCP exposure, thus leading to the loss of their viability and infectivity. PMID:25416775

  13. The influence of deformation height on estimating the center of pressure during level and cross-slope walking on sand.

    PubMed

    Xu, Hang; Wang, Yi; Greenland, Kasey; Bloswick, Donald; Merryweather, Andrew

    2015-07-01

    Force plates are frequently used to collect the ground reaction forces (GRF) and center of pressure (COP) during gait. The calculated COP is affected by the material type and thickness covering the top surface. If the surface is deformable, these effects can be significant. The purpose of this study is to simulate and evaluate the effects of deformation height when calculating the COP in a deformable surface during gait. The GRF and COP data during normal gait were collected from 20 healthy adult males on sand in two conditions (level and cross-slope of 10°). The COP differences in the anteroposterior (AP) and mediolateral (ML) directions were modeled for constant deformation heights (10-50 mm, 10 mm increments). The results showed the magnitude of COP changes in the AP and ML directions were different in both level and cross-slope conditions. A significantly larger COPML difference was shown for the cross-slope condition than level condition for the same deformation height. The COP was more sensitive to the deformation height for the downhill limb than uphill limb in the cross-slope condition. The results of this study suggest that the maximum allowable deformation height before a correction for surface deformation is needed is 20mm for level condition and 10mm for cross-slope condition, where 3mm difference in COP is considered as the tolerance limit. Surface deformations beyond these thresholds may lead to an inaccurate interpretation and evaluation of joint kinetics during gait on deformable surfaces.

  14. Fraction SX of maitake mushroom favorably influences blood glucose levels and blood pressure in streptozotocin-induced diabetic rats.

    PubMed

    Preuss, Harry G; Echard, Bobby; Fu, Jia; Perricone, Nicholas V; Bagchi, Debasis; Kaylor, Mark; Zhuang, Cun

    2012-10-01

    We assessed whether fraction SX derived from maitake mushroom could play a beneficial role in the treatment of a laboratory model of type-1 diabetes by decreasing circulating glucose levels and lowering blood pressure (BP). We injected 50 mg/kg body weight (BW) streptozotocin (STZ) intraperitoneally (i.p.) into 48 male Sprague-Dawley rats (SD) to produce a laboratory model of type-1 diabetes. SD were divided into four groups of 12 SD. A control group ate straight pulverized rat chow. To three treatment groups, we added into the pulverized rat chow: gliclazide (10 mg/kg), pioglitazone (10-30 mg/kg), or maitake SX (2.5 g/kg). In addition to measuring BW, circulating glucose level, and BP, the following procedures were also carried out: insulin challenge (insulin sensitivity), losartan challenge (renin-angiotensin system activity), Nw-nitro-L arginine-methyl ester hydrochloride (LNAME) challenge (nitric oxide [NO] system activity), and evaluation of serum angiotensin converting enzyme (ACE) activity. All treatments compared with control generally decreased circulating glucose levels, but only the maitake SX consistently enhanced measured insulin sensitivity. We found that maitake SX could significantly lower systolic blood pressure (SBP) in diabetic SD. In general, only SD receiving maitake SX, not the two drugs, showed decreased activity of the renin-angiotensin system and increased NO system activity compared with control under the conditions examined. Our results suggest that maitake SX may be useful for treating perturbations in glucose-insulin metabolism and elevated BP in type-1 diabetes.

  15. Blunted sleep-time relative blood pressure decline increases cardiovascular risk independent of blood pressure level--the "normotensive non-dipper" paradox.

    PubMed

    Hermida, Ramón C; Ayala, Diana E; Mojón, Artemio; Fernández, José R

    2013-03-01

    Numerous studies have consistently shown an association between blunted sleep-time relative blood pressure (BP) decline (non-dipping) and increased cardiovascular disease (CVD) risk in hypertension. Normotensive persons with a non-dipper BP profile also have increased target organ damage, namely, increased left ventricular mass and relative wall thickness, reduced myocardial diastolic function, increased urinary albumin excretion, increased prevalence of diabetic retinopathy, and impaired glucose tolerance. It remains a point of contention, however, whether the non-dipper BP pattern or just elevated BP, alone, is the most important predictor of advanced target organ damage and future CVD events. Accordingly, we investigated the role of dipping status and ambulatory BP level as contributing factors for CVD morbidity and mortality in the MAPEC (Monitorización Ambulatoria para Predicción de Eventos Cardiovasculares, i.e., Ambulatory Blood Pressure Monitoring for Prediction of Cardiovascular Events) study. We prospectively studied 3344 individuals (1718 men/1626 women), 52.6 ± 14.5 (mean ± SD) yrs of age, during a median follow-up of 5.6 yrs. BP was measured by ambulatory monitoring (ABPM) for 48 h at baseline, and again annually or more frequently (quarterly) if treatment adjustment was required in treated hypertensive patients. At baseline, those with ABPM-substantiated hypertension were randomized to one of two treatment-time regimen groups: (i) ingestion of all prescribed hypertension medications upon awakening or (ii) ingestion of the entire dose of ≥1 of them at bedtime. Those found to be normotensive at baseline were untreated but followed and evaluated by repeated ABPM like the hypertensive patients. Participants were divided into four investigated categories on the basis of dipping status and ambulatory BP: (i) dipper vs. non-dipper, and (ii) normal ambulatory BP if the awake systolic (SBP)/diastolic (DBP) BP means were <135/85 mm Hg and the

  16. Exhaled and arterial levels of endothelin-1 are increased and correlate with pulmonary systolic pressure in COPD with pulmonary hypertension

    PubMed Central

    Carratu, Pierluigi; Scoditti, Cristina; Maniscalco, Mauro; Seccia, Teresa Maria; Di Gioia, Giuseppe; Gadaleta, Felice; Cardone, Rosa Angela; Dragonieri, Silvano; Pierucci, Paola; Spanevello, Antonio; Resta, Onofrio

    2008-01-01

    Background Endothelin-1 (ET-1) and Nitric Oxide (NO) are crucial mediators for establishing pulmonary artery hypertension (PAH). We tested the hypothesis that their imbalance might also occur in COPD patients with PAH. Methods The aims of the study were to measure exhaled breath condensate (EBC) and circulating levels of ET-1, as well as exhaled NO (FENO) levels by, respectively, a specific enzyme immunoassay kit, and by chemiluminescence analysis in 3 groups of subjects: COPD with PAH (12), COPD only (36), and healthy individuals (15). In order to evaluate pulmonary-artery systolic pressure (PaPs), all COPD patients underwent Echo-Doppler assessment. Results Significantly increased exhaled and circulating levels of ET-1 were found in COPD with PAH compared to both COPD (p < 0.0001) only, and healthy controls (p < 0.0001). In COPD with PAH, linear regression analysis showed good correlation between ET-1 in EBC and PaPs (r = 0.621; p = 0.031), and between arterial levels of ET-1 and PaPs (r = 0.648; p = 0.022), while arterial levels of ET-1 inversely correlated with FEV1%, (r = -0.59, p = 0.043), and PaPs negatively correlated to PaO2 (r = -0.618; p = 0.032). Significantly reduced levels of FENO were found in COPD associated with PAH, compared to COPD only (22.92 ± 11.38 vs.35.07 ± 17.53 ppb; p = 0.03). Thus, we observed an imbalanced output in the breath between ET-1 and NO, as expression of pulmonary endothelium and epithelium impairment, in COPD with PAH compared to COPD only. Whether this imbalance is an early cause or result of PAH due to COPD is still unknown and deserves further investigations. PMID:18822124

  17. A novel transmission-based test of association for multivariate phenotypes: an application to systolic and diastolic blood pressure levels

    PubMed Central

    2014-01-01

    Unlike case-control studies, family-based tests for association are protected against population stratification. Complex genetic traits are often governed by quantitative precursors and it has been argued that it may be a more powerful strategy to analyze these quantitative precursors instead of the clinical end point trait. Although methods have been developed for family-based association tests for single quantitative traits, it is of interest to develop such methods for multivariate phenotypes. We propose a novel transmission-based approach based on a trio design using a simple logistic regression to test for association with a multivariate phenotype. We use our proposed method to analyze data on systolic and diastolic blood pressure levels provided in Genetic Analysis Workshop 18. However, we find that the bivariate analysis of the two phenotypes did not provide more promising results compared to univariate analyses, suggesting a possibility of a different set of major genetic variants modulating the two phenotypes. PMID:25519341

  18. Effects of sound-field frequency modulation amplification on reducing teachers' sound pressure level in the classroom.

    PubMed

    Sapienza, C M; Crandell, C C; Curtis, B

    1999-09-01

    Voice problems are a frequent difficulty that teachers experience. Common complaints by teachers include vocal fatigue and hoarseness. One possible explanation for these symptoms is prolonged elevations in vocal loudness within the classroom. This investigation examined the effectiveness of sound-field frequency modulation (FM) amplification on reducing the sound pressure level (SPL) of the teacher's voice during classroom instruction. Specifically, SPL was examined during speech produced in a classroom lecture by 10 teachers with and without the use of sound-field amplification. Results indicated a significant 2.42-dB decrease in SPL with the use of sound-field FM amplification. These data support the use of sound-field amplification in the vocal hygiene regimen recommended to teachers by speech-language pathologists.

  19. Numerical and analytical solutions for sound propagation and absorption in porous media at high sound pressure levels.

    PubMed

    Zhang, Bo; Chen, Tianning; Zhao, Yuyuan; Zhang, Weiyong; Zhu, Jian

    2012-09-01

    On the basis of the work of Wilson et al. [J. Acoust. Soc. Am. 84, 350-359 (1988)], a more exact numerical approach was constructed for predicting the nonlinear sound propagation and absorption properties of rigid porous media at high sound pressure levels. The numerical solution was validated by the experimental results for sintered fibrous porous steel samples and its predictions were compared with the numerical solution of Wilson et al. An approximate analytical solution was further put forward for the normalized surface acoustic admittance of rigid air-saturated porous materials with infinite thickness, based on the wave perturbation method developed by Lambert and McIntosh [J. Acoust. Soc. Am. 88, 1950-1959 (1990)]. Comparisons were made with the numerical results.

  20. Coupled patterns of spatiotemporal variability in Northern Hemisphere sea level pressure and conterminous U.S. drought

    NASA Astrophysics Data System (ADS)

    Zhang, Zhihua; Mann, Michael E.

    2005-02-01

    We apply the multitaper frequency domain-singular value decomposition signal detection method to the investigation of coherent patterns of variation in seasonal Northern Hemisphere sea level pressure and conterminous U.S. summer drought during the period 1895-1995. The analysis identifies statistically significant patterns of spatiotemporal variability on interannual and bidecadal timescales indicative of both cold-season and warm-season atmospheric influences on North American drought patterns. The most robust signal found appears to be associated with the influences of the El Niño-Southern Oscillation (ENSO) on North American summer drought. Evidence is also found to support the existence of a roughly bidecadal drought signal tied to warm-season atmospheric circulation changes. The "Dust Bowl" conditions of the 1930s appear to result from a combination of these bidecadal influences on drought conditions that coincide with a decrease in the amplitude of interannual ENSO-related variability during the 1930s.

  1. Dynamic Characteristics of Mechanical Ventilation System of Double Lungs with Bi-Level Positive Airway Pressure Model

    PubMed Central

    Shen, Dongkai; Zhang, Qian

    2016-01-01

    In recent studies on the dynamic characteristics of ventilation system, it was considered that human had only one lung, and the coupling effect of double lungs on the air flow can not be illustrated, which has been in regard to be vital to life support of patients. In this article, to illustrate coupling effect of double lungs on flow dynamics of mechanical ventilation system, a mathematical model of a mechanical ventilation system, which consists of double lungs and a bi-level positive airway pressure (BIPAP) controlled ventilator, was proposed. To verify the mathematical model, a prototype of BIPAP system with a double-lung simulators and a BIPAP ventilator was set up for experimental study. Lastly, the study on the influences of key parameters of BIPAP system on dynamic characteristics was carried out. The study can be referred to in the development of research on BIPAP ventilation treatment and real respiratory diagnostics. PMID:27660646

  2. Risk Stratification by Self-Measured Home Blood Pressure across Categories of Conventional Blood Pressure: A Participant-Level Meta-Analysis

    PubMed Central

    Asayama, Kei; Thijs, Lutgarde; Brguljan-Hitij, Jana; Niiranen, Teemu J.; Hozawa, Atsushi; Boggia, José; Aparicio, Lucas S.; Hara, Azusa; Johansson, Jouni K.; Ohkubo, Takayoshi; Tzourio, Christophe; Stergiou, George S.; Sandoya, Edgardo; Tsuji, Ichiro; Jula, Antti M.; Imai, Yutaka; Staessen, Jan A.

    2014-01-01

    Background The Global Burden of Diseases Study 2010 reported that hypertension is worldwide the leading risk factor for cardiovascular disease, causing 9.4 million deaths annually. We examined to what extent self-measurement of home blood pressure (HBP) refines risk stratification across increasing categories of conventional blood pressure (CBP). Methods and Findings This meta-analysis included 5,008 individuals randomly recruited from five populations (56.6% women; mean age, 57.1 y). All were not treated with antihypertensive drugs. In multivariable analyses, hazard ratios (HRs) associated with 10-mm Hg increases in systolic HBP were computed across CBP categories, using the following systolic/diastolic CBP thresholds (in mm Hg): optimal, <120/<80; normal, 120–129/80–84; high-normal, 130–139/85–89; mild hypertension, 140–159/90–99; and severe hypertension, ≥160/≥100. Over 8.3 y, 522 participants died, and 414, 225, and 194 had cardiovascular, cardiac, and cerebrovascular events, respectively. In participants with optimal or normal CBP, HRs for a composite cardiovascular end point associated with a 10-mm Hg higher systolic HBP were 1.28 (1.01–1.62) and 1.22 (1.00–1.49), respectively. At high-normal CBP and in mild hypertension, the HRs were 1.24 (1.03–1.49) and 1.20 (1.06–1.37), respectively, for all cardiovascular events and 1.33 (1.07–1.65) and 1.30 (1.09–1.56), respectively, for stroke. In severe hypertension, the HRs were not significant (p≥0.20). Among people with optimal, normal, and high-normal CBP, 67 (5.0%), 187 (18.4%), and 315 (30.3%), respectively, had masked hypertension (HBP≥130 mm Hg systolic or ≥85 mm Hg diastolic). Compared to true optimal CBP, masked hypertension was associated with a 2.3-fold (1.5–3.5) higher cardiovascular risk. A limitation was few data from low- and middle-income countries. Conclusions HBP substantially refines risk stratification at CBP levels assumed to carry no or only mildly increased

  3. A reconstruction of extratropical Indo-Pacific sea-level pressure patterns during the Medieval Climate Anomaly

    NASA Astrophysics Data System (ADS)

    Goodwin, Ian D.; Browning, Stuart; Lorrey, Andrew M.; Mayewski, Paul A.; Phipps, Steven J.; Bertler, Nancy A. N.; Edwards, Ross P.; Cohen, Tim J.; van Ommen, Tas; Curran, Mark; Barr, Cameron; Stager, J. Curt

    2014-09-01

    Subtropical and extratropical proxy records of wind field, sea level pressure (SLP), temperature and hydrological anomalies from South Africa, Australia/New Zealand, Patagonian South America and Antarctica were used to reconstruct the Indo-Pacific extratropical southern hemisphere sea-level pressure anomaly (SLPa) fields for the Medieval Climate Anomaly (MCA ~700-1350 CE) and transition to the Little Ice Age (LIA 1350-1450 CE). The multivariate array of proxy data were simultaneously evaluated against global climate model output in order to identify climate state analogues that are most consistent with the majority of proxy data. The mean SLP and SLP anomaly patterns derived from these analogues illustrate the evolution of low frequency changes in the extratropics. The Indo-Pacific extratropical mean climate state was dominated by a strong tropical interaction with Antarctica emanating from: (1) the eastern Indian and south-west Pacific regions prior to 1100 CE, then, (2) the eastern Pacific evolving to the central Pacific La Niña-like pattern interacting with a +ve SAM to 1300 CE. A relatively abrupt shift to -ve SAM and the central Pacific El Niño-like pattern occurred at ~1300. A poleward (equatorward) shift in the subtropical ridge occurred during the MCA (MCA-LIA transition). The Hadley Cell expansion in the Australian and Southwest Pacific, region together with the poleward shift of the zonal westerlies is contemporaneous with previously reported Hadley Cell expansion in the North Pacific and Atlantic regions, and suggests that bipolar climate symmetry was a feature of the MCA.

  4. November Dipole Anomaly in Northern Extratropical Sea Level Pressure and its Linkage to the Preceding Wintertime Arctic Oscillation

    NASA Astrophysics Data System (ADS)

    Choi, Y. W.; Ahn, J. B.

    2015-12-01

    This paper examines the impact of the wintertime Arctic Oscillation (AO) on the following November circulation. The application of a set of statistical methods shows that a response of November sea level pressure (SLP) to the preceding wintertime AO operates on a hemispheric scale (Choi et al., 2015). At high and middle latitudes, this response is a well-pronounced seesaw in SLP between the Eastern and Western Hemispheres. Winters of the positive AO polarity tend to be followed by positive SLP anomalies spanning the whole Northern Eurasia and negative SLP anomalies extending from the Bering Sea through the Western North Atlantic. Opposite SLP anomalies prevail after winters of the negative AO polarity. The response of November SLP to the preceding wintertime AO closely resembles the first empirical orthogonal function of November SLP. That is, the polarity of the wintertime AO precedes the polarity of the leading mode of variability of November SLP over the Northern Hemisphere. The wintertime AO exerts a 9-month lag impact on November circulation due to the re-emergence of a sea surface temperature anomaly over the western North Atlantic. Acknowledgements This work was funded by the Korea Meteorological Administration Research and Development Program under grant KMIPA 2015-2081 and Rural Development Administration Cooperative Research Program for Agriculture Science and Technology Development under Grant Project No. PJ009353, Republic of Korea. Reference Choi, Y.-W., J.-B. Ahn, V. N. Kryjov, 2015. November seesaw in northern extratropical sea level pressure and its linkage to the preceding wintertime Arctic Oscillation, Int. J. Climatol., DOI: 10.1002/joc.4431

  5. Offshore exposure experiments on cuttlefish indicate received sound pressure and particle motion levels associated with acoustic trauma

    PubMed Central

    Solé, Marta; Sigray, Peter; Lenoir, Marc; van der Schaar, Mike; Lalander, Emilia; André, Michel

    2017-01-01

    Recent findings on cephalopods in laboratory conditions showed that exposure to artificial noise had a direct consequence on the statocyst, sensory organs, which are responsible for their equilibrium and movements in the water column. The question remained about the contribution of the consequent near-field particle motion influence from the tank walls, to the triggering of the trauma. Offshore noise controlled exposure experiments (CEE) on common cuttlefish (Sepia officinalis), were conducted at three different depths and distances from the source and particle motion and sound pressure measurements were performed at each location. Scanning electron microscopy (SEM) revealed injuries in statocysts, which severity was quantified and found to be proportional to the distance to the transducer. These findings are the first evidence of cephalopods sensitivity to anthropogenic noise sources in their natural habitat. From the measured received power spectrum of the sweep, it was possible to determine that the animals were exposed at levels ranging from 139 to 142 dB re 1 μPa2 and from 139 to 141 dB re 1 μPa2, at 1/3 octave bands centred at 315 Hz and 400 Hz, respectively. These results could therefore be considered a coherent threshold estimation of noise levels that can trigger acoustic trauma in cephalopods. PMID:28378762

  6. Comparative Genomics of the Vertebrate Insulin/TOR Signal Transduction Pathway: A Network-Level Analysis of Selective Pressures

    PubMed Central

    Alvarez-Ponce, David; Aguadé, Montserrat; Rozas, Julio

    2011-01-01

    Complexity of biological function relies on large networks of interacting molecules. However, the evolutionary properties of these networks are not fully understood. It has been shown that selective pressures depend on the position of genes in the network. We have previously shown that in the Drosophila insulin/target of rapamycin (TOR) signal transduction pathway there is a correlation between the pathway position and the strength of purifying selection, with the downstream genes being most constrained. In this study, we investigated the evolutionary dynamics of this well-characterized pathway in vertebrates. More specifically, we determined the impact of natural selection on the evolution of 72 genes of this pathway. We found that in vertebrates there is a similar gradient of selective constraint in the insulin/TOR pathway to that found in Drosophila. This feature is neither the result of a polarity in the impact of positive selection nor of a series of factors affecting selective constraint levels (gene expression level and breadth, codon bias, protein length, and connectivity). We also found that pathway genes encoding physically interacting proteins tend to evolve under similar selective constraints. The results indicate that the architecture of the vertebrate insulin/TOR pathway constrains the molecular evolution of its components. Therefore, the polarity detected in Drosophila is neither specific nor incidental of this genus. Hence, although the underlying biological mechanisms remain unclear, these may be similar in both vertebrates and Drosophila. PMID:21149867

  7. Beneficial Effects of Polyphenol-Rich Chokeberry Juice Consumption on Blood Pressure Level and Lipid Status in Hypertensive Subjects.

    PubMed

    Kardum, Nevena; Milovanović, Branislav; Šavikin, Katarina; Zdunić, Gordana; Mutavdžin, Slavica; Gligorijević, Tatjana; Spasić, Slavica

    2015-11-01

    Epidemiological studies have shown a positive association between intake of foods rich in antioxidants and lower incidence of cardiovascular disease development. Polyphenols are considered the most abundant and important dietary antioxidants. The aim of this study was to evaluate effects of polyphenol-rich chokeberry juice consumption on 24-h ambulatory monitored blood pressure (BP) level in subjects with no pharmacologically treated high normal BP or grade I hypertension. Twenty-three subjects (12 men and 11 women) aged 33-67 were enrolled and instructed to consume 200 mL of juice daily for 4 weeks. Participants were divided in two groups, based on prevalence of sympathetic or parasympathetic activity. Measurements of biochemical parameters and heart rate variability analysis were also applied. At the end of the intervention period, average 24-h and awake systolic and diastolic BP were significantly decreased (P<.05). This was more pronounced in the group with prevalence of sympathetic activity. Significant reduction in triglyceride level (P<.05) and a reducing effect on total and low-density lipoprotein cholesterol were also found. Obtained results indicate a positive impact of regular chokeberry juice consumption on BP and lipid status in pharmacologically untreated hypertensive subjects.

  8. Offshore exposure experiments on cuttlefish indicate received sound pressure and particle motion levels associated with acoustic trauma.

    PubMed

    Solé, Marta; Sigray, Peter; Lenoir, Marc; van der Schaar, Mike; Lalander, Emilia; André, Michel

    2017-04-05

    Recent findings on cephalopods in laboratory conditions showed that exposure to artificial noise had a direct consequence on the statocyst, sensory organs, which are responsible for their equilibrium and movements in the water column. The question remained about the contribution of the consequent near-field particle motion influence from the tank walls, to the triggering of the trauma. Offshore noise controlled exposure experiments (CEE) on common cuttlefish (Sepia officinalis), were conducted at three different depths and distances from the source and particle motion and sound pressure measurements were performed at each location. Scanning electron microscopy (SEM) revealed injuries in statocysts, which severity was quantified and found to be proportional to the distance to the transducer. These findings are the first evidence of cephalopods sensitivity to anthropogenic noise sources in their natural habitat. From the measured received power spectrum of the sweep, it was possible to determine that the animals were exposed at levels ranging from 139 to 142 dB re 1 μPa(2) and from 139 to 141 dB re 1 μPa(2), at 1/3 octave bands centred at 315 Hz and 400 Hz, respectively. These results could therefore be considered a coherent threshold estimation of noise levels that can trigger acoustic trauma in cephalopods.

  9. Development of wafer-level-packaging technology for simultaneous sealing of accelerometer and gyroscope under different pressures

    NASA Astrophysics Data System (ADS)

    Aono, T.; Suzuki, K.; Kanamaru, M.; Okada, R.; Maeda, D.; Hayashi, M.; Isono, Y.

    2016-10-01

    This research demonstrates a newly developed anodic bonding-based wafer-level-packaging technique to simultaneously seal an accelerometer in the atmosphere and a gyroscope in a vacuum with a glass cap for micro-electromechanical systems sensors. It is necessary for the accelerometer, with a damping oscillator, to be sealed in the atmosphere to achieve a high-speed response. As the gyroscope can achieve high sensitivity with a large displacement at the resonant frequency without air-damping, the gyroscope must be sealed in a vacuum. The technique consists of three processing steps: the first bonding step in the atmosphere for the accelerometer, the pressure control step and the second bonding step in a vacuum for the gyroscope. The process conditions were experimentally determined to achieve higher shear strength at the interface of the packaging. The packaging performance of the accelerometer and gyroscope after wafer-level packaging was also investigated using a laser Doppler velocimeter at room temperature. The amplitude at the resonant frequency of the accelerometer was reduced by air damping, and the quality factor of the gyroscope showed a value higher than 1000. The reliability of the gyroscope was also confirmed by a thermal cyclic test and an endurance test at high humidity and high temperature.

  10. Changes in sea-level pressure over South Korea associated with high-speed solar wind events

    NASA Astrophysics Data System (ADS)

    Cho, Il-Hyun; Kwak, Young-Sil; Marubashi, Katsuhide; Kim, Yeon-Han; Park, Young-Deuk; Chang, Heon-Young

    2012-09-01

    We explore a possibility that the daily sea-level pressure (SLP) over South Korea responds to the high-speed solar wind event. This is of interest in two aspects: first, if there is a statistical association this can be another piece of evidence showing that various meteorological observables indeed respond to variations in the interplanetary environment. Second, this can be a very crucial observational constraint since most models proposed so far are expected to preferentially work in higher latitude regions than the low latitude region studied here. We have examined daily solar wind speed V, daily SLP difference ΔSLP, and daily log(BV2) using the superposed epoch analysis in which the key date is set such that the daily solar wind speed exceeds 800 km s-1. We find that the daily ΔSLP averaged out of 12 events reaches its peak at day +1 and gradually decreases back to its normal level. The amount of positive deviation of ΔSLP is +2.5 hPa. The duration of deviation is a few days. We also find that ΔSLP is well correlated with both the speed of solar wind and log(BV2). The obtained linear correlation coefficients and chance probabilities with one-day lag for two cases are r ≃ 0.81 with P > 99.9%, and r ≃ 0.84 with P > 99.9%, respectively. We conclude by briefly discussing future direction to pursue.

  11. Pilot scale evaluation of biological and pressure clarification processes for the removal of high level of iron and manganese

    SciTech Connect

    Yannoni, C.C.; Kinsley, B.P.; Marston, T.R.

    1996-11-01

    Iron and manganese originating from groundwater supplies have a long history of causing consumer complaints in water distribution systems. Although iron and manganese are not public health concerns, they are a major concern from an aesthetic standpoint. The elevated awareness of consumers in regard to the quality of drinking water, an increase in regulations requiring additional treatment and the cost associated with developing new sources of supply, has required many utilities to implement improvements to existing facilities. Historical water quality data collected from the Connecticut Water Company`s (CWC) Westbrook Well revealed an increasing trend in iron and manganese concentrations. As a result, the existing greensand filtration facility located at the well, provides insufficient removal rates and inefficient operating cycles. Variations in operating procedures were not successful in correcting these problems. A water treatment feasibility study recommended evaluation of biological and pressure clarification processes to reduce iron (9 mg/l) and manganese (1.5 mg/l) levels below the secondary maximum contaminant levels of 0.30 and 0.05 mg/l, respectively. Assessment of these processes was accomplished through the construction and operation of a 5 gallon per minute (gpm) capacity pilot plant at the Westbrook Water Treatment Plant. Application of biological treatment for iron removal was then piloted on the existing full-scale treatment facility.

  12. Pressure dependence of the E 2 and E 1 deep levels in GaAs, GaP, and their alloys

    SciTech Connect

    Samara, G.A.; Biefeld, R.M.; Dawson, L.R.; Zipperian, T.E.; Barnes, C.E. )

    1991-03-15

    Measurements of the effects of pressure on the thermal-electron emission rate and capture cross section for the {ital E}2 and {ital E}1 deep levels in GaAs, GaP, and their alloys have yielded the pressure dependences of the energies of these levels, allowed evaluation of the breathing-mode lattice relaxations accompanying carrier emission or capture by these levels, and revealed trends that lead to new insights. The results are consistent with a model which associates {ital E}2 with the ({minus}/0) and {ital E}1 with the (2{minus}/{minus}) charge states of the As (or P) vacancy.

  13. 46 CFR 52.01-110 - Water-level indicators, water columns, gauge-glass connections, gauge cocks, and pressure gauges...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 2 2013-10-01 2013-10-01 false Water-level indicators, water columns, gauge-glass... § 52.01-110 Water-level indicators, water columns, gauge-glass connections, gauge cocks, and pressure... normal and emergency conditions. The secondary indicator may consist of a gage glass, or other...

  14. 46 CFR 52.01-110 - Water-level indicators, water columns, gauge-glass connections, gauge cocks, and pressure gauges...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 2 2012-10-01 2012-10-01 false Water-level indicators, water columns, gauge-glass... § 52.01-110 Water-level indicators, water columns, gauge-glass connections, gauge cocks, and pressure... normal and emergency conditions. The secondary indicator may consist of a gage glass, or other...

  15. 46 CFR 52.01-110 - Water-level indicators, water columns, gauge-glass connections, gauge cocks, and pressure gauges...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 2 2011-10-01 2011-10-01 false Water-level indicators, water columns, gauge-glass... § 52.01-110 Water-level indicators, water columns, gauge-glass connections, gauge cocks, and pressure... normal and emergency conditions. The secondary indicator may consist of a gage glass, or other...

  16. 46 CFR 52.01-110 - Water-level indicators, water columns, gauge-glass connections, gauge cocks, and pressure gauges...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 2 2014-10-01 2014-10-01 false Water-level indicators, water columns, gauge-glass... § 52.01-110 Water-level indicators, water columns, gauge-glass connections, gauge cocks, and pressure... normal and emergency conditions. The secondary indicator may consist of a gage glass, or other...

  17. 46 CFR 52.01-110 - Water-level indicators, water columns, gauge-glass connections, gauge cocks, and pressure gauges...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Water-level indicators, water columns, gauge-glass... § 52.01-110 Water-level indicators, water columns, gauge-glass connections, gauge cocks, and pressure... normal and emergency conditions. The secondary indicator may consist of a gage glass, or other...

  18. Treating metabolic syndrome's metaflammation with low level light therapy: preliminary results

    NASA Astrophysics Data System (ADS)

    Yoshimura, Tania M.; Kato, Ilka T.; Deana, Alessandro M.; Ribeiro, Martha S.

    2014-02-01

    Metabolic syndrome comprises a constellation of morbidities such as insulin resistance, hyperinsulinemia, atherogenic dyslipidemia, dysglycemia and obesity (especially abdominal). Metabolic alterations are observed in major insulin target organs, increasing the risk of cardiovascular diseases, type-2 diabetes and therefore mortality. Tissue alterations are characterized by immune cells infiltrates (especially activated macrophages). Released inflammatory mediators such as TNF-α induce chronic inflammation in subjects with metabolic syndrome, since inflammatory pathways are activated in the neighboring cells. The intra-abdominal adipose tissue appears to be of particular importance in the onset of the inflammatory state, and strategies contributing to modulate the inflammatory process within this adipose tissue can mitigate the metabolic syndrome consequences. Considering the low level light therapy (LLLT) recognized benefits in inflammatory conditions, we hypothesized this therapeutic approach could promote positive effects in modulating the inflammatory state of metabolic syndrome. That being the scope of this study, male C57BL/6 mice were submitted to a high-fat/high-fructose diet among 8 weeks to induce metabolic syndrome. Animals were then irradiated on the abdominal region during 21 days using an 850 nm LED (6 sessions, 300 seconds per session, 60 mW output power, ~6 J/cm2 fluence, ~19 mW/cm2 fluence rate). Before and during treatment, blood was sampled either from the retroorbital plexus or from tail puncture for glucose, total cholesterol and triglycerides analysis. So far our results indicate no alterations on these metabolic parameters after LLLT. For further investigations, blood was collected for plasma inflammatory cytokine quantification and fresh ex vivo samples of liver and intra-abdominal adipose tissue were harvested for immunohistochemistry purposes.

  19. Detection of the transitional layer between laminar and turbulent flow areas on a wing surface. [using an accelerometer to measure pressure levels during wind tunnel tests

    NASA Technical Reports Server (NTRS)

    Hood, W. R.

    1980-01-01

    A system is disclosed for detecting the laminar to turbulent boundary layer transition on a surface while simultaneously taking pressure measurements. The system uses an accelerometer for producing electrical signals proportional to the noise levels along the surface and a transducer for producing electrical signals proportional to pressure along the surface. The signals generated by the accelerometer and transducer are sent to a data reduction system for interpretation and storage.

  20. Evidence-based recommendations for negative pressure wound therapy: treatment variables (pressure levels, wound filler and contact layer)--steps towards an international consensus.

    PubMed

    Birke-Sorensen, H; Malmsjo, M; Rome, P; Hudson, D; Krug, E; Berg, L; Bruhin, A; Caravaggi, C; Chariker, M; Depoorter, M; Dowsett, C; Dunn, R; Duteille, F; Ferreira, F; Francos Martínez, J M; Grudzien, G; Ichioka, S; Ingemansson, R; Jeffery, S; Lee, C; Vig, S; Runkel, N; Martin, R; Smith, J

    2011-09-01

    Negative pressure wound therapy (NPWT) is becoming a commonplace treatment in many clinical settings. New devices and dressings are being introduced. Despite widespread adoption, there remains uncertainty regarding several aspects of NPWT use. To respond to these gaps, a global expert panel was convened to develop evidence-based recommendations describing the use of NPWT. In a previous communication, we have reviewed the evidence base for the use of NPWT within trauma and reconstructive surgery. In this communication, we present results of the assessment of evidence relating to the different NPWT treatment variables: different wound fillers (principally foam and gauze); when to use a wound contact layer; different pressure settings; and the impact of NPWT on bacterial bioburden. Evidence-based recommendations were obtained by a systematic review of the literature, grading of evidence and drafting of the recommendations by a global expert panel. Evidence and recommendations were graded according to the Scottish Intercollegiate Guidelines Network (SIGN) classification system. In general, there is relatively weak evidence on which to base recommendations for any one NPWT treatment variable over another. Overall, 14 recommendations were developed: five for the choice of wound filler and wound contact layer, four for choice of pressure setting and five for use of NPWT in infected wounds. With respect to bioburden, evidence suggests that reduction of bacteria in wounds is not a major mode of action of NPWT.

  1. Study of Defect Levels in InAs/InAsSb Type-II Superlattice Using Pressure-Dependent Photoluminescence

    DTIC Science & Technology

    2015-07-07

    peak energy shift and observing a quenching of the PL intensity we have determined a crossover pressure at which we believe the T2SL electron confined... crossover pressure. These results support and are consistent with the determined values for the pressure 1. REPORT DATE (DD-MM-YYYY) 4. TITLE AND SUBTITLE...should not contrued as an official Department of the Army position, policy or decision, unless so designated by other documentation. 9. SPONSORING

  2. Erectile Dysfunction and Sexual Hormone Levels in Men With Obstructive Sleep Apnea: Efficacy of Continuous Positive Airway Pressure.

    PubMed

    Zhang, Xiao-Bin; Lin, Qi-Chang; Zeng, Hui-Qing; Jiang, Xing-Tang; Chen, Bo; Chen, Xiao

    2016-01-01

    In this study, the prevalence of erectile dysfunction (ED) and serum sexual hormone levels were evaluated in men with obstructive sleep apnea (OSA). In these patients, the efficacy of continuous positive airway pressure (CPAP) was determined. The 207 men (mean age 44.0 ± 11.1 years) enrolled in the study were stratified within four groups based on their apnea-hypopnea index score: simple snoring (n = 32), mild OSA (n = 29), moderate OSA (n = 38), and severe OSA (n = 108). The International Index of Erectile Dysfunction-5 (IIEF-5) score was obtained from each patient, and blood samples for the analysis of sexual hormones (prolactin, luteotropin, follicle-stimulating hormone, estradiol, progestin, and testosterone) were drawn in the morning after polysomnography. The IIEF-5 test and serum sexual hormone measurements were repeated after 3 months of CPAP treatment in 53 men with severe OSA. The prevalence of ED was 60.6 % in OSA patients overall and 72.2 % in those with severe OSA. Compared with the simple snoring group, patients with severe OSA had significantly lower testosterone levels (14.06 ± 5.62 vs. 17.02 ± 4.68, p = .018) and lower IIEF-5 scores (16.33 ± 6.50 vs. 24.09 ± 1.94, p = .001). The differences in the other sexual hormones between groups were not significant. After 3 months of CPAP treatment, there were no significant changes in sexual hormone levels, but the IIEF-5 score had improved significantly (18.21 ± 4.05 vs. 19.21 ± 3.86, p = .001). Severe OSA patients have low testosterone concentration and high ED prevalence. IIEF-5 scores increased significantly after CPAP treatment, but there was no effect on serum testosterone levels.

  3. Investigating the Influence of Anthropogenic Forcing on Observed Mean and Extreme Sea Level Pressure Trends over the Mediterranean Region

    DOE PAGES

    Barkhordarian, Armineh

    2012-01-01

    We investigate whether the observed mean sea level pressure (SLP) trends over the Mediterranean region in the period from 1975 to 2004 are significantly consistent with what 17 models projected as response of SLP to anthropogenic forcing (greenhouse gases and sulphate aerosols, GS). Obtained results indicate that the observed trends in mean SLP cannot be explained by natural (internal) variability. Externally forced changes are detectable in all seasons, except spring. The large-scale component (spatial mean) of the GS signal is detectable in all the 17 models in winter and in 12 of the 17 models in summer. However, the small-scalemore » component (spatial anomalies about the spatial mean) of GS signal is only detectable in winter within 11 of the 17 models. We also show that GS signal has a detectable influence on observed decreasing (increasing) tendency in the frequencies of extremely low (high) SLP days in winter and that these changes cannot be explained by internal climate variability. While the detection of GS forcing is robust in winter and summer, there are striking inconsistencies in autumn, where analysis points to the presence of an external forcing, which is not GS forcing.« less

  4. Sea Level and Ocean Bottom Pressure Variations From Altimetry, Mercator Model and GRACE Mission in the Argentine Basin

    NASA Astrophysics Data System (ADS)

    Garcia-Garcia, D.; Boy, J.; Chao, B. F.

    2008-12-01

    Sea Level Variations (SLV) in the Argentine basin, as already observed from space altimetry missions, show one of the most prominent variances in the oceans. Here we study two major signals in the Argentine basin, the annual and submonthly SLV signals, based on altimetry, various hydrographic data, and the time-variable gravity data from the GRACE mission. We demonstrate that the annual variation is mainly driven by density variations of the water column, that is the steric-SLV. In contrast, the submonthly SLV in the form of the so- called Argentine gyre, a barotropic counterclockwise gyre with a period around 25 days, is mainly mass- induced, that is, mostly produced by mass variations in the region [Fu et al. 2000]. The Argentine gyre signal is well reproduced by the MERCATOR ocean circulation (and bottom pressure) model, unlike the annual signal. We show that now the aliased form (into monthly sampling) is also captured in the GRACE time- variable gravity data after applying appropriated filters; further study awaits higher temporal-resolution GRACE data.

  5. Influence of the copper impurity level on the irradiation response of reactor pressure vessel steels investigated by SANS

    NASA Astrophysics Data System (ADS)

    Wagner, Arne; Ulbricht, Andreas; Bergner, Frank; Altstadt, Eberhard

    2012-06-01

    Reactor pressure vessel (RPV) steel, when exposed to neutron irradiation, induces the formation of nano-sized features. Using small angle neutron scattering (SANS) we have studied the neutron fluence dependence of the precipitate volume fraction for high-Cu and low-Cu materials separately. Cu-rich precipitates have long been recognized to play the dominant role in embrittlement of Cu-bearing RPV steels. In contrast, Mn-Ni-rich precipitates seem to govern embrittlement in the case of low levels of impurity Cu. The objective is to work out the resulting differences from the microstructural point of view. For low-Cu materials, the volume fraction was found to be within the detection limit of SANS at fluences below an apparent threshold fluence, whereas the slope increases considerably beyond. The relationship between irradiation-induced yield stress increase and precipitate volume fraction was also considered. We have derived estimates of the obstacle strength for Cu-rich precipitates and for Mn-Ni-rich precipitates.

  6. Are prenatal mercury levels associated with subsequent blood pressure in childhood and adolescence? The Avon prebirth cohort study

    PubMed Central

    Gregory, Steve; Hibbeln, Joseph R; Taylor, Caroline M; Golding, Jean

    2016-01-01

    Objectives There have been conflicting data suggesting that prenatal mercury exposure is associated with adverse cardiovascular measures in children. We therefore analysed a large prospective population study to investigate whether prenatal mercury exposure might influence offspring blood pressure (BP) and heart rate adversely. Design Prospective birth cohort. Setting The Avon Longitudinal Study of Parents and Children (ALSPAC). Participants Maternal whole blood collected in the first half of pregnancy was assayed for mercury and selenium. The offspring were followed throughout childhood and adolescence. Outcome measures Offspring resting BP and heart rates measured under standard conditions on six occasions between ages 7 and 17 years (numbers analysed: 1754 at 7 years to 1102 at 17). Results Statistical analyses took account of various factors present in pregnancy, including family adversity, maternal age, parity, smoking and alcohol intake. Unadjusted and adjusted regression analyses assessed the relationship between maternal prenatal mercury levels and offspring resting systolic and diastolic BP, and heart rates. A final set of analyses took account of selenium. Each analysis was carried out for all offspring, those whose mothers had, and those that had not, consumed fish during pregnancy. Further analysis for all offspring ascertained whether there were significant interaction effects between the sexes. There was little evidence to suggest that prenatal mercury exposure resulted in a clinically important increase in offspring BP in the whole group, since no effect size for an increase of 1 SD of blood mercury level was >0.3 mm Hg. Only 1 association was significant at p<0.05 and therefore likely due to chance. Conclusions This study reveals no evidence to support the hypothesis that prenatal mercury exposure has adverse long-term effects on offspring BP or heart rates during childhood or adolescence. PMID:27742626

  7. Visit-to-visit blood pressure variability, average BP level and carotid arterial stiffness in the elderly: a prospective study.

    PubMed

    Nagai, M; Dote, K; Kato, M; Sasaki, S; Oda, N; Kagawa, E; Nakano, Y; Yamane, A; Kubo, Y; Higashihara, T; Miyauchi, S; Harada, W; Masuda, H

    2016-10-20

    In a cross-sectional study, visit-to-visit blood pressure (BP) variability was shown to be associated with artery remodelling. Here, we investigated the impact of visit-to-visit BP variability and average BP on the carotid artery remodelling progression in high-risk elderly according to different classes of antihypertension medication use/non-use. BP measurements and carotid ultrasound were performed in the common carotid artery in 164 subjects (mean age 79.7 years at baseline, 74.7% females) with one or more cardiovascular risk factors. Based on 12 visits (1 × /month for 1 year), we calculated visit-to-visit BP variability expressed as the standard deviation (s.d.), coefficient of variation (CV), maximum BP, minimum BP and delta (maximum-minimum) BP. We measured mean intima-media thickness (IMT) as well as stiffness parameter β were measured at baseline and at the mean 4.2-year follow-up. In a multiple regression analysis, the maximum, minimum, s.d. and average of systolic BP (SBP) were significantly associated with a change in β-values between the baseline and follow-up after adjustment for age, smoking, lower high-density lipoprotein level, baseline β-value and follow-up period. There were no significant associations between the visit-to-visit BP variability measures and the change in mean IMT. Significant associations of maximum, minimum, s.d. and average SBP were found with increased β-values in the subjects without calcium channel blocker (CCB) use and in the subjects using renin-angiotensin system inhibitors (RASIs). Thus, exaggerated visit-to-visit SBP variability and a high average SBP level were significant predictors of progression in carotid arterial stiffness in high-risk elderly without CCBs use and in those using a RASI.Journal of Human Hypertension advance online publication, 20 October 2016; doi:10.1038/jhh.2016.77.

  8. Deriving the Properties of Coronal Pressure Fronts in 3D: Application to the 2012 May 17 Ground Level Enhancement

    NASA Astrophysics Data System (ADS)

    Rouillard, A. P.; Plotnikov, I.; Pinto, R. F.; Tirole, M.; Lavarra, M.; Zucca, P.; Vainio, R.; Tylka, A. J.; Vourlidas, A.; De Rosa, M. L.; Linker, J.; Warmuth, A.; Mann, G.; Cohen, C. M. S.; Mewaldt, R. A.

    2016-12-01

    We study the link between an expanding coronal shock and the energetic particles measured near Earth during the ground level enhancement of 2012 May 17. We developed a new technique based on multipoint imaging to triangulate the three-dimensional (3D) expansion of the shock forming in the corona. It uses images from three vantage points by mapping the outermost extent of the coronal region perturbed by the pressure front. We derive for the first time the 3D velocity vector and the distribution of Mach numbers, M FM, of the entire front as a function of time. Our approach uses magnetic field reconstructions of the coronal field, full magnetohydrodynamic simulations and imaging inversion techniques. We find that the highest M FM values appear near the coronal neutral line within a few minutes of the coronal mass ejection onset; this neutral line is usually associated with the source of the heliospheric current and plasma sheet. We illustrate the variability of the shock speed, shock geometry, and Mach number along different modeled magnetic field lines. Despite the level of uncertainty in deriving the shock Mach numbers, all employed reconstruction techniques show that the release time of GeV particles occurs when the coronal shock becomes super-critical (M FM > 3). Combining in situ measurements with heliospheric imagery, we also demonstrate that magnetic connectivity between the accelerator (the coronal shock of 2012 May 17) and the near-Earth environment is established via a magnetic cloud that erupted from the same active region roughly five days earlier.

  9. Patterns of Low-Frequency Monthly Sea Level Pressure Variability (1899-1986) and Associated Wave Cyclone Frequencies.

    NASA Astrophysics Data System (ADS)

    Rogers, Jeffery C.

    1990-12-01

    Spatial patterns of low-frequency sea level pressure (SLP) variability are identified by performing rotated principal component analysis (RPCA) on a long-term (1899-1986) Northern Hemisphere gridded dataset. The analysis is limited to the region 160°E eastward to 40°E due to missing data early in the century. The objective is to identify a comprehensive set of highly recurrent SLP teleconnection patterns; to examine some aspects of their seasonality; and to identify the associated mean winter pressure fields and cyclone frequencies occurring at times of opposite eigenvector polarity. The results are further described in the context of the Southern Oscillation and known midtropospheric teleconnection patterns.Four low-frequency variability patterns are identified over the Atlantic-European sector, including (i) the North Atlantic 0scillation (NAO), and spatial patterns with SLP variability centers over (ii) the eastern Atlantic (EATL), (iii) southern Europe and the northern Mediterranean basin (SENA). and (iv) Scandinavia (SCAN). The Pacific sector low-frequency variability patterns include the (v) North Pacific Oscillation (NPO), and patterns with centers over (vi) the north-central Pacific (PAC) and (vii) the Bering Sea (BER). The EATL, SENA, SCAN and BER patterns have not been identified in previous SLP RPCA studies. Seasonal variations take place in the location of the primary and secondary centre of SLP variability in each teleconnection.Each of the Atlantic teleconnections have at least one polarity mode in which cyclones migrate toward Greenland and Iceland. However, the opposite modes in the NAO and EATL are associated with distinct zonally oriented cyclone tracks along latitudes 40°-45°N. One mode of each Pacific pattern is characterized by a zonally oriented cyclone track but the opposite modes are characterized by cyclone maxima in the eastern Pacific (NPO), the western Bering Sea (PAC) and another track that turns northward toward the Bering Sea

  10. Change in serum TSH levels within the reference range was associated with variation of future blood pressure: a 5-year follow-up study.

    PubMed

    Jiang, F; Liu, A; Lai, Y; Yu, X; Li, C; Han, C; Zhang, Y; Wang, X; Wang, Z; Bao, S; Lv, N; Jin, M; Yang, F; Fan, Y; Jin, T; Zhao, W; Shan, Z; Teng, W

    2017-04-01

    Controversy exists on the relationship between serum thyrotropin (TSH) and blood pressure, and only a few prospective studies are available up to now. The study aimed to investigate the association between serum TSH within the reference range and blood pressure through a 5-year follow-up study. A total of 623 subjects with normal TSH were followed up for 5 years, including the measurement of demographic data, blood pressure, height, weight and serum TSH. Finally, 531 subjects were included in this prospective study. Body mass index (BMI), prevalence of hypertension, and systolic and diastolic blood pressure were all higher at follow-up than at baseline. Adjusted for age, gender, smoking status, BMI and homoeostasis model assessment of insulin resistance (HOMA-IR) at baseline, multiple linear regression analyses found no relationship between serum TSH at baseline and levels of blood pressure at follow-up, but the changes in serum TSH levels during follow-up was positively associated with the changes in systolic blood pressure (B=2.134, P<0.05), which became more significant in women but not significant in men. The change of systolic blood pressure in group of TSH increase >0.5 mIU l(-1) was significantly higher than in group of TSH decrease >0.5 mIU l(-1) within reference, after adjusting for age, gender, smoking status, BMI and HOMA-IR at baseline. This result became more significant in women, but no statistical significance was observed in men. Co-variation with serum TSH levels and blood pressure was observed during 5-year follow-up among people with normal TSH.

  11. School-based screening of plantar pressures during level walking with a backpack among overweight and obese schoolchildren.

    PubMed

    Pau, Massimiliano; Leban, Bruno; Corona, Federica; Gioi, Sara; Nussbaum, Maury A

    2016-05-01

    Among children, postural modifications due to backpack carriage have direct consequences on how forces are exchanged between body and ground and thus on plantar pressure distribution. However, it is unknown whether such alterations are influenced by the foot structure and functionality typical of obesity. In this study, we tested 65 overweight/obese primary schoolchildren using a pressure platform while walking with and without the backpack. Contact areas, arch index, peak and mean plantar pressures in the forefoot, midfoot and rearfoot were compared with those from an additional 65 age- and gender-matched group of normal-weight children. Backpack carriage modified pressure distribution similarly in both groups, with the exception of mean midfoot pressure, which increased significantly among normal-weight children but not in the overweight/obese group. Notably, the pressure values associated with mass excess and backpack carriage still raise some concerns regarding potential long-term adverse consequences on foot structure and functionality of overweight/obese children. Practitioner summary: Backpack carriage by overweight/obese schoolchildren altered plantar pressures similar to what was observed in their normal-weight peers. Yet, high pressures were found among the overweight/obese children. This raises concerns regarding potential long-term adverse consequences on foot structure and functionality, and supports establishing more specific limits for the carried load.

  12. Permissive hypotension does not reduce regional organ perfusion compared to normotensive resuscitation: animal study with fluorescent microspheres

    PubMed Central

    2012-01-01

    Introduction The objective of this study was to investigate regional organ perfusion acutely following uncontrolled hemorrhage in an animal model that simulates a penetrating vascular injury and accounts for prehospital times in urban trauma. We set forth to determine if hypotensive resuscitation (permissive hypotension) would result in equivalent organ perfusion compared to normotensive resuscitation. Methods Twenty four (n=24) male rats randomized to 4 groups: Sham, No Fluid (NF), Permissive Hypotension (PH) (60% of baseline mean arterial pressure - MAP), Normotensive Resuscitation (NBP). Uncontrolled hemorrhage caused by a standardised injury to the abdominal aorta; MAP was monitored continuously and lactated Ringer’s was infused. Fluorimeter readings of regional blood flow of the brain, heart, lung, kidney, liver, and bowel were obtained at baseline and 85 minutes after hemorrhage, as well as, cardiac output, lactic acid, and laboratory tests; intra-abdominal blood loss was assessed. Analysis of variance was used for comparison. Results Intra-abdominal blood loss was higher in NBP group, as well as, lower hematocrit and hemoglobin levels. No statistical differences in perfusion of any organ between PH and NBP groups. No statistical difference in cardiac output between PH and NBP groups, as well as, in lactic acid levels between PH and NBP. NF group had significantly higher lactic acidosis and had significantly lower organ perfusion. Conclusions Hypotensive resuscitation causes less intra-abdominal bleeding than normotensive resuscitation and concurrently maintains equivalent organ perfusion. No fluid resuscitation reduces intra-abdominal bleeding but also significantly reduces organ perfusion. PMID:23531188

  13. Dieulafoy’s lesion with intra-abdominal haemorrhage: a novel association

    PubMed Central

    Liu, Cuiping; Zou, Yantai; Wang, Li; Han, Xiqun; Bai, Lan

    2010-01-01

    Dieulafoy’s lesion is an uncommon but important cause of gastrointestinal bleeding, especially with respect to the upper gastrointestinal tract wherein massive, life-threatening haemorrhage occurs from a calibre-persistent submucosal artery. This report describes a case of a 60-year-old man with gastric Dieulafoy’s lesion presenting with exogastric haemorrhage, which was diagnosed following a pathological examination. PMID:22751207

  14. Angiogenesis Research to Improve Therapies for Vascular Leak Syndromes, Intra-Abdominal Adhesions, and Arterial Injuries

    DTIC Science & Technology

    2009-04-01

    and resuspended in phospate buffer saline (PBS) before use. Preparation of magnetic opsonins Super - paramagnetic beads (1 mm diameter, tosyl-coated...permeability in experimental model systems. These therapies include the following: (i) a newly developed nanoparticle -based oral delivery system for...inhibitors utilized in this study: Lodamin and an Fc-conjugated endostatin fragment. • investigated the efficacy of Lodamin (a nanoparticle -based oral

  15. An adipose segmentation and quantification scheme for the intra abdominal region on minipigs

    NASA Astrophysics Data System (ADS)

    Engholm, Rasmus; Dubinskiy, Aleksandr; Larsen, Rasmus; Hanson, Lars G.; Christoffersen, Berit Østergaard

    2006-03-01

    This article describes a method for automatic segmentation of the abdomen into three anatomical regions: subcutaneous, retroperitoneal and visceral. For the last two regions the amount of adipose tissue (fat) is quantified. According to recent medical research, the distinction between retroperitoneal and visceral fat is important for studying metabolic syndrome, which is closely related to diabetes. However previous work has neglected to address this point, treating the two types of fat together. We use T1-weighted three-dimensional magnetic resonance data of the abdomen of obese minipigs. The pigs were manually dissected right after the scan, to produce the "ground truth" segmentation. We perform automatic segmentation on a representative slice, which on humans has been shown to correlate with the amount of adipose tissue in the abdomen. The process of automatic fat estimation consists of three steps. First, the subcutaneous fat is removed with a modified active contour approach. The energy formulation of the active contour exploits the homogeneous nature of the subcutaneous fat and the smoothness of the boundary. Subsequently the retroperitoneal fat located around the abdominal cavity is separated from the visceral fat. For this, we formulate a cost function on a contour, based on intensities, edges, distance to center and smoothness, so as to exploit the properties of the retroperitoneal fat. We then globally optimize this function using dynamic programming. Finally, the fat content of the retroperitoneal and visceral regions is quantified based on a fuzzy c-means clustering of the intensities within the segmented regions. The segmentation proved satisfactory by visual inspection, and closely correlated with the manual dissection data. The correlation was 0.89 for the retroperitoneal fat, and 0.74 for the visceral fat.

  16. [Paravertebral and intra-abdominal abscess due to oxygen-ozone therapy for lower back pain].

    PubMed

    Menéndez, P; García, A; Peláez, R

    2014-01-01

    Complications secondary to oxygen-ozone therapy are rare, but they have been described in medical literature. There are only two cases of infectious complications after oxygen-ozone therapy. Our aim is to describe a rare case of purulent complication that was secondary to oxygen-ozone therapy for the treatment of lower back pain. We report the clinical improvement with conservative treatment for a local complication after percutaneous oxygen-ozone treatment. According to the clinical improvement of our patient, conservative treatment should be considered before any aggressive surgery.

  17. Angiogenesis Research to Improve Therapies for Vascular Leak Syndromes, Intra-Abdominal Adhesions, and Arterial Injuries

    DTIC Science & Technology

    2006-02-01

    production Endostatin protein was initially purified from the urine of tumor-bearing mice, providing a few micrograms for analysis of amino acid...whereas the wild-type bound 10 atoms of Zn per endostatin molecule. This finding is problematic because, in our crystal structure analysis of endostatin...complete prevention of pulmonary metas - tases. Lowest inhibition of tumor growth was ¨40–45% (Table 2B). In transgenic mice overexpressing endostatin, a

  18. Intra-abdominal cavernous lymphangiomatosis in Siamese twins: a case report.

    PubMed

    Jain, Manjula; Aggarwal, Shilpi; Singh, Sarika

    2007-07-01

    Lymphangioma is a benign tumor like condition which is a developmental anomaly, involving any site but rarely involves retroperitoneum and abdomen (< 5%). Intraabdominal lymphangiomatosis is an even rarer entity that too occurring in a siamese twins. No such reports have been found in literature, although other congenital anomalies do coexist in Siamese twins and have been reported such as biliary tract and respiratory tract anomalies.

  19. A case of intra-abdominal hemorrhage secondary to peliosis hepatis

    PubMed Central

    Downes, Ross O.; Cambridge, Craig L.; Diggiss, Charles; Iferenta, James; Sharma, Muneesh

    2014-01-01

    Introduction peliosis hepatis (PH) is a rare vascular condition of the liver characterized by the presence of cystic blood filled cavities distributed randomly throughout the liver parenchyma Tsokos and co-workers [1–6]. Peliosis is most commonly found in the liver but can also involve the spleen, bone marrow, lungs, and abdominal lymph nodes Tsokos and Erbersdobler [1]. Presentation of case We report a case of peliosis hepatis diagnosed post laparotomy. She required a re-look laparotomy with removal of packs peritoneal lavage, placement of intraseed and subhepatic drain. The patient was discharged after an 11-day recovery period. Conclusion We examine the literature and subsequently discuss the etiology and management of peliosis. Peliosis is a rare vascular condition of the liver characterized by the presence of cystic blood filled cavities. Causes are associated with a number of conditions, however, etiology is largely unknown. Management is overwhelmingly conservative except in a handful of cases. PMID:25576958

  20. Spontaneous Intra-Abdominal Hemorrhage Due to Rupture of Jejunal Artery Aneurysm in Behcet Disease

    PubMed Central

    Wu, Xiao-yan; Wei, Jiang-peng; Zhao, Xiu-yuan; Wang, Yue; Wu, Huan-huan; Shi, Tao; Liu, Tong; Liu, Gang

    2015-01-01

    Abstract Rupture of jejunal artery aneurysm is a very rare event resulting in life-threatening hemorrhage in Behcet disease (BD). We report a case of ruptured jejunal artery aneurysm in a 35-year-old patient with BD. The patient had a 1-year history of intermittent abdominal pain caused by superior mesenteric artery aneurysm with thrombosis. Anticoagulation treatment showed a good response. Past surgical history included stenting for aortic pseudoaneurysm. On admission, the patient underwent an urgent operation due to sudden hemorrhagic shock. Resection was performed for jejunal artery aneurysm and partial ischemia of intestine. The patient was diagnosed with BD, based on a history of recurrent oral and skin lesions over the past 6 years. Treatment with anti-inflammatory medications showed a good response during the 8-month follow-up. An increased awareness of BD and its vascular complications is essential. Aneurysms in BD involving jejunal artery are rare, neglected and require proper management to prevent rupture and death. To our knowledge, this is the first reported case of jejunal artery aneurysm caused by BD. PMID:26559278

  1. 77 FR 59928 - Draft Guidance for Industry on Complicated Intra-Abdominal Infections: Developing Drugs for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-01

    ... responsible for cIAIs, including Gram-negative aerobic bacteria, Gram-positive bacteria, and anaerobic bacteria, and there are also mixed infections. This draft guidance includes recommendations for an...

  2. Uterine Perforation with Intra-Abdominal Clostridium perfringens Gas Gangrene: A Rare and Fatal Infection.

    PubMed

    Kashan, David; Muthu, Nagarajan; Chaucer, Benjamin; Davalos, Fidencio; Bernstein, Michael; Chendrasekhar, Akella

    2016-06-01

    Background:Clostridium perfringens gas gangrene is an extremely rare and fatal infection. Necrosis of the myometrium is rarely seen and has only been recorded in 18 cases to date. Of these 18 reported cases, only 5 have occurred in nonpregnant women. This article presents the 6th case of myometrium necrosis from C. perfringens.Case: A 72-year-old woman, gravida 2, para 2, presented with abdominal pain and vaginal bleeding. After examinations, laboratory testing, and several surgical interventions, she was found to have C. perfringens infection and advanced high-grade serous adenocarcinoma of the endometrium with >50% invasion into the myometrium. Results: Despite the surgical interventions and use of several antibiotics, this patient did not improve. She was weaned from treatment per her advance directive and died after weaning. Conclusions: Awareness of the many etiologies for peritonitis is of great importance when a fatal infection may be the cause of the condition. Correct diagnosis and proper treatment is essential for the survival of patients infected with C. perfringens. (J GYNECOL SURG 32:182).

  3. Uterine Perforation with Intra-Abdominal Clostridium perfringens Gas Gangrene: A Rare and Fatal Infection

    PubMed Central

    Kashan, David; Muthu, Nagarajan; Davalos, Fidencio; Bernstein, Michael; Chendrasekhar, Akella

    2016-01-01

    Abstract Background: Clostridium perfringens gas gangrene is an extremely rare and fatal infection. Necrosis of the myometrium is rarely seen and has only been recorded in 18 cases to date. Of these 18 reported cases, only 5 have occurred in nonpregnant women. This article presents the 6th case of myometrium necrosis from C. perfringens. Case: A 72-year-old woman, gravida 2, para 2, presented with abdominal pain and vaginal bleeding. After examinations, laboratory testing, and several surgical interventions, she was found to have C. perfringens infection and advanced high-grade serous adenocarcinoma of the endometrium with >50% invasion into the myometrium. Results: Despite the surgical interventions and use of several antibiotics, this patient did not improve. She was weaned from treatment per her advance directive and died after weaning. Conclusions: Awareness of the many etiologies for peritonitis is of great importance when a fatal infection may be the cause of the condition. Correct diagnosis and proper treatment is essential for the survival of patients infected with C. perfringens. (J GYNECOL SURG 32:182) PMID:27274183

  4. Diagnosis of Intra-Abdominal Extralobar Pulmonary Sequestration by means of Ultrasound in a Neonate

    PubMed Central

    Pires, Claudio Rodrigues; Czapkowski, Adriano; Zanforlin Filho, Sebastião Marques

    2013-01-01

    Pulmonary sequestration is a congenital abnormality consisting of a mass of pulmonary tissue that presents an abnormal connection with the tracheobronchial tree, with a blood supply coming from an anomalous artery derived from the systemic circulation. Extralobar pulmonary sequestration is characterized by having pleural coverings that are independent of the normal lungs, with vascular supply usually coming from the aorta or from one of its branches. This diagnosis can be suspected prenatally if an abdominal mass, generally below the diaphragm, is seen. Here, we present a case of a neonate on the second day of life, with ultrasonography showing extralobar pulmonary sequestration located above the left adrenal gland that prenatally simulated a neuroblastoma. PMID:23762717

  5. Spontaneous Rupture of a Leiomyoma Causing Life-Threatening Intra-Abdominal Hemorrhage

    PubMed Central

    Powell, Kristin

    2017-01-01

    Background. Uterine fibroids are common benign tumors in women. Clinical manifestations are well known. Acute complications necessitating emergent surgical intervention are rare. Case. We report a case of a 53-year-old woman with a history of uterine fibroids presenting with acute-onset severe abdominal pain. Imaging indicated massive free fluid and a large partially solid uterine mass. Vitals were consistent with hypovolemic shock. Examination revealed a surgical abdomen. She underwent an emergent laparotomy and total hysterectomy. Surgery revealed 4.5 L of hemoperitoneum and a 15 cm degenerated uterine fibroid with active bleeding. Pathology was consistent with intraoperative findings. She required transfusion of numerous blood products perioperatively. Her postoperative course was uncomplicated. Conclusion. It is rare for a uterine fibroid to spontaneously rupture. However, prompt recognition of this severe complication is critical for expeditious, life-saving surgical management. PMID:28127487

  6. [Low back pain as a manifestation of an intra-abdominal desmoplastic small round cell tumor].

    PubMed

    Camarero-Mulas, C; Andrés García-Marín, A; Sánchez-Rodríguez, T; Vaquero-Rodríguez, A; Fábregues-Olea, A; Pino-Jiménez, A; Turégano-Fuentes, F

    2010-01-01

    The desmoplastic small round cell tumor is infrequent.That mainly affects male youngsters and is normally located at the abdomino-pelvic cavity, being its clinic unspecific. The diagnosis is confirmed by the presence of a specific chromosomal translocation: t (11; 22), (p13; q12). As to its treatment, it is mostly recommended to follow a multimodal aggressive one. We present the case of a man, whose atypicality is due to his advanced age (63 years old) and the symptoms he presents (lumbar ache).

  7. Angiogenesis Research to Improve Therapies for Vascular Leak Syndromes, Intra-Abdominal Adhesions, and Arterial Injuries

    DTIC Science & Technology

    2007-02-01

    Celebrex was effective in preventing tendinous adhesions. In our initial experiment, rabbits were treated with Celebrex for 10 days at 75mg/kg/day...Celebrex for preventing tendinous adhesions. In the third quarter we increased the dose of the drug to 100mg/kg/day (given twice a day), and had...the prevention of tendinous adhesions in a rabbit model. IV. REPORTABLE OUTCOMES: None V. CONCLUSION: Several techniques have been

  8. Angiogenesis Research to Improve Therapies for Vascular Leak Syndromes, Intra-abdominal Adhesions, and Arterial Injuries

    DTIC Science & Technology

    2008-04-01

    tumour. Thalidomide has a slightly higher incidence of thromboembolic complica- tions, as well as constipation and peripheral neuropathy — these...endothelial progenitor cells (EPCs) isolated from a small amount of peripheral blood can be used to create non-thrombogenic long- lasting functional...endothelial cells (2). In addition, we showed that EPCs from adult peripheral blood had the same vasculogenic potential when combined with human

  9. Laparoscopic repair of intra-abdominal bladder perforation in preschool children

    PubMed Central

    Deshpande, Aniruddh V.; Michail, Peter; Gera, Parshotam

    2017-01-01

    Intraperitoneal bladder rupture is uncommon in very young children, but its incidence may increase with increasing use of seat and lap belts. To the best of our knowledge, there are no prior reports of laparoscopic repair of this injury in children. We describe two recent cases and discuss useful technical points that facilitate a successful laparoscopic repair. Both our patients were preschool age girls who sustained seat and lap belt injuries. Contrast computed tomography scan suggested a large amount of free peritoneal fluid and cystogram confirmed intraperitoneal bladder perforation (isolated injury). The injury was repaired using delayed absorbable sutures and intracorporeal suturing (continuous in 1, interrupted in 1) using a 3 port laparoscopic technique. Meticulous peritoneal lavage was carried out to minimise urinary peritonitis and the bladder as well as the peritoneal cavity were drained. Check cystograms (day 7) revealed no leaks. Young girls appear to be at risk of intraperitoneal bladder injuries following lap belt injuries. After exclusion of life-threatening injuries and concurrent abdominal injuries which need rapid control or preclude pneumoperitoneum, a laparoscopic repair can be safely performed. PMID:27143696

  10. Thyroid storm presenting as intra-abdominal sepsis with multi-organ failure requiring intensive care.

    PubMed

    Karanikolas, M; Velissaris, D; Karamouzos, V; Filos, K S

    2009-11-01

    Thyroid storm is a rare but life-threatening condition manifesting with several clinical presentations. Atypical thyroid storm should be part of the differential diagnosis in patients with multiple organ dysfunction of unknown aetiology. In this case report, delayed recognition of thyroid storm in a young female who presented with acute abdomen increased the risk of poor outcome. Prompt initiation of anti-thyroid therapy once the diagnosis of thyroid storm was established, combined with adequate vital organ support using a goal-directed therapy protocol in the intensive care unit resulted in a good outcome.

  11. Intra-abdominal Lippes Loop removed at laparoscopy. A case report.

    PubMed

    Gibils, L A; Moragne, R

    1971-04-01

    A case of abdominal Lippes loop removed by laparoscopy is reported and illustrated. Some diagnostic pitfalls are discussed. A 25 year old, gravida 1, para 1 was seen on April 17, 1970 stating that she had been fitted with an IUD 5 weeks earlier. No strings were visible, the uterus was of normal size, and a flat plate of the abdomen revealed a "Lippes loop" in the pelvis. On May 21, after a normal period, attempts at probing the uterus were made, but no IUD was felt. No IUD was obtained on July 20 when a D and C was performed. A hysterosalpingogram was subsequently performed and was interpreted by the radiologist as: "foreign body, IUD, within the uterus." When the films were requested and viewed, it was shown that the IUD was in the abdominal cavity. On September 13, the IUD was removed at laparoscopy. The patient had an uneventful postoperative course and was discharged the following day in good condition. It is noted that a report of a test must be accepted with caution by the clinician, particularly when there is discrepancy with the clinical diagnosis. In this case, the films were taken with a clearly improper technique which led to faulty readings. Laparoscopy was chosen in the removal of the IUD because it offers the chance of an accurate visual diagnosis and, circumstances permitting, avoiding laparotomy.

  12. Non-Invasive Monitoring of Intra-Abdominal Bleeding Rate Using Electrical Impedance Tomography

    DTIC Science & Technology

    2009-09-01

    6. The error bars showing standard deviations over the ten locations used are two to three times larger than those for the two-dimensional full array...against volume with standard deviations over ten positions for two- dimensional hemiarray reconstructions of blood-equivalent anomalies of 50, 100, 150 and...VD+ DVT = V [ Ik 0 0 0 ] VT , (14) where Ik (k × k) is the identity matrix. It is also clear in (14) that the blurring depends on the truncation

  13. Large Gastric Teratoma: A Rare Intra-abdominal Mass of Infancy

    PubMed Central

    Hasan, Roumina; Monappa, Vidya; Kumar, Sandeep; Kumar, Vijay

    2016-01-01

    Amongst the varied, diverse causes of intraabdominal masses in infancy and early childhood, gastric teratomas (GTs) account for a very small proportion. A worldwide literature search reveals only around one hundred cases of GT and also supports the fact that its preoperative diagnosis remains elusive. Here we report the case of a two-month-old male who presented to the pediatric surgery outpatient department of Kasturba Medical College and Hospital, Karnataka, India, with progressive distension of abdomen since birth. Clinically, a large firm, non-mobile and non-tender mass involving all four quadrants of the abdomen was seen. Ultrasound revealed a large solid-cystic mass with internal septations extending from the epigastrium up to the pelvis. Computed tomography revealed a large intraperitoneal fat containing solid-cystic mass lesion showing curvilinear and chunky areas of calcification, with the mass focally indenting the posterior gastric wall and showing focal polypoidal intragastric extension. Exploratory laparotomy revealed a large cystic tumor with a solid component, arising from lesser curvature of the stomach, showing focal intraluminal extension across the posterior gastric wall, and occupying the whole lesser sac and abdominal cavity. The tumor was excised in toto along with the body of the stomach. Histopathological examination showed mature tissue derived from all three germ cell layers and confirmed the diagnosis of mature gastric teratoma. The patient was disease free at one-year follow-up. PMID:27162596

  14. Low-Level Lead Exposure Increases Systolic Arterial Pressure and Endothelium-Derived Vasodilator Factors in Rat Aortas

    PubMed Central

    Fiorim, Jonaina; Ribeiro Júnior, Rogério F.; Silveira, Edna A.; Padilha, Alessandra S.; Vescovi, Marcos Vinícius A.; de Jesus, Honério C.; Stefanon, Ivanita; Salaices, Mercedes; Vassallo, Dalton V.

    2011-01-01

    Chronic lead exposure induces hypertension and alters endothelial function. However, treatment with low lead concentrations was not yet explored. We analyzed the effects of 7 day exposure to low lead concentrations on endothelium-dependent responses. Wistar rats were treated with lead (1st dose 4 µg/100 g, subsequent dose 0.05 µg/100 g, i.m. to cover daily loss) or vehicle; blood levels attained at the end of treatment were 9.98 µg/dL. Lead treatment had the following effects: increase in systolic blood pressure (SBP); reduction of contractile response to phenylephrine (1 nM–100 µM) of aortic rings; unaffected relaxation induced by acetylcholine (0.1 nM–300 µM) or sodium nitroprusside (0.01 nM–0.3 µM). Endothelium removal, NG-nitro-L-arginine methyl ester (100 µM) and tetraethylammonium (2 mM) increased the response to phenylephrine in treated rats more than in untreated rats. Aminoguanidine (50 µM) increased but losartan (10 µM) and enalapril (10 µM) reduced the response to phenylephrine in treated rats. Lead treatment also increased aortic Na+/K+-ATPase functional activity, plasma angiotensin-converting enzyme (ACE) activity, protein expression of the Na+/K+-ATPase alpha-1 subunit, phosphorylated endothelial nitric oxide synthase (p-eNOS), and inducible nitric oxide synthase (iNOS). Our results suggest that on initial stages of lead exposure, increased SBP is caused by the increase in plasma ACE activity. This effect is accompanied by increased p-eNOS, iNOS protein expression and Na+/K+-ATPase functional activity. These factors might be a compensatory mechanism to the increase in SBP. PMID:21364929

  15. Linking a sea level pressure anomaly dipole over North America to the central Pacific El Niño

    NASA Astrophysics Data System (ADS)

    Ding, Ruiqiang; Li, Jianping; Tseng, Yu-heng; Sun, Cheng; Zheng, Fei

    2016-10-01

    This study demonstrates the close connection between the north-south dipole pattern of sea level pressure anomalies over northeastern North America to the western tropical North Atlantic, referred to as the North American dipole (NAD), and the central Pacific (CP)-type El Niño a year later. In contrast to other ENSO precursors, such as the North Pacific Oscillation (NPO) and Pacific-North America (PNA) pattern, the NAD appears more closely related to the CP-type El Niño than to the eastern Pacific (EP)-type El Niño, indicating that the NAD may serve as a unique precursor for the CP El Niño. The wintertime NAD induces sea surface temperature anomalies in the northern tropical Atlantic (NTA), which subsequently play an important role in developing the CP El Niño-like pattern in the tropical Pacific over the course of the following year. It appears that the NAD influence on CP El Niño involves air-sea interaction over several major basins, including the subtropical/tropical Pacific and the NTA. Additional analysis indicates that the correlation of either the NAD index or the NPO index with the CP El Niño state a year later depends on the status of the other index. When the wintertime NAD index is of the opposite sign to the simultaneous NPO index, the correlation of the NAD or NPO index with the Niño4 index becomes much weaker.

  16. Primary care of patients with high cardiovascular risk : Blood pressure, lipid and diabetic target levels and their achievement in Hungary.

    PubMed

    Szigethy, Endre; Jancsó, Zoltán; Móczár, Csaba; Ilyés, István; Kovács, Eszter; Róbert Kolozsvári, László; Rurik, Imre

    2013-07-01

    Cardiovascular diseases are responsible for the majority of premature deaths in Hungary as well. Most of them could be prevented with healthy lifestyle of patients and adequate drug prescription of primary care physicians. Earlier European surveys found wide differences between the practices and achievements of different countries in this field. The study was based on and designed according to the framework of previous European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) studies and aimed presenting Hungarian results and comparing with the achievements of other countries and previous Hungarian surveys. Among rural and urban settings, 679 patients under continuous care (236 diabetics, 218 with dyslipidaemia, and 225 with hypertension) were consecutively selected by 20 experienced general practitioners. The mean age of patients was 60.3 years (men) and 64.0 years (women). Among diabetics, less than 7 % of glycated hemoglobin (HbA1c) values were found in 42.5 % patients, while only 11.4 % patients had fasting plasma sugar less than 6.0 mmol/L. Of the patients treated for dyslipidaemia, the target level of triglyceride was reached by 40.6 %, recommended total cholesterol by 14.2 % and the HDL-cholesterol by 71.8 %. The therapeutic control of total and HDL-cholesterol was better in men, although women had better triglyceride values. The achievement among patients with hypertension was 42.0 %. Significantly higher blood pressure was measured by patients who were treated with not recommended combinations of antihypertensive medication. A remarkable improvement could be observed in Hungary in the field of secondary prevention. It was greater among patients with hypertension and dyslipidaemia and smaller in diabetes care. Compared to the results of published European surveys, Hungary occupies a good position, but further improvement is still required.

  17. Changes in Blood Pressure Levels and Antihypertensive Medication Use before and after Renal Transplantation among Patients in Nairobi, Kenya: A Comparative Cross-Sectional Study

    PubMed Central

    Kayima, Joshua K.; Were, Anthony J.; Ezzi, Mohammed S.; McLigeyo, Seth O.; Ogola, Elijah N.

    2016-01-01

    Objectives. To determine the changes in blood pressure levels and antihypertensive medication use in the postrenal transplantation period compared to pretransplantation one. Methods. A comparative cross-sectional study was carried out on renal transplant recipients at the Kenyatta National Hospital, a national referral hospital in Kenya. Sociodemographic details, blood pressure levels, and antihypertensive medication use before and after renal transplantation were noted. Changes in mean blood pressure levels and mean number of antihypertensive medications after renal transplantation were determined using paired t-test. Results. 85 subjects were evaluated. Mean age was 42.4 (SD ± 12.2) years, with a male : female ratio of 1.9 : 1. Compared to the pretransplant period, significantly lower mean systolic and diastolic blood pressure levels after transplantation were noted (mean SBP 144.5 mmHg versus 131.8 mmHg; mean DBP 103.6 mmHg versus 83.5 mmHg in the pre- and posttransplant periods, respectively, p < 0.001). Mean number of antihypertensive medications also reduced significantly after transplantation, with an average of 3.3 (±1.6) versus 2.1 (±0.9) in the pre- and posttransplant periods, respectively (p < 0.001). Conclusion. There is a significant reduction in blood pressure levels and number of antihypertensive medications used after renal transplantation. The positive impact of renal transplantation on blood pressure control should be confirmed using prospective cohort studies of patients with end stage renal disease who then undergo renal transplantation. PMID:28053780

  18. Treatment of sleep central apnea with non-invasive mechanical ventilation with 2 levels of positive pressure (bilevel) in a patient with myotonic dystrophy type 1

    PubMed Central

    Akamine, Ricardo Tera; Grossklauss, Luís Fernando; Moreira, Gustavo Antonio; Pradella-Hallinan, Marcia; Chiéia, Marco Antônio; Mesquita, Denis; Bulle Oliveira, Acary Souza; Tufik, Sergio

    2014-01-01

    We are reporting a case of a 29 year-old female with diagnosis of myotonic dystrophy type 1 (Steinert’s disease) with excessive daytime sleepiness, muscle fatigue, snoring, frequent arousals, non-restorative sleep, and witnessed apneas. Pulmonary function tests revealed a mild decrease of forced vital capacity. Nocturnal polysomnography showed an increase of apnea/hypopnea index (85.9 events/h), mainly of central type (236), minimal oxygen saturation of 72%, and end-tidal carbon dioxide values that varied from 45 to 53 mmHg. Bi-level positive airway pressure titration was initiated at an inspiratory pressure (IPAP) of 8 and an expiratory pressure (EPAP) of 4 cm H2O. IPAP was then gradually increased to eliminate respiratory events and improve oxygen saturation. An IPAP of 12cm H20 and an EPAP of 4cm H2O eliminated all respiratory events, and the oxygen saturation remained above 90%. Bi-level positive airway pressure treatment at spontaneous/timed mode showed an improvement in snoring, apneas, and Epworth sleepiness scale decreased from 20 to 10. This case illustrates the beneficial effects of Bi-level positive airway pressure support in central sleep apnea syndrome of a patient with myotonic dystrophy type 1. PMID:26483914

  19. A cross-sectional study of age-related changes in plantar pressure distribution between 4 and 7 years: a comparison of regional and pixel-level analyses.

    PubMed

    Phethean, Jill; Pataky, Todd C; Nester, Christopher J; Findlow, Andrew H

    2014-01-01

    Quantifying morphological and functional development in children's feet, and thereby establishing development norms is difficult. In addition to practical challenges of experimentation on children, measurement equipment like plantar pressure (PP) platforms are almost exclusively geared towards adult-sized feet. These PP quantification problems may be exacerbated by typical regional data analysis techniques, which further reduce spatial resolution. The goal of this study was to quantify PP distributions in developing children, and also to compare the results obtained from typical (regional) techniques with those obtained from a higher-resolution (pixel-level) technique. Ninety-eight children between four and seven years of age were assessed in a cross-sectional design. Maximum PP distributions were collected for each child, and these pressures were linearly regressed against age. Present results agree with previous investigations in that maximum pressures and maximum pressure changes occurred in the forefoot. However, results from the present pixel-level technique suggest that these changes are limited to the central metatarsals, and that regional methods can suggest significance where none exists in the actual raw (pixel-level) data, due to signal aliasing and, in particular, to conflation of regional boundaries. We postulate that increased central metatarsal pressures are reflective of the coupling between generalised joint laxity decreases and relatively increasingly inclined central metatarsal bones with age.

  20. Physical activity levels and torso orientations of hospitalized patients at risk of developing a pressure injury: an observational study.

    PubMed

    Chaboyer, Wendy; Mills, Peter M; Roberts, Shelley; Latimer, Sharon

    2015-02-01

    Pressure injury guidelines recommend regular repositioning yet patients' mobility and repositioning patterns are unknown. An observational study using activity monitors was undertaken to describe the 24 h activity patterns of 84 hospitalized patients at risk of developing a pressure injury. The vast majority of participants' time was spent in the sedentary activity range (94% ± 3%) followed by the light range (5% ± 4 %). Patients changed their posture a median of 94 (interquartile range 48) time in the 24-h period (range 11-154), or ≈ 3.8 times per hour. Although a main focus for pressure injury prevention has been on repositioning, this study shows that patients with restricted mobility are actually moving quite often. Therefore, it might be appropriate to focus more attention on other pressure injury prevention strategies such as adequate nutrition, appropriate support surfaces and good skin care.

  1. Single-point but not tonic cuff pressure pain sensitivity is associated with level of physical fitness--a study of non-athletic healthy subjects.

    PubMed

    Lemming, Dag; Börsbo, Björn; Sjörs, Anna; Lind, Eva-Britt; Arendt-Nielsen, Lars; Graven-Nielsen, Thomas; Gerdle, Björn

    2015-01-01

    Exercise is often used for pain rehabilitation but the link between physical activity level and pain sensitivity is still not fully understood. Pressure pain sensitivity to cuff algometry and conditioned pain modulation (CPM) were evaluated in highly active men (n=22), normally active men (n=26), highly active women (n=27) and normally active women (n=23) based on the Godin Leisure-Time Exercise Questionnaire. Cuff pressure pain sensitivity was assessed at the arm and lower leg. The subjects scored the pain intensity on an electronic Visual Analogue Scale (VAS) during ten minutes with 25 kPa constant cuff pressure and two minutes with zero pressure. The maximal VAS score and area under the VAS-curve were extracted. Pressure pain thresholds (PPT) were recorded by manual pressure algometry on the ipsilateral tibialis anterior muscle before, during and after the tonic arm stimulation. Tonic cuff stimulation of the arm and leg resulted in higher VAS peak scores in women compared with men (p<0.04). In all groups the PPTs were reduced during and after the cuff stimulation compared with baseline (p=0.001). PPT were higher in men compared with women (p=0.03) and higher in highly physical active compared with normal active (p=0.048). Besides the well-known gender difference in pressure pain sensitivity this study demonstrates that a high physical fitness degree in non-athletic subjects is associated with increased pressure pain thresholds but does not affect cuff pressure pain sensitivity in healthy people.

  2. Pressure tuning the Fermi level through the Dirac point of giant Rashba semiconductor BiTeI.

    PubMed

    VanGennep, D; Maiti, S; Graf, D; Tozer, S W; Martin, C; Berger, H; Maslov, D L; Hamlin, J J

    2014-08-27

    We report measurements of Shubnikov-de Haas oscillations in the giant Rashba semiconductor BiTeI under applied pressures up to ∼2 GPa. We observe one high frequency oscillation at all pressures and one low frequency oscillation that emerges between ∼0.3-0.7 GPa indicating the appearance of a second small Fermi surface. BiTeI has a conduction band bottom that is split into two sub-bands due to the strong Rashba coupling, resulting in a 'Dirac point'. Our results suggest that the chemical potential starts below the Dirac point in the conduction band at ambient pressure and moves upward, crossing it as pressure is increased. The presence of the chemical potential above this Dirac point results in two Fermi surfaces. We present a simple model that captures this effect and can be used to understand the pressure dependence of our sample parameters. These extracted parameters are in quantitative agreement with first-principles calculations and other experiments. The parameters extracted via our model support the notion that pressure brings the system closer to the predicted topological quantum phase transition.

  3. Acute effects of traditional Thai massage on cortisol levels, arterial blood pressure and stress perception in academic stress condition: A single blind randomised controlled trial.

    PubMed

    Bennett, Surussawadi; Bennett, Michael John; Chatchawan, Uraiwon; Jenjaiwit, Patcharaporn; Pantumethakul, Rungthip; Kunhasura, Soontorn; Eungpinichpong, Wichai

    2016-04-01

    Traditional Thai massage (TTM) has been applied widely to promote relaxation. However, there is little evidence to support its efficacy on academic stress. A randomised controlled trial was performed to examine the acute effects of TTM on cortisol level, blood pressure, heart rate and stress perception in academic stress. This prospective trial included 36 physiotherapy students with a self perceived stress score of between 3 and 5. They were randomly allocated into the TTM (18 people) group or the control group (18 people). Saliva cortisol level, blood pressure, heart rate and stress perception rating were measured before and after the intervention. Both groups showed a significant reduction in cortisol level and heart rate when compared with baseline (p < 0.001). There were no significant differences in cortisol level between the two groups. The results suggest the need for further study into other possible physiological effects on stress of TTM.

  4. Hydrological response to earthquakes in the Haibara well, central Japan - I. Groundwater level changes revealed using state space decomposition of atmospheric pressure, rainfall and tidal responses

    USGS Publications Warehouse

    Matsumoto, N.; Kitagawa, G.; Roeloffs, E.A.

    2003-01-01

    For the groundwater level observed at the Haibara well, Shizuoka Prefecture, central Japan, time series analysis using state-space modelling is applied to extract hydrological anomalies related to earthquakes. This method can decompose observed groundwater level time series into five components: atmospheric pressure, tidal, and precipitation responses, observation noise, and residual water level. The decomposed responses to atmospheric pressure and precipitation are independently determined and are consistent with the expected response to surface loading. In the groundwater level at the Haibara well, 28 coseismic changes can be discerned during the period from 1981 April to 1997 December. There is a threshold in the relationship between earthquake magnitude and the well-hypocentre distance, above which earthquakes cause coseismic changes in the residual water level. All of the coseismic water level changes at the Haibara well are decreases, although 33 per cent of the estimated coseismic volumetric strain steps are contraction, which would be expected to cause water level increases. The coseismic changes in groundwater level are more closely proportional to the estimated ground motion than to coseismic volumetric strain steps, suggesting that ground motion due to earthquakes is the major cause of the coseismic water level drops and that the contribution from static strain is rather small. Possible pre- or inter-earthquake water level changes have occurred at the Haibara well and may have been caused by local aseismic crustal deformation.

  5. Assessing Stationarity in Ice Core Record-Sea Level Pressure Relationships for Yukon Territory Ice Core Records

    NASA Astrophysics Data System (ADS)

    Kelsey, E. P.; Wake, C. P.; Osterberg, E. C.

    2014-12-01

    We assess the stationarity of the relationship between Northern Hemisphere winter (Dec-Feb) sea-level pressure (SLP) and proxy time series (major ions, accumulation, and stable isotopes) from the Eclipse (3017 m asl) and the Mt. Logan Prospector-Russell Col (PRCol; 5340 m asl) ice cores from Yukon, Canada. We develop a novel spatial calibration procedure to identify ranges of ice core values that are associated with consistent winter SLP anomaly patterns. Each ice core variable time series was ranked and divided into groups of 13 years each. We assess stationarity by splitting the 1872-2001 analysis period in half (1872-1936 and 1937-2001) and comparing the locations and magnitudes of SLP anomaly patterns during the two periods for each group of ice core values. Northern Hemisphere monthly mean SLP from the 20th Century Reanalysis dataset are used. The high accumulation rate (1.38 m a-1) at Eclipse allows us to analyze 6-month seasonal mean values (Oct-Mar and Apr-Sep), whereas annual mean values are used from PRCol where the accumulation rate is lower (0.40 m a-1). The Eclipse cold season accumulation and PRCol annual mean sodium concentrations (Na+) exhibit the strongest correlations with winter SLP anomaly patterns. In particular, the lowest and highest 20% annual Na+ values at PRCol and lowest 10% cold season accumulation values at Eclipse exhibit stationarity with consistent SLP anomaly patterns in the North Pacific for all three time periods. A weaker Aleutian Low consistently occurred in the central to eastern North Pacific for the lowest Na+ years at PRCol and lowest accumulation cold seasons at Eclipse, although these groups of years are mostly independent. A stronger Aleutian Low occurs in the North Pacific for the highest Na+ years at PRCol. A stationary SLP anomaly pattern is not observed through all three time periods for high cold season accumulation at Eclipse. Application of this calibration procedure with other traditional calibration and

  6. Are changes of the geomagnetic field intensity related to changes of the tropical Pacific sea-level pressure during the last 50 years?

    NASA Astrophysics Data System (ADS)

    Vieira, Luis Eduardo Antunes; da Silva, Ligia Alves; Guarnieri, Fernando LuíS.

    2008-08-01

    The influence of solar variability into the lower atmospheric regions has been suggested on different atmospheric parameters in different time scales. However, a plausible mechanism to explain these observations remains unclear. Although it is widely accepted that the climate change over the past 50 years is attributed to human influence, we present the case that local climate change in the tropical Pacific may be due to changes in the Earth's magnetic field strength. The changes in the tropical Pacific circulation have been observed during the last 50 years, and they are attributed to the increase of the global surface temperature. However, a geomagnetic modulation of the net radiative flux in the southern tropical Pacific was recently suggested. Moreover, comparisons of long-term reconstructions of the Northern Hemisphere surface temperature and solar activity proxies indicated that the existence of a geomagnetic signal in climate data would support a direct link between solar variability and their effects on climate. Here we show that in the tropical Pacific the sea-level pressure, which is a component of the Walker circulation, could be related to the magnetospheric, ionospheric, and upper-atmosphere processes which may propagate downward to the lower atmosphere. Furthermore, we show that the changes in sea-level pressure and the Walker circulation are correlated to the westward drift of the magnetic anomaly. We compare the region averaged monthly values of the sea-level pressure in the tropical Pacific with those of the magnetic field intensity near the surface for the last 50 years. We find that the sea-level pressure in the tropical Pacific is increasing as the magnetic field intensity is decreasing. The correlation coefficient of the sea-level pressure 36-month running means versus the magnetic field intensity is 0.96. We anticipate our investigation to be a starting point for a more sophisticated investigation of the coupling between the space weather

  7. Leveling

    USGS Publications Warehouse

    1966-01-01

    Geodetic leveling by the U.S. Geological Survey provides a framework of accurate elevations for topographic mapping. Elevations are referred to the Sea Level Datum of 1929. Lines of leveling may be run either with automatic or with precise spirit levels, by either the center-wire or the three-wire method. For future use, the surveys are monumented with bench marks, using standard metal tablets or other marking devices. The elevations are adjusted by least squares or other suitable method and are published in lists of control.

  8. Impact of the postpump resistance on pressure-flow waveform and hemodynamic energy level in a neonatal pulsatile centrifugal pump.

    PubMed

    Wang, Shigang; Haines, Nikkole; Richardson, J Scott; Dasse, Kurt A; Undar, Akif

    2009-01-01

    This study tested the impact of different postpump resistances on pulsatile pressure-flow waveforms and hemodynamic energy output in a mock extracorporeal system. The circuit was primed with a 40% glycerin-water mixture, and a PediVAS centrifugal pump was used. The pre- and postpump pressures and flow rates were monitored via a data acquisition system. The postpump resistance was adjusted using a Hoffman clamp at the outlet of the pump. Five different postpump resistances and rotational speeds were tested with nonpulsatile (NP: 5000 RPM) and pulsatile (P: 4000 RPM) modes. No backflow was found when using pulsatile flow. With isoresistance, increased arterial resistances decreased pump flow rates (NP: from 1,912 ml/min to 373 ml/min; P: from 1,485 ml/min to 288 ml/min), increased postpump pressures (NP: from 333 mm Hg to 402 mm Hg; P: from 223 mm Hg to 274 mm Hg), and increased hemodynamic energy output with pulsatile mode. Pump flow rate correlated linearly with rotational speed (RPMs) of the pump, whereas postpump pressures and hemodynamic energy outputs showed curvilinear relationships with RPMs. The maximal pump flow rate also increased from 618 ml/min to 4,293 ml/min with pulsatile mode and from 581 ml/min to 5,665 ml/min with nonpulsatile mode. Results showed that higher postpump resistance reduced the pump flow range, and increased postpump pressure and surplus hemodynamic energy output with pulsatile mode. Higher rotational speeds also generated higher pump flow rates, postpump pressures, and increased pulsatility.

  9. Changes in endotracheal tube cuff pressure during laparoscopic surgery in head-up or head-down position

    PubMed Central

    2014-01-01

    Background The abdominal insufflation and surgical positioning in the laparoscopic surgery have been reported to result in an increase of airway pressure. However, associated effects on changes of endotracheal tube cuff pressure are not well established. Methods 70 patients undergoing elective laparoscopic colorectal tumor resection (head-down position, n = 38) and laparoscopic cholecystecomy (head-up position, n = 32) were enrolled and were compared to 15 patients undergoing elective open abdominal surgery. Changes of cuff and airway pressures before and after abdominal insufflation in supine position and after head-down or head-up positioning were analysed and compared. Results There was no significant cuff and airway pressure changes during the first fifteen minutes in open abdominal surgery. After insufflation, the cuff pressure increased from 26 ± 3 to 32 ± 6 and 27 ± 3 to 33 ± 5 cmH2O in patients receiving laparoscopic cholecystecomy and laparoscopic colorectal tumor resection respectively (both p < 0.001). The head-down tilt further increased cuff pressure from 33 ± 5 to 35 ± 5 cmH2O (p < 0.001). There six patients undergoing colorectal tumor resection (18.8%) and eight patients undergoing cholecystecomy (21.1%) had a total increase of cuff pressure more than 10 cm H2O (18.8%). There was no significant correlation between increase of cuff pressure and either the patient's body mass index or the common range of intra-abdominal pressure (10-15 mmHg) used in laparoscopic surgery. Conclusions An increase of endotracheal tube cuff pressure may occur during laparoscopic surgery especially in the head-down position. PMID:25210501

  10. Effects of intermittent electrical stimulation on superficial pressure, tissue oxygenation, and discomfort levels for the prevention of deep tissue injury.

    PubMed

    Solis, Leandro R; Gyawali, Selina; Seres, Peter; Curtis, Cara A; Chong, Su Ling; Thompson, Richard B; Mushahwar, Vivian K

    2011-02-01

    The overall goal of this project is to develop effective methods for the prevention of deep tissue injury (DTI). DTI is a severe type of pressure ulcer that originates at deep bone-muscle interfaces as a result of the prolonged compression of tissue. It afflicts individuals with reduced mobility and sensation, particularly those with spinal cord injury. We previously proposed using a novel electrical stimulation paradigm called intermittent electrical stimulation (IES) for the prophylactic prevention of DTI. IES-induced contractions mimic the natural repositioning performed by intact individuals, who subconsciously reposition themselves as a result of discomfort due to prolonged sitting. In this study, we investigated the effectiveness of various IES paradigms in reducing pressure around the ischial tuberosities, increasing tissue oxygenation throughout the gluteus muscles, and reducing sitting discomfort in able-bodied volunteers. The results were compared to the effects of voluntary muscle contractions and conventional pressure relief maneuvers (wheelchair push-ups). IES significantly reduced pressure around the tuberosities, produced significant and long-lasting elevations in tissue oxygenation, and significantly reduced discomfort produced by prolonged sitting. IES performed as well or better than both voluntary contractions and chair push-ups. The results suggest that IES may be an effective means for the prevention of DTI.

  11. Renovascular hypertension. Ability to renal vein ratio to predict the blood pressure level 18-24 months after surgery.

    PubMed

    Pedersen, E B; Danielsen, H; Fjeldborg, O; Kornerup, H J; Madsen, B

    1986-01-01

    Fourteen patients with severe hypertension and renal artery stenosis were treated surgically. One patient died 4 days after surgery due to a cerebral thrombosis. The other 13 patients were followed for 18-24 months. Five were considered cured since the diastolic blood pressure (DBP) was less than or equal to 90 mm Hg without therapy. Five were improved since DBP was less than or equal to 100 mm Hg during treatment with only one or two antihypertensive agents. There were unchanged. Renal vein renin ratio (RVRR) was greater than or equal to 1.5 either before or after furosemide in all patients who were cured or improved and less than or equal to 1.5 in 2 of 3 who were unchanged. It can be concluded that surgical treatment cured or improved 77% of the patients, and that a RVRR greater than or equal to 1.5 is a good predictor of the blood pressure lowering effect of surgery.

  12. Pressures on a Slender, Axisymmetric Body at High Angle of Attack in a Very Low Turbulence Level Air Stream.

    DTIC Science & Technology

    1979-09-01

    previously associated with high incidence aerodynamics can be overcome, by ensuring that tests are always carried out in this ’regular’ state. This may...on high incidence aerodynamics contains so many anomalies. If tests have been performed at arcitrary roll angles then the results are likely to be...the model and coat it in soap solution. It has also been found that at test speeds corresponding to the Reynolds numbers used in the pressure tests more

  13. High blood pressure medicines

    MedlinePlus

    Hypertension - medicines ... blood vessel diseases. You may need to take medicines to lower your blood pressure if lifestyle changes ... blood pressure to the target level. WHEN ARE MEDICINES FOR HIGH BLOOD PRESSURE USED Most of the ...

  14. Adsorption and reaction of methanol on supported palladium catalysts: microscopic-level studies from ultrahigh vacuum to ambient pressure conditions.

    PubMed

    Bäumer, Marcus; Libuda, Jörg; Neyman, Konstantin M; Rösch, Notker; Rupprechter, Günther; Freund, Hans-Joachim

    2007-07-21

    We investigated the decomposition and (partial) oxidation of methanol on Pd based catalysts in an integrated attempt, simultaneously bridging both the pressure and the materials gap. Combined studies were performed on well-defined Pd model catalysts based on ordered Al(2)O(3) and Fe(3)O(4) thin films, on well-defined particles supported on powders and on Pd single crystals. The interaction of Pd nanoparticles and Pd(111) with CH(3)OH and CH(3)OH/O(2) mixtures was examined from ultrahigh vacuum conditions up to ambient pressures, utilizing a broad range of surface specific vibrational spectroscopies which included IRAS, TR-IRAS, PM-IRAS, SFG, and DRIFTS. Detailed kinetic studies in the low pressure region were performed by molecular beam methods, providing comprehensive insights into the microkinetics of the reaction system. The underlying microscopic processes were studied theoretically on the basis of specially designed 3-D nanocluster models containing approximately 10(2) metal atoms. The efficiency of this novel modelling approach was demonstrated by rationalizing and complementing pertinent experimental results. In order to connect these results to the behavior under ambient conditions, kinetic and spectroscopic investigations were performed in reaction cells and lab reactors. Specifically, we focused on (1) particle size and structure dependent effects in methanol oxidation and decomposition, (2) support effects and their relation to activity and selectivity, (3) the influence of poisons such as carbon, and (4) the role of oxide and surface oxide formation on Pd nanoparticles.

  15. Overall fluctuating pressure levels on prospective space shuttle launch configurations at Mach numbers from 0.8 to 2.2

    NASA Technical Reports Server (NTRS)

    Dods, J. B., Jr.; Hanly, R. D.; Efting, J. H.

    1973-01-01

    Overall fluctuating pressure levels of seven space shuttle launch configurations are presented. The model was a 4-percent-scale space shuttle vehicle, tested in both a 11- by 11-foot transonic wind tunnel and a 9- by 7-foot supersonic wind tunnel. Mach numbers varied from 0.8 to 2.2, and the angle of attack range was from -8 deg to 8 deg at angles of sideslip of -5 deg, and 5 deg. The model configurations included both series-burn and parallel-burn configurations, two canopy configurations, two positions of the orbiter nose relative to the HO tank nose and two HO tank nose-cone angles (15 deg and 20 deg). The fluctuating pressure levels are presented in three forms.

  16. Correlation between the levels of non-specific physical symptoms and pressure pain thresholds measured by algometry in patients with temporomandibular disorders.

    PubMed

    Ramalho, D; Macedo, L; Goffredo Filho, G; Goes, C; Tesch, R

    2015-02-01

    Recent studies showed that patients with chronic TMD pain also feature increased sensitivity in other craniofacial regions, and even in remote peripheral areas, suggesting that nociceptive processing is centrally facilitated in this patient population. The aim of this study was to investigate the existence of a negative correlation between the levels of non-specific physical symptoms and pressure pain thresholds measured by algometry at sites distant from the chief complaint of oro-facial pain in patients with TMD. A total of 20 female patients were evaluated comprising 11 patients diagnosed with myofascial pain (Group I of RDC/TMD) and 9 patients with arthralgia (Group III of RDC/TMD), with both reporting chronic TMD pain for at least 3 months. Patients were tested by the pressure algometry technique, and, in the same visit, clinical diagnosis and levels of non-specific physical symptoms, including pain-related issues or not, were obtained. The raw scores were then standardised into a T-score. The possible correlation between the dependent variable levels of non-specific physical symptoms and pressure pain thresholds measured by algometry at sites distant from the chief complaint of oro-facial pain was assessed with Spearman's correlation coefficient. Results were considered statistically significant, which stood a lower than 5% probability of occurring by chance (P < 0·05). A statistically significant (P = 0·02) negative correlation (-0·51) was found to exist between the levels of non-specific physical symptoms, only if including issues involving pain-related symptoms, and experimental pressure pain thresholds in patients with painful TMD.

  17. [Research on Adaptive Balance Reaction for Gait Slippery Instability Events on Level Walk Based on Plantar Pressure and Gait Parameter Analysis].

    PubMed

    Li, Yang; Zhang, Junxia; Si, Ying

    2015-12-01

    Nowadays, for gait instability phenomenon, many researches have been carried out at home and abroad. However, the relationship between plantar pressure and gait parameters in the process of balance adjustment is still unclear. This study describes the human body adaptive balance reaction during slip events on slippery level walk by plantar pressure and gait analysis. Ten healthy male subjects walked on a level path wearing shoes with two contrastive contaminants (dry, oil). The study collected and analyzed the change rule of spatiotemporal parameters, plantar pressure parameters, vertical ground reaction force (VGRF), etc. The results showed that the human body adaptive balance reaction during slip events on slippery level walk mainly included lighter touch at the heel strikes, tighter grip at the toe offs, a lower velocity, a shorter stride length and longer support time. These changes are used to maintain or recover body balance. These results would be able to explore new ideas and provide reference value for slip injury prevention, walking rehabilitation training design, research and development of walking assistive equipments, etc.

  18. High Pressure Shock Tube Ignition Delay Time Measurements During Oxy-Methane Combustion With High Levels of CO 2 Dilution

    DOE PAGES

    Pryor, Owen; Barak, Samuel; Lopez, Joseph; ...

    2017-03-30

    For this study, ignition delay times and methane species time-histories were measured for methane/O2 mixtures in a high CO2 diluted environment using shock tube and laser absorption spectroscopy. The experiments were performed between 1300 K and 2000 K at pressures between 6 and 31 atm. The test mixtures were at an equivalence ratio of 1 with CH4 mole fractions ranging from 3.5% -5% and up to 85% CO2 with a bath of argon gas as necessary. The ignition delay times and methane time histories were measured using pressure, emission, and laser diagnostics. Predictive ability of two literature kinetic mechanisms (GRImore » 3.0 and ARAMCO Mech 1.3) was tested against current data. In general, both mechanisms performed reasonably well against measured ignition delay time data. The methane time-histories showed good agreement with the mechanisms for most of the conditions measured. A correlation for ignition delay time was created taking into the different parameters showing that the ignition activation energy for the fuel to be 49.64 kcal/mol. Through a sensitivity analysis, CO2 is shown to slow the overall reaction rate and increase the ignition delay time. To the best of our knowledge, we present the first shock tube data during ignition of methane/CO2/O2 under these conditions. In conclusion, current data provides crucial validation data needed for development of future kinetic mechanisms.« less

  19. System-Level Design of a Shape Memory Alloy Actuator for Active Clearance Control in the High-Pressure Turbine

    NASA Technical Reports Server (NTRS)

    DeCastro, Jonathan A.; Melcher, Kevin J.; Noebe, Ronald D.

    2005-01-01

    This paper describes results of a numerical analysis evaluating the feasibility of high-temperature shape memory alloys (HTSMA) for active clearance control actuation in the high-pressure turbine section of a modern turbofan engine. The prototype actuator concept considered here consists of parallel HTSMA wires attached to the shroud that is located on the exterior of the turbine case. A transient model of an HTSMA actuator was used to evaluate active clearance control at various operating points in a test bed aircraft engine simulation. For the engine under consideration, each actuator must be designed to counteract loads from 380 to 2000 lbf and displace at least 0.033 inches. Design results show that an actuator comprised of 10 wires 2 inches in length is adequate for control at critical engine operating points and still exhibits acceptable failsafe operability and cycle life. A proportional-integral-derivative (PID) controller with integrator windup protection was implemented to control clearance amidst engine transients during a normal mission. Simulation results show that the control system exhibits minimal variability in clearance control performance across the operating envelope. The final actuator design is sufficiently small to fit within the limited space outside the high-pressure turbine case and is shown to consume only small amounts of bleed air to adequately regulate temperature.

  20. Investigation of the level difference between sound pressure and sound intensity in an aircraft cabin under different fuselage conditions

    NASA Technical Reports Server (NTRS)

    Atwal, M. S.; Crocker, M. J.; Heitman, K. E.

    1985-01-01

    Problems in using two-microphone sound-intensity (SI) measurements to measure structural transmission losses are investigated in experiments involving light-aircraft fuselage panels and windows. Both sound pressure (SP) and SI are measured near the passenger and door windows and panels of a single-engine aircraft and with these barriers removed, and the effect of increasing interior acoustic absorption and blocking flanking transmission paths is also tested. The results are presented graphically, and the SP measurements are used to indicate frequency ranges in which the two-microphone technique significantly underestimates SI. It is inferred that flanking paths and interior reverberation must be effectively suppressed in order to obtain accurate transmission-loss measurements.

  1. Simulation of Liquid Level, Temperature and Pressure Inside a 2000 Liter Liquid Hydrogen Tank During Truck Transportation

    NASA Astrophysics Data System (ADS)

    Takeda, Minoru; Nara, Hiroyuki; Maekawa, Kazuma; Fujikawa, Shizuichi; Matsuno, Yu; Kuroda, Tsuneo; Kumakura, Hiroaki

    Hydrogen is an ultimate energy source because only water is produced after the chemical reaction of hydrogen and oxygen. In the near future, a large amount of hydrogen, produced using sustainable/renewable energy, is expected to be consumed. Since liquid hydrogen (LH2) has the advantage of high storage efficiency, it is expected to be the ultimate medium for the worldwide storage and transportation of large amounts of hydrogen. To make a simulation model of the sloshing of LH2 inside a 2000 liter tank, simulation analyses of LH2 surface oscillation, temperature and pressure inside the tank during a truck transportation have been carried out using a multipurpose software ANSYS CFX. Numerical results are discussed in comparison with experimental results.

  2. Modular organization of residue-level contacts shape the selection pressure on individual amino acid sites of ribosomal proteins.

    PubMed

    Mallik, Saurav; Kundu, Sudip

    2017-02-22

    Understanding the molecular evolution of macromolecular complexes in the light of their structure, assembly and stability is of central importance. Here we address how the modular organization of native molecular contacts shapes the selection pressure on individual residue sites of ribosomal complexes. The bacterial ribosomal complex is represented as a residue contact network where nodes represent amino acid/nucleotide residues and edges represent their van der Waals interactions. We find statistically overrepresented native amino acid-nucleotide contacts (OaantC, one amino acid contacts one or multiple nucleotides, inter-nucleotide contacts are disregarded). Contact number is defined as the number of nucleotides contacted. Involvement of individual amino acids in OaantCs with smaller contact numbers is more random, while only a few amino acids significantly contribute to OaantCs with higher contact numbers. An investigation of structure, stability and assembly of bacterial ribosome depicts the involvement of these OaantCs in diverse biophysical interactions stabilizing the complex, including high-affinity protein-RNA contacts, inter-protein cooperativity, inter-subunit bridge, packing of multiple ribosomal RNA domains etc. Amino acid-nucleotide constituents of OaantCs with higher contact numbers are generally associated with significantly slower substitution rates compared to that of OaantCs with smaller contact numbers. This evolutionary rate heterogeneity emerges from the strong purifying selection pressure that conserves the respective amino acid physicochemical properties relevant to the stabilizing interaction with OaantC nucleotides. An analysis of relative molecular orientations of OaantC residues and their interaction energetics provides the biophysical ground of purifying selection conserving OaantC amino acid physicochemical properties.

  3. Energy levels in self-assembled InAs/GaAs quantum dots above the pressure-induced Γ-X crossover

    NASA Astrophysics Data System (ADS)

    Itskevich, I. E.; Lyapin, S. G.; Troyan, I. A.; Klipstein, P. C.; Eaves, L.; Main, P. C.; Henini, M.

    1998-08-01

    Low-temperature photoluminescence (PL) studies of InAs self-assembled quantum dots (SAQD's) embedded in a GaAs matrix have been performed under hydrostatic pressure P up to 70 kbar. A strong blueshift of the PL line from the SAQD's with P up to 53 kbar changes to a relatively small redshift at higher P. This is the fingerprint of a Γ-X crossover. Above the crossover pressure, we find experimental evidence for type-II band alignment in the InAs SAQD/GaAs heterostructure system. This gives a reference point that allows us to determine independently the energies of the electron and hole levels in the QD.

  4. Porcine liver decellularization under oscillating pressure conditions: a technical refinement to improve the homogeneity of the decellularization process.

    PubMed

    Struecker, Benjamin; Hillebrandt, Karl Herbert; Voitl, Robert; Butter, Antje; Schmuck, Rosa B; Reutzel-Selke, Anja; Geisel, Dominik; Joehrens, Korinna; Pickerodt, Philipp A; Raschzok, Nathanael; Puhl, Gero; Neuhaus, Peter; Pratschke, Johann; Sauer, Igor M

    2015-03-01

    Decellularization and recellularization of parenchymal organs may facilitate the generation of autologous functional liver organoids by repopulation of decellularized porcine liver matrices with induced liver cells. We present an accelerated (7 h overall perfusion time) and effective protocol for human-scale liver decellularization by pressure-controlled perfusion with 1% Triton X-100 and 1% sodium dodecyl sulfate via the hepatic artery (120 mmHg) and portal vein (60 mmHg). In addition, we analyzed the effect of oscillating pressure conditions on pig liver decellularization (n=19). The proprietary perfusion device used to generate these pressure conditions mimics intra-abdominal conditions during respiration to optimize microperfusion within livers and thus optimize the homogeneity of the decellularization process. The efficiency of perfusion decellularization was analyzed by macroscopic observation, histological staining (hematoxylin and eosin [H&E], Sirius red, and alcian blue), immunohistochemical staining (collagen IV, laminin, and fibronectin), and biochemical assessment (DNA, collagen, and glycosaminoglycans) of decellularized liver matrices. The integrity of the extracellular matrix (ECM) postdecellularization was visualized by corrosion casting and three-dimensional computed tomography scanning. We found that livers perfused under oscillating pressure conditions (P(+)) showed a more homogenous course of decellularization and contained less DNA compared with livers perfused without oscillating pressure conditions (P(-)). Microscopically, livers from the (P(-)) group showed remnant cell clusters, while no cells were found in livers from the (P(+)) group. The grade of disruption of the ECM was higher in livers from the (P(-)) group, although the perfusion rates and pressure did not significantly differ. Immunohistochemical staining revealed that important matrix components were still present after decellularization. Corrosion casting showed an intact

  5. Relationship between long-term exposure to low-level arsenic in drinking water and the prevalence of abnormal blood pressure.

    PubMed

    Zhang, Chuanwu; Mao, Guangyun; He, Suxia; Yang, Zuopeng; Yang, Wei; Zhang, Xiaojing; Qiu, Wenting; Ta, Na; Cao, Li; Yang, Hui; Guo, Xiaojuan

    2013-11-15

    Arsenic increases the risk and incidence of cardiovascular disease. To explore the impact of long-term exposure to low-level arsenic in drinking water on blood pressure including pulse pressure (PP) and mean arterial blood pressure (MAP), a cross-sectional study was conducted in 2010 in which the blood pressure of 405 villagers was measured, who had been drinking water with an inorganic arsenic content <50 μg/L. A multivariate logistic regression model was used to estimate odds ratios and 95% confidence intervals. After adjusting for age, gender, Body Mass Index (BMI), alcohol consumption and smoking, the odds ratios showed a 1.45-fold (95%CI: 0.63-3.35) increase in the group with >30-50 years of arsenic exposure and a 2.95-fold (95%CI: 1.31-6.67) increase in the group with >50 years exposure. Furthermore, the odds ratio for prevalence of abnormal PP and MAP were 1.06 (95%CI: 0.24-4.66) and 0.87 (95%CI: 0.36-2.14) in the group with >30-50 years of exposure, and were 2.46 (95%CI: 0.87-6.97) and 3.75 (95%CI: 1.61-8.71) for the group with >50 years exposure, compared to the group with arsenic exposure ≤ 30 years respectively. Significant trends for Hypertension (p<0.0001), PP (p<0.0001) and MAP (p=0.0016) were found. The prevalence of hypertension and abnormal PP as well as MAP is marked among a low-level arsenic exposure population, and significantly increases with the duration of arsenic exposure.

  6. The effects of increasing levels of dietary garlic bulb on growth performance, systolic blood pressure, hematology, and ascites syndrome in broiler chickens.

    PubMed

    Varmaghany, Saifali; Karimi Torshizi, Mohammad Amir; Rahimi, Shaban; Lotfollahian, Houshang; Hassanzadeh, Mohammad

    2015-08-01

    The effects of dietary garlic bulb were studied separately on hematological parameters, ascites incidence, and growth performance of an ascites susceptible broiler hybrid under both standard temperature conditions ( STC: ) and cold temperature conditions ( CTC: ). A total of 336 one-day-old male broiler chickens were allocated to 4 experimental groups with 4 replicates of 21 birds each under STC. In addition, the same grouping with another 336 birds was used for CTC. Under CTC, the birds were exposed to cold temperatures for induction of ascites. Experimental groups were defined by the inclusion of 0 (control), 5, 10 or 15 g/kg garlic bulbs in the diets under both STC and CTC. Growth performance, systolic blood pressure (as a measure of systemic arterial blood pressure), physiological and biochemical parameters, as well as ascites indices (right ventricle [ RV: ], total ventricle [ TV: ] weights, and RV/TV: ) were evaluated. Systolic blood pressure was determined using an indirect method with a sphygmomanometer, a pediatric cuff, and a Doppler device. The final body weight decreased quadratically (P = 0.003), with increasing garlic bulb levels in the diets under STC. The feed conversion ratio showed no significant differences among all groups under both STC and CTC. No significant differences were observed in total mortality and ascites-related mortality in all groups under STC, although total mortality (L: P = 0.01; Q: P = 0.001) and ascites-related mortality (L: P = 0.007; Q: P = 0.001) were significantly different among the diets under CTC. Under STC, the systolic blood pressure, packed cell volume, hemoglobin, RV, TV, and RV/TV did not vary significantly among the diets. However, red blood cell count and erythrocyte osmotic fragility decreased linearly (P < 0.005) with increasing garlic bulb levels in the diets under STC. Under CTC, the systolic blood pressure, packed cell volume, red blood cell count, and erythrocyte osmotic fragility decreased

  7. The Intraocular Pressure under Deep versus Moderate Neuromuscular Blockade during Low-Pressure Robot Assisted Laparoscopic Radical Prostatectomy in a Randomized Trial

    PubMed Central

    Shin, Seokyung; Choi, Young Deuk; Hong, Jung Hwa; Kim, Chan Yun; Park, HeeJoon; Bai, Sun-Joon

    2015-01-01

    Background This study aimed to determine whether continuous deep neuromuscular blockade (NMB) improves the surgical conditions and facilitates robotic-assisted laparoscopic radical prostatectomy (RALRP) under low intra-abdominal pressure (IAP) to attenuate the increase in intraocular pressure (IOP) during CO2 pneumoperitoneum in the steep Trendelenburg (ST) position. Methods Sixty-seven patients undergoing RALRP were randomly assigned to a moderate NMB group (Group M), including patients who received atracurium infusion until the end of the ST position, maintaining a train of four count of 1–2; and the deep NMB group (Group D), including patients who received rocuronium infusion, maintaining a post-tetanic count of 1–2. IOP was measured in all patients at nine separate time points. All RALRPs were performed by one surgeon, who rated the overall and worst surgical conditions at the end of the ST position. Results The highest IOP value was observed at T4 (60 min after the ST position) in both Group M (23.3 ± 2.7 mmHg) and Group D (19.8 ± 2.1 mmHg). RALRP was accomplished at an IAP of 8 mmHg in 88% Group D patients and 25% Group M patients. The overall surgical condition grade was 4.0 (3.0–5.0) in Group D and 3.0 (2.0–5.0) in Group M (P < 0.001). Conclusion The current study demonstrated that continuous deep NMB may improve surgical conditions and facilitate RALRP at a low IAP, resulting in significant attenuation of the increase on IOP. Moreover, low-pressure pneumoperitoneum, facilitated by deep NMB still provided acceptable surgical conditions. Trial Registration ClinicalTrials.gov NCT02109133 PMID:26317357

  8. A longitudinal study of arterial blood pressure in chronic haemodialysis patients with different levels of plasma renin concentration.

    PubMed

    Kornerup, H J; Fredsted, B; Pedersen, R S

    1978-01-01

    The purpose of the study was to examine the value of regular measurements of plasma renin concentration (PRC) in selecting those chronic haemodialysis patients suitable for bilateral nephrectomy to prevent development of uncontrollable hypertension. Regular measurements of arterial blood pressure (BP) and PRC were performed during one year in 31 patients undergoing regular haemodialysis because of end-stage renal disease. Among 18 patients with PRC greater than or equal to 100 micro Goldblatt units per ml plasma (microGU/ml) systolic and/or diastolic hypertension persisted or developed in 12. In contrast, among 13 patients with PRC greater than 100microGU/ml, BP became normal in all but one, who had a slightly increased systolic BP. However, hypertension was mild and easily controlled by conventional therapy in all except one, who probably had an overlying volume-dependent hypertension. Therefore, bilateral nephrectomy was not necessary in any case. The results indicate that hypertension in the majority of chronic haemodialysis patients with high PRC can be adequately controlled without surgical intervention and that regular measurements of PRC have no practical value in forecasting the development of uncontrollable hypertension in chronic haemodialysis patients.

  9. Compression of Root Level in a Patient with Hereditary Neuropathy with Liability to Pressure Palsy Diagnosed by Magnetic Resonance Imaging.

    PubMed

    Park, Donghwi; Ryu, Ju Seok; Kim, Ki-Jeong

    2016-09-01

    Hereditary neuropathy with liability to pressure palsies (HNPP) is characterized by acute, painless, and recurrent mononeuropathies that are secondary to compression or minor trauma. This case is the first to report an intraspinal compression of the radicular nerve by schwannoma in a patient with HNPP. A 66-year-old woman developed left foot drop and paresthesia of the lateral aspects of left distal lower leg. An electromyography showed left L5 radiculopathy and severe peripheral polyneuropathy. A lumbosacral magnetic resonance imaging revealed a radicular nerve in the intradural and extramedullary space being compressed by schwannoma. She previously had symptoms of foot drop several years ago, and HNPP was confirmed by peripheral myelin protein 22 deletion. She was surgically treated for L5 radiculopathy, which might have been caused by a traction of the nerve root by schwannoma at the intradural and extramedullary space. After surgical treatment, her symptoms of foot drop had improved from zero grade to IV+ grade within 4 weeks. The occurrence of HNPP and schwannoma in the same patient may be coincidental, but it is tempting to speculate that they share a common genetic basis. Therefore, for patients with HNPP, it is important to consider not only an electrophysiologic study but also a magnetic resonance imaging to locate the exact pathologic site.

  10. Plasma PCSK9 level is unrelated to blood pressure and not associated independently with carotid intima-media thickness in hypertensives.

    PubMed

    Yang, Sheng-Hua; Du, Ying; Li, Sha; Zhang, Yan; Xu, Rui-Xia; Zhu, Cheng-Gang; Guo, Yuan-Lin; Wu, Na-Qiong; Dong, Qian; Sun, Jing; Li, Jian-Jun

    2016-08-01

    Proprotein convertase subtilisin/kexin type 9 (PCSK9), a novel target for low-density lipoprotein cholesterol (LDL-C)-lowering therapy, has been found to possess multiple off-target effects in humans. The aim of the present study was to investigate the association of blood pressure (BP) with plasma PCSK9 levels in a large Chinese cohort and the relation of PCSK9 level to carotid intima-media thickness (cIMT) in hypertensive patients. A total of 805 patients without lipid-lowering drug therapy were consecutively enrolled. First, the relationship between BP and PCSK9 was evaluated in hypertensives and normotensives. Furthermore, we examined the relation of PCSK9 to cIMT in 256 enrolled patients who had received a carotid ultrasound test. Plasma PCSK9 levels were measured by enzyme-linked immunosorbent assay, and cITM of left and right carotid arteries was assessed by B-mode ultrasound. There was no significant difference in PCSK9 levels between hypertensives and normotensives. PCSK9 level was not associated with systolic and diastolic BP and pulse pressure in hypertensives and normotensives regardless of sex. A positive correlation between PCSK9 and maximum-IMT and mean-MIT in hypertensives was found in univariate analyses, whereas such an association was absent in normotensives. In addition, the positive association of PCSK9 with cIMT disappeared in hypertensives in multivariate analyses. PCSK9 level is not associated with systolic or diastolic BP in hypertensives or normotensives, but it positively correlates with cIMT in hypertensives in univariate but not multivariate analyses, and further researches are needed.

  11. Quantification of clenbuterol at trace level in human urine by ultra-high pressure liquid chromatography-tandem mass spectrometry.

    PubMed

    Nicoli, Raul; Petrou, Michael; Badoud, Flavia; Dvorak, Jiri; Saugy, Martial; Baume, Norbert

    2013-05-31

    Clenbuterol is a β2 agonist agent with anabolic properties given by the increase in the muscular mass in parallel to the decrease of the body fat. For this reason, the use of clenbuterol is forbidden by the World Anti-Doping Agency (WADA) in the practice of sport. This compound is of particular interest for anti-doping authorities and WADA-accredited laboratories due to the recent reporting of risk of unintentional doping following the eating of meat contaminated with traces of clenbuterol in some countries. In this work, the development and the validation of an ultra-high pressure liquid chromatography coupled to electrospray ionization tandem mass spectrometry (UHPLC-ESI-MS/MS) method for the quantification of clenbuterol in human urine is described. The analyte was extracted from urine samples by liquid-liquid extraction (LLE) in basic conditions using tert butyl-methyl ether (TBME) and analyzed by UHPLC-MS/MS with a linear gradient of acetonitrile in 9min only. The simple and rapid method presented here was validated in compliance with authority guidelines and showed a limit of quantification at 5pg/mL and a linearity range from 5pg/mL to 300pg/mL. Good trueness (85.8-105%), repeatability (5.7-10.6% RSD) and intermediate precision (5.9-14.9% RSD) results were obtained. The method was then applied to real samples from eighteen volunteers collecting urines after single oral doses administration (1, 5 and 10μg) of clenbuterol-enriched yogurts.

  12. Changes in left ventricular function as determined by the multi-wire gamma camera at near presyncopal levels of lower body negative pressure

    NASA Technical Reports Server (NTRS)

    Pintner, R.; Fortney, S.; Mulvagh, S.; Lacy, J.

    1992-01-01

    At presyncopal levels of lower body negative pressure (LBNP), we have frequently observed electrocardiographic responses that may be due to changes in cardiac position and/or shape, but could be indicative of altered myocardial function. To further investigate this, we evaluated cardiac function using a nuclear imaging technique in 21 healthy subjects (17 men and 4 women) after 30 minutes of supine rest and near the end of a presyncopal-limited LBNP exposure (LBNP averaged 65 plus or minus 3 mmHg at injection). Cardiac first pass images were obtained with a Multi-Wire Gamma Camera following an intravenous bolus injection of 30-50 millicurries of Tantalum-178. Manual blood pressures and electrocardiograms were obtained throughout the 3 minute graded LBNP protocol. Between rest and injection during LBNP, heart rate increased (P less than 0.01) from 67 plus or minus 3 beats per minute to 99 plus or minus beats per minute, systolic blood pressure decreased (P less than 0.01) from 110 plus or minus 3 mmHg to 107 plus or minus 3 mmHg and left ventricular ejection fraction (EF) decreased (P less than 0.01) from 0.57 plus or minus 0.02 to 0.48 plus or minus 0.02. During LBNP, ST segment depression of at least 0.5 mm occurred in 7 subjects. Subjects with ST depression had greater reductions (P = 0.05) in EF than subjects without ST depression (0.15 plus or minus 0.07 versus 0.005 plus or minus 0.03), but also tolerated greater levels (P less than 0.05) of negative pressure (88 plus or minus mmHg versus 69 plus or minus 5 mmHg). There was a significant relationship between presyncopal LBNP level and EF (R(exp 2) = 0.50, P less than 0.05). Our findings suggest there may be a decrease in systolic myocardial function at high levels of LBNP.

  13. Probing the energy levels of perovskite solar cells via Kelvin probe and UV ambient pressure photoemission spectroscopy.

    PubMed

    Harwell, J R; Baikie, T K; Baikie, I D; Payne, J L; Ni, C; Irvine, J T S; Turnbull, G A; Samuel, I D W

    2016-07-20

    The field of organo-lead halide perovskite solar cells has been rapidly growing since their discovery in 2009. State of the art devices are now achieving efficiencies comparable to much older technologies like silicon, while utilising simple manufacturing processes and starting materials. A key parameter to consider when optimising solar cell devices or when designing new materials is the position and effects of the energy levels in the materials. We present here a comprehensive study of the energy levels present in a common structure of perovskite solar cell using an advanced macroscopic Kelvin probe and UV air photoemission setup. By constructing a detailed map of the energy levels in the system we are able to predict the importance of each layer to the open circuit voltage of the solar cell, which we then back up through measurements of the surface photovoltage of the cell under white illumination. Our results demonstrate the effectiveness of air photoemission and Kelvin probe contact potential difference measurements as a method of identifying the factors contributing to the open circuit voltage in a solar cell, as well as being an excellent way of probing the physics of new materials.

  14. Mechanism of action of nitrogen pressure in controlling striatal dopamine level of freely moving rats is changed by recurrent exposures to nitrogen narcosis.

    PubMed

    Lavoute, Cécile; Weiss, Michel; Risso, Jean-Jacques; Rostain, Jean-Claude

    2012-03-01

    In rats, a single exposure to 3 MPa nitrogen induces change in motor processes, a sedative action and a decrease in dopamine release in the striatum. These changes due to a narcotic effect of nitrogen have been attributed to a decrease in glutamatergic control and the facilitation of GABAergic neurotransmission involving NMDA and GABA(A) receptors, respectively. After repeated exposure to nitrogen narcosis, a second exposure to 3 MPa increased dopamine levels suggesting a change in the control of the dopaminergic pathway. We investigated the role of the nigral NMDA and GABA(A) receptors in changes in the striatal dopamine levels. Dopamine-sensitive electrodes were implanted into the striatum under general anesthesia, together with a guide-cannula for drug injections into the SNc. Dopamine level was monitored by in vivo voltammetry. The effects of NMDA/GABA(A) receptor agonists (NMDA/muscimol) and antagonists (AP7/gabazine) on dopamine levels were investigated. Rats were exposed to 3 MPa nitrogen before and after five daily exposures to 1 MPa. After these exposures to nitrogen narcosis, gabazine, NMDA and AP7 had no effect on the nitrogen-induced increase in dopamine levels. By contrast, muscimol strongly enhanced the increase in dopamine level induced by nitrogen. Our findings suggest that repeated nitrogen exposure disrupted NMDA receptor function and decreased GABAergic input by modifying GABA(A) receptor sensitivity. These findings demonstrated a change in the mechanism of action of nitrogen at pressure.

  15. Cross-sectional study on the relationship between the level of serum cystatin C and blood pressure reverse dipping in hypertensive patients

    PubMed Central

    Han, Jin; Gao, Ya; Guo, Qi; Su, Dan; Yan, Bin; Peng, Liyuan; Du, Yuxing; Li, Ke; Wang, Gang

    2016-01-01

    Objective To investigate the relationship between the level of serum cystatin C (s-CC) and reverse-dipper blood pressure (BP) pattern. Design Cross-sectional study. Setting Single centre. Participants A total of 718 hypertensive patients were eventually recruited from cardiac clinics between 2012 and 2014 in the Second Affiliated Hospital, Xi'an Jiaotong University. They were diagnosed as essential hypertension according to their casual office records of systolic blood pressure (SBP) and/or diastolic blood pressure (DBP). Patients were excluded if they were <18 or >90 years old, under antihypertensive treatment, night workers, suffering from acute stroke or myocardial infarction within the past 6 months, diagnosed as secondary hypertension, sleep apnoea or other sleep disorders, renal failure, cardiac failure, chronic obstructive pulmonary disease, women during pregnancy or intolerant to the ambulatory BP monitoring (ABPM). Measurement The selected patients were evaluated with 24 hours ABPM. Peripheral venous blood samples were collected to evaluate the s-CC levels by ELISA. Methods The distribution of hypertensive patients with different levels of s-CC among each circadian BP pattern group was analysed using analysis of variance. Multinomial logistic regression analysis was applied to explore the relationship between the relevant variables and ABPM results. Results S-CC level in reverse-dipper group (1.19±0.53 mg/L) was increased significantly when compared with dipper group (1.06±0.36 mg/L) (p=0.021). In addition, after multinomial logistic regression analysis, s-CC (OR 1.717; 95% CI 1.033 to 2.854; p=0.037) and diabetes (OR 2.313; 95% CI 1.401 to 3.821; p=0.01) were significantly differen