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Sample records for intravenous fluid restriction

  1. Intravenous Fluid Generation System

    NASA Technical Reports Server (NTRS)

    McQuillen, John; McKay, Terri; Brown, Daniel; Zoldak, John

    2013-01-01

    The ability to stabilize and treat patients on exploration missions will depend on access to needed consumables. Intravenous (IV) fluids have been identified as required consumables. A review of the Space Medicine Exploration Medical Condition List (SMEMCL) lists over 400 medical conditions that could present and require treatment during ISS missions. The Intravenous Fluid Generation System (IVGEN) technology provides the scalable capability to generate IV fluids from indigenous water supplies. It meets USP (U.S. Pharmacopeia) standards. This capability was performed using potable water from the ISS; water from more extreme environments would need preconditioning. The key advantage is the ability to filter mass and volume, providing the equivalent amount of IV fluid: this is critical for remote operations or resource- poor environments. The IVGEN technology purifies drinking water, mixes it with salt, and transfers it to a suitable bag to deliver a sterile normal saline solution. Operational constraints such as mass limitations and lack of refrigeration may limit the type and volume of such fluids that can be carried onboard the spacecraft. In addition, most medical fluids have a shelf life that is shorter than some mission durations. Consequently, the objective of the IVGEN experiment was to develop, design, and validate the necessary methodology to purify spacecraft potable water into a normal saline solution, thus reducing the amount of IV fluids that are included in the launch manifest. As currently conceived, an IVGEN system for a space exploration mission would consist of an accumulator, a purifier, a mixing assembly, a salt bag, and a sterile bag. The accumulator is used to transfer a measured amount of drinking water from the spacecraft to the purifier. The purifier uses filters to separate any air bubbles that may have gotten trapped during the drinking water transfer from flowing through a high-quality deionizing cartridge that removes the impurities in

  2. Portable Intravenous Fluid Production Device for Ground Use

    NASA Technical Reports Server (NTRS)

    Scarpa, Philip J.; Scheuer, Wolfgang K.

    2012-01-01

    There are several medical conditions that require intravenous (IV) fluids. Limitations of mass, volume, storage space, shelf-life, transportation, and local resources can restrict the availability of such important fluids. These limitations are expected in long-duration space exploration missions and in remote or austere environments on Earth. Current IV fluid production requires large factory-based processes. Easy, portable, on-site production of IV fluids can eliminate these limitations. Based on experience gained in developing a device for spaceflight, a ground-use device was developed. This design uses regular drinking water that is pumped through two filters to produce, in minutes, sterile, ultrapure water that meets the stringent quality standards of the United States Pharmacopeia for Water for Injection (Total Bacteria, Conductivity, Endotoxins, Total Organic Carbon). The device weighs 2.2 lb (1 kg) and is 10 in. long, 5 in. wide, and 3 in. high (.25, 13, and 7.5 cm, respectively) in its storage configuration. This handheld device produces one liter of medical-grade water in 21 minutes. Total production capacity for this innovation is expected to be in the hundreds of liters.

  3. Portable Intravenous Fluid Production Device For Ground Use Project

    NASA Technical Reports Server (NTRS)

    Oliva-Buisson, Yvette J.

    2014-01-01

    Several medical conditions require the administration of intravenous (IV) fluids,but limitations of mass, volume, shelf-life, transportation, and local resources can restrict the availability of these important fluids. Such limitations are expected in long-duration space exploration missions and in remote or austere places on Earth. This design uses regular drinking water that is pumped through two filters to produce, in minutes, sterile, ultrapure water that meets the stringent quality standards of the United States Pharmacopeia for Water for Injection (Total Bacteria, Conductivity, Endo - toxins, Total Organic Carbon). The device weighs 2.2 lb (1 kg) and is 10 in. long, 5 in. wide, and 3 in. high (˜25, 13, and 7.5 cm, respectively) in its storage configuration. This handheld device produces one liter of medical-grade water in 21 minutes. Total production capacity for this innovation is expected to be in the hundreds of liters. The device contains one battery powered electric mini-pump. Alternatively, a manually powered pump can be attached and used. Drinking water enters the device from a source water bag, flows through two filters, and final sterile production water exits into a sealed, medical-grade collection bag. The collection bag contains pre-placed crystalline salts to mix with product water to form isotonic intravenous medical solutions. Alternatively, a hypertonic salt solution can be injected into a filled bag. The filled collection bag is detached from the device and is ready for use or storage. This device currently contains one collection bag, but a manifold of several pre-attached bags or replacement of single collection bags under sterile needle technique is possible for the production of multiple liters. The entire system will be flushed, sealed, and radiation-sterilized. Operation of the device is easy and requires minimal training. Drinking water is placed into the collection bag. Inline stopcock flow valves at the source and collection bags

  4. Hydration and endocrine responses to intravenous fluid and oral glycerol.

    PubMed

    van Rosendal, S P; Strobel, N A; Osborne, M A; Fassett, R G; Coombes, J S

    2015-06-01

    Athletes use intravenous (IV) saline in an attempt to maximize rehydration. The diuresis from IV rehydration may be circumvented through the concomitant use of oral glycerol. We examined the effects of rehydrating with differing regimes of oral and IV fluid, with or without oral glycerol, on hydration, urine, and endocrine indices. Nine endurance-trained men were dehydrated by 4% bodyweight, then rehydrated with 150% of the fluid lost via four protocols: (a) oral = oral fluid only; (b) oral glycerol = oral fluid with added glycerol (1.5 g/kg); (c) IV = 50% IV fluid, 50% oral fluid; and (d) IV with oral glycerol = 50% IV fluid, 50% oral fluid with added glycerol (1.5 g/kg), using a randomized, crossover design. They then completed a cycling performance test. Plasma volume restoration was highest in IV with oral glycerol > IV > oral glycerol  > oral. Urine volume was reduced in both IV trials compared with oral. IV and IV with oral glycerol resulted in lower aldosterone levels during rehydration and performance, and lower cortisol levels during rehydration. IV with oral glycerol resulted in the greatest fluid retention. In summary, the IV conditions resulted in greater fluid retention compared with oral and lower levels of fluid regulatory and stress hormones compared with both oral conditions.

  5. Contamination of intravenous infusion fluid: effects of changing administration sets.

    PubMed

    Buxton, A E; Highsmith, A K; Garner, J S; West, C M; Stamm, W E; Dixon, R E; McGowan, J E

    1979-05-01

    Daily change of intravenous (i.v.) infusion administration sets has been recommended by the Center for Disease Control since 1973 to reduce the risk of infusion bacteremia. To evaluate this recommendation, we undertook a prospective, randomized, controlled trial that compared the rates of i.v.-associated bacteremia, in-use i.v. fluid contamination, and phlebitis in 300 patients whose administration sets were changed every 24 h with those in 300 patients whose administration sets were changed every 48 h. No i.v.-associated bacteremia occurred. Twelve of 600 infusions (2%) had positive infusion-fluid cultures: five in one group and seven in the other. Both groups had comparable rates of phlebitis. In this study population with low rates of fluid contamination, no benefit accrued from changing the administration sets every 24 h instead of every 48 h. In hospitals with low rates of fluid contamination, the routine changing of i.v. administration sets every 48 h will result in substantial financial savings.

  6. Final Report for Intravenous Fluid Generation (IVGEN) Spaceflight Experiment

    NASA Technical Reports Server (NTRS)

    McQuillen, John B.; McKay, Terri L.; Griffin, DeVon W.; Brown, Dan F.; Zoldak, John T.

    2011-01-01

    NASA designed and operated the Intravenous Fluid Generation (IVGEN) experiment onboard the International Space Station (ISS), Increment 23/24, during May 2010. This hardware was a demonstration experiment to generate intravenous (IV) fluid from ISS Water Processing Assembly (WPA) potable water using a water purification technique and pharmaceutical mixing system. The IVGEN experiment utilizes a deionizing resin bed to remove contaminants from feedstock water to a purity level that meets the standards of the United States Pharmacopeia (USP), the governing body for pharmaceuticals in the United States. The water was then introduced into an IV bag where the fluid was mixed with USP-grade crystalline salt to produce USP normal saline (NS). Inline conductivity sensors quantified the feedstock water quality, output water purity, and NS mixing uniformity. Six 1.5-L bags of purified water were produced. Two of these bags were mixed with sodium chloride to make 0.9 percent NS solution. These two bags were returned to Earth to test for compliance with USP requirements. On-orbit results indicated that all of the experimental success criteria were met with the exception of the salt concentration. Problems with a large air bubble in the first bag of purified water resulted in a slightly concentrated saline solution of 117 percent of the target value of 0.9 g/L. The second bag had an inadequate amount of salt premeasured into the mixing bag resulting in a slightly deficient salt concentration of 93.8 percent of the target value. The USP permits a range from 95 to 105 percent of the target value. The testing plans for improvements for an operational system are also presented.

  7. Intravenous fluids: should we go with the flow?

    PubMed Central

    2015-01-01

    Sensitive monitoring should be used when prescribing intravenous fluids for volume resuscitation. The extent and duration of tissue hypoperfusion determine the severity of cellular damage, which should be kept to a minimum with timely volume substitution. Optimizing the filling status to normovolaemia may boost the resuscitation success. Macrocirculatory pressure values are not sensitive in this indication. While the Surviving Sepsis Campaign guidelines focus on these conventional pressure parameters, the guidelines from the European Society of Anaesthesiology (ESA) on perioperative bleeding management recommend individualized care by monitoring the actual volume status and correcting hypovolaemia promptly if present. The motto is: 'give what is missing'. The credo of the ESA guidelines is to use management algorithms with predefined intervention triggers. Stop signals should help in avoiding hyper-resuscitation. The high-quality evidence-based S3 guidelines on volume therapy in adults have recently been prepared by 14 German scientific societies. Statements include, for example, repeated clinical inspection including turgor of the skin and mucosa. Adjunctive laboratory parameters such as central venous oxygen saturation, lactate, base excess and haematocrit should be considered. The S3 guidelines propose the use of flow-based and/or dynamic preload parameters for guiding volume therapy. Fluid challenges and/or the leg-raising test (autotransfusion) should be performed. The statement from the Co-ordination group for Mutual Recognition and Decentralized Procedures--Human informs healthcare professionals to consider applying individualized medicine and using sensitive monitoring to assess hypovolaemia. The authorities encourage a personalized goal-directed volume resuscitation technique. PMID:26728428

  8. Concentration guidelines for parenteral antibiotics in fluid-restricted patients.

    PubMed

    Robinson, D C; Cookson, T L; Grisafe, J A

    1987-12-01

    A guideline for the preparation of peripherally administered antibiotics in fluid-restricted patients was developed. A maximum osmolality of 560 mOsmol/kg was selected since this corresponds to the theoretical osmolality of dextrose 5% in NaCl 0.9%, a solution commonly administered peripherally without significant incidence of phlebitis. Percentage concentrations corresponding to 560 mOsmol/kg of 26 intravenous antibiotics were calculated using sodium chloride equivalents. The antibiotics were reconstituted using sterile water, dextrose 5%, and NaCl 0.9% to provide an osmolality of 560 mOsmol/kg. The resulting solutions were measured for osmolality using a freezing-point depression osmometer. A total of 78 solutions were prepared and measured in triplicate. Of the 78 measured osmolalities, 67 (86 percent) were within 20 percent of the desired 560 mOsmol/kg. Only two osmolalities were more than 10 percent above the projected value. The percentage concentrations of 26 antibiotics in three solutions corresponding to 560 mOsmol/kg are presented. A method is also provided for tailoring concentrations to achieve desired osmolalities other than 560 mOsmol/kg.

  9. Personal paths of fluid restriction in patients on hemodialysis.

    PubMed

    Tovazzi, Maria Elena; Mazzoni, Valentina

    2012-01-01

    The aim of this study was to explore the perspectives of patients on hemodialysis about their experience of fluid restriction. Qualitative interviews were conducted to grasp the patients' lived experience, and from a phenomenological analysis, several categories emerged that describe patients' understanding. Three themes in particular from patients' experiences are described and discussed because of their relevance for health professionals. These include (a) fluid restriction introduces the perception of individuals to see themselves as addicts who deal with a constant inner conflict, (b) the difficulty in finding the right boundaries between common sense and scientific knowledge about fluid restriction, and (c) the role of personal motivations and willingness in pursuit of compliance. Recognizing the force of personal meaning for individuals with renal disease will support health professionals to help patients in pursuing the regime of fluid restriction. PMID:22866360

  10. Intravenous fluid flow meter concept for zero gravity environment

    NASA Technical Reports Server (NTRS)

    Miller, C. G.

    1972-01-01

    Measuring chamber, included in infusion-set tubing, and peristaltic flow meter concept can be incorporated into flow meter that measures fluid flow rates between 100 and 600 cu cm per hour and at the same time maintains sterilization.

  11. [Azlocillin--synovial fluid levels after intravenous doses].

    PubMed

    Härle, A; Ritzerfeld, W; Wiynck, G; Knoche, U

    1983-01-01

    The corresponding levels of azlocillin in serum and in synovial fluid in the knee-joint were investigated in patients who had undergone aseptic surgery of the lower limbs. The mean synovial fluid concentrations for azlocillin were determined on the basis of 30 samples. Clinically relevant azlocillin levels of approximately 40 mu g/ml were recorded in synovial fluid 10 minutes after start of a short infusion of 5 gm. These increased until about 90 minutes after commencement of antibiotic administration when the maximum level was attained. Subsequently synovial fluid levels decreased slowly and approximately 170 minutes after commencement of the short infusion the mean for serum and synovial concentrations corresponded. The results confirm that with an i.v. infusion of 5 g azlocillin levels can be attained for 3 hours in the synovial fluid that are above the break-point for this antibiotic of 64 mu g/ml. However, despite these good pharmacokinetic data it should be remembered that experience has shown that surgical reintervention is often necessary in addition in joint infections to achieve ultimate cure. PMID:6405553

  12. Intravenous Fluid Therapy in Traumatic Brain Injury and Decompressive Craniectomy

    PubMed Central

    Alvis-Miranda, Hernando Raphael; Castellar-Leones, Sandra Milena; Moscote-Salazar, Luis Rafael

    2014-01-01

    The patient with head trauma is a challenge for the emergency physician and for the neurosurgeon. Currently traumatic brain injury constitutes a public health problem. Knowledge of the various supportive therapeutic strategies in the pre-hospital and pre-operative stages is essential for optimal care. The immediate rapid infusion of large volumes of crystalloids to restore blood volume and blood pressure is now the standard treatment of patients with combined traumatic brain injury (TBI) and hemorrhagic shock (HS). The fluid in patients with brain trauma and especially in patients with brain injur y is a critical issue. In this context we present a review of the literature about the history, physiology of current fluid preparations, and a discussion regarding the use of fluid therapy in traumatic brain injury and decompressive craniectomy. PMID:27162857

  13. Acute kidney injury: intravenous fluid to prevent contrast-induced AKI.

    PubMed

    Weisbord, Steven D; Palevsky, Paul M

    2009-05-01

    Trials that compared sodium bicarbonate and sodium chloride for the prevention of contrast-induced acute kidney injury have yielded highly conflicting results. The authors of a recent meta-analysis endeavored to provide a definitive assessment of the relative efficacy of these two intravenous fluids.

  14. An inventory model for optimizing purchasing of intravenous fluids for hospitals: a case study.

    PubMed

    Kwak, N K; Durbin, E; Stanley, D

    1991-04-01

    This paper deals with determining the optimal level of purchase of intravenous fluids for hospitals by utilizing inventory control concepts. Using the conceptual framework of the economic order quantity (EOQ) model, the hospital administrators can elicit the efficient materials management, thus reducing both the space and capital requirements without compromising the quality of services rendered.

  15. Restricting oral fluid and food intake during labour

    PubMed Central

    Singata, Mandisa; Tranmer, Joan; Gyte, Gillian ML

    2014-01-01

    Background Restricting fluids and foods during labour is common practice across many birth settings with some women only being allowed sips of water or ice chips. Restriction of oral intake may be unpleasant for some women, and may adversely influence their experience of labour. Objectives To determine the benefits and harms of oral fluid or food restriction during labour. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (April 2009). Selection criteria Randomised controlled trials (RCTs) and quasi-RCTs of restricting fluids and food for women in labour compared with women free to eat and drink. Data collection and analysis Two authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction. Main results We identified five studies (3130 women). All studies looked at women in active labour and at low risk of potentially requiring a general anaesthetic. One study looked at complete restriction versus giving women the freedom to eat and drink at will; two studies looked at water only versus giving women specific fluids and foods and two studies looked at water only versus giving women carbohydrate drinks. When comparing any restriction of fluids and food versus women given some nutrition in labour, the meta-analysis was dominated by one study undertaken in a highly medicalised environment. There were no statistically significant differences identified in: caesarean section (average risk ratio (RR) 0.89, 95% confidence interval (CI) 0.63 to 1.25, five studies, 3103 women), operative vaginal births (average RR 0.98, 95% CI 0.88 to 1.10, five studies, 3103 women) and Apgar scores less than seven at five minutes (average RR 1.43, 95% CI 0.77 to 2.68, three studies, 2574 infants), nor in any of the other outcomes assessed. Women’s views were not assessed. The pooled data were insufficient to assess the incidence of Mendelson’s syndrome, an extremely rare outcome. Other comparisons

  16. Cerebrospinal fluid passage of intravenous magnesium sulfate in neurosurgical patients.

    PubMed

    Fuchs-Buder, T; Tramèr, M R; Tassonyi, E

    1997-10-01

    Increasing evidence suggests a neuroprotective potential of magnesium sulfate (MgSO4). Only limited information about the passage of MgSO4 to the cerebrospinal fluid (CSF) is available in neurosurgical patients. However, with regard to the clinical relevance of magnesium's neuroprotective properties, quantitative data about its CSF passage are needed. The present study aims to assess the amount and the time course of magnesium's CSF passage in neurosurgical patients. To this end, 20 patients undergoing general anesthesia for neurosurgery and needing CSF drainage were included. Patients received an i.v. bolus of 60 mg/kg MgSO4. The increase in plasma and CSF magnesium concentration were measured 30, 90, and 240 min after the end of the MgSO4 infusion. These values were compared with the baseline levels taken before the start of the MgSO4 infusion. Thus, each patient served as his or her own control. Values are expressed as means +/- SD. The plasma magnesium levels were measured as follows: baseline, 0.74 +/- 0.12 mM; at 30 min, 1.24 +/- 0.1 mM (p < 0.01); at 90 min, 0.95 +/- 0.15 mM (p < 0.01), and at 240 min, 0.82 +/- 0.14 mM (p < 0.05). The CSF magnesium levels were measured as follows: baseline, 0.95 +/- 0.11 mM; at 30 min, 1.00 +/- 0.15 mM (NS); at 90 min, 1.10 +/- 0.17 mM (p < 0.01); and at 240 min, 1.13 +/- 0.19 mM (p < 0.001). We concluded that a bolus of 60 mg/kg of MgSO4 leads at least after 90 min to a significant increase in the CSF magnesium concentration. Moreover, the increase in plasma and CSF magnesium concentration is not parallel. Thus, plasma magnesium concentration cannot be used to predict the changes in CSF concentrations.

  17. Glutamine-enriched intravenous feedings attenuate extracellular fluid expansion after a standard stress.

    PubMed Central

    Scheltinga, M R; Young, L S; Benfell, K; Bye, R L; Ziegler, T R; Santos, A A; Antin, J H; Schloerb, P R; Wilmore, D W

    1991-01-01

    A double-blind, randomized controlled trial was performed to determine the effect of glutamine (GLN)-enriched intravenous feedings on the volume and distribution of body fluids in catabolic patients. Subjects with hematologic malignancies in remission underwent a standard treatment of high-dose chemotherapy and total body irradiation before bone marrow transplantation. After completion of this regimen, they were randomized to receive either standard parenteral nutrition (STD, n = 10) or an isocaloric, isonitrogenous nutrient solution enriched with crystalline L-glutamine (0.57 g/kg/day, GLN, n = 10). Extracellular water (ECW) and total body water (TBW), determined by bromide and heavy water dilution techniques, were measured before the conditioning treatment and after termination of the intravenous feedings that were administered for 27 +/- 1 days. In addition electrical resistance (R, in ohms, omega) and reactance (Xc, omega) of the body to a weak alternating current were measured at these time points. Both study groups were comparable for age, weight, height, sex, and diagnosis. Initial TBW was highly related to electrical resistance (r = -0.93, p less than 0.001). After conditioning therapy, bone marrow infusion, and intravenous feedings, a 20% expansion in ECW was observed in the STD group (ECW: 18.0 +/- 1.1 L vs. 14.9 +/- 1.0, p = 0.012), and this fluid retention was associated with a marked decrease in electrical resistance (R: 514 +/- 28 omega vs. 558 +/- 26, p less than 0.05). In contrast the extracellular fluid compartment in patients receiving GLN-supplementation did not change (ECW: 15.8 +/- 0.9 L vs. 15.4 +/- 0.8, p = 0.49), and the body's resistance was maintained (R: 552 +/- 27 omega vs. 565 +/- 23, p = 0.42). Expansion of ECW could not be related to differences in fluid or sodium intake, or to the use of diuretics or steroids. Patients receiving the STD solution, however, exhibited a greater number of positive microbial cultures (p less than 0

  18. Use of cold intravenous fluid to induce hypothermia in a comatose child after cardiac arrest due to a lightning strike.

    PubMed

    Kim, Young-Min; Jeong, Ju-Hwan; Kyong, Yeon-Young; Kim, Han-Joon; Kim, Ji-Hoon; Park, Jeong-Ho; Park, Kyu-Nam

    2008-11-01

    We report a case in which mild hypothermia was induced successfully using a cold intravenous fluid infusion in a 12-year-old boy who was comatose following 21 min of cardiac arrest caused by a lightning strike. PMID:18805616

  19. Fluid and electrolyte balance during 24-hour fluid and/or energy restriction.

    PubMed

    James, Lewis J; Shirreffs, Susan M

    2013-12-01

    Weight categorized athletes use a variety of techniques to induce rapid weight loss (RWL) in the days leading up to weigh in. This study examined the fluid and electrolyte balance responses to 24-hr fluid restriction (FR), energy restriction (ER) and fluid and energy restriction (F+ER) compared with a control trial (C), which are commonly used techniques to induce RWL in weight category sports. Twelve subjects (six male, six female) received adequate energy and water (C) intake, adequate energy and restricted water (~10% of C; FR) intake, restricted energy (~25% of C) and adequate water (ER) intake or restricted energy (~25% of C) and restricted (~10% of C) water intake (F+ER) in a randomized counterbalanced order. Subjects visited the laboratory at 0 hr, 12 hr, and 24 hr for blood and urine sample collection. Total body mass loss was 0.33% (C), 1.88% (FR), 1.97% (ER), and 2.44% (F+ER). Plasma volume was reduced at 24 hr during FR, ER, and F+ER, while serum osmolality was increased at 24 hr for FR and F+ER and was greater at 24 hr for FR compared with all other trials. Negative balances of sodium, potassium, and chloride developed during ER and F+ER but not during C and FR. These results demonstrate that 24 hr fluid and/ or energy restriction significantly reduces body mass and plasma volume, but has a disparate effect on serum osmolality, resulting in hypertonic hypohydration during FR and isotonic hypohydration during ER. These findings might be explained by the difference in electrolyte balance between the trials.

  20. Randomized study of intravenous fluid preload before epidural analgesia during labour.

    PubMed

    Kinsella, S M; Pirlet, M; Mills, M S; Tuckey, J P; Thomas, T A

    2000-08-01

    We performed a randomized controlled trial of the effect of intravenous fluid preload on maternal hypotension and fetal heart rate (FHR) changes in labour after the first epidural injection. Group 1 (49 women) received 1 litre of crystalloid preload. Group 2 (46 women) received no preload. No statistically significant difference was shown between the two groups for either of the outcomes. Hypotension was found in three women in group 1 and five in group 2 (P = 0.4). Deterioration in FHR pattern was found in four women in group 1 and 11 in group 2 (P = 0.08). This study has not shown a significant increase in the incidence of hypotension when intravenous preload is omitted before epidural analgesia using a low concentration of bupivacaine during labour. Because of the clinical importance of the difference in the rate of FHR deterioration between the two groups, we continue to administer preload for high-risk cases.

  1. Randomized study of intravenous fluid preload before epidural analgesia during labour.

    PubMed

    Kinsella, S M; Pirlet, M; Mills, M S; Tuckey, J P; Thomas, T A

    2000-08-01

    We performed a randomized controlled trial of the effect of intravenous fluid preload on maternal hypotension and fetal heart rate (FHR) changes in labour after the first epidural injection. Group 1 (49 women) received 1 litre of crystalloid preload. Group 2 (46 women) received no preload. No statistically significant difference was shown between the two groups for either of the outcomes. Hypotension was found in three women in group 1 and five in group 2 (P = 0.4). Deterioration in FHR pattern was found in four women in group 1 and 11 in group 2 (P = 0.08). This study has not shown a significant increase in the incidence of hypotension when intravenous preload is omitted before epidural analgesia using a low concentration of bupivacaine during labour. Because of the clinical importance of the difference in the rate of FHR deterioration between the two groups, we continue to administer preload for high-risk cases. PMID:10992845

  2. Medical Grade Water Generation for Intravenous Fluid Production on Exploration Missions

    NASA Technical Reports Server (NTRS)

    Niederhaus, Charles E.; Barlow, Karen L.; Griffin, DeVon W.; Miller, Fletcher J.

    2008-01-01

    This document describes the intravenous (IV) fluids requirements for medical care during NASA s future Exploration class missions. It further discusses potential methods for generating such fluids and the challenges associated with different fluid generation technologies. The current Exploration baseline mission profiles are introduced, potential medical conditions described and evaluated for fluidic needs, and operational issues assessed. Conclusions on the fluid volume requirements are presented, and the feasibility of various fluid generation options are discussed. A separate report will document a more complete trade study on the options to provide the required fluids.At the time this document was developed, NASA had not yet determined requirements for medical care during Exploration missions. As a result, this study was based on the current requirements for care onboard the International Space Station (ISS). While we expect that medical requirements will be different for Exploration missions, this document will provide a useful baseline for not only developing hardware to generate medical water for injection (WFI), but as a foundation for meeting future requirements. As a final note, we expect WFI requirements for Exploration will be higher than for ISS care, and system capacity may well need to be higher than currently specified.

  3. Investigating the impact of clinical anaesthetic practice on bacterial contamination of intravenous fluids and drugs.

    PubMed

    Mahida, N; Levi, K; Kearns, A; Snape, S; Moppett, I

    2015-05-01

    Syringes (N = 426), ventilator machine swabs (N = 202) and intravenous (IV) fluid administration sets (N = 47) from 101 surgical cases were evaluated for bacterial contamination. Cultures from the external surface of syringe tips and syringe contents were positive in 46% and 15% of cases, respectively. The same bacterial species was cultured from both ventilator and syringe in 13% of cases, and was also detected in the IV fluid administration set in two cases. A significant association was found between emergency cases and contaminated syringes (odds ratio 4.5, 95% confidence interval 1.37-14.8; P = 0.01). Other risk factors included not using gloves and failure to cap syringes. PMID:25648939

  4. Intravenous magnesium sulphate effect on maternal serum and amniotic fluid cytokines levels in preterm labour patients.

    PubMed

    Mezad, Daphna; Hallak, Mordechai; Huleihel, Mahmoud; Gortzak-Uzan, Limor; Smolin, Ana; Mazor, Moshe

    2002-12-01

    Our objective was to evaluate the effect of intravenous magnesium sulphate administration to patients with preterm labour on maternal serum and amniotic fluid IL-1beta, IL-6, IL-10 and TNFalpha concentrations. Thirty-six patients at 24-34 weeks of singleton gestation, who presented with contractions (> or = 8 in 60 min) had amniocentesis to rule out intrauterine infection. The patients received intravenous MgSO4 for tocolysis. Twenty-six patients had amniocentesis performed before initiation of MgSO4 (controls) while 10 others had the procedure during tocolytic therapy (study patients). Magnesium, IL-1beta, IL-6, TNFalpha and IL-10 concentrations were measured. Study and control groups were statistically compared using Student t test. Mean magnesium levels were significantly higher in the study group (P < 0.01). There were no significant differences between the cytokines levels in maternal serum and in amniotic fluid between the groups. Our results suggest that the mechanism of magnesium as a tocolytic agent may not be mediated via the examined cytokines. PMID:12635880

  5. Effects on health of fluid restriction during fasting in Ramadan.

    PubMed

    Leiper, J B; Molla, A M; Molla, A M

    2003-12-01

    During the 9th month (Ramadan) of the Islamic calendar (Hijra) many millions of adult Muslims all over the world fast during the daylight hours. Since Hijra is a lunar calendar, Ramadan occurs at different times in the seasonal year over a 33-year cycle. Fasting during Ramadan is partial because the abstention from food, fluid, tobacco and caffeine is from sunrise to sunset. Several categories of people are exempt or can postpone the Ramadan fast. The effect on health and well being of the month-long intermittent fast and fluid restriction has been studied in various potentially vulnerable groups in addition to normal healthy individuals in many countries. The majority of the studies have found significant metabolic changes, but few health problems arising from the fast. A reduction in drug compliance was an inherent negative aspect of the fast. Common findings of the studies reviewed were increased irritability and incidences of headaches with sleep deprivation and lassitude prevalent. A small body mass loss is a frequent, but not universal, outcome of Ramadan. During the daylight hours of Ramadan fasting, practising Muslims are undoubtedly dehydrating, but it is not clear whether they are chronically hypohydrated during the month of Ramadan. No detrimental effects on health have as yet been directly attributed to negative water balance at the levels that may be produced during Ramadan. PMID:14681711

  6. Evaluation of the effectiveness of an intravenous line and fluid bottle fixation design.

    PubMed

    Chiou, Piao-Yi; Chien, Chih-Yin; Shiu, Ting-Ru; Lin, Pei-Jiun; Lin, Wan-Yu; Jiang, Yi-Rung

    2015-01-01

    It's important to improve the stability of intravenous (IV) lines and bottles during patient activity and nursing care. We developed an intravenous line and fluid bottle fixation design (ILFBFD) which includes a bottle retaining clip and line fixation kit. We randomly assigned 60 participants each to the experimental and control groups. Participants were asked to push an IV stand without and with ILFBFD 11 meters on uneven pavement and a sloping floor. The distance the IV bottle moved was recorded. Self-administered questionnaires were used to collect the opinions of the participants. Use of ILFBFD, resulted in less movement in the anteroposterior and left/right directions (differences of 46.98 cm2, t= 12.80, p < 0.000 and 39.24 cm2, t= 8.01, p< 0.000, respectively) compared with not using ILFBFD. The average scores for bottle movement when participants walked on a flat floor, uneven pavement and sloping floor, IV line tangling and dropping, and organization of Liv lines were significantly better in those using than not using ILFBFD. The results can be used in clinical practice to reduce knotting of IV lines, and to enhance the safety and quality of patient care. PMID:26409547

  7. Maji: A New Tool to Prevent Overhydration of Children Receiving Intravenous Fluid Therapy in Low-Resource Settings

    PubMed Central

    Shah, Kamal; Skerrett, Erica; Nojoomi, Matthew; Walker, Thor; Maynard, Kelley; Pan, Michael; Flynn, Bailey; Yuan, Melissa; Horton, Paige; Vaughn, Taylor; Miros, Robert; Molyneux, Elizabeth; Saterbak, Ann; Oden, Z Maria; Richards-Kortum, Rebecca

    2015-01-01

    We designed and evaluated the accuracy and usability of a device to regulate the volume of fluid dispensed during intravenous drip therapy. The mechanical system was developed in response to a pressing need articulated by clinicians in pediatric wards throughout sub-Saharan Africa, who require a tool to prevent overhydration in children receiving intravenous fluid in settings that lack burettes or electronic infusion pumps. The device is compatible with most intravenous bags and limits the volume dispensed to a preset amount that can be adjusted in 50 mL increments. Laboratory accuracy over a range of clinically-relevant flow rates, initial bag volumes, and target volumes was within 12.0 mL of the target volume. The ease of use is “excellent,” with a mean system usability score of 84.4 out of 100. Use of the device limits the volume of fluid dispensed during intravenous therapy and could potentially reduce the morbidity and mortality associated with overhydration in children receiving intravenous therapy. PMID:25732685

  8. Intravenous Fluid Mixing in Normal Gravity, Partial Gravity, and Microgravity: Down-Selection of Mixing Methods

    NASA Technical Reports Server (NTRS)

    Niederhaus, Charles E.; Miller, Fletcher J.

    2008-01-01

    The missions envisioned under the Vision for Space Exploration will require development of new methods to handle crew medical care. Medications and intravenous (IV) fluids have been identified as one area needing development. Storing certain medications and solutions as powders or concentrates can both increase the shelf life and reduce the overall mass and volume of medical supplies. The powders or concentrates would then be mixed in an IV bag with Sterile Water for Injection produced in situ from the potable water supply. Fluid handling in microgravity is different than terrestrial settings, and requires special consideration in the design of equipment. This document describes the analyses and down-select activities used to identify the IV mixing method to be developed that is suitable for ISS and exploration missions. The chosen method is compatible with both normal gravity and microgravity, maintains sterility of the solution, and has low mass and power requirements. The method will undergo further development, including reduced gravity aircraft experiments and computations, in order to fully develop the mixing method and associated operational parameters.

  9. Intravenous therapy

    PubMed Central

    Waitt, C; Waitt, P; Pirmohamed, M

    2004-01-01

    Intravenous administration of fluids, drugs, and nutrition is very common in hospitals. Although insertion of peripheral and central cannulae and subsequent intravenous therapy are usually well tolerated, complications that prolong hospitalisation, and in some cases cause death, can arise on occasions. Additionally, many cannulae are inserted unnecessarily. This article seeks to review this area and to outline good medical practice. PMID:14760169

  10. Stability studies of lincomycin hydrochloride in aqueous solution and intravenous infusion fluids

    PubMed Central

    Czarniak, Petra; Boddy, Michael; Sunderland, Bruce; Hughes, Jeff D

    2016-01-01

    Purpose The purpose of this study was to evaluate the chemical stability of Lincocin® (lincomycin hydrochloride) in commonly used intravenous fluids at room temperature (25°C), at accelerated-degradation temperatures and in selected buffer solutions. Materials and methods The stability of Lincocin® injection (containing lincomycin 600 mg/2 mL as the hydrochloride) stored at 25°C±0.1°C in sodium lactate (Hartmann’s), 0.9% sodium chloride, 5% glucose, and 10% glucose solutions was investigated over 31 days. Forced degradation of Lincocin® in hydrochloric acid, sodium hydroxide, and hydrogen peroxide was performed at 60°C. The effect of pH on the degradation rate of lincomycin hydrochloride stored at 80°C was determined. Results Lincomycin hydrochloride w as found to maintain its shelf life at 25°C in sodium lactate (Hartmann’s) solution, 0.9% sodium chloride solution, 5% glucose solution, and 10% glucose solution, with less than 5% lincomycin degradation occurring in all intravenous solutions over a 31-day period. Lincomycin hydrochloride showed less rapid degradation at 60°C in acid than in basic solution, but degraded rapidly in hydrogen peroxide. At all pH values tested, lincomycin followed first-order kinetics. It had the greatest stability near pH 4 when stored at 80°C (calculated shelf life of 4.59 days), and was least stable at pH 2 (calculated shelf life of 0.38 days). Conclusion Lincocin® injection was chemically found to have a shelf life of at least 31 days at 25°C when added to sodium lactate (Hartmann’s) solution, 0.9% sodium chloride solution, 5% glucose solution, and 10% glucose solution. Solutions prepared at approximately pH 4 are likely to have optimum stability. PMID:27022242

  11. Systemic Pharmacokinetics and Cerebrospinal Fluid Uptake of Intravenous Ceftriaxone in Patients with Amyotrophic Lateral Sclerosis

    PubMed Central

    Zhao, Yanli; Cudkowicz, Merit E.; Shefner, Jeremy; Krivickas, Lisa; David, William S.; Vriesendorp, Francine; Pestronk, Alan; Caress, James B.; Katz, Jonathan; Simpson, Ericka; Rosenfeld, Jeffrey; Pascuzzi, Robert; Glass, Jonathan; Rezania, Kourosh; Harmatz, Jerold S.; Schoenfeld, David; Greenblatt, David J

    2015-01-01

    The cephalosporin antibiotic ceftriaxone was evaluated as a potential therapeutic agent for the treatment of amyotrophic lateral sclerosis (ALS). The pharmacokinetics (PK) of ceftriaxone in plasma and cerebrospinal fluid (CSF) were investigated in 66 participants in a previously reported clinical trial. Their mean age was 51 years, and 65 % were male. Participants were randomly assigned to one of three treatment groups receiving intravenous infusions (mean duration: 25 minutes) every 12 hours of either: placebo and placebo; 2 grams ceftriaxone and placebo; or 2 grams ceftriaxone twice. Mean steady-state plasma PK variables were: volume of distribution, 14 liters (0.17 liters/kg); elimination half-life, 8 - 9 hours; total clearance, 17-21 mL/min (0.22 - 0.25 mL/min/kg). Values were not different between dosage groups. CSF PK analysis, determined through sparse CSF sampling, indicated apparent entry and elimination half-life values of 1.0 and 34 hours, respectively. With both dosage regimens, CSF concentrations were maintained above the target threshold of 1.0 μM (0.55 μg/mL) as determined from in vitro models. The plasma and CSF PK profile of ceftriaxone were used as a basis for planning the Phase 3 clinical trial of ceftriaxone in ALS. PMID:24771634

  12. Oral fluid cocaine and benzoylecgonine concentrations following controlled intravenous cocaine administration.

    PubMed

    Ellefsen, Kayla N; Concheiro, Marta; Pirard, Sandrine; Gorelick, David A; Huestis, Marilyn A

    2016-03-01

    Limited oral fluid (OF) pharmacokinetic data collected with commercially available collection devices after controlled cocaine administration hinder OF result interpretations. Ten cocaine-using adults provided OF, collected with Oral-Eze(®) (OE) and StatSure Saliva Sampler™ (SS) devices, an hour prior to and up to 69 h after 25mg intravenous (IV) cocaine administration. Cocaine and benzoylecgonine (BE) were quantified by a validated 2D-GC-MS method. Large inter-subject variability was observed. Cocaine was detected in OF in the first 0.17 h sample after IV administration, with much more rapid elimination than BE. OE observed Cmax median (range) concentrations were 932 (394-1574)μg/L for cocaine and 248 (96.9-953)μg/L for BE. SS observed cocaine and BE Cmax median (range) concentrations trended lower at 732 (83.3-1892)μg/L and 360 (77.2-836)μg/L, respectively. OE and SS cocaine OF detection times were 12.5 and 6.5h and for BE 30.5 and 28.0 h, respectively at 1 μg/L. There were no significant pharmacokinetic differences between OE and SS OF collection devices, except cocaine half-life was significantly shorter in SS OF specimens. This difference could be attributed to differences in stabilizing buffers present in OF collection devices, which may affect cocaine stability in OF specimens, or decreased recovery from collection pads. Both OE and SS OF collection devices were effective in monitoring cocaine and metabolite concentrations with similar detection windows. Furthermore, we demonstrated that different confirmatory OF cutoffs can be selected to produce shorter or longer cocaine and metabolite detection windows to address specific needs of clinical and forensic drug testing programs. PMID:26851651

  13. Restricted versus Standard Maintenance Fluid Volume in Management of Transient Tachypnea of Newborn: A Clinical Trial

    PubMed Central

    Dehdashtian, Masoud; Aramesh, Mohammad-Reza; Melekian, Arash; Aletayeb, Mohammad-Hasan; Ghaemmaghami, Anahita

    2014-01-01

    Objective: The incidence of Transient Tachypnea of Newborn (TTN) is higher in infants born by cesarean section than with  vaginal delivery. Treatment of transient tachypnea of newborn is supportive. The purpose of this study was to assess the effect of restricted fluid volume intake on the course of respiratory distress in patients with TTN. Methods: This is a quasi-experimental clinical trial of 83 neonates diagnosed with TTN admitted to a neonatal intensive care unit in south west Iran. In this study the effect of restriction of maintenance fluid volume in the course of respiratory distress in newborns with transient tachypnea was assessed. Findings: In the standard fluid volume intake group 18 (42.8%) cases needed nasal continuous positive airway pressure (NCPAP) and one (2.38%) case mechanical ventilation, and in restricted fluid volume intake group 13 (32.5%) cases needed NCPAP and two (5%) cases mechanical ventilation. 54.82% of cases were supported with oxyhood in the standard fluid volume and 62.5% in the restricted fluid volume intake group. Differences in duration of the needed NCPAP and oxygen hood between the two groups were significant. Fluid restriction had no adverse effect on the urine specific gravity or weight loss of the studied newborns. Conclusion: Limited fluid administered to newborns with transient tachypnea of newborn is safe and resulted in shorter duration of respiratory support. PMID:25793064

  14. Peripheral intravenous line (image)

    MedlinePlus

    A peripheral intravenous line is a small, short plastic catheter that is placed through the skin into a vein, ... or foot, but occasionally in the head. A peripheral intravenous line is used to give fluids and ...

  15. Fluid management in patients with trauma: Restrictive versus liberal approach

    PubMed Central

    Chatrath, Veena; Khetarpal, Ranjana; Ahuja, Jogesh

    2015-01-01

    Trauma is a leading cause of death worldwide, and almost 30% of trauma deaths are due to blood loss. A number of concerns have been raised regarding the advisability of the classic principles of aggressive crystalloid resuscitation in traumatic hemorrhagic shock. Some recent studies have shown that early volume restoration in certain types of trauma before definite hemostasis may result in accelerated blood loss, hypothermia, and dilutional coagulopathy. This review discusses the advances and changes in protocols in fluid resuscitation and blood transfusion for treatment of traumatic hemorrhage shock. The concept of low volume fluid resuscitation also known as permissive hypotension avoids the adverse effects of early aggressive resuscitation while maintaining a level of tissue perfusion that although lower than normal, is adequate for short periods. Permissive hypotension is part of the damage control resuscitation strategy, which targets the conditions that exacerbate hemorrhage. The elements of this strategy are permissive hypotension, minimization of crystalloid resuscitation, control of hypothermia, prevention of acidosis, and early use of blood products to minimize coagulopathy. PMID:26330707

  16. Intravenous Fluid Therapy Course for the Licensed Practical Nurse. Instructor Guide.

    ERIC Educational Resources Information Center

    Missouri Univ., Columbia. Instructional Materials Lab.

    This curriculum guide provides materials for a 10-unit intravenous (IV) therapy course for licensed practical nurses. Units contain from one to nine lessons. The first unit provides an introduction and orientation to the course. Subsequent units concern documentation, anatomy and physiology as applied to IV therapy, fundamental aspects of fluid…

  17. Fluid Restriction and Prophylactic Indomethacin in Extremely Low Birth Weight Infants

    PubMed Central

    Anabrees, Jasim A.; AIFaleh, Khalid M.

    2012-01-01

    Although survival of extremely low birth weight (ELBW) infants dramatically improved over last decades, bronchopulmonary dysplasia (BPD) rate has not changed. The use of indomethacin prophylaxis in ELBW infants results in improved short-term outcomes with no effect on long-term outcomes. The addition of fluid restriction to the indomethacin prophylaxis policy could result in a reduction of BPD and improve long-term survival without neurosensory impairment at 18 months corrected age. To determine the effect of a policy of fluid restriction compared with a policy of no fluid restriction on morbidity and mortality in ELBW infants receiving indomethacin prophylaxis. The standard search strategy for the Cochrane Neonatal Review Group was used. This included search of OVID MEDLINE-National Library of Medicine, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 8, 2011). Additional search included conference proceedings, references in articles, and unpublished data. All randomized or quasi-randomized trials that compared fluid restriction and indomethacin prophylaxis vs. indomethacin prophylaxis alone in ELBW infants were included. Standard methods of the Cochrane Neonatal Review Group were planned to assess the methodological quality of the trials. Review Manager 5 software was planned to be used for statistical analysis. We found no randomized controlled trials to investigate the possible interaction between fluid restriction and indomethacin prophylaxis vs. indomethacin prophylaxis alone in ELBW infants. A well-designed randomized trial is needed to address this question. PMID:24027673

  18. A model for restricted diffusion in complex fluids

    NASA Astrophysics Data System (ADS)

    de Bruyn, John; Wylie, Jonathan

    2014-03-01

    We use a model originally due to Tanner to study the diffusion of tracer particles in complex fluids both analytically and through Monte-Carlo simulations. The model consists of regions through which the particles diffuse freely, separated by membranes with a specified low permeability. The mean squared displacement of the particles calculated from the model agrees well with experimental data on the diffusion of particles in a concentrated colloidal suspension when the membrane permeability is used as an adjustable parameter. Data on a micro-phase-separated polymer system can be well modeled by considering two populations of particles constrained by membranes with different permeabilites. Supported by the Hong Kong Research Grants Council and the Natural Sciences and Engineering Research Council of Canada.

  19. Inadvertent venous air embolism during cesarean section: collapsible intravenous fluid bags without self-sealing outlet have risks. Case report.

    PubMed

    Bakan, Mefkur; Topuz, Ufuk; Esen, Asim; Basaranoglu, Gokcen; Ozturk, Erdogan

    2013-01-01

    The anesthesiologist must be aware of the causes, diagnosis and treatment of venous air embolism and adopt the practice patterns to prevent its occurrence. Although venous air embolism is a known complication of cesarean section, we describe an unusual inattention that causes iatrogenic near fatal venous air embolism during a cesarean section under spinal anesthesia. One of the reasons for using self-collapsible intravenous (IV) infusion bags instead of conventional glass or plastic bottles is to take precaution against air embolism. We also demonstrated the risk of air embolism for two kinds of plastic collapsible intravenous fluid bags: polyvinyl chloride (PVC) and polypropylene-based. Fluid bags without self-sealing outlets pose a risk for air embolism if the closed system is broken down, while the flexibility of the bag limits the amount of air entry. PVC-based bags, which have more flexibility, have significantly less risk of air entry when IV administration set is disconnected from the outlet. Using a pressure bag for rapid infusion can be dangerous without checking and emptying all air from the IV bag.

  20. Inadvertent venous air embolism during cesarean section: Collapsible intravenous fluid bags without self-sealing outlet have risks. Case report.

    PubMed

    Bakan, Mefkur; Topuz, Ufuk; Esen, Asim; Basaranoglu, Gokcen; Ozturk, Erdogan

    2013-01-01

    The anesthesiologist must be aware of the causes, diagnosis and treatment of venous air embolism and adopt the practice patterns to prevent its occurrence. Although venous air embolism is a known complication of cesarean section, we describe an unusual inattention that causes iatrogenic near fatal venous air embolism during a cesarean section under spinal anesthesia. One of the reasons for using self-collapsible intravenous (IV) infusion bags instead of conventional glass or plastic bottles is to take precaution against air embolism. We also demonstrated the risk of air embolism for two kinds of plastic collapsible intravenous fluid bags: polyvinyl chloride (PVC) and polypropylene-based. Fluid bags without self-sealing outlets pose a risk for air embolism if the closed system is broken down, while the flexibility of the bag limits the amount of air entry. PVC-based bags, which have more flexibility, have significantly less risk of air entry when IV administration set is disconnected from the outlet. Using a pressure bag for rapid infusion can be dangerous without checking and emptying all air from the IV bag.

  1. An intelligent flow control system for long term fluid restriction in small animals.

    PubMed

    Zheng, Can; Li, Meihua; Kawada, Toru; Uemura, Kazunori; Inagaki, Masashi; Sugimachi, Masaru

    2013-01-01

    Fluid retention is one of the most common symptoms in patients with chronic heart failure. Although fluid restriction may be a therapeutic strategy, the degree of fluid restriction necessary for the best therapeutic outcome remains unknown partly due to the lack of proper experimental method to restrict water consumption in small animals. The traditional methods that allow animals to access water only in a limited time window or within pre-determined daily volume can be stressful because the animals may become thirsty during the time of water deprivation. To provide a less stressful water restriction paradigm, we designed a feedback-control system of drinking flow to modulate the drinking behavior of small animals. This system consisted of an infrared droplet sensor for monitoring the drinking flow and a computer controlled electric valve to regulate the water availability. A light signal which synchronized with the command for opening the valve was set to establish a conditioned reflex. An animal test indicated that rats were adaptable to a precisely programmed water supply. This system may warrant investigation into the consequences of fluid restriction in chronic experimental animal study. PMID:24110742

  2. An intelligent flow control system for long term fluid restriction in small animals.

    PubMed

    Zheng, Can; Li, Meihua; Kawada, Toru; Uemura, Kazunori; Inagaki, Masashi; Sugimachi, Masaru

    2013-01-01

    Fluid retention is one of the most common symptoms in patients with chronic heart failure. Although fluid restriction may be a therapeutic strategy, the degree of fluid restriction necessary for the best therapeutic outcome remains unknown partly due to the lack of proper experimental method to restrict water consumption in small animals. The traditional methods that allow animals to access water only in a limited time window or within pre-determined daily volume can be stressful because the animals may become thirsty during the time of water deprivation. To provide a less stressful water restriction paradigm, we designed a feedback-control system of drinking flow to modulate the drinking behavior of small animals. This system consisted of an infrared droplet sensor for monitoring the drinking flow and a computer controlled electric valve to regulate the water availability. A light signal which synchronized with the command for opening the valve was set to establish a conditioned reflex. An animal test indicated that rats were adaptable to a precisely programmed water supply. This system may warrant investigation into the consequences of fluid restriction in chronic experimental animal study.

  3. CONDENSED MATTER: STRUCTURAL, MECHANICAL, AND THERMAL PROPERTIES: Gas-Fluid and Fluid-Solid Phase Instability for Restricted Primitive Model

    NASA Astrophysics Data System (ADS)

    Guo, Yuan-Yuan; Chen, Xiao-Song

    2009-08-01

    By considering the fluctuation of grand potential Ω around equilibrium with respect to small one-particle density fluctuations δρα(vec r), the phase instability of restricted primitive model (RPM) of ionic systems is investigated. We use the integral equation theory to calculate the direct correlation functions in the reference hypernetted chain approximation and obtain the spinodal line of RPM. Our analysis explicitly indicates that the gas-fluid phase instability is induced by k = 0 fluctuation mode, while the fluid-solid phase instability is related to k ≠ 0 fluctuation modes. The spinodal line is qualitatively consistent with the result of computer simulations by others.

  4. Fluid intelligence loss linked to restricted regions of damage within frontal and parietal cortex

    PubMed Central

    Woolgar, Alexandra; Parr, Alice; Cusack, Rhodri; Thompson, Russell; Nimmo-Smith, Ian; Torralva, Teresa; Roca, Maria; Antoun, Nagui; Manes, Facundo; Duncan, John

    2010-01-01

    Tests of fluid intelligence predict success in a wide range of cognitive activities. Much uncertainty has surrounded brain lesions producing deficits in these tests, with standard group comparisons delivering no clear result. Based on findings from functional imaging, we propose that the uncertainty of lesion data may arise from the specificity and complexity of the relevant neural circuit. Fluid intelligence tests give a characteristic pattern of activity in posterolateral frontal, dorsomedial frontal, and midparietal cortex. To test the causal role of these regions, we examined fluid intelligence in 80 patients with focal cortical lesions. Damage to each of the proposed regions predicted fluid intelligence loss, whereas damage outside these regions was not predictive. The results suggest that coarse group comparisons (e.g., frontal vs. posterior) cannot show the neural underpinnings of fluid intelligence tests. Instead, deficits reflect the extent of damage to a restricted but complex brain circuit comprising specific regions within both frontal and posterior cortex. PMID:20679241

  5. Absorption, elimination and cerebrospinal fluid concentrations of nimodipine in healthy beagle dogs receiving human intravenous and oral formulation.

    PubMed

    Koskimäki, Janne; Tarkia, Miikka; Ahtola-Sätilä, Tuula; Saloranta, Lasse; Laakso, Aki; Frantzén, Janek

    2016-06-01

    Nimodipine is an L-type calcium channel blocker and is used to treat vasospasm in patients with subarachnoid hemorrhage. Its putative mechanism of action is relaxation of smooth muscle cells in cerebral arteries. In addition, nimodipine may have pleiotropic effects against vasospasm. Systemic hypotension is an adverse effect when patients are treated with oral or intravenous nimodipine. Intracranial administration of nimodipine formulations may produce higher concentration of nimodipine in the cerebrospinal fluid (CSF) than is possible to achieve orally or intravenously, while resulting in lower incidence of systemic hypotension. The aim of this study was to provide information on plasma and CSF levels of nimodipine in beagle dogs as a comparative data for development of experimental intracranial treatment modalities. Plasma levels of nimodipine were measured after current 30 and 60 mg single oral dose of nimodipine (Nimotop(®) 30 mg tablets), a single intravenous bolus 0.72 mg/dog of nimodipine (Nimotop(®) 0.2 mg/ml infusion solution) and CSF levels after 60 mg single oral dose of nimodipine. CSF/Plasma concentration ratio of nimodipine after oral administration of 60 mg at 1 h was 0.013 ± 0.0005. The mean terminal elimination half-life of nimodipine after i.v. bolus dose 0.72 mg was 1.8 h and mean plasma clearance was 40.3 and 3.4 l/h/kg. Absolute bioavailability was 22 %. Maximum plasma concentration and area under the plasma concentration-time curve from time of administration until the last measurable plasma concentration increased in a dose-proportional manner comparing the exposure parameters at oral doses of 30 and 60 mg. Individual variation in the kinetic profile of nimodipine was measured.

  6. Impact of different intravenous fluids on blood glucose levels in nondiabetic patients undergoing elective major noncardiac surgeries

    PubMed Central

    Khetarpal, Ranjana; Chatrath, Veena; Kaur, Jagjit; Bala, Anju; Singh, Harjeet

    2016-01-01

    Background: Intravenous (IV) fluids are an integral part of perioperative management. Intraoperative hyperglycemia is associated with poor clinical outcomes in patients undergoing major surgeries even in nondiabetics. Aim: This study was conducted to observe the effect of different maintenance fluid regimens on intraoperative blood glucose levels in nondiabetic patients undergoing major surgeries under general anesthesia. Settings and Design: Randomized double-blind study. Materials and Methods: One hundred nondiabetic patients of either sex were divided randomly into two Groups I and II of 50 each undergoing elective major surgeries of more than 90 min duration under general anesthesia. Both groups were given calculated dosage of IV fluids accordingly 4-2-1 formula while Group I was given Ringer lactate (RL) and Group II was given 0.45% dextrose normal saline and potassium chloride 20 mmol/L. Changes in vital parameters, % oxygen saturation, and urine output were monitored at regular intervals. Capillary blood glucose (CBG) was measured half-hourly until end of surgery. If CBG level was more than 150 mg%, then calculated dose of human insulin (CBG/100) was given as IV bolus dose. Statistical Analysis: Statistical analysis was done using SPSS 22.0 software (IBM Corporation, Armonk, New York, USA), paired t-test and Chi-square test. Results: A significant increase of CBG level and was observed during intraoperative and immediate postoperative period (P < 0.001) in Group II. Conclusion: RL solution is probably the alternative choice of IV fluid for perioperative maintenance and can be used as replacement fluid in nondiabetic patients undergoing major surgeries. PMID:27746527

  7. [Therapeutic hypothermia after cardiac arrest. A cold intravenous fluid, a cooling helmet and a cooling blanket efficiently reduce body temperature].

    PubMed

    Friberg, Hans; Nielsen, Niklas; Karlsson, Torbjörn; Cronberg, Tobias; Widner, Håkan; Englund, Elisabet; Ersson, Anders

    2004-07-22

    Two controlled randomized trials have shown that mild systemic hypothermia after cardiac arrest is beneficial for neurological outcome and one of the studies shows an improved survival rate. A pilot study was performed to evaluate a model of induced hypothermia after cardiac arrest, using cold intravenous fluids and surface cooling with a cold helmet and a coldwater blanket (Thermowrap). The main purpose was to evaluate our cooling method regarding efficacy, safety and usability. Five unconscious patients after cardiac arrest were treated with induced hypothermia of whom three survived with good recovery to six-month follow up. Two patients died in the ICU without regaining consciousness. There were no adverse events during treatment. We conclude that our method is reasonably fast compared to other published methods, it is easy to perform and it offers a good temperature control during cooling and rewarming. Routines for evaluating prognosis and neurological outcome after cardiac arrest and hypothermia treatment need to be revised. PMID:15314936

  8. Dextrose containing intravenous fluid impairs outcome and increases death after eight minutes of cardiac arrest and resuscitation in dogs.

    PubMed

    D'Alecy, L G; Lundy, E F; Barton, K J; Zelenock, G B

    1986-09-01

    Use of dextrose in intravenous resuscitation fluids is common practice; however, this study indicates that 5% dextrose solutions, even if administered in physiologic quantities, greatly worsens the outcome of survivable cardiac arrest. Twelve adult male mongrel dogs were premedicated with morphine, anesthetized with halothane, instrumented, intubated, and ventilated. Each dog was first given 500 ml of either lactated Ringer's (LR) (n = 6) or 5% dextrose in LR (D5LR) (n = 6). Halothane was stopped and fibrillation was induced (60 Hz). Blood glucose just before cardiac arrest was 129 mg/dl in the LR dogs and was increased to 335 mg/dl in the D5LR dogs. After eight minutes of arrest, resuscitation, including internal cardiac massage and standard advanced cardiac life support drug protocols (modified for dogs), was begun. When stable cardiac rhythm was obtained, the chest was closed, and LR or D5LR continued until a total of 1L was given. A neurologic score (0 = normal to 100 = dead) was assigned at 1, 2, 6, and 24 hours. The LR group did not differ statistically from the D5LR group in operative time, number of defibrillatory shocks, time to spontaneous ventilation, time to extubation, or drugs required. Resuscitation was successful in all six LR and five of six D5LR group; however, by 2 hours after resuscitation and thereafter, D5LR group had a significantly greater neurologic deficit (p less than 0.05) than did the LR group. By 9 hours, four of six D5LR dogs displayed convulsive activity and died. At 24 hours the D5LR group had a greater (p less than 0.008) neurologic deficit (82 +/- 11) than did the LR group (21 +/- 7), which walked and ate. We conclude that the addition of 5% dextrose to standard intravenous fluids greatly increases the morbidity and mortality associated with cardiac resuscitation. PMID:3738770

  9. Effects of large volume, ice-cold intravenous fluid infusion on respiratory function in cardiac arrest survivors.

    PubMed

    Jacobshagen, Claudius; Pax, Anja; Unsöld, Bernhard W; Seidler, Tim; Schmidt-Schweda, Stephan; Hasenfuss, Gerd; Maier, Lars S

    2009-11-01

    International guidelines for cardiopulmonary resuscitation recommend mild hypothermia (32-34 degrees C) for 12-24h in comatose survivors of cardiac arrest. To induce therapeutic hypothermia a variety of external and intravascular cooling devices are available. A cheap and effective method for inducing hypothermia is the infusion of large volume, ice-cold intravenous fluid. There are concerns regarding the effects of rapid infusion of large volumes of fluid on respiratory function in cardiac arrest survivors. We have retrospectively studied the effects of high volume cold fluid infusion on respiratory function in 52 resuscitated cardiac arrest patients. The target temperature of 32-34 degrees C was achieved after 4.1+/-0.5h (cooling rate 0.48 degrees C/h). During this period 3427+/-210 mL ice-cold fluid was infused. Despite significantly reduced LV-function (EF 35.8+/-2.2%) the respiratory status of these patients did not deteriorate significantly. On intensive care unit admission the mean PaO(2) was 231.4+/-20.6 mmHg at a F(i)O(2) of 0.82+/-0.03 (PaO(2)/F(i)O(2)=290.0+/-24.1) and a PEEP level of 7.14+/-0.31 mbar. Until reaching the target temperature of fluid is an effective and inexpensive method for inducing therapeutic hypothermia. Resuscitation from cardiac arrest is associated with a deterioration in respiratory function. The infusion of large volumes of cold fluid does not cause a statistically significant further deterioration in respiratory function. A larger, randomized and prospective study is required to assess the efficacy and safety of ice-cold fluid infusion for

  10. Tiludronate concentrations and cytologic findings in synovial fluid after intravenous regional limb perfusion with tiludronate in horses

    PubMed Central

    Hunter, Barbara G.; Larson, Maureen K.

    2015-01-01

    Anecdotal accounts of tiludronate administration via intravenous regional limb perfusion (IVRLP) exist despite a lack of information regarding safety for synovial structures in the perfused area. The objective of this study was to determine whether tiludronate concentrations in synovial structures after IVRLP with low dose (0.5 mg, LDT) or high dose (50 mg, HDT) tiludronate remain below a value demonstrated in vitro to be safe for articular cartilage (<19,000 ng/ml), and to determine effects of tiludronate on synovial fluid cytology variables compared to saline perfused control limbs. Using a randomized controlled experimental study design, horses received IVRLP with LDT (n = 6) or HDT (n = 6) in one forelimb and IVRLP with saline in the contralateral limb. Synovial fluid cytology variables and tiludronate concentrations were evaluated in navicular bursae (NB), and distal interphalangeal (DIP) and metacarpophalangeal (MCP) joints one week before and 30–45 min after IVRLP, and in DIP and MCP joints 24 h after IVRLP. Data were analyzed with 2-way rmANOVA (p < 0.05). Highest measured synovial fluid tiludronate concentrations occurred 30–45 min post-perfusion. Mean tiludronate concentrations were lower in LDT limbs (MCP = 39.6 ± 14.3 ng/ml, DIP = 118.1 ± 66.6 ng/ml, NB = 82.1 ± 30.2 ng/ml) than in HDT limbs (MCP = 3,745.1 ± 1,536.6 ng/ml, DIP = 16,274.0 ± 5,460.2 ng/ml, NB = 6,049.3 ± 1,931.7 ng/ml). Tiludronate concentration was >19,000 ng/ml in DIP joints of two HDT limbs. Tiludronate was measurable only in synovial fluid from HDT limbs 24 h post-perfusion. There were no differences in synovial fluid cytology variables between control and treated limbs. Conclusions. In some horses, IVRLP with HDT may result in synovial fluid concentrations of tiludronate that may have adverse effects on articular cartilage, based on in vitro data. IVRLP with LDT is unlikely to promote articular cartilage degradation. Further studies to determine a safe and effective dose

  11. [Cerebrospinal fluid pressure studies after the intravenous administration of the steroid narcotic, alphaxolone + alphadolone acetate (Althesin)].

    PubMed

    Ekhart, E; List, W F; Vadon, P; Oberbauer, R

    1979-09-30

    The effect of alphaxalon + alphadolon-acetate on cerebrospinal fluid pressure (CSFP), mean arterial blood pressure (MPA), heart rate (BMP) and blood gases was investigated in 18 patients. Cerebral perfusion pressure (CPP) was calculated from the difference MAP minus CSFP. Alphaxalon + alphadolon-acetate lowered the normal CSFP and normalized ketamin induced increase of CSFP. Premedication with alphaxalon + alphadolon-acetate delayed the ketamin induced increase of CSFP, which returned to norm after a second dose of alphaxalon + alphadolon-acetate. This effect was seen despite elevation of pCO2 in all patients breathing spontaneously.

  12. Comparison of the effects of oral hydration and intravenous fluid replacement in adult patients with non-shock dengue hemorrhagic fever in Taiwan.

    PubMed

    Lee, Ing-Kit; Lee, Wen-Huei; Yang, Kuender D; Liu, Jien-Wei

    2010-08-01

    The level of plasma leakage is mild to moderate in patients with non-shock dengue hemorrhagic fever (DHF grade I and grade II), and the necessity of intravenous fluid replacement for these patients remains controversial. We conducted an observational study in adult patients (>18 years) with non-shock DHF admitted to a medical centre in southern Taiwan comparing the effects of oral hydration [group 1 (n=19); age (mean+/-SD) 54.6+/-15.5 years] and intravenous fluid replacement, with a volume of >40ml/kg/day in the first 72h of hospitalization [group 2 (n=30); age 55.9+/-11.6 years]. No significant difference was found in demographics, clinical manifestations, and mean peak level of hematocrit between the two groups. Patients in group 2 had a significantly longer hospital stay compared to those in group 1 (P=0.007), and there was a trend suggesting patients in group 2 were prone to develop pleural effusion and/or pulmonary edema. No difference was found in daily mean pulse pressure, mean hematocrit level, and mean platelet count between the groups for the duration of the 7 days in hospital. All 49 patients survived. Our data suggest that oral hydration may be as effective as intravenous fluid replacement for adults with non-shock DHF and this warrants investigation in a larger series of patients.

  13. The effects of restricted energy and fluid intake on simulated amateur boxing performance.

    PubMed

    Smith, M; Dyson, R; Hale, T; Hamilton, M; Kelly, J; Wellington, P

    2001-06-01

    This study examined the effects of serial reductions in energy and fluid intake on two simulated boxing performances separated by 2 days recovery. Eight amateur boxers (age: 23.6 +/- 3.2 years; height 175 +/- 5 cm; body mass [BM] 73.3 +/- 8.3 kg [Mean +/- SD]) performed two simulated boxing bouts (BB) under normal (N-trial) and restricted (R-trial) diets in a counterbalanced design over 5 days. The trials were separated by a 9-day period of normal dietary behavior (X-trial). BM was recorded on days 1, 3, and 5 of each trial. Simulated bouts of three, 3-min rounds with 1-min recovery were completed on days 3 (BB1) and 5 (BB2) of each 5-day trial. Punching force (N) was recorded from 8 sets of 7 punches by a purpose-built boxing ergometer. Heart rate (fC) was monitored continuously (PE3000 Polar Sports Tester, Kempele, Finland), and blood lactate (BLa) and glucose (BG) were determined 4-min post-performance (2300 StaPlus, YSI, Ohio). Energy and fluid intakes were significantly lower in the R-trial (p < .05). Body mass was maintained during the N-trial but fell 3% (p < .05) during the R-trial. There were no significant differences in end-of-bout fC or post-bout BG, but BLa was higher in the N- than the R-trial (p < .05). R-trial punching forces were 3.2% and 4.6% lower, respectively, compared to the corresponding N-trial bouts, but the differences did not reach statistical significance. These results suggest that energy and fluid restrictions in weight-governed sports do not always lead to a significant decrease in performance, but because of the small sample size and big variations in individual performances, these findings should be interpreted with care.

  14. Fluid electrolyte changes in physically healthy subjects during prolonged restriction of motor activity and daily hyperhydration.

    PubMed

    Zorbas, Y G; Ichinose, M N; Sakagamis, M B

    1993-01-01

    that prolonged restriction of motor activity induced significant changes in fluid, excretion and concentration of electrolytes in plasma, as well as in the rate of their excretion by the kidneys.

  15. MHC restriction of synovial fluid lymphocyte responses to the triggering organism in reactive arthritis. Absence of a class I-restricted response.

    PubMed Central

    Hassell, A B; Pilling, D; Reynolds, D; Life, P F; Bacon, P A; Gaston, J S

    1992-01-01

    Synovial fluid mononuclear cells (SFMC) from patients with reactive arthritis (ReA) show marked proliferative responses to preparations of the organism triggering the arthritis. Initial studies with MHC-specific MoAbs have indicated that a significant element of these proliferative responses is mediated by class II MHC-restricted CD4+ T cells. It is imperative to establish the presence or absence of a class I-restricted response, for two reasons. Firstly, the association of ReA with the MHC class I molecule, HLA B27, raises the possibility of there being a B27-restricted response to the triggering organism. Secondly, a number of the organisms associated with ReA are intracellular pathogens, whose antigens might be expected to be presented by class I MHC molecules. In an effort to identify a class I MHC-restricted pathogen-specific response in the SFMC of ReA patients, we have assessed the proliferative responses of SFMC depleted of CD4+ T cells. Responses were grossly diminished by CD4+ T cell depletion. We also investigated Chlamydia-specific cytotoxicity in the SFMC of patients with sexually acquired ReA in a system using productive chlamydial infection to produce both targets and effectors. Significant antigen specific cytotoxicity was not seen. These experiments do not provide evidence to support the existence of pathogen-specific responses by CD8+, class I-restricted synovial fluid T cells in ReA. PMID:1606728

  16. Effect of External Pressure and Catheter Gauge on Flow Rate, Kinetic Energy, and Endothelial Injury During Intravenous Fluid Administration in a Rabbit Model.

    PubMed

    Hu, Mei-Hua; Chan, Wei-Hung; Chen, Yao-Chang; Cherng, Chen-Hwan; Lin, Chih-Kung; Tsai, Chien-Sung; Chou, Yu-Ching; Huang, Go-Shine

    2016-01-01

    The effects of intravenous (IV) catheter gauge and pressurization of IV fluid (IVF) bags on fluid flow rate have been studied. However, the pressure needed to achieve a flow rate equivalent to that of a 16 gauge (G) catheter through smaller G catheters and the potential for endothelial damage from the increased kinetic energy produced by higher pressurization are unclear. Constant pressure on an IVF bag was maintained by an automatic adjustable pneumatic pressure regulator of our own design. Fluids running through 16 G, 18 G, 20 G, and 22 G catheters were assessed while using IV bag pressurization to achieve the flow rate equivalent to that of a 16 G catheter. We assessed flow rates, kinetic energy, and flow injury to rabbit inferior vena cava endothelium. By applying sufficient external constant pressure to an IVF bag, all fluids could be run through smaller (G) catheters at the flow rate in a 16 G catheter. However, the kinetic energy increased significantly as the catheter G increased. Damage to the venous endothelium was negligible or minimal/patchy cell loss. We designed a new rapid infusion system, which provides a constant pressure that compresses the fluid volume until it is free from visible residual fluid. When large-bore venous access cannot be obtained, multiple smaller catheters, external pressure, or both should be considered. However, caution should be exercised when fluid pressurized to reach a flow rate equivalent to that in a 16 G catheter is run through a smaller G catheter because of the profound increase in kinetic energy that can lead to venous endothelium injury.

  17. Effect of External Pressure and Catheter Gauge on Flow Rate, Kinetic Energy, and Endothelial Injury During Intravenous Fluid Administration in a Rabbit Model.

    PubMed

    Hu, Mei-Hua; Chan, Wei-Hung; Chen, Yao-Chang; Cherng, Chen-Hwan; Lin, Chih-Kung; Tsai, Chien-Sung; Chou, Yu-Ching; Huang, Go-Shine

    2016-01-01

    The effects of intravenous (IV) catheter gauge and pressurization of IV fluid (IVF) bags on fluid flow rate have been studied. However, the pressure needed to achieve a flow rate equivalent to that of a 16 gauge (G) catheter through smaller G catheters and the potential for endothelial damage from the increased kinetic energy produced by higher pressurization are unclear. Constant pressure on an IVF bag was maintained by an automatic adjustable pneumatic pressure regulator of our own design. Fluids running through 16 G, 18 G, 20 G, and 22 G catheters were assessed while using IV bag pressurization to achieve the flow rate equivalent to that of a 16 G catheter. We assessed flow rates, kinetic energy, and flow injury to rabbit inferior vena cava endothelium. By applying sufficient external constant pressure to an IVF bag, all fluids could be run through smaller (G) catheters at the flow rate in a 16 G catheter. However, the kinetic energy increased significantly as the catheter G increased. Damage to the venous endothelium was negligible or minimal/patchy cell loss. We designed a new rapid infusion system, which provides a constant pressure that compresses the fluid volume until it is free from visible residual fluid. When large-bore venous access cannot be obtained, multiple smaller catheters, external pressure, or both should be considered. However, caution should be exercised when fluid pressurized to reach a flow rate equivalent to that in a 16 G catheter is run through a smaller G catheter because of the profound increase in kinetic energy that can lead to venous endothelium injury. PMID:26674456

  18. Fluid restriction during exercise in the heat reduces tolerance to progressive central hypovolaemia

    PubMed Central

    Schlader, Zachary J.; Gagnon, Daniel; Rivas, Eric; Convertino, Victor A.; Crandall, Craig G.

    2016-01-01

    This study tested the hypothesis that dehydration induced via exercise in the heat impairs tolerance to central hypovolaemia. Eleven male subjects (32 ± 7 years old, 81.5 ± 11.1 kg) walked (O2 uptake 1.7 ± 0.4 l min−1) in a 40°C, 30% relative humidity environment on three occasions, as follows: (i) subjects walked for 90 min, drinking water to offset sweat loss (Hydrated, n =11); (ii) water intake was restricted, and exercise was terminated when intestinal temperature increased to the same level as in the Hydrated trial (Isothermic Dehydrated, n = 11); and (iii) water intake was restricted, and exercise duration was 90 min (Time Match Dehydrated, n = 9). For each trial, tolerance to central hypovolaemia was determined following exercise via progressive lower body negative pressure and quantified as time to presyncope. Increases in intestinal temperature prior to lower body negative pressure were not different (P = 0.91) between Hydrated (1.1 ± 0.4°C) and Isothermic Dehydrated trials (1.1 ± 0.4°C), but both were lower than in the Time Match Dehydrated trial (1.7 ± 0.5°C, P < 0.01). Prior to lower body negative pressure, body weight was unchanged in the Hydrated trial (−0.1 ± 0.2%), but was reduced in Isothermic Dehydrated (−0.9 ± 0.4%) and further so in Time Match Dehydrated trial (−1.9 ± 0.6%, all P < 0.01). Time to presyncope was greater in Hydrated (14.7 ± 3.2 min) compared with Isothermic Dehydrated (11.9 ± 3.3 min, P < 0.01) and Time Match Dehydrated trials (10.2 ± 1.6 min, P = 0.03), which were not different (P = 0.19). These data indicate that inadequate fluid intake during exercise in the heat reduces tolerance to central hypovolaemia independent of increases in body temperature. PMID:26096953

  19. Effect of electrolyte addition to rehydration drinks consumed after severe fluid and energy restriction.

    PubMed

    James, Lewis J; Shirreffs, Susan M

    2015-02-01

    This study examined the effect of electrolyte addition to drinks ingested after severe fluid and energy restriction (FER). Twelve subjects (6 male and 6 female) completed 3 trials consisting of 24-hour FER (energy intake: 21 kJ·kg body mass; water intake: 5 ml·kg body mass), followed by a 2-hour rehydration period and a 4-hour monitoring period. During rehydration, subjects ingested a volume of drink equal to 125% of the body mass lost during FER in 6 aliquots, once every 20 minutes. Drinks were a sugar-free lemon squash (P) or the P drink with the addition of 50 mmol·L sodium chloride (Na) or 30 mmol·L potassium chloride (K). Total void urine samples were given before and after FER and every hour during rehydration and monitoring. Over all trials, FER produced a 2.1% reduction in body mass and negative sodium (-67 mmol), potassium (-48 mmol), and chloride (-84 mmol) balances. Urine output after drinking was 1627 (540) ml (P), 1391 (388) ml (K), and 1150 (438) ml (Na), with a greater postdrinking urine output during P than Na (p ≤ 0.05). Ingestion of drink Na resulted in a more positive sodium balance compared with P or K (p < 0.001), whereas ingestion of drink K resulted in a more positive potassium balance compared with P or Na (p < 0.001). These results demonstrate that after 24-hour FER, ingestion of a high sodium drink results in an increased sodium balance that augments greater drink retention compared with a low electrolyte placebo drink.

  20. Effect of electrolyte addition to rehydration drinks consumed after severe fluid and energy restriction.

    PubMed

    James, Lewis J; Shirreffs, Susan M

    2015-02-01

    This study examined the effect of electrolyte addition to drinks ingested after severe fluid and energy restriction (FER). Twelve subjects (6 male and 6 female) completed 3 trials consisting of 24-hour FER (energy intake: 21 kJ·kg body mass; water intake: 5 ml·kg body mass), followed by a 2-hour rehydration period and a 4-hour monitoring period. During rehydration, subjects ingested a volume of drink equal to 125% of the body mass lost during FER in 6 aliquots, once every 20 minutes. Drinks were a sugar-free lemon squash (P) or the P drink with the addition of 50 mmol·L sodium chloride (Na) or 30 mmol·L potassium chloride (K). Total void urine samples were given before and after FER and every hour during rehydration and monitoring. Over all trials, FER produced a 2.1% reduction in body mass and negative sodium (-67 mmol), potassium (-48 mmol), and chloride (-84 mmol) balances. Urine output after drinking was 1627 (540) ml (P), 1391 (388) ml (K), and 1150 (438) ml (Na), with a greater postdrinking urine output during P than Na (p ≤ 0.05). Ingestion of drink Na resulted in a more positive sodium balance compared with P or K (p < 0.001), whereas ingestion of drink K resulted in a more positive potassium balance compared with P or Na (p < 0.001). These results demonstrate that after 24-hour FER, ingestion of a high sodium drink results in an increased sodium balance that augments greater drink retention compared with a low electrolyte placebo drink. PMID:25162651

  1. Disregarded Effect of Biological Fluids in siRNA Delivery: Human Ascites Fluid Severely Restricts Cellular Uptake of Nanoparticles.

    PubMed

    Dakwar, George R; Braeckmans, Kevin; Demeester, Joseph; Ceelen, Wim; De Smedt, Stefaan C; Remaut, Katrien

    2015-11-01

    Small interfering RNA (siRNA) offers a great potential for the treatment of various diseases and disorders. Nevertheless, inefficient in vivo siRNA delivery hampers its translation into the clinic. While numerous successful in vitro siRNA delivery stories exist in reduced-protein conditions, most studies so far overlook the influence of the biological fluids present in the in vivo environment. In this study, we compared the transfection efficiency of liposomal formulations in Opti-MEM (low protein content, routinely used for in vitro screening) and human undiluted ascites fluid obtained from a peritoneal carcinomatosis patient (high protein content, representing the in vivo situation). In Opti-MEM, all formulations are biologically active. In ascites fluid, however, the biological activity of all lipoplexes is lost except for lipofectamine RNAiMAX. The drop in transfection efficiency was not correlated to the physicochemical properties of the nanoparticles, such as premature siRNA release and aggregation of the nanoparticles in the human ascites fluid. Remarkably, however, all of the formulations except for lipofectamine RNAiMAX lost their ability to be taken up by cells following incubation in ascites fluid. To take into account the possible effects of a protein corona formed around the nanoparticles, we recommend always using undiluted biological fluids for the in vitro optimization of nanosized siRNA formulations next to conventional screening in low-protein content media. This should tighten the gap between in vitro and in vivo performance of nanoparticles and ensure the optimal selection of nanoparticles for further in vivo studies.

  2. Intravenous Therapy.

    ERIC Educational Resources Information Center

    Galliart, Barbara

    Intended for teaching licensed practical nurses, this curriculum guide provides information related to the equipment and skills required for nursing care of patients needing intravenous (IV) therapy. It also explains the roles and responsibilities of the licensed practical nurse with regard to intravenous therapy. Each of the 15 instructional…

  3. A rapid infusion pump driven by micro electromagnetic linear actuation for pre-hospital intravenous fluid administration.

    PubMed

    Zhao, Peng; Chong, Yinbao; Zhao, An; Lang, Lang; Wang, Qing; Liu, Jiuling

    2015-02-01

    A rapid infusion pump with a maximum flow rate of 6 L/h was designed experimentally using a micro electromagnetic linear actuator, and its effectiveness was evaluated by comparing with that of a commercial Power Infuser under preset flow rates of 0.2, 2, and 6 L/h. The flow rate, air detection sensitivity, occlusion response time, quantitative determination of hemolysis, and power consumption of the infusion devices were extensively investigated using statistical analysis methods (p < 0.05). The experimental results revealed that the flow rate of the designed infusion pump was more stable and accurate, and the hemolysis was significantly less than that of the Power Infuser. The air detection sensitivity and the power consumption could be comparable to that of the Power Infuser except the occlusion response time. The favorable performance made the designed infusion pump a potential candidate for applications in pre-hospital fluid administration.

  4. Intravenous Solutions for Exploration Missions

    NASA Technical Reports Server (NTRS)

    Miller, Fletcher J.; Niederhaus, Charles; Barlow, Karen; Griffin, DeVon

    2007-01-01

    This paper describes the intravenous (IV) fluids requirements being developed for medical care during NASA s future exploration class missions. Previous research on IV solution generation and mixing in space is summarized. The current exploration baseline mission profiles are introduced, potential medical conditions described and evaluated for fluidic needs, and operational issues assessed. We briefly introduce potential methods for generating IV fluids in microgravity. Conclusions on the recommended fluid volume requirements are presented.

  5. Diffusion-weighted imaging–fluid-attenuated inversion recovery mismatch is associated with better neurologic response to intravenous thrombolytic therapy in acute ischemic stroke patients

    PubMed Central

    Jeong, Jong Yeong; Han, Sang Kuk; Shin, Dong Hyuk; Na, Ji Ung; Lee, Hyun Jung; Choi, Pil Cho; Lee, Jeong Hun

    2015-01-01

    Objective To investigate differences in the effect of intravenous (IV) thrombolysis regarding the mismatch of diffusion-weighted imaging–fluid-attenuated inversion recovery (DWI-FLAIR) among acute ischemic stroke patients who visited the emergency department (ED) within 3 hours from the onset of symptoms. Methods Among ED patients presenting with an acute ischemic stroke between January 2011 and May 2013 at a tertiary hospital, those who underwent magnetic resonance imaging before IV thrombolytic therapy were included in this retrospective study. Patients were divided into DWI-FLAIR mismatch and match groups. National Institutes of Health Stroke Scale (NIHSS) scores obtained initially, 24 hours after thrombolytic therapy, and on discharge, and early neurologic improvement (ENI) and major neurologic improvement (MNI) were compared. Results During the study period, 50 of the 213 acute ischemic stroke patients who presented to the ED were included. The DWI-FLAIR mismatch group showed a statistically significantly greater reduction in NIHSS both at 24 hours after thrombolytic therapy and upon discharge than did the match group (5.5 vs. 1.2, P<0.001; 6.0 vs. 2.3, P<0.01, respectively). Moreover, ENI and MNI were significantly greater for the DWI-FLAIR mismatch group than for the match group (27/36 vs. 2/14, P<0.001; 12/36 vs. 0/14, P=0.012, respectively). Conclusion Among acute ischemic stroke patients who visited the ED within 3 hours from the onset of symptoms, patients who showed DWI-FLAIR mismatch showed a significantly better response to IV thrombolytic therapy than did the DWI-FLAIR match group in terms of neurologic outcome.

  6. Maternal intravenous treatment with either azithromycin or solithromycin clears Ureaplasma parvum from the amniotic fluid in an ovine model of intrauterine infection.

    PubMed

    Miura, Yuichiro; Payne, Matthew S; Keelan, Jeffrey A; Noe, Andres; Carter, Sean; Watts, Rory; Spiller, Owen B; Jobe, Alan H; Kallapur, Suhas G; Saito, Masatoshi; Stock, Sarah J; Newnham, John P; Kemp, Matthew W

    2014-09-01

    Intrauterine infection with Ureaplasma spp. is strongly associated with preterm birth and adverse neonatal outcomes. We assessed whether combined intraamniotic (IA) and maternal intravenous (IV) treatment with one of two candidate antibiotics, azithromycin (AZ) or solithromycin (SOLI), would eradicate intrauterine Ureaplasma parvum infection in a sheep model of pregnancy. Sheep with singleton pregnancies received an IA injection of U. parvum serovar 3 at 85 days of gestational age (GA). At 120 days of GA, animals (n=5 to 8/group) received one of the following treatments: (i) maternal IV SOLI with a single IA injection of vehicle (IV SOLI only); (ii) maternal IV SOLI with a single IA injection of SOLI (IV+IA SOLI); (iii) maternal IV AZ and a single IA injection of vehicle (IV AZ only); (iv) maternal IV AZ and a single IA injection of AZ (IV+IA AZ); or (v) maternal IV and single IA injection of vehicle (control). Lambs were surgically delivered at 125 days of GA. Treatment efficacies were assessed by U. parvum culture, quantitative PCR, enzyme-linked immunosorbent assay, and histopathology. Amniotic fluid (AF) from all control animals contained culturable U. parvum. AF, lung, and chorioamnion from all AZ- or SOLI-treated animals (IV only or IV plus IA) were negative for culturable U. parvum. Relative to the results for the control, the levels of expression of interleukin 1β (IL-1β), IL-6, IL-8, and monocyte chemoattractant protein 2 (MCP-2) in fetal skin were significantly decreased in the IV SOLI-only group, the MCP-1 protein concentration in the amniotic fluid was significantly increased in the IV+IA SOLI group, and there was no significant difference in the histological inflammation scoring of lung or chorioamnion among the five groups. In the present study, treatment with either AZ or SOLI (IV only or IV+IA) effectively eradicated macrolide-sensitive U. parvum from the AF. There was no discernible difference in antibiotic therapy efficacy between IV-only and IV

  7. Restricted access magnetic materials prepared by dual surface modification for selective extraction of therapeutic drugs from biological fluids

    NASA Astrophysics Data System (ADS)

    Wang, Yu; Wang, Yuxia; Chen, Lei; Wan, Qian-Hong

    2012-02-01

    Magnetic porous particles with dual functionality have been prepared by a two-step procedure and evaluated as novel restricted access materials for extraction of therapeutic agents from biological fluids. The magnetic silica particles served as scaffolds were first modified with diol groups, which were then converted to octadecyl esters through reaction with stearoyl chloride. In the second step, the octadecyl esters on the exterior surface were hydrolyzed by the action of lipase to yield magnetic particles with hydrophobic reversed-phase ligands on the inner surface and biocompatible diol groups on the outer surface. The restricted access behavior of the resulting materials was confirmed by differential binding of small molecules such as methotrexate (MTX), leucovorin (LV) and folic acid (FA) relative to bovine serum albumin. While MTX, LV and FA were all bound to the magnetic particles with high affinity, the adsorption of the protein was markedly reduced due to size exclusion effect. The utility of the magnetic particles for sample preparation was tested in solid-phase extraction of MTX, LV and FA from spiked human serum and the effects of the SPE conditions on the recovery of the analytes were systematically studied. Moreover, the magnetic particle-based sample preparation procedure coupled with reversed-phase liquid chromatography analysis was validated in terms of specificity, linearity and reproducibility. The method was shown to be free from interference of endogenous compounds and linear over the concentration range of 0.5-10 μg/mL for the three drugs studied. The limits of detection for the three drugs in serum were in the range of 0.160-0.302 μg/mL. Reproducibility expressed as the RSD of the recovery for ten replicated extractions at three different concentrations was found to be less than 8.93%. With a unique combination of surface functionality with magnetic cores, the restricted access magnetic particles may be adapted in automated and high

  8. A prototype space flight intravenous injection system

    NASA Technical Reports Server (NTRS)

    Colombo, G. V.

    1985-01-01

    Medical emergencies, especially those resulting from accidents, frequently require the administration of intravenous fluids to replace lost body liquids. The development of a prototype space flight intravenous injection system is presented. The definition of requirements, injectable concentrates development, water polisher, reconstitution hardware development, administration hardware development, and prototype fabrication and testing are discussed.

  9. Screening and confirmatory analyses of flunixin in tissues and bodily fluids after intravenous or intramuscular administration to cull dairy cows with or without lipopolysaccharide challenge

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Twenty cull dairy cows (645 ± 83 kg) were treated with 2.2 mg/kg bw flunixin by intravenous (IV) or intramuscular (IM) administration with, or without, exposure to lipopolysaccharide in a two factor balanced design. The usefulness of screening assays to identify violative flunixin levels in a varie...

  10. The relationship between arginine vasopressin levels and hyponatremia following a percutaneous renal biopsy in children receiving hypotonic or isotonic intravenous fluids.

    PubMed

    Kanda, Kyoko; Nozu, Kandai; Kaito, Hiroshi; Iijima, Kazumoto; Nakanishi, Koichi; Yoshikawa, Norishige; Ninchoji, Takeshi; Hashimura, Yuya; Matsuo, Masafumi; Moritz, Michael L

    2011-01-01

    Post-operative hyponatremia is a common complication in children which results from hypotonic fluid administration in the presence of arginine vasopressin (AVP) excess. We evaluated the relationship between the change in serum sodium and AVP levels following percutaneous renal biopsy in children receiving either hypotonic or isotonic fluids. This study was prompted after we encountered a patient who developed near-fatal hyponatremic encephalopathy following a renal biopsy while receiving hypotonic fluids. The relationship between the change in serum sodium and AVP levels was evaluated prior to (T0) and at 5 h (T5) following a percutaneous renal biopsy in 60 children receiving either hypotonic (0.6% NaCl, 90 mEq/L) or isotonic fluids (0.9% NaCl, 154 mEq/L). The proportion of patients with elevated AVP levels post-procedure was similar between those receiving 0.6 or 0.9% NaCl (30 vs. 26%). Patients receiving 0.6% NaCl with elevated AVP levels experienced a fall in serum sodium of 1.9 ± 1.5 mEq/L, whereas those receiving 0.9% NaCl had a rise in serum sodium of 0.85 ± 0.34 mEq/L with no patients developing hyponatremia. There were no significant changes in serum sodium levels in patients with normal AVP concentrations post-procedure in either group. In conclusion, elevated AVP levels were common among our patients following a percutaneous renal biopsy. Isotonic fluids prevented a fall in serum sodium and hyponatremia, while hypotonic fluids did not.

  11. Impact of fluid restriction and ad libitum water intake or an 8% carbohydrate-electrolyte beverage on skill performance of elite adolescent basketball players.

    PubMed

    Carvalho, Pedro; Oliveira, Bruno; Barros, Renata; Padrão, Patricia; Moreira, Pedro; Teixeira, Vitor Hugo

    2011-06-01

    Twelve adolescent athletes underwent, in a crossover-design study, 3 separate 90-min training sessions in the following conditions: no fluid ingestion allowed (NF), ad libitum ingestion of water (W), and ad libitum ingestion of a commercial 8% carbohydrate-electrolyte sports beverage (CSB). After each session athletes performed a set of basketball drills (2-point, 3-point, and free-throw shootout, suicide sprints, and defensive zigzags). Body weight (before and after sessions), rating of perceived exertion (RPE), urine color, and beverage acceptability were determined in each session. Athletes also completed a survey about their knowledge and behaviors regarding hydration and fluid replacement. The percentage of weight loss was significantly higher in NF (2.46% ± 0.87%) than in the other 2 conditions (W, 1.08% ± 0.67%, p = .006; CSB, 0.65% ± 0.62%, p = .001) but also higher in W than CSB (p = .012). RPE was higher in NF (16.8 ± 1.96) than in the W (14.2 ± 1.99, p = .004) and CSB (13.3 ± 2.06, p = .002) trials. Athletes' fluid intake was positively correlated with proper self-reported behaviors (r = .75, p = .005) and knowledge (r = .76, p = .004) about fluid and hydration. In conclusion, fluid restriction during exercise was associated with a greater level of dehydration and increased perceived exertion but had no impact on basketball performance compared with ad libitum drinking of water or a CSB. Athletes with more knowledge about hydration and better self-reported hydration behaviors ingested more fluids during training sessions.

  12. Pharmacokinetics of intravenous linezolid in cerebrospinal fluid and plasma in neurointensive care patients with staphylococcal ventriculitis associated with external ventricular drains.

    PubMed

    Beer, Ronny; Engelhardt, Klaus W; Pfausler, Bettina; Broessner, Gregor; Helbok, Raimund; Lackner, Peter; Brenneis, Christian; Kaehler, Stefan T; Georgopoulos, Apostolos; Schmutzhard, Erich

    2007-01-01

    The pharmacokinetic profile of linezolid in cerebrospinal fluid (CSF) in five neurointensive care patients with staphylococcal ventriculitis was studied. The mean area under concentration-time curve (+/- standard deviation) was 63 +/- 18.9 mg x h/liter, with a CSF-to-plasma ratio of 0.8 +/- 0.3. Times above MIC in CSF were 99.8% and 57.2% for pathogens with MICs of 2 mg/liter and 4 mg/liter, respectively. PMID:17043116

  13. Plasma and interstitial fluid pharmacokinetics of enrofloxacin, its metabolite ciprofloxacin, and marbofloxacin after oral administration and a constant rate intravenous infusion in dogs.

    PubMed

    Bidgood, T L; Papich, M G

    2005-08-01

    Enrofloxacin and marbofloxacin were administered to six healthy dogs in separate crossover experiments as a single oral dose (5 mg/kg) and as a constant rate IV infusion (1.24 and 0.12 mg/h.kg, respectively) following a loading dose (4.47 and 2 mg/kg, respectively) to achieve a steady-state concentration of approximately 1 microg/mL for 8 h. Interstitial fluid (ISF) was collected with an in vivo ultrafiltration device at the same time period as plasma to measure protein unbound drug concentrations at the tissue site and assess the dynamics of drug distribution. Plasma and ISF were analyzed for enrofloxacin, its active metabolite ciprofloxacin, and for marbofloxacin by high performance liquid chromatography (HPLC). Lipophilicity and protein binding of enrofloxacin were higher than for marbofloxacin and ciprofloxacin. Compared to enrofloxacin, marbofloxacin had a longer half-life, higher Cmax, and larger AUC(0-infinity) in plasma and ISF after oral administration. Establishing steady state allowed an assessment of the dynamics of drug concentrations between plasma and ISF. The ISF and plasma-unbound concentrations were similar during the steady-state period despite differences in lipophilicity and pharmacokinetic parameters of the drugs.

  14. Antenatal Corticosteroids and Postnatal Fluid Restriction Produce Differential Effects on AQP3 Expression, Water Handling, and Barrier Function in Perinatal Rat Epidermis

    PubMed Central

    Agren, Johan; Zelenin, Sergey; Svensson, Lill-Britt; Nejsum, Lene N.; Nielsen, Soren; Aperia, Anita; Sedin, Gunnar

    2010-01-01

    Loss of water through the immature skin can lead to hypothermia and dehydration in preterm infants. The water and glycerol channel aquaglyceroporin-3 (AQP3) is abundant in fetal epidermis and might influence epidermal water handling and transepidermal water flux around birth. To investigate the role of AQP3 in immature skin, we measured in vivo transepidermal water transport and AQP3 expression in rat pups exposed to clinically relevant fluid homeostasis perturbations. Preterm (E18) rat pups were studied after antenatal corticosteroid exposure (ANS), and neonatal (P1) rat pups after an 18 h fast. Transepidermal water loss (TEWL) and skin hydration were determined, AQP3 mRNA was quantified by RT-PCR, and in-situ hybridization and immunocytochemistry were applied to map AQP3 expression. ANS resulted in an improved skin barrier (lower TEWL and skin hydration), while AQP3 mRNA and protein increased. Fasting led to loss of barrier integrity along with an increase in skin hydration. These alterations were not paralleled by any changes in AQP3. To conclude, antenatal corticosteroids and early postnatal fluid restriction produce differential effects on skin barrier function and epidermal AQP3 expression in the rat. In perinatal rats, AQP3 does not directly determine net water transport through the skin. PMID:21234324

  15. Intravenous paracetamol (acetaminophen).

    PubMed

    Duggan, Sean T; Scott, Lesley J

    2009-01-01

    Intravenous paracetamol (rINN)/intravenous acetaminophen (USAN) is an analgesic and antipyretic agent, recommended worldwide as a first-line agent for the treatment of pain and fever in adults and children. In double-blind clinical trials, single or multiple doses of intravenous paracetamol 1 g generally provided significantly better analgesic efficacy than placebo treatment (as determined by primary efficacy endpoints) in adult patients who had undergone dental, orthopaedic or gynaecological surgery. Furthermore, where evaluated, intravenous paracetamol 1 g generally showed similar analgesic efficacy to a bioequivalent dose of propacetamol, and a reduced need for opioid rescue medication. In paediatric surgical patients, recommended doses of intravenous paracetamol 15 mg/kg were not significantly different from propacetamol 30 mg/kg for the treatment of pain, and showed equivocal analgesic efficacy compared with intramuscular pethidine 1 mg/kg in several randomized, active comparator-controlled studies. In a randomized, noninferiority study in paediatric patients with an infection-induced fever, intravenous paracetamol 15 mg/kg treatment was shown to be no less effective than propacetamol 30 mg/kg in terms of antipyretic efficacy. Intravenous paracetamol was well tolerated in clinical trials, having a tolerability profile similar to placebo. Additionally, adverse reactions emerging from the use of the intravenous formulation of paracetamol are extremely rare (<1/10 000). [table: see text]. PMID:19192939

  16. Peripheral intravenous line - infants

    MedlinePlus

    PIV - infants; Peripheral IV - infants; Peripheral line - infants; Peripheral line - neonatal ... A peripheral intravenous line (PIV) is a small, short, plastic tube, called a catheter. A health care provider puts ...

  17. Intravenous cannula site management.

    PubMed

    Brooks, Nicola

    2016-08-24

    Intravenous cannulation is becoming one of the most common procedures in healthcare as increasing numbers of patients are treated for acute and chronic illnesses. The use of an intravenous cannula is not without risk, so it is essential that the healthcare practitioner can justify why the patient requires cannulation, as well as being able to safely manage and provide ongoing care for patients with the device. This article provides an overview of intravenous cannulation, including the selection of appropriate cannulation sites, identification of the different types and sizes of cannula used, and cannula maintenance. Specific complications related to intravenous cannulation are discussed and guidance is given on how to recognise and avoid potential complications to ensure that practice is safe and effective. PMID:27641593

  18. Fluid management in pre-eclampsia

    PubMed Central

    Schoeman, Leann K

    2013-01-01

    Intravenous fluid given to women with pre-eclampsia may be a necessary form of treatment; however, intravenous fluid therapy can also cause iatrogenic pulmonary oedema. The indications for the use of intravenous fluids, the titration of the amount of fluid given and the use of invasive monitoring have not been subject to adequate examination in randomised studies. Clinical experience, combined with available evidence and a reasoned approach are the basis for a suggested management algorithm. PMID:27708700

  19. Effects of parturition and feed restriction on concentrations and distribution of the insulin-like growth factor-binding proteins in plasma and cerebrospinal fluid of dairy cows.

    PubMed

    Laeger, T; Wirthgen, E; Piechotta, M; Metzger, F; Metges, C C; Kuhla, B; Hoeflich, A

    2014-05-01

    Hormones and metabolites act as satiety signals in the brain and play an important role in the control of feed intake (FI). These signals can reach the hypothalamus and brainstem, 2 major centers of FI regulation, via the blood stream or the cerebrospinal fluid (CSF). During the early lactation period of high-yielding dairy cows, the increase of FI is often insufficient. Recently, it has been demonstrated that insulin-like growth factors (IGF) may control FI. Thus, we asked in the present study if IGF-binding proteins (IGFBP) are regulated during the periparturient period and in response to feed restriction and therefore might affect FI as well. In addition, we specifically addressed conditional distribution of IGFBP in plasma and CSF. In one experiment, 10 multiparous German Holstein dairy cows were fed ad libitum and samples of CSF and plasma were obtained before morning feeding on d -20, -10, +1, +10, +20, and +40 relative to calving. In a second experiment, 7 cows in second mid-lactation were sampled for CSF and plasma after ad libitum feeding and again after feeding 50% of the previous ad libitum intake for 4 d. Intact IGFBP-2, IGFBP-3, and IGFBP-4 were detected in plasma by quantitative Western ligand blot analysis. In CSF, we were able to predominantly identify intact IGFBP-2 and a specific IGFBP-2 fragment containing detectable binding affinities for biotinylated IGF-II. Whereas plasma concentrations of IGFBP-2 and IGFBP-4 increased during the periparturient period, IGFBP-3 was unaffected over time. In CSF, concentrations of IGFBP-2, both intact and fragmented, were not affected during the periparturient period. Plasma IGF-I continuously decreased until calving but remained at a lower concentration in early lactation than in late pregnancy. Food restriction did not affect concentrations of IGF components present in plasma or CSF. We could show that the IGFBP profiles in plasma and CSF are clearly distinct and that changes in IGFBP in plasma do not simply

  20. [Inhalational or intravenous anesthesia?].

    PubMed

    Dahan, A; Aarts, L P H J

    2016-01-01

    The debate continues whether there is a difference in patient outcome following inhalational versus intravenous anesthesia. A recent meta-analysis showed improved outcome following inhalational anesthesia in patients undergoing cardiac surgery but not in patients undergoing non-cardiac procedures. In this article we discuss the meta-analysis and its caveats, taking into account additional comparative studies. Our overall conclusion is that it is too early to definitively claim that one anesthesia technique results in a better outcome than the other. PMID:27650024

  1. The Variable Rate Intravenous Insulin Infusion Protocol.

    PubMed

    Collard, Benjamin; Sturgeon, Jonathan; Patel, Natasha; Asharia, Shabbar

    2014-01-01

    Insulin use among inpatients is high and associated with severe and regular medication errors. An initial baseline audit showed a wide variation in the prescription of intravenous insulin within the trust. These included variation in the choice of fluid prescribed, electrolyte levels not consistently checked, handwritten illegible prescriptions, and varying parameters set for adjustment of the prescription. A Variable Rate Intravenous Insulin Infusion protocol (VRIII)) was introduced to standardize intravenous insulin prescription throughout the trust by all members of the clinical team. We looked at and measured uptake and effects of the VRIII protocol in improving standardization of insulin prescription for inpatients on insulin at St George's NHS trust. The protocol was uploaded to the intranet to allow access 24 hours a day and the staff educated about it. The VRIII protocol was routinely used successfully throughout the trust. Any initial problems were addressed through education of clinical staff. The protocol has shown decreased prescribing and administrative errors, whilst demonstrating good glucose and electrolyte control. Use of a standardized protocol helps reduce medication errors and demonstrates good glycaemic control. Regular and continued education of clinical staff is necessary to maintain its efficacy. PMID:26734228

  2. Assisting the Adult Receiving Inhalation and Intravenous Therapy. Care of the Adult.

    ERIC Educational Resources Information Center

    Anoka-Hennepin Area Vocational Technical Inst., MN.

    These two units for students in a practical nursing program provide supplemental instruction in caring for adult patients receiving inhalation and intravenous therapy. Unit titles are The Administration of Intermittent Positive Pressure Breathing (IPPB RX) and Intravenous Therapy of Fluids and Blood. Each unit contains the following: objectives,…

  3. Intravenous acetaminophen use in pediatrics.

    PubMed

    Shastri, Nirav

    2015-06-01

    Acetaminophen is a commonly used pediatric medication that has recently been approved for intravenous use in the United States. The purpose of this article was to review the pharmacodynamics, indications, contraindications, and precautions for the use of intravenous acetaminophen in pediatrics.

  4. Restrictive cardiomyopathy

    MedlinePlus

    Cardiomyopathy - restrictive; Infiltrative cardiomyopathy; Idiopathic myocardial fibrosis ... of the heart lining (endocardium), such as endomyocardial fibrosis and Loeffler syndrome (rare) Iron overload (hemochromatosis) Sarcoidosis ...

  5. Regolith and Environment Science and Oxygen and Lunar Volatile Extraction (RESOLVE): Lunar Advanced Volatile Analysis (LAVA) Capillary Fluid Dynamic Restriction Effects on Gas Chromatography

    NASA Technical Reports Server (NTRS)

    Gonzalez, Marianne; Quinn, Jacqueline; Captain, Janine; Santiago-Bond, Josephine; Starr, Stanley

    2015-01-01

    The Resource Prospector (RP) mission with the Regolith and Environment Science and Oxygen Lunar Volatile Extraction (RESOLVE) payload aims to show the presence of water in lunar regolith, and establish a proving ground for NASAs mission to Mars. One of the analysis is performed by the Lunar Advanced Volatiles Analysis (LAVA) subsystem, which consists of a fluid network that facilitates the transport of volatile samples to a gas chromatograph and mass spectrometer (GC-MS) instrument. The understanding of fluid dynamics directed from the GC to the MS is important due to the influence of flow rates and pressures that affect the accuracy of and prevent the damage to the overall GC-MS instrument. The micro-scale capillary fluid network within the GC alone has various lengths and inner-diameters; therefore, determination of pressure differentials and flow rates are difficult to model computationally, with additional complexity from the vacuum conditions in space and lack of a lunar atmosphere. A series of tests were performed on an experimental set-up of the system where the inner diameters of the GC transfer line connecting to the MS were varied. The effect on chromatography readings were also studied by applying these lines onto a GC instrument. It was found that a smaller inner diameter transfer line resulted in a lower flow rate, as well as a lower pressure differential across the thermal conductivity detector (TCD) unit of the GC and a negligible pressure drop across the mock-up capillary column. The chromatography was affected with longer retention times and broader peak integrations. It was concluded that a 0.050 mm inner diameter line still proved most suitable for the systems flow rate preferences. In addition, it was evident that this small transfer line portrayed some expense to GC signal characteristics and the wait time for steady-state operation.

  6. Emergency intravenous access through the femoral vein.

    PubMed

    Swanson, R S; Uhlig, P N; Gross, P L; McCabe, C J

    1984-04-01

    A study was undertaken to assess the efficacy and safety of femoral venous catheterization for resuscitation of critically ill patients in the emergency department setting. From May 1982 to April 1983, 100 attempts were made at percutaneous insertion of a large-bore catheter into the femoral veins of patients presenting to our emergency department in cardiac arrest or requiring rapid fluid resuscitation. Eighty-nine attempts were successful. Insertion was generally considered easy, and flow rates were excellent. The only noted complications were four arterial punctures and one minor groin hematoma. This study suggests that short-term percutaneous catheterization of the femoral vein provides rapid, safe, and effective intravenous access. PMID:6703430

  7. Orthostatic stability with intravenous levodopa.

    PubMed

    Siddiqi, Shan H; Creech, Mary L; Black, Kevin J

    2015-01-01

    Intravenous levodopa has been used in a multitude of research studies due to its more predictable pharmacokinetics compared to the oral form, which is used frequently as a treatment for Parkinson's disease (PD). Levodopa is the precursor for dopamine, and intravenous dopamine would strongly affect vascular tone, but peripheral decarboxylase inhibitors are intended to block such effects. Pulse and blood pressure, with orthostatic changes, were recorded before and after intravenous levodopa or placebo-after oral carbidopa-in 13 adults with a chronic tic disorder and 16 tic-free adult control subjects. Levodopa caused no statistically or clinically significant changes in blood pressure or pulse. These data add to previous data that support the safety of i.v. levodopa when given with adequate peripheral inhibition of DOPA decarboxylase. PMID:26336641

  8. [Complications caused by intravenous therapy].

    PubMed

    Quirós Luque, José María; Gago Fornells, Manuel

    2005-11-01

    Nursing professionals must know everything related to complications caused by intravenous therapy including the ways to prevent and solve these complications. We need not forget that nurses are the ones mainly responsible for the insertion, manipulation, removal and care of catheters.

  9. Rhabdomyolysis After Performing Blood Flow Restriction Training: A Case Report.

    PubMed

    Tabata, Shogo; Suzuki, Yukio; Azuma, Koichiro; Matsumoto, Hideo

    2016-07-01

    Tabata, S, Suzuki, Y, Azuma, K, and Matsumoto, H. Rhabdomyolysis after performing blood flow restriction training: a case report. J Strength Cond Res 30(7): 2064-2068, 2016-Rhabdomyolysis is a serious and potentially life-threatening condition related to resistance training. Despite numerous reports of low-intensity blood flow restriction (BFR) training inducing muscle hypertrophy and increasing strength, few reports of rhabdomyolysis related to BFR training have been published. Here, we report a 30-year-old obese Japanese man admitted to our hospital the day after his first BFR training session with complaints of severe muscle pain in his upper and lower extremities, high fever, and pharyngeal pain. He was diagnosed with acute rhabdomyolysis based on a serum creatine phosphokinase level of 56,475 U·L and a urine myoglobin level of >3,000 ng·ml, and with acute tonsillitis based on a white blood cell count of 17,390 and C-reactive protein level of 10.43 mg·dl. A number of factors are suspected to be related to the onset and exacerbation of rhabdomyolysis, including excessive muscular training with BFR, bacterial infection, and medication. After 10 days of hospitalization with intravenous fluids and antibacterial drugs, he recovered without complications. This case indicates that BFR training should be conducted with careful consideration of the physical condition and strength of the individual to prevent serious complications, such as rhabdomyolysis. PMID:26677831

  10. Intravenous magnetic nanoparticle cancer hyperthermia

    PubMed Central

    Huang, Hui S; Hainfeld, James F

    2013-01-01

    Magnetic nanoparticles heated by an alternating magnetic field could be used to treat cancers, either alone or in combination with radiotherapy or chemotherapy. However, direct intratumoral injections suffer from tumor incongruence and invasiveness, typically leaving undertreated regions, which lead to cancer regrowth. Intravenous injection more faithfully loads tumors, but, so far, it has been difficult achieving the necessary concentration in tumors before systemic toxicity occurs. Here, we describe use of a magnetic nanoparticle that, with a well-tolerated intravenous dose, achieved a tumor concentration of 1.9 mg Fe/g tumor in a subcutaneous squamous cell carcinoma mouse model, with a tumor to non-tumor ratio > 16. With an applied field of 38 kA/m at 980 kHz, tumors could be heated to 60°C in 2 minutes, durably ablating them with millimeter (mm) precision, leaving surrounding tissue intact. PMID:23901270

  11. Intravenous bisphosphonates for postmenopausal osteoporosis

    PubMed Central

    Mottaghi, Peyman

    2010-01-01

    Numerous clinical studies have shown bisphoshonates (BPs) to be useful and cost-effective options for the fractures prevention and postmenopausal bone loss. The use of oral bisphoshonates is an established option for managment of osteoporosis in postmenopausal women, but many of them complaint from gastrointestinal side effect or frequently dosed oral regimens. To improve upon the suboptimal therapeutic compliance in postmenopausal women, newer, longer-acting intravenous formulations of BPs has been approved for intermittent administration in postmenopausal women. These preparations would become an option for patients who can not tolerate oral BPs or it was ineffective in increasing their bone density. This article proposed to review effectiveness and tolerability of intravenous BPs in postmenopausal women with osteoporosis. PMID:21526078

  12. Fluid imbalance

    MedlinePlus

    ... fluid imbalance; Hypernatremia - fluid imbalance; Hypokalemia - fluid imbalance; Hyperkalemia - fluid imbalance ... of sodium or potassium is present as well. Medicines can also affect fluid balance. The most common ...

  13. Venipuncture and intravenous infusion access during zero-gravity flight

    NASA Technical Reports Server (NTRS)

    Krupa, Debra T.; Gosbee, John; Billica, Roger; Bechtle, Perry; Creager, Gerald J.; Boyce, Joey B.

    1991-01-01

    The purpose of this experiment is to establish the difficulty associated with securing an intravenous (IV) catheter in place in microgravity flight and the techniques applicable in training the Crew Medical Officer (CMO) for Space Station Freedom, as well as aiding in the selection of appropriate hardware and supplies for the Health Maintenance Facility (HMF). The objectives are the following: (1) to determine the difficulties associated with venipuncture in a microgravity environment; (2) to evaluate the various methods of securing an IV catheter and attached tubing for infusion with regard to the unique environment; (3) to evaluate the various materials available for securing an intravenous catheter in place; and (4) to evaluate the fluid therapy administration system when functioning in a complete system. The inflight test procedures and other aspects of the KC-135 parabolic flight test to simulate microgravity are presented.

  14. Evaluation of Cerebral Perfusion in Patients Undergoing Intravenous Recombinant Tissue Plasminogen Activator Thrombolysis

    PubMed Central

    HIRANO, Teruyuki

    2015-01-01

    Currently, the indication for thrombolytic therapy using intravenous recombinant tissue plasminogen activator (rt-PA) is restricted strictly to patients with acute ischemic stroke within 4.5 h of onset. The effect of rt-PA declines over time; therefore, we need to minimize the time delay while generating imaging information. The use of cerebral blood flow imaging is not recommended within this time window. Conversely, the balance of efficacy and the risk of bleeding complications differ among patients > 4.5 h after onset. Several ongoing studies are using mismatch concepts to extend the therapeutic time window for rt-PA. Long-awaited reliable software, such as RAPID and PMA, are now available to analyze computed tomography/magnetic resonance perfusion data. Patients with wake-up stroke (WUS) are another group that can be used to expand rt-PA candidates. Diffusion fluid- attenuated inversion recovery mismatch is a promising imaging surrogate to select good candidates with WUS. These trials will cause a therapeutic paradigm shift from time-based to tissue-based strategies in the near future. PMID:26369875

  15. Clinical applications of intravenous immunoglobulins in neurology

    PubMed Central

    Hughes, R A C; Dalakas, M C; Cornblath, D R; Latov, N; Weksler, M E; Relkin, N

    2009-01-01

    Intravenous immunoglobulin (IVIg) is used increasingly in the management of patients with neurological conditions. The efficacy and safety of IVIg treatment in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and Guillain–Barré syndrome (GBS) have been established clearly in randomized controlled trials and summarized in Cochrane systematic reviews. However, questions remain regarding the dose, timing and duration of IVIg treatment in both disorders. Reports about successful IVIg treatment in other neurological conditions exist, but its use remains investigational. IVIg has been shown to be efficacious as second-line therapy in patients with dermatomyositis and suggested to be of benefit in some patients with polymyositis. In patients with inclusion body myositis, IVIg was not shown to be effective. IVIg is also a treatment option in exacerbations of myasthenia gravis. Studies with IVIg in patients with Alzheimer's disease have reported increased plasma anti-Aβ antibody titres associated with decreased Aβ peptide levels in the cerebrospinal fluid following IVIg treatment. These changes at the molecular level were accompanied by improved cognitive function, and large-scale randomized trials are under way. PMID:19883422

  16. Assessing volume status and fluid responsiveness in the emergency department

    PubMed Central

    Mackenzie, David C.; Noble, Vicki E.

    2014-01-01

    Resuscitation with intravenous fluid can restore intravascular volume and improve stroke volume. However, in unstable patients, approximately 50% of fluid boluses fail to improve cardiac output as intended. Increasing evidence suggests that excess fluid may worsen patient outcomes. Clinical examination and vital signs are unreliable predictors of the response to a fluid challenge. We review the importance of fluid management in the critically ill, methods of evaluating volume status, and tools to predict fluid responsiveness. PMID:27752556

  17. Intravenous regional analgesia using bupivacaine.

    PubMed

    Ware, R J

    1975-11-01

    Intravenous regional analgesia using bupivacaine (Marcain) was employed as the anaesthetic technique in a series of 50 cases undergoing a variety of surgical procedures on the upper limb. A short pilot study was undertaken to determine the optimal dosage and concentration of bupivacaine. This was found to be 1-5 mg/kg in 0-2% concentration and proved suitable for all patients regardless of age or physical condition. The use of bupivacaine produced highly successful results in 98% of cases. Onset of analgesia was very rapid (3-5 minutes) and profound muscular relaxation occurred in approximately half of the cases. The degree of muscle relaxation was, however, always adequate for the successful reduction of fractures. Only one patient exhibited an adverse reaction to the dose of bupivacaine used and this was limited to a brief period of slight drowsiness. The results of this series suggest that bupivacaine may provide advantages over previously used local analgesic agents for intravenous regional analgesia and that it may be the agent of choice for this useful technique.

  18. Drug Utilization, Dosing, and Costs After Implementation of Intravenous Acetaminophen Guidelines for Pediatric Patients

    PubMed Central

    Fusco, Nicholas M.; Parbuoni, Kristine; Morgan, Jill A.

    2014-01-01

    OBJECTIVES The objectives of this evaluation of medication use were to characterize the use of intravenous acetaminophen at our institution and to determine if acetaminophen was prescribed at age-appropriate dosages per institutional guidelines, as well as to evaluate compliance with restrictions for use. Total acquisition costs associated with intravenous acetaminophen usage is described as well. METHODS This retrospective study evaluated the use of acetaminophen in pediatric patients younger than 18 years of age, admitted to a tertiary care hospital, who received at least 1 dose of intravenous acet-aminophen between August 1, 2011, and January 31, 2012. RESULTS A total of 52 doses of intravenous acetaminophen were administered to 31 patients during the 6-month study period. Most patients were admitted to the otorhinolaryngology service (55%), and the majority of doses were administered either in the operating room (46%) or in the intensive care unit (46%). Nineteen doses (37%) of intravenous acetaminophen were administered to patients who did not meet institutional guidelines' eligibility criteria. Three patients received single doses of intravenous acetaminophen that were greater than the dose recommended for their age. One patient during the study period received more than the recommended 24-hour maximum cumulative dose for acetaminophen. Total acquisition cost of intravenous acetaminophen therapy over the 6-month study period was $530.40. CONCLUSIONS Intravenous acetaminophen was used most frequently among pediatric patients admitted to the otorhinolaryngology service during the perioperative period. Nineteen doses (37%) were administered to patients who did not meet the institutional guidelines' eligibility criteria. Our data support reinforcing the availability of institutional guidelines to promote cost-effective use of intravenous acetaminophen while minimizing the prescription of inappropriate doses. PMID:24782690

  19. Pancreatic enzyme secretion during intravenous fat infusion.

    PubMed

    Burns, G P; Stein, T A

    1987-01-01

    The nutritional support of patients with pancreatic and high gastrointestinal fistulas and severe pancreatitis frequently involves intravenous fat infusion. There are conflicting reports on the effect of intravenous fat on pancreatic exocrine secretion. In 10 dogs with chronic pancreatic fistulas, pancreatic juice was collected during secretin (n = 10) or secretin + cholecystokinin (n = 4) stimulation, with and without intravenous fat infusion (5 g/hr). The hormonal-stimulated secretion of lipase, amylase, trypsin, total protein, bicarbonate, and water was unchanged during fat infusion. This study supports the use of intravenous fat as a nutritional source when it is desirable to avoid stimulation of the pancreas.

  20. Repackaging of Intravenous Fat Emulsions: A Clinical Conundrum.

    PubMed

    Cober, M Petrea

    2016-10-01

    To accommodate small fluid volumes, repackaging of intravenous fat emulsions (IVFEs) is frequently performed in institutions providing parenteral nutrition to neonates and smaller pediatric patients. However, some consider this an unsafe practice. Concerns for potential administration errors leading to an overdose of IVFEs are weighed against the potential for microbial contamination from the repackaging process. The clinician providing pediatric nutrition support should tailor repackaging practices to ensure patient safety and quality. This discussion aims to describe the strengths and limitations surrounding IVFE repackaging to provide guidance regarding the practice.

  1. Fluid therapy in critical illness

    PubMed Central

    2014-01-01

    Major surgery and critical illnesses such as sepsis and trauma all disturb normal physiological fluid handling. Intravenous fluid therapy for resuscitation and fluid maintenance is a central part of medical care during these conditions, yet the evidence base supporting practice in this area lacks answers to a number of important questions. Recent research developments include a refinement of our knowledge of the endothelial barrier structure and function and a focus on the potential harm that may be associated with intravenous fluid therapy. Here, we briefly describe the contemporary view of fluid physiology and how this may be disrupted by pathological processes. The important themes in critical illness fluid research are discussed, with a particular focus on two emerging ideas: firstly, that individualising fluid treatment to the patient, their underlying disease state and the phase of that illness may be key to improving clinical outcomes using fluid interventions and, secondly, that fluids should be considered to be drugs, with specific indications and contraindications, dose ranges and potential toxicities. PMID:25276346

  2. Sepsis Resuscitation: Fluid Choice and Dose.

    PubMed

    Semler, Matthew W; Rice, Todd W

    2016-06-01

    Sepsis is a common and life-threatening inflammatory response to severe infection treated with antibiotics and fluid resuscitation. Despite the central role of intravenous fluid in sepsis management, fundamental questions regarding which fluid and in what amount remain unanswered. Recent advances in understanding the physiologic response to fluid administration, and large clinical studies examining resuscitation strategies, fluid balance after resuscitation, colloid versus crystalloid solutions, and high- versus low-chloride crystalloids, inform the current approach to sepsis fluid management and suggest areas for future research.

  3. Partial intravenous anesthesia in cats and dogs.

    PubMed

    Duke, Tanya

    2013-03-01

    The partial intravenous anesthesia technique (PIVA) is used to lower the inspired concentration of an inhalational anesthetic by concurrent use of injectable drugs. This technique reduces the incidence of undesirable side-effects and provides superior quality of anesthesia and analgesia. Drugs commonly used for PIVA include opioids, alpha-2 adrenergic agonists, injectable anesthetic agents, and lidocaine. Most are administered by intravenous infusion.

  4. A consortium approach to intravenous certification.

    PubMed

    Kelly, D; Ziemba, S; Shumlas, D; Files, B

    1998-01-01

    Providing education for intravenous therapy without offering redundant courses is a concern for staff development educators. The consortium approach maximizes resources, provides a standard and consistent level of intravenous training, and provides a cost-effective remedy. Problems, solutions, and benefits to students, educators, and hospitals are described in this article. Emergent issues are also discussed.

  5. Optical detection of intravenous infiltration

    NASA Astrophysics Data System (ADS)

    Winchester, Leonard W.; Chou, Nee-Yin

    2006-02-01

    Infiltration of medications during infusion therapy results in complications ranging from erythema and pain to tissue necrosis requiring amputation. Infiltration occurs from improper insertion of the cannula, separation of the cannula from the vein, penetration of the vein by the cannula during movement, and response of the vein to the medication. At present, visual inspection by the clinical staff is the primary means for detecting intravenous (IV) infiltration. An optical sensor was developed to monitor the needle insertion site for signs of IV infiltration. Initial studies on simulated and induced infiltrations on a swine model validated the feasibility of the methodology. The presence of IV infiltration was confirmed by visual inspection of the infusion site and/or absence of blood return in the IV line. Potential sources of error due to illumination changes, motion artifacts, and edema were also investigated. A comparison of the performance of the optical device and blinded expert observers showed that the optical sensor has higher sensitivity and specificity, and shorter detection time than the expert observers. An improved model of the infiltration monitoring device was developed and evaluated in a clinical study on induced infiltrations of healthy adult volunteers. The performance of the device was compared with the observation of a blinded expert observer. The results show that the rates of detection of infiltrations are 98% and 82% for the optical sensor and the observer, respectively. The sensitivity and specificity of the optical sensor are 0.97 and 0.98, respectively.

  6. Disposition of intravenous radioactive acyclovir

    SciTech Connect

    de Miranda, P.; Good, S.S.; Laskin, O.L.; Krasny, H.C.; Connor, J.D.; Lietman, P.S.

    1981-11-01

    The kinetic and metabolic disposition of (8-14C)acyclovir (ACV) was investigated in five subjects with advanced malignancy. The drug was administered by 1-hr intravenous infusion at doses of 0.5 and 2.5 mg/kg. Plasma and blood radioactivity-time, and plasma concentration-time data were defined by a two-compartment open kinetic model. There was nearly equivalent distribution of radioactivity in blood and plasma. The overall mean plasma half-life and total body clearance +/- SD of ACV were 2.1 +/- 0.5 hr and 297 +/- 53 ml/min/1.73 m2. Binding of ACV to plasma proteins was 15.4 +/- 4.4%. Most of the radioactive dose excreted was recovered in the urine (71% to 99%) with less than 2% excretion in the feces and only trace amounts in the expired Co2. Analyses by reverse-phase high-performance liquid chromatography indicated that 9-(carboxymethoxymethyl)guanine was the only significant urinary metabolite of ACV, accounting for 8.5% to 14.1% of the dose. A minor metabolite (less than 0.2% of dose) had the retention time of 8-hydroxy-9-((2-hydroxyethoxy)methyl)guanine. Unchanged urinary ACV ranged from 62% to 91% of the dose. There was no indication of ACV cleavage to guanine. Renal clearance of ACV was approximately three times the corresponding creatinine clearances.

  7. Acyclovir kinetics after intravenous infusion.

    PubMed

    de Miranda, P; Whitley, R J; Blum, M R; Keeney, R E; Barton, N; Cocchetto, D M; Good, S; Hemstreet, G P; Kirk, L E; Page, D A; Elion, G B

    1979-12-01

    The disposition and safety of the antiviral drug acyclovir were studied in 14 subjects with advanced malignancies. Acyclovir was administered by a 1-hr intravenous infusion at doses of 0.5, 1.0, 2.5, and 5.0 mg/kg. At the end of infusion, mean peak plasma levels (+/- SEM), determined by radioimmunoassay, were 6.4 +/- 0.7, 12.1 +/- 2.3, 14.9 +/- 2.7, and 33.7 +/- 7.1 microM. The plasma concentration-time profiles could be described by a biexponential equation. The half-life of acyclovir in the slow disposition phase ranged from 2.2 to 5 hr and the drug was detected in the plasma for at least 18 hr after infusion. The total body clearance ranged from 117 to 396 ml/min/1.73 m2. A proportionality between area under the curve and dose suggests that acyclovir exhibits dose-independent kinetics in the dose range studied. There was wide variation in cumulative urinary excretion of unchanged drug, ranging from 30 to 69% of the dose. From renal clearances of acyclovir, which were higher than creatinine clearances, it appears that both glomerular filtration and tubular secretion contribute to its renal excretion. Analysis of the urine by reverse-phase high-performance liquid chromatography revealed the presence of the metabolite 9-carboxymethoxymethylguanine. There was no indication of toxicity either clinically or from laboratory findings in any of the study subjects. This study demonstrates that in addition to selectivity and low toxicity, the kinetic profile and metabolic disposition of acyclovir make it an attractive candidate for therapy in a variety of herpes infections.

  8. Regional intravenous limb perfusion compared to systemic intravenous administration for marimastat delivery to equine lamellar tissue.

    PubMed

    Underwood, C; Collins, S N; Mills, P C; Van Eps, A W; Allavena, R E; Medina Torres, C E; Pollitt, C C

    2015-08-01

    Pharmaceutical agents with potential for laminitis prevention have been identified. Many of these, including the MMP inhibitor marimastat, are impractical for systemic administration. This study compared local delivery of marimastat by regional limb perfusion (RLP) to systemic intravenous bolus dosing (SIVB), and established whether RLP results in local lamellar drug delivery. Six adult horses received 0.23 mg/kg of marimastat by RLP followed by 0.23 mg/kg marimastat by SIVB, with a 24-h washout period. Lamellar ultrafiltration probes sampled lamellar interstitial fluid as lamellar ultrafiltrate (LUF). LUF and plasma marimastat concentrations (LUF[M] and P[M] respectively) were measured for 24 h after each treatment. Regional pharmacokinetic parameters were calculated using noncompartmental analyses. The LUF C(max) following RLP was 232 [34-457] times that following SIVB. LUF[M] after RLP were higher than those obtained after SIVB for 18 h (P < 0.03). Median LUF[M] were > IC(90) of equine lamellar MMP-2 and MMP-9 for 9 h after tourniquet removal. RLP appeared superior to SIVB for lamellar marimastat delivery (higher LUF C(max),, AUC and T > IC(90) of lamellar MMPs). However, frequent dosing is necessary to achieve therapeutic lamellar concentrations. RLP could be used to investigate whether marimastat prevents experimentally induced laminitis. Further refinement of the technique and dosing interval is necessary before clinical application. PMID:25641095

  9. Intravenous balanced solutions: from physiology to clinical evidence.

    PubMed

    Langer, Thomas; Santini, Alessandro; Scotti, Eleonora; Van Regenmortel, Niels; Malbrain, Manu L N G; Caironi, Pietro

    2015-01-01

    "Balanced" solutions are commonly defined as intravenous fluids having an electrolyte composition close to that of plasma. As such, they should minimally affect acid-base equilibrium, as compared to the commonly reported 0.9% NaCl-related hyperchloremic metabolic acidosis. Recently, the term "balanced" solution has been also employed to indicate intravenous fluids with low chloride content, being the concentration of this electrolyte the most altered and supra-physiologic in 0.9% NaCl as compared to plasma, and based upon a suggested detrimental effect on renal function associated with hyperchloremia. Despite efforts for its identification, the ideal balanced solution, with minimal effects on acid-base status, low chloride content, and adequate tonicity, is not yet available. After the accumulation of pre-clinical and clinical physiologic data, in the last three years, several clinical trials, mostly observational and retrospective, have addressed the question of whether the use of balanced solutions has beneficial effects as compared to the standard of care, sometimes even suggesting an improvement in survival. Nonetheless, the first large randomized controlled trial comparing the effects of a balanced vs. unbalanced solution on renal function in critically-ill patients (SPLIT trial, the 0.9% Saline vs Plasma-Lyte 148 for Intensive Cate Unit Fluid Therapy), just recently published, showed identical equipoise between the two treatments. In the present review, we offer a comprehensive and updated summary on this issue, firstly, by providing a full physiological background of balanced solutions, secondly, by summarizing their potential pathophysiologic effects, and lastly, by presenting the clinical evidence available to support, at the moment, their use. PMID:26588483

  10. Partial intravenous anesthesia in cats and dogs

    PubMed Central

    Duke, Tanya

    2013-01-01

    The partial intravenous anesthesia technique (PIVA) is used to lower the inspired concentration of an inhalational anesthetic by concurrent use of injectable drugs. This technique reduces the incidence of undesirable side-effects and provides superior quality of anesthesia and analgesia. Drugs commonly used for PIVA include opioids, alpha-2 adrenergic agonists, injectable anesthetic agents, and lidocaine. Most are administered by intravenous infusion. PMID:23997266

  11. Intravenous iron-containing products: EMA procrastination.

    PubMed

    2014-07-01

    A European reassessment has led to identical changes in the summaries of product characteristics (SPCs) for all intravenous iron-containing products: the risk of serious adverse effects is now highlighted, underlining the fact that intravenous iron-containing products should only be used when the benefits clearly outweigh the harms. Unfortunately, iron dextran still remains on the market despite a higher risk of hypersensitivity reactions than with iron sucrose. PMID:25162093

  12. Intravenous iron-containing products: EMA procrastination.

    PubMed

    2014-07-01

    A European reassessment has led to identical changes in the summaries of product characteristics (SPCs) for all intravenous iron-containing products: the risk of serious adverse effects is now highlighted, underlining the fact that intravenous iron-containing products should only be used when the benefits clearly outweigh the harms. Unfortunately, iron dextran still remains on the market despite a higher risk of hypersensitivity reactions than with iron sucrose.

  13. Synthetic Base Fluids

    NASA Astrophysics Data System (ADS)

    Brown, M.; Fotheringham, J. D.; Hoyes, T. J.; Mortier, R. M.; Orszulik, S. T.; Randles, S. J.; Stroud, P. M.

    The chemical nature and technology of the main synthetic lubricant base fluids is described, covering polyalphaolefins, alkylated aromatics, gas-to-liquid (GTL) base fluids, polybutenes, aliphatic diesters, polyolesters, polyalkylene glycols or PAGs and phosphate esters.Other synthetic lubricant base oils such as the silicones, borate esters, perfluoroethers and polyphenylene ethers are considered to have restricted applications due to either high cost or performance limitations and are not considered here.Each of the main synthetic base fluids is described for their chemical and physical properties, manufacture and production, their chemistry, key properties, applications and their implications when used in the environment.

  14. Effects of intravenous solutions on acid-base equilibrium: from crystalloids to colloids and blood components.

    PubMed

    Langer, Thomas; Ferrari, Michele; Zazzeron, Luca; Gattinoni, Luciano; Caironi, Pietro

    2014-01-01

    Intravenous fluid administration is a medical intervention performed worldwide on a daily basis. Nevertheless, only a few physicians are aware of the characteristics of intravenous fluids and their possible effects on plasma acid-base equilibrium. According to Stewart's theory, pH is independently regulated by three variables: partial pressure of carbon dioxide, strong ion difference (SID), and total amount of weak acids (ATOT). When fluids are infused, plasma SID and ATOT tend toward the SID and ATOT of the administered fluid. Depending on their composition, fluids can therefore lower, increase, or leave pH unchanged. As a general rule, crystalloids having a SID greater than plasma bicarbonate concentration (HCO₃-) cause an increase in plasma pH (alkalosis), those having a SID lower than HCO₃- cause a decrease in plasma pH (acidosis), while crystalloids with a SID equal to HCO₃- leave pH unchanged, regardless of the extent of the dilution. Colloids and blood components are composed of a crystalloid solution as solvent, and the abovementioned rules partially hold true also for these fluids. The scenario is however complicated by the possible presence of weak anions (albumin, phosphates and gelatins) and their effect on plasma pH. The present manuscript summarises the characteristics of crystalloids, colloids, buffer solutions and blood components and reviews their effect on acid-base equilibrium. Understanding the composition of intravenous fluids, along with the application of simple physicochemical rules best described by Stewart's approach, are pivotal steps to fully elucidate and predict alterations of plasma acid-base equilibrium induced by fluid therapy.

  15. Artificial in vivo biofiltration: slow continuous intravenous plasmafiltration (SCIP) and artificial organ support.

    PubMed

    Handley, H H; Ronco, F; Gorsuch, R; Peters, H; Cooper, T G; Levin, N W

    2004-03-01

    An intravenous plasmafiltration (SCIP) catheter has been developed and is proposed for clinical investigation into the alleviation of acute fluid overload by SCUF of the extracted plasma. The system utilizes a unique backflushing technique, high intravenous shear flow rates and biocompatible polymers to minimize protein and platelet aggregation along the filter surfaces. The absence of platelets from the extracted plasma promotes the longevity of ultrafiltration cartridges, thus theoretically minimizing attendant labor associated with continuous renal replacement therapies. Clinical studies are currently being planned for the near future. Plasma SCUF is envisioned as a predecessor technology to future applications in therapeutic apheresis, tissue engineering, therapeutic sorbent technologies. Further, with improved longevity profiles, intravenous SCUF or dialysis and implantable or wearable artificial organs based upon artificial in vivo biofiltration are possible.

  16. An Unexpected Transient Breakdown of the Blood Brain Barrier Triggers Passage of Large Intravenously Administered Nanoparticles

    NASA Astrophysics Data System (ADS)

    Smith, Nicole M.; Gachulincova, Ivana; Ho, Diwei; Bailey, Charlotte; Bartlett, Carole A.; Norret, Marck; Murphy, John; Buckley, Alysia; Rigby, Paul J.; House, Michael J.; St. Pierre, Timothy; Fitzgerald, Melinda; Iyer, K. Swaminathan; Dunlop, Sarah A.

    2016-03-01

    The highly restrictive blood-brain barrier (BBB) plays a critically important role in maintaining brain homeostasis and is pivotal for proper neuronal function. The BBB is currently considered the main limiting factor restricting the passage of large (up to 200 nm) intravenously administered nanoparticles to the brain. Breakdown of the barrier occurs as a consequence of cerebrovascular diseases and traumatic brain injury. In this article, we report that remote injuries in the CNS are also associated with BBB dysfunction. In particular, we show that a focal partial transection of the optic nerve triggers a previously unknown transient opening of the mammalian BBB that occurs in the visual centres. Importantly, we demonstrate that this transient BBB breakdown results in a dramatic change in the biodistribution of intravenously administered large polymeric nanoparticles which were previously deemed as BBB-impermeable.

  17. An Unexpected Transient Breakdown of the Blood Brain Barrier Triggers Passage of Large Intravenously Administered Nanoparticles

    PubMed Central

    Smith, Nicole M.; Gachulincova, Ivana; Ho, Diwei; Bailey, Charlotte; Bartlett, Carole A.; Norret, Marck; Murphy, John; Buckley, Alysia; Rigby, Paul J.; House, Michael J.; St. Pierre, Timothy; Fitzgerald, Melinda; Iyer, K. Swaminathan; Dunlop, Sarah A.

    2016-01-01

    The highly restrictive blood-brain barrier (BBB) plays a critically important role in maintaining brain homeostasis and is pivotal for proper neuronal function. The BBB is currently considered the main limiting factor restricting the passage of large (up to 200 nm) intravenously administered nanoparticles to the brain. Breakdown of the barrier occurs as a consequence of cerebrovascular diseases and traumatic brain injury. In this article, we report that remote injuries in the CNS are also associated with BBB dysfunction. In particular, we show that a focal partial transection of the optic nerve triggers a previously unknown transient opening of the mammalian BBB that occurs in the visual centres. Importantly, we demonstrate that this transient BBB breakdown results in a dramatic change in the biodistribution of intravenously administered large polymeric nanoparticles which were previously deemed as BBB-impermeable. PMID:26940762

  18. Modification of the diuretic and natriuretic effects of a dopamine infusion by fluid loading in preoperative cardiac surgical patients.

    PubMed

    Bryan, A G; Bolsin, S N; Vianna, P T; Haloush, H

    1995-04-01

    An intravenous infusion of dopamine at 2.5 microgram/kg/min was administered for 40 minutes to anesthetized cardiac surgical patients, and their renal function was measured. Five patients had the usual preoperative regimen of reduced fluid intake for the night and morning before surgery (nonhydrated), and five patients received normal saline, 2 mL/kg/hr intravenously, for 6 hours before anesthesia (hydrated). Renal function (measured by urine output, sodium excretion, free water clearance, and fractional excretion of sodium) was similar immediately before starting the dopamine infusion. All four variables were significantly higher in the hydrated group after 10 minutes; this difference becoming maximal after 40 minutes. Twenty minutes after stopping the dopamine infusion, renal function was similar in the two groups. This study indicates that preoperatively fluid-restricted patients demonstrate powerful salt and water conservation with reduced natriuretic and diuretic responses to a low-dose dopamine infusion when compared with hydrated patients. Patients with adequate fluid loading and intravascular volume will demonstrate a marked natriuresis and diuresis in response to low-dose dopamine infusion.

  19. Compact fluid-flow restrictor

    NASA Technical Reports Server (NTRS)

    Sheere, R. W.

    1970-01-01

    Fluid-flow restrictor has degree of restriction easily and accurately controlled during manufacture. Restrictor's flow channel is machined square thread around a solid slug which is shrink-fitted to cylindrical case. One end of case is closed, open end capped, and both ends tapped for tube fittings for fluid flow.

  20. Pharmacokinetics of acyclovir after intravenous and oral administration.

    PubMed

    de Miranda, P; Blum, M R

    1983-09-01

    Acyclovir pharmacokinetics has been extensively investigated during the various phases of clinical development. Most of the administered drug is eliminated from the body unchanged, via the kidneys by glomerular filtration and tubular secretion. After intravenous dosing of patients with normal renal function, 8 to 14% of the dose is recovered in the urine as the metabolite 9-carboxymethoxymethylguanine. Adequate distribution of acyclovir has been demonstrated in the cerebrospinal fluid, vesicular fluid, vaginal secretions and tissues. The low plasma protein binding of acyclovir precludes drug interactions involving binding displacement. When intravenous doses in the range of 2.5 to 15 mg/kg were given every 8 h to adult patients, dose-independent kinetics was observed. Continuous infusions of acyclovir over an equivalent daily dose range have achieved predictable plasma levels. Acyclovir half-life (T1/2 beta) and total body clearance (Cltot) are influenced significantly by renal function, and dosage adjustments should be made for patients with impaired renal function. For patients with normal renal function (creatinine clearance (Clcr) greater than 80 ml/min/1.73m2) mean T1/2 beta and Cltot were 2.5 h and 327 ml/min/1.73 m2, respectively. In children 1-year-old or older, Cltot normalized by body surface area was essentially the same as in adults with normal renal function, whereas Cltot for neonates was approximately one-third the adult value. In the adult population, age-related decreases in acyclovir Cltot reflect age-related changes in renal function; therefore dosage adjustments based on Clcr will compensate for age effects on acyclovir pharmacokinetics. After oral administration, the bioavailability of acyclovir was approximately 20%.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. [Intravenous drug users and the HIV epidemic].

    PubMed

    Skretting, A

    1992-06-10

    Data are taken from a study of 1,765 arrested intravenous drug users at the Oslo Central Police Station. Intravenous drug users in Oslo seem to get themselves tested for HIV regularly. In 1990-91 the average number of HIV-tests was 5.3, and the time since last test was, an average, between eight and nine months. Most intravenous drug users do not share needles and syringes. The most important source of needles and syringes in Oslo is an ambulant bus which can be found in city centre at night. HIV-seropositive drug users seem to have more regular contact with treatment programmes than those who are HIV-seronegative. Most of the HIV-seropositive drug users who are under treatment are to be found in a few institutions.

  2. Fluid fertilizers. [Fluids

    SciTech Connect

    Potts, J.M.

    1984-09-01

    The use of fertilizer in the United States has increased spectacularly in the past 20 years. In 1981 plant nutrient use (N + P/sub 2/O/sub 5/ + K/sub 2/O) totaled 23.5 million short tons - compared with only 7.5 million tons in 1960 (table 2). Nutrient use doubled from 1960 to 1970 and tripled from 1960 to 1981. In 1981 fluid nutrient use (mixtures plus nitrogen solutions) totaled 4.1 million tons, more than doubling since 1970 and increasing from 6.3% to 17.5% of the total nutrient use since 1960. Fluid mixtures (NPK) use in 1981 totaled 1.8 million tons of nutrients - about 17% of total mixed fertilizers or 7.5% of total nutrients used. The proportion of total fertilizer nutrients applied in fluid from increases greatly if anhydrous ammonia is included. The 4.6 million tons of nitrogen applied as anhydrous ammonia in 1981 increases total fluid nutrients to 8.1 million tons - 34.5% of the total nutrients applied in the United States. Fluid fertilizer use has grown nearly twice as fast as total fertilizer use, averaging more than 15% per year increase between 1960 and 1970, and an 11% increase between 1960 and 1980. A large part of this increase occurred during the introductory stages of the new product form and was aided by rapid advances in technology.

  3. Comparison of 2 techniques for regional antibiotic delivery to the equine forelimb: intraosseous perfusion vs. intravenous perfusion.

    PubMed Central

    Butt, T D; Bailey, J V; Dowling, P M; Fretz, P B

    2001-01-01

    The purpose of this study was to compare the synovial fluid concentrations and pharmacokinetics of amikacin in the equine limb distal to the carpus following intraosseous and intravenous regional perfusion. The front limbs of 6 horses were randomly assigned to either intraosseous or intravenous perfusion. A tourniquet was placed distal to each carpus and the limb perfused with 500 mg of amikacin. Systemic blood samples and synovial fluid samples were collected over 70 min from the distal interphalangeal (DIP) joint, metacarpophalangeal joint, and digital flexor sheath. The tourniquet was removed following the 30 min sample collection. The mean peak amikacin concentration for the DIP joint was significantly higher with intravenous perfusion. There were no significant differences in time to peak concentration or elimination half-life between methods at each synovial structure. Each technique produced mean peak concentrations ranging from 5 to 50 times that of recommended peak serum concentrations for therapeutic efficacy. PMID:11519271

  4. Predicting and measuring fluid responsiveness with echocardiography

    PubMed Central

    Mandeville, Justin

    2016-01-01

    Echocardiography is ideally suited to guide fluid resuscitation in critically ill patients. It can be used to assess fluid responsiveness by looking at the left ventricle, aortic outflow, inferior vena cava and right ventricle. Static measurements and dynamic variables based on heart–lung interactions all combine to predict and measure fluid responsiveness and assess response to intravenous fluid resuscitation. Thorough knowledge of these variables, the physiology behind them and the pitfalls in their use allows the echocardiographer to confidently assess these patients and in combination with clinical judgement manage them appropriately. PMID:27249550

  5. Health Instruction Packages: Venipuncture and Intravenous Therapy.

    ERIC Educational Resources Information Center

    Gray, P. Allen, Jr.; And Others

    Text, illustrations, and exercises are utilized in these five learning modules to instruct nursing students in techniques for initiating intravenous (I.V.) therapy. The first module, "Selection of a Venipuncture Site: Arm" by P. Allen Gray, Jr., describes the utilization of a tourniquet in locating filled veins in the arm. The second module,…

  6. Eastern Equine Encephalitis Treated With Intravenous Immunoglobulins

    PubMed Central

    Mukerji, Shibani S.; Lam, Alice D.

    2016-01-01

    We report the case of a 68-year-old man from southeastern Massachusetts presenting with encephalitis due to eastern equine encephalitis (EEE) virus. Despite the high morbidity and mortality rate of EEE, the patient made a near complete recovery in the setting of receiving early intravenous immunoglobulins. PMID:26740855

  7. Safety and Efficacy of Intravenous Colistin in Neonates With Culture Proven Sepsis

    PubMed Central

    Serafettin Tekgunduz, Kadir; Kara, Mustafa; Caner, Ibrahim; Demirelli, Yasar

    2015-01-01

    Background: Although it is well described among adults, intravenous colistin use and its associated toxicities in newborns are poorly understood. Objectives: We present our experience of efficacy and safety of intravenous colistin in the treatment of sepsis in term and preterm neonates. Patients and Methods: The records of neonates who received colistin between January 2013 and February 2014 were retrospectively reviewed. All neonates with culture proven nosocomial infections due to multidrug resistant organisms and treated continuously with colistin for more than 72 hours were included in the study. Results: Patients were evaluated for clinical and microbiological response to the drug and its and side effects. Twelve newborn infants with mean 31.8 ± 3.5 weeks gestational age and median 1482 (810 - 3200) gram birth weight were included. 11/12 (91.7%) patients showed microbiological clearance with intravenous colistin. One patient who had recurrent cerebrospinal fluid positive culture was treated with intraventricular colistin. The major side effects observed was hyponatremia and hypokalemia in 2 (16.6%) patients, all infants required magnesium supplementation. Conclusions: Intravenous colistin administration appears to be safe and efficacious for multidrug-resistant gram-negative infections in neonates, including preterm infants. However, we believe that large prospective controlled studies are needed to confirm its efficacy and safety in neonates. PMID:26396706

  8. The effects of intravenous ephedrine during spinal anesthesia for cesarean delivery: a randomized controlled trial.

    PubMed

    Kol, Iclal Ozdemir; Kaygusuz, Kenan; Gursoy, Sinan; Cetin, Ali; Kahramanoglu, Zeki; Ozkan, Fikret; Mimaroglu, Caner

    2009-10-01

    We designed a randomized, double-blinded study to determine the efficacy and safety of 0.5 mg/kg intravenous ephedrine for the prevention of hypotension during spinal anesthesia for cesarean delivery. Patients were randomly allocated into two groups: ephedrine group (n=21) and control group (n=21). Intravenous preload of 15 mL/kg lactated Ringer's solution was given. Shortly after the spinal injection, ephedrine 0.5 mg/kg or saline was injected intravenous for 60 sec. The mean of highest and lowest heart rate in the ephedrine group was higher than those of control group (P<0.05). There were significant lower incidences of hypotension and nausea and vomiting in the ephedrine group compared with the control group (8 [38.1%] vs. 18 [85.7%]); (4 [19%] vs. 12 [57.1%], respectively) (P<0.05). The first rescue ephedrine time in the ephedrine group was significantly longer (14.9+/-7.1 min vs. 7.9+/-5.4 min) than that of the control group (P<0.05). Neonatal outcome were similar between the study groups. These findings suggest, the prophylactic bolus dose of 0.5 mg/kg intravenous ephedrine given at the time of intrathecal block after a crystalloid fluid preload, plus rescue boluses reduce the incidence of hypotension.

  9. Intravenous methylprednisolone pulse therapy in ankylosing spondylitis.

    PubMed

    Ejstrup, L; Peters, N D

    1985-08-01

    For several years the medical treatment of active ankylosing spondylitis (AS) has been NSAID because gold, penicillamine, antimalarials and steroids have been without efficacy. In 1981, Mintz et al reported that methylprednisolone pulse therapy (MPPT) had an excellent effect in patients with AS. Seven patients with active AS and insufficient efficacy of NSAID for three months were treated with one gram methylprednisolone daily given intravenously for three successive days. Mobility and pain were recorded before, during, and after treatment. Significant pain relief and improvement of mobility of the spine for at least six weeks were clearly demonstrated (p less than 0.05). Finger to floor distance and chin manubrium distance improved significantly for at least six months (p less than 0.05). We conclude that intravenous MPPT is a useful treatment in patients with active AS when NSAID is insufficient. PMID:4042697

  10. Visualization of Coronary Arteries from Intravenous Angiograms

    NASA Technical Reports Server (NTRS)

    Selzer, Robert H.

    1985-01-01

    Under most circumstances, the coronary arteries are not satisfactorily visualized in intravenous angiograms. The objective of this study is to develop computer image enhancement methods that will improve the quality of the latent coronary images to a degree sufficient to detect an obstructive lesion. Such a technique, if successful, could be used as a first step alternative to conventional coronary angiography for individuals with ambiguous noninvasive cardiac tests. The determination of no lesion from the intravenous procedure would relieve the need for the conventional angiogram, while verification of an obstructive lesion could be followed by a conventional angiogram. The nature of the imaging problem and a description of the methods and initial processing results are described in this paper.

  11. [How to control postoperative pain: intravenous route].

    PubMed

    Occella, P; Vivaldi, F

    2003-12-01

    Intravenous administration of analgesic drugs is one of the most common ways to control post-operative pain. It can be used in almost all kinds of surgical interventions and particularly those of medium and high complexity. Besides, when other techniques are contraindicated because of clinical and/or managing problems, intravenous way finds its best application. Among analgesic drugs NSAID (ketorolac) and opioids (tramadol, morphine, buprenorphine) are most frequently used. As to administration techniques, elastomeric pump is, according to personal experience, a simple-to-manage, practical and precise device with lower cost respect to other administration set. Elastomeric pump is a single use reservoir that allows continuous administration of drugs with a uniform pre-set infusion speed. Finally, guide-lines, showing pre-load and infusion doses of analgesic drugs, based on pain intensity, are presented. PMID:14663417

  12. Intravenous Lipid Emulsions in Parenteral Nutrition123

    PubMed Central

    Fell, Gillian L; Nandivada, Prathima; Gura, Kathleen M; Puder, Mark

    2015-01-01

    Fat is an important macronutrient in the human diet. For patients with intestinal failure who are unable to absorb nutrients via the enteral route, intravenous lipid emulsions play a critical role in providing an energy-dense source of calories and supplying the essential fatty acids that cannot be endogenously synthesized. Over the last 50 y, lipid emulsions have been an important component of parenteral nutrition (PN), and over the last 10–15 y many new lipid emulsions have been manufactured with the goal of improving safety and efficacy profiles and achieving physiologically optimal formulations. The purpose of this review is to provide a background on the components of lipid emulsions, their role in PN, and to discuss the lipid emulsions available for intravenous use. Finally, the role of parenteral fat emulsions in the pathogenesis and management of PN-associated liver disease in PN-dependent pediatric patients is reviewed. PMID:26374182

  13. Diurnal Variation in Response to Intravenous Glucose*

    PubMed Central

    Whichelow, Margaret J.; Sturge, R. A.; Keen, H.; Jarrett, R. J.; Stimmler, L.; Grainger, Susan

    1974-01-01

    Intravenous glucose tolerance tests (25 g) were performed in the morning and afternoon on 13 apparently normal persons. The individual K values (rate of decline of blood sugar) were all higher in the morning tests, and the mean values were significantly higher in the morning. Fasting blood sugar levels were slightly lower in the afternoon. There was no difference between the fasting morning and afternoon plasma insulin levels, but the levels after glucose were lower in the afternoon. Growth hormone levels were low at all times in non-apprehensive subjects and unaffected by glucose. The results suggest that the impaired afternoon intravenous glucose tolerance, like oral glucose tolerance, is associated with impaired insulin release and insulin resistance. PMID:4817160

  14. Intravenous Lipid Emulsions in Parenteral Nutrition.

    PubMed

    Fell, Gillian L; Nandivada, Prathima; Gura, Kathleen M; Puder, Mark

    2015-09-01

    Fat is an important macronutrient in the human diet. For patients with intestinal failure who are unable to absorb nutrients via the enteral route, intravenous lipid emulsions play a critical role in providing an energy-dense source of calories and supplying the essential fatty acids that cannot be endogenously synthesized. Over the last 50 y, lipid emulsions have been an important component of parenteral nutrition (PN), and over the last 10-15 y many new lipid emulsions have been manufactured with the goal of improving safety and efficacy profiles and achieving physiologically optimal formulations. The purpose of this review is to provide a background on the components of lipid emulsions, their role in PN, and to discuss the lipid emulsions available for intravenous use. Finally, the role of parenteral fat emulsions in the pathogenesis and management of PN-associated liver disease in PN-dependent pediatric patients is reviewed. PMID:26374182

  15. Case report: multisystem failure following intravenous iopamidol.

    PubMed

    Lucas, L M; Colley, C A; Gordon, G H

    1992-04-01

    A case of life-threatening adverse effects following intravenous administration of a non-ionic contrast medium is reported. The patient, a 68-year-old diabetic hypertensive male with dyspnoea and cough had an abnormal chest radiograph, revealing congestive heart failure and an enlarged right hilum. Computed tomography (CT) of the chest was performed using 100 cm3 of intravenous iopamidol. Within half an hour the patient developed abdominal cramping, vomiting, and diarrhoea, followed by hypotension, tachycardia, fever to 40 degrees C, and delirium. His course was complicated by disseminated intravascular coagulation, rhabdomyolysis, renal failure, respiratory arrest, and atrial fibrillation. There was no evidence of infection, neoplastic disease, or myocardial infarction. Over the next month the patient slowly recovered. One other case report implicates a contrast agent with a similar syndrome. The features of this case fulfil the criteria for a probable adverse drug reaction of a type and severity rarely encountered.

  16. Pharmacokinetics and pharmacodynamics of intravenous inotropic agents.

    PubMed

    Lehtonen, Lasse A; Antila, Saila; Pentikäinen, Pertti J

    2004-01-01

    Positive inotropic drugs have various mechanisms of action. Long-term use of cyclic adenosine monophosphate (cAMP)-dependent drugs has adverse effects on the prognosis of heart failure patients, whereas digoxin has neutral effect on mortality. There are, however, little data on the effects of intravenous inotropic drugs on the outcome of patients. Intravenous inotropic agents are used to treat cardiac emergencies and refractory heart failure. beta-Adrenergic agonists are rapid acting and easy to titrate, with short elimination half-life. However, they increase myocardial oxygen consumption and are thus hazardous during myocardial ischaemia. Furthermore they may promote myocyte apoptosis. Phosphodiesterase (PDE) III inhibiting drugs (amrinone, milrinone and enoximone) increase contractility by reducing the degradation of cAMP. In addition, they reduce both preload and afterload via vasodilation. Short-term use of intravenous milrinone is not associated with increased mortality, and some symptomatic benefit may be obtained when it is used in refractory heart failure. Furthermore, PDE III inhibitors facilitate weaning from the cardiopulmonary bypass machine after cardiac surgery. Levosimendan belongs to a new group of positive inotropic drugs, the calcium sensitisers. It has complex pharmacokinetics and long-lasting haemodynamic effects as a result of its active metabolites. In comparative trials, it has been better tolerated than the most widely used beta-agonist inotropic drug, dobutamine. The pharmacokinetics of the intravenous inotropic drugs might sometimes greatly modify and prolong the response to the therapy, for example because of long-acting active metabolites. These drugs display considerable differences in their pharmacokinetics and pharmacodynamics, and the selection of the most appropriate inotropic drug for each patient should be based on careful consideration of the clinical status of the patient and on the pharmacology of the drug.

  17. Pulmonary Thromboembolism: Evaluation By Intravenous Angiography

    NASA Astrophysics Data System (ADS)

    Pond, Gerald D.; Cook, Glenn C.; Woolfenden, James M.; Dodge, Russell R.

    1981-11-01

    Using perfusion lung scans as a guide, digital video subtraction angiography of the pulmonary arteries was performed in human subjects suspected of having pulmonary embolism. Dogs were employed as a pulmonary embolism model and both routine pulmonary angiography and intravenous pulmonary angiograms were obtained for comparison purposes. We have shown by our preliminary results that the technique is extremely promising as a safe and accurate alternative to routine pulmonary angiography in selected patients.

  18. Discovery of an intravenous hepatoselective glucokinase activator for the treatment of inpatient hyperglycemia.

    PubMed

    Stevens, Benjamin D; Litchfield, John; Pfefferkorn, Jeffrey A; Atkinson, Karen; Perreault, Christian; Amor, Paul; Bahnck, Kevin; Berliner, Martin A; Calloway, Jessica; Carlo, Anthony; Derksen, David R; Filipski, Kevin J; Gumkowski, Mike; Jassal, Charanjeet; MacDougall, Margit; Murphy, Brendan; Nkansah, Paul; Pettersen, John; Rotter, Charles; Zhang, Yan

    2013-12-15

    Glucokinase (hexokinase IV) continues to be a compelling target for the treatment of type 2 diabetes given the wealth of supporting human genetics data and numerous reports of robust clinical glucose lowering in patients treated with small molecule allosteric activators. Recent work has demonstrated the ability of hepatoselective activators to deliver glucose lowering efficacy with minimal risk of hypoglycemia. While orally administered agents require a considerable degree of passive permeability to promote suitable exposures, there is no such restriction on intravenously delivered drugs. Therefore, minimization of membrane diffusion in the context of an intravenously agent should ensure optimal hepatic targeting and therapeutic index. This work details the identification a hepatoselective GKA exhibiting the aforementioned properties.

  19. Contrast agent choice for intravenous coronary angiography

    SciTech Connect

    Zeman, H.D.; Siddons, D.P.

    1989-01-01

    The screening of the general population for coronary artery disease would be practical if a method existed for visualizing the extent of occlusion after an intravenous injection of contrast agent. Measurements performed with monochromatic synchrotron radiation x-rays and an iodine containing contrast agent at the Stanford Synchrotron Radiation Laboratory have shown that such an intravenous angiography procedure would be possible with an adequately intense monochromatic x-ray source. Because of the size and cost of synchrotron radiation facilities it would be desirable to make the most efficient use of the intensity available, while reducing as much as possible the radiation dose experienced by the patient. By choosing contrast agents containing elements with a higher atomic number than iodine, it is possible to both improve the image quality and reduce the patient radiation dose, while using the same synchrotron source. By using Si monochromator crystals with a small mosaic spread, it is possible to increase the x-ray flux available for imaging by over an order of magnitude, without any changes in the storage ring or wiggler magnet. The most critical imaging task for intravenous coronary angiography utilizing synchrotron radiation x-rays is visualizing a coronary artery through the left ventricle or aorta which also contains a contrast agent. Calculations have been made of the signal to noise ratio expected for this imaging task for various contrast agents with atomic numbers between that of iodine and bismuth.

  20. Intravenous lipids for preterm infants: a review.

    PubMed

    Salama, Ghassan Sa; Kaabneh, Mahmmoud Af; Almasaeed, Mai N; Alquran, Mohammad Ia

    2015-01-01

    Extremely low birth weight infants (ELBW) are born at a time when the fetus is undergoing rapid intrauterine brain and body growth. Continuation of this growth in the first several weeks postnatally during the time these infants are on ventilator support and receiving critical care is often a challenge. These infants are usually highly stressed and at risk for catabolism. Parenteral nutrition is needed in these infants because most cannot meet the majority of their nutritional needs using the enteral route. Despite adoption of a more aggressive approach with amino acid infusions, there still appears to be a reluctance to use early intravenous lipids. This is based on several dogmas that suggest that lipid infusions may be associated with the development or exacerbation of lung disease, displace bilirubin from albumin, exacerbate sepsis, and cause CNS injury and thrombocytopena. Several recent reviews have focused on intravenous nutrition for premature neonate, but very little exists that provides a comprehensive review of intravenous lipid for very low birth and other critically ill neonates. Here, we would like to provide a brief basic overview, of lipid biochemistry and metabolism of lipids, especially as they pertain to the preterm infant, discuss the origin of some of the current clinical practices, and provide a review of the literature, that can be used as a basis for revising clinical care, and provide some clarity in this controversial area, where clinical care is often based more on tradition and dogma than science. PMID:25698888

  1. Synthetic Strategies for Engineering Intravenous Hemostats

    PubMed Central

    Chan, Leslie W.-G.; White, Nathan J.; Pun, Suzie H.

    2015-01-01

    While there are currently many well-established topical hemostatic agents for field administration, there are still limited tools to staunch bleeding at less accessible injury sites. Current clinical methods of restoring hemostasis after large volume blood loss include platelet and clotting factor transfusion, which have respective drawbacks of short shelf-life and risk of viral transmission. Therefore, synthetic hemostatic agents that can be delivered intravenously and encourage stable clot formation after localizing to sites of vascular injury are particularly appealing. In the past three decades, platelet substitutes have been prepared using drug delivery vehicles such as liposomes and PLGA nanoparticles that have been modified to mimic platelet properties. Additionally, structural considerations such as particle size, shape, and flexibility have been addressed in a number of reports. Since platelets are the first responders after vascular injury, platelet substitutes represent an important class of intravenous hemostats under development. More recently, materials affecting fibrin formation have been introduced to induce faster or more stable blood clot formation through fibrin crosslinking. Fibrin represents a major structural component in the final blood clot, and a fibrin-based hemostatic mechanism acting downstream of initial platelet plug formation may be a safer alternative to platelets to avoid undesired thrombotic activity. This review explores intravenous hemostats under development and strategies to optimize their clotting activity. PMID:25803791

  2. Intensive care experience with intravenous cimetidine.

    PubMed

    Hall, W M; Ratliff, T B

    1990-10-01

    This study reports the results of a retrospective review of the case records of 28 seriously ill patients who received intravenous cimetidine (generally 300 mg q8h) for the treatment of gastric discomfort and/or hemorrhage or for prophylaxis against stress-induced ulcers. Most of these patients presented with complex symptoms arising from a variety of pathological conditions including ischemic heart disease, myocardial infarction, cerebrovascular accident, pneumonia, and trauma. A number of patients also had acute gastrointestinal hemorrhage. Over two-thirds of the patients treated with intravenous cimetidine demonstrated a reduction in gastrointestinal symptom severity, and a statistically significant reduction in the mean severity rating for all patients was observed. Adverse reactions reported during cimetidine therapy were generally mild to moderate in severity and required discontinuance of therapy in only one patient. The most common complaint was headache. Intravenous cimetidine administered q8h offers a safe and cost-effective approach to H2-receptor blockade and reduction of gastric acid secretion in patients who are temporarily unable to take oral medication.

  3. Fluid therapy for the emergent small animal patient: crystalloids, colloids, and albumin products.

    PubMed

    Mazzaferro, Elisa; Powell, Lisa L

    2013-07-01

    Fluid therapy is essential in the treatment of emergent veterinary patients. Many different types of intravenous fluids are available, including crystalloids, artificial colloids, and natural colloids. The type, dose, and administration rate can determine the outcome in a critically ill patient. This article discusses the various types of fluids and their indication for use.

  4. Forebrain circumventricular organs mediate salt appetite induced by intravenous angiotensin II in rats.

    PubMed

    Morris, Michael J; Wilson, Wendy L; Starbuck, Elizabeth M; Fitts, Douglas A

    2002-09-13

    Two circumventricular organs, the subfornical organ (SFO) and organum vasculosum laminae terminalis (OVLT), may mediate salt appetite in response to acute intravenous infusions of angiotensin (ANG) II. Fluid intakes and mean arterial pressures were measured in rats with sham lesions or electrolytic lesions of the SFO or OVLT during an intravenous infusion of 30 ng/min ANG II. Beginning 21 h before the 90-min infusion, the rats were depleted of sodium with furosemide and given a total of 300 mg/kg captopril in 75 ml/kg water in three spaced gavages to block the usual salt appetite and to hydrate the rats. No other food or fluids were available for ingestion. Sham-lesioned rats drank 9.3+/-1.2 ml if 0.3 M NaCl alone was available and drank 8.9+/-1.6 ml of saline and 3.7+/-1.6 ml of water if both were available. Either SFO or OVLT lesions reduced the intakes of saline to <5 ml in both conditions and of water to <1 ml. Mean arterial pressure did not differ among the groups and was maintained above 100 mmHg after the depletion and captopril treatments because of the large doses of water. Thus, a full expression of salt appetite in response to an acute intravenous infusion of ANG II requires the integrity of both the SFO and OVLT. PMID:12213298

  5. Comparing the Efficacy of Intravenous Acetaminophen and Intravenous Meperidine in Pain Relief After Outpatient Urological Surgery

    PubMed Central

    Kolahdouzan, Khosro; Eydi, Mahmood; Mohammadipour Anvari, Hassan; Golzari, Samad EJ; Abri, Reyhaneh; Ghojazadeh, Morteza; Ojaghihaghighi, Seyed Hossein

    2014-01-01

    Background: Pain relief after surgery is an essential component of postoperative care. Objectives: The purpose of this study was to compare the efficacy of intravenous acetaminophen and intravenous meperidine in pain relief after outpatient urological surgery. Patients and Methods: In a prospective, randomized, double-blind clinical trial, 100 outpatients of urological surgery were studied in two groups of acetaminophen (A) and meperidine (M). Patients in group A received 1g of acetaminophen in 100 mL saline within 15 minutes and patients in group M received a single intravenous injection of meperidine 0.5 mg/kg, 15 minutes prior to the end of operation. Postoperative pain was recorded using visual analog scale (VAS). Vital signs, nausea, vomiting, dizziness and respiratory depressions were compared between the two groups. Results: Pain severity in patients treated with intravenous acetaminophen six hours after the operation within one-hour interval was significantly lower than meperidine group (P < 0.0001). Ninety patients in the meperidine group and five patients in the acetaminophen group required additional doses of analgesics. Nausea was significantly lower in acetaminophen group than meperidine group. Conclusions: Intravenous acetaminophen reduced pain following outpatient urological surgery more significantly than meperidine. PMID:25798377

  6. Fluid infusion system

    NASA Technical Reports Server (NTRS)

    Hammond, J. C.

    1975-01-01

    Development of a fluid infusion system was undertaken in response to a need for an intravenous infusion device operable under conditions of zero-g. The initial design approach, pursued in the construction of the first breadboard instrument, was to regulate the pressure of the motive gas to produce a similar regulated pressure in the infusion liquid. This scheme was not workable because of the varying bag contact area, and a major design iteration was made. A floating sensor plate in the center of the bag pressure plate was made to operate a pressure regulator built into the bellows assembly, effectively making liquid pressure the directly controlled variable. Other design changes were made as experience was gained with the breadboard. Extensive performance tests were conducted on both the breadboard and the prototype device; accurately regulated flows from 6 m1/min to 100 m1/min were achieved. All system functions were shown to operate satisfactorily.

  7. Fluid Mechanics.

    ERIC Educational Resources Information Center

    Drazin, Philip

    1987-01-01

    Outlines the contents of Volume II of "Principia" by Sir Isaac Newton. Reviews the contributions of subsequent scientists to the physics of fluid dynamics. Discusses the treatment of fluid mechanics in physics curricula. Highlights a few of the problems of modern research in fluid dynamics. Shows that problems still remain. (CW)

  8. Anti-inflammatory effects of intravenous methotrexate associated with lipid nanoemulsions on antigen-induced arthritis

    PubMed Central

    Mello, Suzana B V; Tavares, Elaine R; Guido, Maria Carolina; Bonfá, Eloisa; Maranhão, Raul C

    2016-01-01

    OBJECTIVE: To test the hypothesis that intravenous use of methotrexate associated with lipid nanoemulsions can achieve superior anti-inflammatory effects in the joints of rabbits with antigen-induced arthritis compared with commercial methotrexate. METHODS: Arthritis was induced in New Zealand rabbits sensitized with methylated bovine serum albumin and subsequently intra-articularly injected with the antigen. A nanoemulsion of methotrexate labeled with 3H-cholesteryl ether (4 mg/kg methotrexate) was then intravenously injected into four rabbits to determine the plasma decaying curves and the biodistribution of the methotrexate nanoemulsion by radioactive counting. Additionally, the pharmacokinetics of the methotrexate nanoemulsion were determined by high-pressure liquid chromatography. Twenty-four hours after arthritis induction, the animals were allocated into three groups, with intravenous injection with saline solution (n=9), methotrexate nanoemulsion (0.5 µmol/kg methotrexate, n=7), or commercial methotrexate (0.5 µmol/kg, n=4). The rabbits were sacrificed 24 h afterward. Synovial fluid was then collected for protein leakage and cell content analyses and synovial membranes were collected for histopathological analysis. RESULTS: The methotrexate nanoemulsion was taken up mainly by the liver and the uptake by arthritic joints was two-fold greater than that by control joints. The methotrexate nanoemulsion treatment reduced leukocyte influx into the synovial fluid by nearly 65%; in particular, mononuclear and polymorphonuclear cells were reduced by 47 and 72%, respectively. In contrast, cell influx was unaffected following treatment with commercial methotrexate. Protein leakage into the arthritic knees of the rabbits was also more limited following methotrexate nanoemulsion treatment than following commercial methotrexate treatment. CONCLUSIONS: The intravenous methotrexate nanoemulsion showed anti-inflammatory effects on the synovia of arthritic joints that were

  9. [Intravenous urography with a nonionic low osmolality contrast medium (iopamidol) in elderly patients].

    PubMed

    Tanaka, H; Senju, M; Ikeuchi, H; Nakatani, T; Yamamoto, K; Kishimoto, T; Maekawa, M

    1988-12-01

    Intravenous urography was carried out with a nonionic low osmolality contrast medium, iopamidol (Iopamiron 300) in 30 elderly patients (aged 65 to 86; with the mean age of 75 +/- 6), and the safety for the aged and radiopacity were evaluated. Although no purgative was given and water was not restricted in consideration of dehydration and bad influence on renal function, the total urinary system was well visualized. Side-effect was observed in none of 30 patients. This method seems to be useful for patients with a risk of dehydration and elderly patients.

  10. Pulmonary toxicity of inhaled and intravenous talc.

    PubMed

    Hollinger, M A

    1990-07-01

    Talc (magnesium silicate) is a widely used, generally considered benign substance. It is principally used as an inert filler material in drug tablets or as a drying ingredient in baby powders. However, in both cases inappropriate use can lead to severe pulmonary toxicological responses. On the one hand, intravenous injection of 'solubilized', CNS active pills can produce microemboli in small pulmonary vessels. This can lead to various degrees of granuloma formation, compromised pulmonary function, or death. Overzealous application of baby powder can also produce severe pulmonary complications if the infant inspires the powder. Although the data are relatively scarce, a number of reports suggest the existence of a chronic problem in this area.

  11. Wireless Application in Intravenous Infiltration Detection System

    PubMed Central

    Alley, Matthew S.; Naramore, William J.; Chou, Nee-Yin; Winchester, Leonard W.

    2008-01-01

    The IrDA wireless protocol has been applied to a fiber optics based point-of-care system for the detection of intravenous infiltration. The system is used for monitoring patients under infusion therapy. It is optimized for portability by incorporating a battery source and wireless communication. The IrDA protocol provides secure data communication between the electronic module of the system and the PDAs carried by the nurses. The PDA is used for initiating the actions of the electronic module and for data transfer. Security is provided by specially designed software and hardware. PMID:19162821

  12. Wireless application in intravenous infiltration detection system.

    PubMed

    Alley, Matthew S; Naramore, William J; Chou, Nee-Yin; Winchester, Leonard W

    2008-01-01

    The IrDA wireless protocol has been applied to a fiber optics based point-of-care system for the detection of intravenous infiltration. The system is used for monitoring patients under infusion therapy. It is optimized for portability by incorporating a battery source and wireless communication. The IrDA protocol provides secure data communication between the electronic module of the system and the PDAs carried by the nurses. The PDA is used for initiating the actions of the electronic module and for data transfer. Security is provided by specially designed software and hardware.

  13. Advances in Pediatric Intravenous Iron Therapy.

    PubMed

    Mantadakis, Elpis

    2016-01-01

    Iron deficiency anemia (IDA) continues to be very common worldwide. Intravenous (IV) iron is an infrequently used therapeutic option in children with IDA despite numerous studies in adults and several small but notable pediatric studies showing efficacy and safety. Presently, the availability of newer IV iron products allows for replacement of the total iron deficit at a single setting. These products appear safer compared to the high molecular weight iron dextrans of the past. Herein, we review the medical literature and suggest that front line use of IV iron should be strongly considered in diseases associated with IDA in children.

  14. [Intravenous monoanesthesia and antianesthetics in emergency surgery].

    PubMed

    D'iachenko, P K; Kostiuchenko, A L

    1984-04-01

    Profiles of using the intravenous mononarcosis (sodium hydroxybutyrate, viadryl , ketamin , sombrevin, seduxen) in urgent surgery and traumatology are analyzed. Choice of certain narcotics is motivated for patients with blood loss and shock, intoxication, insufficiency of kidneys, adrenals and liver, cardio-vascular and respiratory disorders. The problem of antinarcotics is considered with reference to the efficiency of specific (bemegride, gutimine , amtizol , cytochrome "C") and nonspecific ( osmodiuretics , infusion media containing thawing water) antinarcotics . A preliminary assessment of the efficiency of different drugs of antinarcotic action is given.

  15. Intravenous infection of mice with Naegleria fowleri.

    PubMed

    May, R G; John, D T

    1982-01-01

    Naegleria fowleri produced fatal meningoencephalitis in mice following intravenous (i.v.) inoculation. Amebae were present in the peripheral circulation for 120 minutes after i.v. inoculation with a dose of 10(7) trophozoites per mouse. Amebae were cultured from and observed in brain (days 1-21), lung (days 1-12), and liver and kidney (days 1-5). Infected mice exhibited weight loss, leukocytosis, reduced lymphocyte/neutrophil ratio, neurologic symptoms, and mortality. Histologically, the disease was characterized by an acute, hemorrhagic, necrotizing meningoencephalitis. Although amebae were detected in tissues other than brain, pathologic involvement of these tissues was minimal.

  16. Antiretroviral restriction factors.

    PubMed

    Hatziioannou, Theodora; Bieniasz, Paul D

    2011-12-01

    Studies of retroviruses have been instrumental in revealing the existence of an array of antiviral proteins, or restriction factors, and the mechanisms by which they function. Some restriction factors appear to specifically inhibit retrovirus replication, while others have a broader antiviral action. Here, we briefly review current understanding of the mechanisms by which several such proteins exert antiviral activity. We also discuss how retroviruses have evolved to evade or antagonize antiviral proteins, including through the action of viral accessory proteins. Restriction factors, their viral targets and antagonists have exerted evolutionary pressure on each other, resulting in specialization and barriers to cross-species transmission. Potentially, this recently revealed intrinsic system of antiviral immunity might be mobilized for therapeutic benefit.

  17. Something's missing: peripheral intravenous catheter fracture.

    PubMed

    Glassberg, Elon; Lending, Gadi; Abbou, Benyamine; Lipsky, Ari M

    2013-01-01

    We describe a case of peripheral intravenous catheter fracture occurring during a routine training exercise. The supervising instructor immediately placed a venous tourniquet proximal to the insertion site and urgently transported the patient to the hospital. The missing catheter segment was identified within the median cubital vein under ultrasonography and was removed by venous cutdown under local anesthesia. An investigation determined that reinsertion of the needle into the advanced catheter likely caused the fracture and that application of a tourniquet may have prevented embolism of the fractured segment. Our literature review suggested that peripheral intravenous catheter fracture is likely vastly underreported, with only one prior case identified in the English literature. Action was taken following the event to educate all Israeli Defense Force medical providers regarding both proper preventive measures and recognition and treatment of catheter fracture should it occur. This case highlights the importance of health care providers being aware of the possibility of catheter fracture, as well as steps to take to prevent and mitigate its occurrence.

  18. The Human Experience with Intravenous Levodopa

    PubMed Central

    Siddiqi, Shan H.; Abraham, Natalia K.; Geiger, Christopher L.; Karimi, Morvarid; Perlmutter, Joel S.; Black, Kevin J.

    2016-01-01

    Objective: To compile a comprehensive summary of published human experience with levodopa given intravenously, with a focus on information required by regulatory agencies. Background: While safe intravenous (IV) use of levodopa has been documented for over 50 years, regulatory supervision for pharmaceuticals given by a route other than that approved by the U.S. Food and Drug Administration (FDA) has become increasingly cautious. If delivering a drug by an alternate route raises the risk of adverse events, an investigational new drug (IND) application is required, including a comprehensive review of toxicity data. Methods: Over 200 articles referring to IV levodopa were examined for details of administration, pharmacokinetics, benefit, and side effects. Results: We identified 142 original reports describing IVLD use in humans, beginning with psychiatric research in 1959–1960 before the development of peripheral decarboxylase inhibitors. At least 2760 subjects have received IV levodopa, and reported outcomes include parkinsonian signs, sleep variables, hormone levels, hemodynamics, CSF amino acid composition, regional cerebral blood flow, cognition, perception and complex behavior. Mean pharmacokinetic variables were summarized for 49 healthy subjects and 190 with Parkinson's disease. Side effects were those expected from clinical experience with oral levodopa and dopamine agonists. No articles reported deaths or induction of psychosis. Conclusion: At least 2760 patients have received IV levodopa with a safety profile comparable to that seen with oral administration. PMID:26779024

  19. Efficacy of Intravenous Immunoglobulin in Neurological Diseases.

    PubMed

    Lünemann, Jan D; Quast, Isaak; Dalakas, Marinos C

    2016-01-01

    Owing to its anti-inflammatory efficacy in various autoimmune disease conditions, intravenous immunoglobulin (IVIG)-pooled IgG obtained from the plasma of several thousands individuals-has been used for nearly three decades and is proving to be efficient in a growing number of neurological diseases. IVIG therapy has been firmly established for the treatment of Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, and multifocal motor neuropathy, either as first-line therapy or adjunctive treatment. IVIG is also recommended as rescue therapy in patients with worsening myasthenia gravis and is beneficial as a second-line therapy for dermatomyositis and stiff-person syndrome. Subcutaneous rather than intravenous administration of IgG is gaining momentum because of its effectiveness in patients with primary immunodeficiency and the ease with which it can be administered independently from hospital-based infusions. The demand for IVIG therapy is growing, resulting in rising costs and supply shortages. Strategies to replace IVIG with recombinant products have been developed based on proposed mechanisms that confer the anti-inflammatory activity of IVIG, but their efficacy has not been tested in clinical trials. This review covers new developments in the immunobiology and clinical applications of IVIG in neurological diseases.

  20. Panlobular emphysema in young intravenous Ritalin abusers

    SciTech Connect

    Schmidt, R.A.; Glenny, R.W.; Godwin, J.D.; Hampson, N.B.; Cantino, M.E.; Reichenbach, D.D. )

    1991-03-01

    We studied a distinctive group of young intravenous Ritalin abusers with profound obstructive lung disease. Clinically, they seemed to have severe emphysema, but the pathologic basis of their symptoms had not been investigated previously. Seven patients have died and been autopsied: in four, the lungs were fixed, inflated, dried, and examined in detail radiologically, grossly, microscopically, and by electron probe X-ray microanalysis. All seven patients had severe panlobular (panacinar) emphysema that tended to be more severe in the lower lung zones and that was associated with microscopic talc granulomas. Vascular involvement by talc granulomas was variable, but significant interstitial fibrosis was not present. Five patients were tested for alpha-1-antitrypsin deficiency and found to be normal, as were six similar living patients. These findings indicate that some intravenous drug abusers develop emphysema that clinically, radiologically, and pathologically resembles that caused by alpha-1-antitrypsin deficiency but which must have a different pathogenesis. Talc from the Ritalin tablets may be important, but the mechanism remains to be elucidated.

  1. Intravenous radionuclide cystography for the detection of vesicorenal reflux

    SciTech Connect

    Pollet, J.E.; Sharp, P.F.; Smith, F.W.; Davidson, A.I.; Miller, S.S.

    1981-01-01

    Intravenous radionuclide cystography using a single intravenous injection of 99mtechnetium diethylenetriaminepentaacetic acid, provides information on individual kidney function, coarse anatomy and vesicorenal reflux. This study investigates the effectiveness of intravenous radionuclide cystography in detecting reflux. In 58 children intravenous radionuclide cystography detected 53 ureters with reflux compared to 32 detected by voiding cystography. This difference was investigated further with patients in whom other test suggested reflux. While there was no statistically significant difference for patients having pyelonephritis or hydronephrosis, intravenous radionuclide cystography detected significantly more ureters with reflux in patients with abnormal ureteral orifices or infected urine and, therefore, predisposed to reflux. Intravenous radionuclide cystography is a more comprehensive and sensitive test for vesicorenal reflux than voiding cystography.

  2. Neuroaesthetics: range and restrictions.

    PubMed

    Chatterjee, Anjan

    2013-04-01

    Bullot & Reber (B&R) should be commended for highlighting tensions between scientific aesthetics and art history. The question of how each tradition can learn from the other is timely. While I am sympathetic to their views, their diagnosis of the problem appears exaggerated and their solution partial. They underestimate the reach of scientific aesthetics while failing to identify its inherent restrictions. PMID:23507092

  3. Intraventricular and Intravenous Tobramycin with Ceftazidime for Ventriculitis Secondary to Pseudomonas aeruginosa

    PubMed Central

    Masvosva, Priscilla; Buckingham, Steven C.; Einhaus, Stephanie; Phelps, Stephanie J.

    2003-01-01

    The preferred method for shunting cerebrospinal fluid in the ventricles is via a ventriculoperitoneal or ventriculoatrial shunt. Unfortunately, infection is a major complication of shunt surgery, which places the patient at risk of intellectual impairment and death. Although the most common causative pathogens are Staphylococcus epidermidis and Staphylococcus aureus, gram-negative bacterial infections have increased over the last three decades. Treatment of Pseudomonas ventriculitis is highly variable, because there are few guidelines for drug selection, administration, and monitoring. We report a case of post-shunt revision Pseudomonas meningitis/ ventriculitis that was successfully treated by the intraventricular adminstration tobramycin in conjunction with intravenous tobramycin and ceftazidime. PMID:23300401

  4. A life-threatening flecainide overdose treated with intravenous fat emulsion.

    PubMed

    Ellsworth, Heather; Stellpflug, Samuel J; Cole, Jon B; Dolan, Joseph A; Harris, Carson R

    2013-03-01

    Flecainide is a Vaughan Williams Class Ic antidysrhythmic associated with PR, QRS, and QTc prolongation on the electrocardiogram and development of life-threatening cardiac toxicity in overdose. The cornerstone of treatment is fluid resuscitation and the administration of magnesium and sodium bicarbonate. We report a case of flecainide overdose associated with life-threatening hemodynamic compromise successfully treated with intravenous fat emulsion (IFE) therapy. IFE should be considered as a novel adjunctive therapy in patients with life-threatening toxicity following flecainide overdose.

  5. Covariates of intravenous paracetamol pharmacokinetics in adults

    PubMed Central

    2014-01-01

    Background Pharmacokinetic estimates for intravenous paracetamol in individual adult cohorts are different to a certain extent, and understanding the covariates of these differences may guide dose individualization. In order to assess covariate effects of intravenous paracetamol disposition in adults, pharmacokinetic data on discrete studies were pooled. Methods This pooled analysis was based on 7 studies, resulting in 2755 time-concentration observations in 189 adults (mean age 46 SD 23 years; weight 73 SD 13 kg) given intravenous paracetamol. The effects of size, age, pregnancy and other clinical settings (intensive care, high dependency, orthopaedic or abdominal surgery) on clearance and volume of distribution were explored using non-linear mixed effects models. Results Paracetamol disposition was best described using normal fat mass (NFM) with allometric scaling as a size descriptor. A three-compartment linear disposition model revealed that the population parameter estimates (between subject variability,%) were central volume (V1) 24.6 (55.5%) L/70 kg with peripheral volumes of distribution V2 23.1 (49.6%) L/70 kg and V3 30.6 (78.9%) L/70 kg. Clearance (CL) was 16.7 (24.6%) L/h/70 kg and inter-compartment clearances were Q2 67.3 (25.7%) L/h/70 kg and Q3 2.04 (71.3%) L/h/70 kg. Clearance and V2 decreased only slightly with age. Sex differences in clearance were minor and of no significance. Clearance, relative to median values, was increased during pregnancy (FPREG = 1.14) and decreased during abdominal surgery (FABDCL = 0.715). Patients undergoing orthopaedic surgery had a reduced V2 (FORTHOV = 0.649), while those in intensive care had increased V2 (FICV = 1.51). Conclusions Size and age are important covariates for paracetamol pharmacokinetics explaining approximately 40% of clearance and V2 variability. Dose individualization in adult subpopulations would achieve little benefit in the scenarios explored. PMID:25342929

  6. Contrast agent choice for intravenous coronary angiography

    NASA Astrophysics Data System (ADS)

    Zeman, H. D.; Siddons, D. P.

    1990-05-01

    The screening of the general population for coronary artery disease would be practical if a method existed for visualizing the extent of occlusion after an intravenous injection of contrast agent. Measurements performed with monochromatic synchrotron radiation X-rays and an iodine-containing contrast agent at the Stanford Synchrotron Radiation Laboratory have shown that such an intravenous angiography procedure would be possible with an adequately intense monochromatic X-ray source. Because of the size and cost of synchrotron radiation facilities it would be desirable to make the most efficient use of the intensity available, while reducing as much as possible the radiation dose experienced by the patient. By choosing contrast agents containing elements with a higher atomic number than iodine, it is possible to both improve the image quality and reduce the patient radiation dose, while using the same synchrotron radiation source. By using Si monochromator crystals with a small mosaic spread, it is possible to increase the X-ray flux available for imaging by over an order of magnitude, without any changes in the storage ring or wiggler magnet. The most critical imaging task for intravenous coronary angiography utilizing synchrotron radiation X-rays is visualizing a coronary artery through the left ventricle or aorta which also contain contrast agent. Calculations have been made of the signal to noise ratio expected for this imaging task for various contrast agents with atomic numbers between that of iodine and bismuth. The X-ray energy spectrum of the X-17 superconduction wiggler beam line at the National Synchrotron Light Source at Brookhaven National Laboratory has been used for these calculations. Both perfect Si crystals and Si crystals with a small mosaic spread are considered as monochromators. Contrast agents containing Gd or Yb seem to have about the optimal calculated signal to noise ratio. Gd-DTPA is already approved for use as a contrast agent for

  7. Hyperammonemia in neonates receiving intravenous nutrition.

    PubMed

    Thomas, D W; Sinatra, F R; Hack, S L; Smith, T M; Platzker, A C; Merritt, R J

    1982-01-01

    Inadequate arginine intake has been suggested as an etiology for hyperammonemia in neonates on parenteral nutrition. We randomized 26 nonasphyxiated neonates to receive amino acid solutions containing either 3.6 or 10.4% of total nitrogen as arginine when intravenous nutrition (IVN) therapy was initiated. Neonates in both amino acid solution study groups were observed to have significantly elevated blood ammonia (BA) concentrations during IVN (p less than 0.01) as compared to pre-IVN levels. Blood ammonia concentrations tended to be higher in infants receiving the 3.6% arginine amino acid solution. Septic infants were at particular risk for hyperammonemia as compared to nonseptic patients (p less than 0.025). Other clinical parameters including birth weight, gestational age, oxygen requirements, enteral nutritional intake, congenital anomalies, and heart disease did not appear to be related to BA concentration.

  8. Cyanide and arsenic poisoning by intravenous injection.

    PubMed

    DiNapoli, J; Hall, A H; Drake, R; Rumack, B H

    1989-03-01

    A 29-year-old man was found unresponsive a few minutes after self-injecting undetermined amounts of potassium cyanide and sodium arsenite intravenously in a suicide attempt. Treatment with the Lilly Cyanide Antidote kit rapidly resolved the initial coma, despite a whole blood cyanide level of 4.4 micrograms/mL. A 12-hour urine arsenic collection begun on admission showed 10,065 micrograms arsenic/12 hr. The patient received intramuscular BAL initially, which was followed by two ten-day courses of oral D-penicillamine. Complications included upper gastrointestinal tract bleeding requiring transfusion, transient elevations of liver function tests, self-limited complaints of decreased vision with conjunctival hyperemia and photophobia, and an abscess at the injection site. Although specific antidote therapy completely resolved the cyanide toxicity, early and prolonged arsenic chelation did not prevent a mild sensory peripheral neuropathy from developing with onset about 17 days after self-injection.

  9. Aztreonam penetration into synovial fluid and bone.

    PubMed Central

    MacLeod, C M; Bartley, E A; Galante, J O; Friedhoff, L T; Dhruv, R

    1986-01-01

    Eighteen patients with uncomplicated degenerative joint disease requiring joint replacement (hip or knee) were given a single 2-g intravenous dose of aztreonam over a 5-min period preoperatively. The mean concentration in synovial fluid of 83.0 +/- 9.2 micrograms/ml averaged 0.99 times the concomitant levels in serum. The mean concentration in cancellous bone of 16.0 +/- 4.3 micrograms/g averaged 0.20 times the concomitant levels in serum. PMID:3707115

  10. Safety of rapid intravenous of infusion acetaminophen

    PubMed Central

    2013-01-01

    Intravenous acetaminophen, Ofirmev®, is approved for management of mild to moderate pain, management of moderate to severe pain with adjunctive opioids, and reduction of fever. The product is supplied as a 100 mL glass vial. As stated in the prescribing information, it is recommended to be infused over 15 minutes. This recommendation is related to the formulation propacetamol, the prodrug to acetaminophen, approved in Europe, which caused pain on infusion, and data from the clinical development of acetaminophen. The objective of this retrospective chart review study was to show the lack of side effects of rapidly infusing intravenous acetaminophen. Charts of American Society of Anesthesiology (ASA) Class I–III ambulatory surgical patients who received only acetaminophen in the preoperative setting were reviewed for any infusion-related side effects. Using standard binomial proportion analyses and employing SAS/JMP software, all vital signs were analyzed for statistically significant changes between pre- and postinfusion values. One hundred charts were reviewed. Only one patient had pain on infusion, which lasted 10 seconds. No reported side effects or erythema was seen at the injection site. No infusions had to be slowed or discontinued. The median infusion time was 3:41 minutes. Of the vital signs monitored, only the systolic (P < 0.0001) and diastolic (P < 0.0099) blood pressures had statistically significant changes from pre- to postinfusion; however, they were of no clinical relevance. Acetaminophen can be administered as a rapid infusion with no significant infusion-related side effects or complications. PMID:23814378

  11. Safety of rapid intravenous of infusion acetaminophen.

    PubMed

    Needleman, Steven M

    2013-07-01

    Intravenous acetaminophen, Ofirmev®, is approved for management of mild to moderate pain, management of moderate to severe pain with adjunctive opioids, and reduction of fever. The product is supplied as a 100 mL glass vial. As stated in the prescribing information, it is recommended to be infused over 15 minutes. This recommendation is related to the formulation propacetamol, the prodrug to acetaminophen, approved in Europe, which caused pain on infusion, and data from the clinical development of acetaminophen. The objective of this retrospective chart review study was to show the lack of side effects of rapidly infusing intravenous acetaminophen. Charts of American Society of Anesthesiology (ASA) Class I-III ambulatory surgical patients who received only acetaminophen in the preoperative setting were reviewed for any infusion-related side effects. Using standard binomial proportion analyses and employing SAS/JMP software, all vital signs were analyzed for statistically significant changes between pre- and postinfusion values. One hundred charts were reviewed. Only one patient had pain on infusion, which lasted 10 seconds. No reported side effects or erythema was seen at the injection site. No infusions had to be slowed or discontinued. The median infusion time was 3:41 minutes. Of the vital signs monitored, only the systolic (P < 0.0001) and diastolic (P < 0.0099) blood pressures had statistically significant changes from pre- to postinfusion; however, they were of no clinical relevance. Acetaminophen can be administered as a rapid infusion with no significant infusion-related side effects or complications. PMID:23814378

  12. The cost of treating immune thrombocytopenic purpura using intravenous Rh immune globulin versus intravenous immune globulin.

    PubMed

    Sandler, S G; Novak, S C; Roland, B

    2000-03-01

    Multiple factors, including efficacy, toxicity and cost, may influence the decision to treat immune thrombocytopenic purpura (ITP) with intravenous immune globulin (IVIG) or intravenous Rho (D) immune globulin (IV RhIG). We conducted a survey of 50 hospitals in 31 states to determine the costs for treating ITP using conventional doses for IVIG or IV RhIG, based on package insert recommendations. The average cost for a dose of IVIG ($2,771) was 71.7% ($1,157) more than that for a dose of IV RhIG ($1,614). In the absence of clearly defined differences in clinical outcomes when treating ITP with IVIG or IV RhIG, the difference in cost may be an important factor in selecting the treatment.

  13. Comparison of postinfusion phlebitis in intravenous push versus intravenous piggyback cefazolin.

    PubMed

    Biggar, Constance; Nichols, Cynthia

    2012-01-01

    Reducing health care costs without adversely affecting patient safety is a constant challenge for health care institutions. Cefazolin prophylaxis via intravenous push (IVP) is more cost-effective than via intravenous piggyback (IVPB). The purpose of this study was to determine whether patient safety would be compromised (ie, an increased rate of phlebitis) with a change to the IVP method. Rates of phlebitis in orthopedic surgical patients receiving cefazolin prophylaxis via IVP versus IVPB were evaluated in a prospective quasi-experimental design of 240 patients. The first 120 subjects received cefazolin via IVPB, and the second 120 subjects received it via IVP. Results indicated no statistically significant difference in phlebitis rates in the IVPB (3.4%) versus the IVP groups (3.3%).

  14. AIDS and Intravenous Drug Use: A Growing Menace.

    ERIC Educational Resources Information Center

    Zapata, Vicente; Blanton, Carlton

    1994-01-01

    Needle sharing by intravenous drug users has been a means of transmission of acquired immune deficiency syndrome virus. Educational efforts have been directed at reduction of needle sharing, and some cities have supplied free needles. While transmission of human immunodeficiency virus through intravenous drug use remains significant problem, there…

  15. License restrictions at Barnwell

    SciTech Connect

    Autry, V.R.

    1991-12-31

    The State of South Carolina was delegated the authority by the US Nuclear Regulatory Commission to regulate the receipt, possession, use and disposal of radioactive material as an Agreement State. Since 1970, the state has been the principal regulatory authority for the Barnwell Low-Level Waste Disposal Facility operated by Chem-Nuclear Systems, Inc. The radioactive material license issued authorizing the receipt and disposal of low-level waste contains numerous restrictions to ensure environmental protection and compliance with shallow land disposal performance criteria. Low-level waste has evolved from minimally contaminated items to complex waste streams containing high concentrations of radionuclides and processing chemicals which necessitated these restrictions. Additionally, some waste with their specific radionuclides and concentration levels, many classified as low-level radioactive waste, are not appropriate for shallow land disposal unless additional precautions are taken. This paper will represent a number of these restrictions, the rationale for them, and how they are being dealt with at the Barnwell disposal facility.

  16. Help Desk Answers: Are IV fluids better than oral rehydration for children with acute diarrhea and vomiting?

    PubMed

    Patnaik, Suvag; Nanda, Mitali; Tiburicio, Jose

    2016-04-01

    Intravenous fluid therapy (IVF) has a slightly lower failure rate than oral replacement therapy (ORT) in children with acute gastroenteritis, but the clinical significance is questionable. IVF takes longer to initiate than ORT and lengthens the hospital stay. PMID:27262252

  17. Glass Microfluidics for Quantum Fluids in Restricted Geometries

    NASA Astrophysics Data System (ADS)

    Davis, J. P.; Rojas, X.

    2015-03-01

    Over the past few years we have developed a suite of measurements based on precisely defined glass microfluidic structures. Such measurements include sound velocity and attenuation in an acoustic analog of a Fabry-Perot cavity and now a superfluid 4He nanomechanical Helmholtz resonator. The latter is capable of precisely determining the superfluid density, which will be useful of exploration of Majorana fermions at the surface of 3He-B, as well as studies of quantum nanomechanical resonators. I will describe our devices and measurements, as well as possible future measurements including studies of quantum turbulence and low-temperature optomechanics. This work was supported by the University of Alberta, Faculty of Science; the Natural Sciences and Engineering Research Council, Canada; the Canada Foundation for Innovation; Alberta Innovates Technology Futures; and the Alfred P. Sloan Foundation.

  18. False-positive tests for syphilis associated with human immunodeficiency virus and hepatitis B virus infection among intravenous drug abusers. Valencian Study Group on HIV Epidemiology.

    PubMed

    Hernández-Aguado, I; Bolumar, F; Moreno, R; Pardo, F J; Torres, N; Belda, J; Espacio, A

    1998-11-01

    The role of HIV, hepatitis C virus, and hepatitis B virus infections in the production of biological false-positive reactions for syphilis was evaluated in two large samples of intravenous drug abusers and homosexual men attending AIDS prevention centers in Spain. A significantly increased odds ratio (OR) for false-positive tests for syphilis [OR 2.23, 95% confidence intervals (CI) 1.76-2.83] was observed for HIV-seropositive intravenous drug abusers; biological false-positive reactions were also more frequent (OR 1.73, 95% CI 1.30-2.31) among intravenous drug abusers who were hepatitis B virus seropositive but not among those who were hepatitis C virus seropositive (OR 0.90; 95% CI 0.48-1.69). Among homosexuals, the association between HIV and biological false-positive reactions was restricted to subjects who were also intravenous drug abusers, indicating the crucial role of intravenous drug abuse. Only 20.5% of intravenous drug abusers with a previous biological false-positive reaction yielded a false-positive result in their subsequent visit.

  19. Fluid Shifts

    NASA Technical Reports Server (NTRS)

    Stenger, M.; Hargens, A.; Dulchavsky, S.; Ebert, D.; Lee, S.; Lauriie, S.; Garcia, K.; Sargsyan, A.; Martin, D.; Ribeiro, L.; Lui, J.; Macias, B.; Arbeille, P.; Danielson, R.; Chang, D.; Johnston, S.; Ploutz-Snyder, R.; Smith, S.

    2016-01-01

    NASA is focusing on long-duration missions on the International Space Station (ISS) and future exploration-class missions beyond low-Earth orbit. Visual acuity changes observed after short-duration missions were largely transient, but more than 50% of ISS astronauts experienced more profound, chronic changes with objective structural and functional findings such as papilledema and choroidal folds. Globe flattening, optic nerve sheath dilation, and optic nerve tortuosity also are apparent. This pattern is referred to as the visual impairment and intracranial pressure (VIIP) syndrome. VIIP signs and symptoms, as well as postflight lumbar puncture data, suggest that elevated intracranial pressure (ICP) may be associated with the spaceflight-induced cephalad fluid shifts, but this hypothesis has not been tested. The purpose of this study is to characterize fluid distribution and compartmentalization associated with long-duration spaceflight, and to correlate these findings with vision changes and other elements of the VIIP syndrome. We also seek to determine whether the magnitude of fluid shifts during spaceflight, as well as the VIIP-related effects of those shifts, is predicted by the crewmember's preflight conditions and responses to acute hemodynamic manipulations (such as head-down tilt). Lastly, we will evaluate the patterns of fluid distribution in ISS astronauts during acute reversal of fluid shifts through application of lower body negative pressure (LBNP) interventions to characterize and explain general and individual responses. METHODS: We will examine a variety of physiologic variables in 10 long-duration ISS crewmembers using the test conditions and timeline presented in the Figure below. Measures include: (1) fluid compartmentalization (total body water by D2O, extracellular fluid by NaBr, intracellular fluid by calculation, plasma volume by CO rebreathe, interstitial fluid by calculation); (2) forehead/eyelids, tibia, calcaneus tissue thickness (by

  20. Fluid inflation

    SciTech Connect

    Chen, X.; Firouzjahi, H.; Namjoo, M.H.; Sasaki, M. E-mail: firouz@ipm.ir E-mail: misao@yukawa.kyoto-u.ac.jp

    2013-09-01

    In this work we present an inflationary mechanism based on fluid dynamics. Starting with the action for a single barotropic perfect fluid, we outline the procedure to calculate the power spectrum and the bispectrum of the curvature perturbation. It is shown that a perfect barotropic fluid naturally gives rise to a non-attractor inflationary universe in which the curvature perturbation is not frozen on super-horizon scales. We show that a scale-invariant power spectrum can be obtained with the local non-Gaussianity parameter f{sub NL} = 5/2.

  1. Intraoperative Fluids and Fluid Management for Ambulatory Dental Sedation and General Anesthesia.

    PubMed

    Saraghi, Mana

    2015-01-01

    Intravenous fluids are administered in virtually every parenteral sedation and general anesthetic. The purpose of this article is to review the physiology of body-water distribution and fluid dynamics at the vascular endothelium, evaluation of fluid status, calculation of fluid requirements, and the clinical rationale for the use of various crystalloid and colloid solutions. In the setting of elective dental outpatient procedures with minor blood loss, isotonic balanced crystalloid solutions are the fluids of choice. Colloids, on the other hand, have no use in outpatient sedation or general anesthesia for dental or minor oral surgery procedures but may have several desirable properties in long and invasive maxillofacial surgical procedures where advanced hemodynamic monitoring may assess the adequacy of intravascular volume. PMID:26650497

  2. Intraoperative Fluids and Fluid Management for Ambulatory Dental Sedation and General Anesthesia.

    PubMed

    Saraghi, Mana

    2015-01-01

    Intravenous fluids are administered in virtually every parenteral sedation and general anesthetic. The purpose of this article is to review the physiology of body-water distribution and fluid dynamics at the vascular endothelium, evaluation of fluid status, calculation of fluid requirements, and the clinical rationale for the use of various crystalloid and colloid solutions. In the setting of elective dental outpatient procedures with minor blood loss, isotonic balanced crystalloid solutions are the fluids of choice. Colloids, on the other hand, have no use in outpatient sedation or general anesthesia for dental or minor oral surgery procedures but may have several desirable properties in long and invasive maxillofacial surgical procedures where advanced hemodynamic monitoring may assess the adequacy of intravascular volume.

  3. Fluid Shifts

    NASA Technical Reports Server (NTRS)

    Stenger, Michael B.; Hargens, Alan R.; Dulchavsky, Scott A.; Ebert, Douglas J.; Lee, Stuart M. C.; Laurie, Steven S.; Garcia, Kathleen M.; Sargsyan, Ashot E.; Martin, David S.; Liu, John; Macias, Brandon R.; Arbeille, Philippe; Danielson, Richard; Chang, Douglas; Gunga, Hanns-Christian; Johnston, Smith L.; Westby, Christian M.; Ploutz-Snyder, Robert J.; Smith, Scott M.

    2016-01-01

    We hypothesize that microgravity-induced cephalad fluid shifts elevate intracranial pressure (ICP) and contribute to VIIP. We will test this hypothesis and a possible countermeasure in ISS astronauts.

  4. Amniotic fluid

    MedlinePlus

    ... baby is born), or gestational diabetes . Too little amniotic fluid is known as oligohydramnios. This condition may occur with late pregnancies, ruptured membranes, placental dysfunction , or fetal abnormalities. Abnormal amounts of ...

  5. Drilling fluids

    SciTech Connect

    Swanson, B.L.

    1984-01-10

    Polyethylene glycols in combination with at least one water-dispersible polymeric viscosifier comprising cellulose ethers, cellulose sulfate esters, polyacrylamides, guar gum, or heteropolysaccharides improve the water loss properties of water-based drilling fluids, particularly in hard brine environments.

  6. Amniotic Fluid

    PubMed Central

    Smith, Heather C.; Muglia, Louis J.; Morrow, Ardythe L.

    2014-01-01

    Our aim was to review the use of high-dimensional biology techniques, specifically transcriptomics, proteomics, and metabolomics, in amniotic fluid to elucidate the mechanisms behind preterm birth or assessment of fetal development. We performed a comprehensive MEDLINE literature search on the use of transcriptomic, proteomic, and metabolomic technologies for amniotic fluid analysis. All abstracts were reviewed for pertinence to preterm birth or fetal maturation in human subjects. Nineteen articles qualified for inclusion. Most articles described the discovery of biomarker candidates, but few larger, multicenter replication or validation studies have been done. We conclude that the use of high-dimensional systems biology techniques to analyze amniotic fluid has significant potential to elucidate the mechanisms of preterm birth and fetal maturation. However, further multicenter collaborative efforts are needed to replicate and validate candidate biomarkers before they can become useful tools for clinical practice. Ideally, amniotic fluid biomarkers should be translated to a noninvasive test performed in maternal serum or urine. PMID:23599373

  7. Fluid Shifts

    NASA Technical Reports Server (NTRS)

    Stenger, M. B.; Hargens, A.; Dulchavsky, S.; Ebert, D.; Lee, S.; Laurie, S.; Garcia, K.; Sargsyan, A.; Martin, D.; Lui, J.; Macias, B.; Arbeille, P.; Danielson, R.; Chang, D.; Gunga, H.; Johnston, S.; Westby, C.; Ribeiro, L.; Ploutz-Snyder, R.; Smith, S.

    2015-01-01

    INTRODUCTION: Mechanisms responsible for the ocular structural and functional changes that characterize the visual impairment and intracranial pressure (ICP) syndrome (VIIP) are unclear, but hypothesized to be secondary to the cephalad fluid shift experienced in spaceflight. This study will relate the fluid distribution and compartmentalization associated with long-duration spaceflight with VIIP symptoms. We also seek to determine whether the magnitude of fluid shifts during spaceflight, as well as the VIIP-related effects of those shifts, can be predicted preflight with acute hemodynamic manipulations, and also if lower body negative pressure (LBNP) can reverse the VIIP effects. METHODS: Physiologic variables will be examined pre-, in- and post-flight in 10 International Space Station crewmembers including: fluid compartmentalization (D2O and NaBr dilution); interstitial tissue thickness (ultrasound); vascular dimensions and dynamics (ultrasound and MRI (including cerebrospinal fluid pulsatility)); ocular measures (optical coherence tomography, intraocular pressure, ultrasound); and ICP measures (tympanic membrane displacement, otoacoustic emissions). Pre- and post-flight measures will be assessed while upright, supine and during 15 deg head-down tilt (HDT). In-flight measures will occur early and late during 6 or 12 month missions. LBNP will be evaluated as a countermeasure during HDT and during spaceflight. RESULTS: The first two crewmembers are in the preflight testing phase. Preliminary results characterize the acute fluid shifts experienced from upright, to supine and HDT postures (increased stroke volume, jugular dimensions and measures of ICP) which are reversed with 25 millimeters Hg LBNP. DISCUSSION: Initial results indicate that acute cephalad fluid shifts may be related to VIIP symptoms, but also may be reversible by LBNP. The effect of a chronic fluid shift has yet to be evaluated. Learning Objectives: Current spaceflight VIIP research is described

  8. Electrorheological fluids

    SciTech Connect

    Halsey, T.C.; Martin, J.E.

    1993-10-01

    An electrorheological fluid is a substance whose form changes in the presence of electric fields. Depending on the strength of the field to which it is subjected, an electrorheological fluid can run freely like water, ooze like honey or solidify like gelatin. Indeed, the substance can switch from ne state to another within a few milliseconds. Electrorheological fluids are easy to make; they consist of microscopic particles suspended in an insulating liquid. Yet they are not ready for most commercial applications. They tend to suffer from a number of problems, including structural weakness as solids, abrasiveness as liquids and chemical breakdown, especially at high temperatures. Automotive engineers could imagine, for instance, constructing an electrorheological clutch. It was also hoped that electrorheological fluids would lead to valveless hydraulic systems, in which solidifying fluid would shut off flow through a thin section of pipe. Electrorheological fluids also offer the possibility of a shock absorber that provides response times of milliseconds and does not require mechanical adjustments. 3 refs.

  9. Intravenous angiotensin and salt appetite in rats.

    PubMed

    Fitts, Douglas A; Zierath, Dannielle K; Savos, Anna V; Ho, Jacqueline M; Bassett, John E

    2007-01-01

    Circulating angiotensin II is crucial for the activation of salt appetite after sodium depletion. We tested if angiotensin (ANG) II infused intravenously at 50 ng/kg/min overnight (chronic) can mimic the rapid salt appetite similar to furosemide and overnight sodium depletion. In experiment 1, rats received chronic ANG II or vehicle infusions all night with access to water and chow but no saline solution. In the morning, the infusions continued, but half of the vehicle-infused group was switched to ANG II (acute). Thirty minutes after the switch, all rats received 10 mg/kg furosemide SC. One hour later they were provided water and 0.3 M NaCl to drink. Rats infused with vehicle or acute ANG drank little, but the chronic ANG group drank 11+/-1 ml of saline in 90 min. In experiment 2, the furosemide was omitted, and a group receiving a chronic infusion of phenylephrine at 6.25 microg/kg/min was included. The chronic ANG group drank 10+/-1 ml saline in 90 min, but the phenylephrine group, which also incurred a significant negative sodium balance overnight, drank little. Thus, an overnight infusion of ANG II is sufficient to mimic the robust expression of salt appetite as observed after furosemide and overnight sodium depletion.

  10. Pharmacokinetic interaction of intravenous fentanyl with ketoconazole.

    PubMed

    Ziesenitz, Victoria C; König, Sonja K; Mahlke, Nina S; Skopp, Gisela; Haefeli, Walter E; Mikus, Gerd

    2015-06-01

    Fentanyl is primarily metabolized by CYP3A, but has also been suggested to act as a weak inhibitor of CYP3A. We investigated the influence of CYP3A inhibition by ketoconazole on the pharmacokinetics of intravenously administered fentanyl and the effect of fentanyl on CYP3A activity. A prospective, open-label, randomized, monocentre, crossover study was conducted in 16 healthy volunteers. They received fentanyl alone (5 microgram per kilogram) or fentanyl plus ketoconazole (200 milligram orally B.I.D. over 2 days). Naloxone (2 × 0.2 milligram i.v.) was given simultaneously with fentanyl to mitigate any opioid effect. Midazolam was administered as a CYP3A probe drug. Fentanyl and its metabolites were quantified by LC/MS/MS in blood and urine samples obtained over 24 hour. Exposure of fentanyl (AUC0- ∞ ) was significantly increased to 133% and systemic clearance was reduced to 78% by ketoconazole, norfentanyl formation was significantly delayed and partial metabolic clearance decreased to 18%. Fentanyl had no influence on midazolam exposure and CYP3A activity whereas ketoconazole decreased CYP3A activity to 13%. Although fentanyl N-dealkylation is substantially inhibited by ketoconazole, exposure of fentanyl itself increased by one third only. Clinically fentanyl dosage adjustments may become necessary when ketoconazole or other strong CYP3A inhibitors are given simultaneously. Fentanyl itself does not influence CYP3A activity.

  11. Do we need an intravenous fluoroquinolone?

    PubMed Central

    Maddix, D S; Warner, L

    1992-01-01

    Intravenous ciprofloxacin, the first parenteral fluoroquinolone available in this country, represents another class of antimicrobial agents from which physicians must choose when treating nosocomial infections. Fluoroquinolones are bactericidal antimicrobial agents that act by inhibiting DNA gyrase. They are active in vitro against most gram-negative bacteria and methicillin-susceptible staphylococci. Activity against anaerobic bacteria and streptococci is poor. The rapid development of bacterial resistance in centers with high quinolone usage is of great concern. Resistance develops most commonly in Pseudomonas aeruginosa and staphylococci. Resistance emerges most often when quinolones are used to treat chronic infections or in patients with poorly drained abscesses, necrotic tissue, or indwelling catheters. Clinical trials have shown ciprofloxacin to be as effective as ceftazidime in the treatment of infections caused by gram-negative bacteria. Although the overall frequency of side effects to fluoroquinolones is low, seizures and allergic reactions have been attributed to their use. Ciprofloxacin inhibits the metabolism of theophylline, and morbidity and death have been reported in patients taking the two drugs concomitantly. Parenteral fluoroquinolones should be reserved for the treatment of gram-negative bacterial infections in patients in whom standard agents cannot be used. PMID:1413744

  12. Multiple Intravenous Infusions Phase 1b

    PubMed Central

    Cassano-Piché, A; Fan, M; Sabovitch, S; Masino, C; Easty, AC

    2012-01-01

    Background Minimal research has been conducted into the potential patient safety issues related to administering multiple intravenous (IV) infusions to a single patient. Previous research has highlighted that there are a number of related safety risks. In Phase 1a of this study, an analysis of 2 national incident-reporting databases (Institute for Safe Medical Practices Canada and United States Food and Drug Administration MAUDE) found that a high percentage of incidents associated with the administration of multiple IV infusions resulted in patient harm. Objectives The primary objectives of Phase 1b of this study were to identify safety issues with the potential to cause patient harm stemming from the administration of multiple IV infusions; and to identify how nurses are being educated on key principles required to safely administer multiple IV infusions. Data Sources and Review Methods A field study was conducted at 12 hospital clinical units (sites) across Ontario, and telephone interviews were conducted with program coordinators or instructors from both the Ontario baccalaureate nursing degree programs and the Ontario postgraduate Critical Care Nursing Certificate programs. Data were analyzed using Rasmussen’s 1997 Risk Management Framework and a Health Care Failure Modes and Effects Analysis. Results Twenty-two primary patient safety issues were identified with the potential to directly cause patient harm. Seventeen of these (critical issues) were categorized into 6 themes. A cause-consequence tree was established to outline all possible contributing factors for each critical issue. Clinical recommendations were identified for immediate distribution to, and implementation by, Ontario hospitals. Future investigation efforts were planned for Phase 2 of the study. Limitations This exploratory field study identifies the potential for errors, but does not describe the direct observation of such errors, except in a few cases where errors were observed. Not all

  13. Automated administration of intermittent intravenous doses.

    PubMed

    Lutomski, D M; Schwartz-Fulton, J; Rivera, J O

    1985-11-01

    The cost difference of administering cimetidine 300 mg via intravenous piggyback (IVPB) every six hours by a conventional separate container system versus using an automated intermittent i.v. administration system was evaluated. The study was conducted in two phases. Phase 1 documented the amount of drug waste with the two systems, and phase 2 examined the practical use of the IVAC Multi Dose System. Nurses who administered the medication using the multiple-dose system completed a questionnaire on its operation. A materials cost analysis was performed to compare the two methods. The two systems were found to have approximately equivalent amounts of drug waste over the 30-day evaluation period of phase 1. The mean percentage of doses wasted was 12.2% with the conventional single-dose minibag method and 12.7% with the automated multiple-dose method. The multiple-dose system had a lower cost per dose of cimetidine ($2.25 versus $3.47). These savings appear to outweigh the cost of the additional equipment necessary for the automated system. The majority of nurses preferred the multiple-dose system. Potential problems encountered in accurately delivering doses with the multiple-dose automated system were identified, and possible solutions are suggested. The use of an automated multiple-dose i.v. administration system can potentially decrease the materials cost portion of drug administration. The total impact on hospital costs needs to be evaluated, and other comparisons with alternative administration systems need to be performed.

  14. Repeated intravenous doxapram induces phrenic motor facilitation

    PubMed Central

    Sandhu, MS; Lee, KZ; Gonzalez-Rothi, EJ; Fuller, DD

    2013-01-01

    Doxapram is a respiratory stimulant used to treat hypoventilation. Here we investigated whether doxapram could also trigger respiratory neuroplasticity. Specifically, we hypothesized that intermittent delivery of doxapram at low doses would lead to long-lasting increases (i.e., facilitation) of phrenic motor output in anesthetized, vagotomized, and mechanically-ventilated rats. Doxapram was delivered intravenously in a single bolus (2 or 6 mg/kg) or as a series of 3 injections (2 mg/kg) at 5 min intervals. Control groups received pH-matched saline injections (vehicle) or no treatment (anesthesia time control). Doxapram evoked an immediate increase in phrenic output in all groups, but a persistent increase in burst amplitude only occurred after repeated dosing with 2 mg/kg. At 60 min following the last injection, phrenic burst amplitude was 168±24% of baseline (%BL) in the group receiving 3 injections (P < 0.05 vs. controls), but was 103±8%BL and 112±4%BL in the groups receiving a single dose of 2 or 6 mg/kg, respectively. Following bilateral section of the carotid sinus nerves, the acute phrenic response to doxapram (2 mg/kg) was reduced by 68% suggesting that at low doses the drug was acting primarily via the carotid chemoreceptors. We conclude that intermittent application of doxapram can trigger phrenic neuroplasticity, and this approach might be of use in the context of respiratory rehabilitation following neurologic injury. PMID:24013015

  15. Intravenous buprenorphine and norbuprenorphine pharmacokinetics in humans

    PubMed Central

    Huestis, M.A.; Cone, E.J.; Pirnay, S.O.; Umbricht, A.; Preston, K.L.

    2013-01-01

    Background Prescribed sublingual (SL) buprenorphine is sometimes diverted for intravenous (IV) abuse, but no human pharmacokinetic data are available following high-dose IV buprenorphine. Methods Plasma was collected for 72 h after administration of placebo or 2, 4, 8, 12, or 16 mg IV buprenorphine in escalating order (single-blind, double-dummy) in 5 healthy male non-dependent opioid users. Buprenorphine and its primary active metabolite, norbuprenorphine, were quantified by liquid chromatography tandem mass spectrometry with limits of quantitation of 0.1 μg/L. Results Maximum buprenorphine concentrations (mean ± SE) were detected 10 min after 2, 4, 8, 12, 16 mg IV: 19.3±1.0, 44.5±4.8, 85.2±7.7, 124.6±16.6, and 137.7±18.8 μg/L, respectively. Maximum norbuprenorphine concentrations occurred 10–15 min (3.7±0.7 μg/L) after 16 mg IV administration. Conclusions Buprenorphine concentrations increased in a significantly linear dose-dependent manner up to 12 mg IV buprenorphine. Thus, previously demonstrated pharmacodynamic ceiling effects (over 2–16 mg) are not due to pharmacokinetic adaptations within this range, although they may play a role at doses higher than 12 mg. PMID:23246635

  16. Do colloids in comparison to crystalloids for fluid resuscitation improve mortality?

    PubMed

    Naing, Cho-Min; Win, Daw-Khin

    2010-05-01

    Permanent neurological impairment or death arising from hospital-acquired hyponatremia in both children and adults is well documented. The choice of intravenous fluids for fluid resuscitation in critically ill patients is a top priority in evidence-based medicine. The question of whether colloids in comparison to crystalloids can improve mortality in such cases remains to be answered. Well powered, randomized clinical trials addressing the comparative efficacy of different types of intravenous fluids is a high priority as is the ethical justification for such trials. The understanding of the pathophysiological process serves important information on clinical practice.

  17. Intravenous Rh immune globulin for treating immune thrombocytopenic purpura.

    PubMed

    Sandler, S G

    2001-11-01

    Intravenous Rh [corrected] immune globulin was licensed by the U. S. Food and Drug administration in 1995 for the treatment of acute and chronic immune thrombocytopenic purpura in children and chronic immune thrombocytopenic purpura in adults. In 1996, the American Society of Hematology published a practice guideline for immune thrombocytopenic purpura, but treatment recommendations of necessity were formulated using only results of early clinical trials with intravenous Rh immune globulin. To date, there are no published results of large-scale clinical trials comparing conventional doses of intravenous immune globulin with the most promising dose range for intravenous Rh immune globulin (50-75 microg/kg). However, clinical experience is accumulating to indicate that intravenous Rh immune globulin is as effective, probably safer, and easier to administer than intravenous immune globulin. Acute intravascular hemolysis after infusions of intravenous Rh immune globulin for immune thrombocytopenic purpura has been reported with an estimated incidence of 1 in 1,115 patients. The risk factors for this adverse event have not been defined.

  18. Intravenous iron therapy: how far have we come?

    PubMed Central

    Cançado, Rodolfo Delfini; Muñoz, Manuel

    2011-01-01

    Oral iron supplementation is usually the first choice for the treatment of iron deficiency anemia (IDA) because of its effectiveness and low cost. But unfortunately in many iron deficient conditions, oral iron is a less than the ideal treatment mainly because of adverse events related to the gastrointestinal tract as well as the long course required to treat anemia and replenish body iron stores. The first iron product for intravenous use was high-molecular-weight iron dextran. However, dextran-containing intravenous iron preparations are associated with an elevated risk of anaphylactic reactions, which made physicians reluctant to prescribe intravenous iron in the treatment of iron deficiency anemia for many years. In 1999 and 2001, two new intravenous iron preparations (ferric gluconate and iron sucrose) were introduced into the market as safer alternatives to iron dextran. Over the last five years, three new intravenous iron dextran-free preparations have been developed and have better safety profiles than the more traditional intravenous compounds, as none require test doses and all these products are promising in respect to a more rapid replacement of body iron stores (15-60 minutes/infusion) as they can be given at higher doses (from 500 mg to more than 1000 mg/infusion). The purpose of this review is to discuss some pertinent issues in relation to the history, pharmacology, administration, efficacy, safety profile and toxicity of intravenous iron for the treatment of iron deficiency anemia. PMID:23049364

  19. Concept to comfort-condition subjects wearing restrictive clothing

    NASA Technical Reports Server (NTRS)

    Tucker, E. M.

    1968-01-01

    Heat exchanger maintains a desirable thermal balance in a subject wearing restrictive clothing. A grid of high thermal conductance fibers, in contact with the skin, transfers heat to or from the skin surface by means of a system of ducts, carrying the transfer fluid which is maintained at a controlled temperature.

  20. Comparison of analgesic efficacy of intravenous Paracetamol and intravenous dexketoprofen trometamol in multimodal analgesia after hysterectomy

    PubMed Central

    Ünal, Çiğdem; Çakan, Türkay; Baltaci, Bülent; Başar, Hülya

    2013-01-01

    Backround: We aimed to evaluate analgesic efficacy, opioid-sparing, and opioid-related adverse effects of intravenous paracetamol and intravenous dexketoprofen trometamol in combination with iv morphine after total abdominal hysterectomy. Materials and Methods: Sixty American Society of Anesthesiologist Physical Status Classification I-II patients scheduled for total abdominal hysterectomy were enrolled to this double-blinded, randomized, placebo controlled, and prospective study. Patients were divided into three groups as paracetamol, dexketoprofen trometamol, and placebo (0.9% NaCl) due to their post-operative analgesic usage. Intravenous patient controlled analgesia morphine was used as a rescue analgesic in all groups. Pain scores, hemodynamic parameters, morphine consumption, patient satisfaction, and side-effects were evaluated. Results: Visual Analog Scale (VAS) scores were not statistically significantly different among the groups in all evaluation times, but decrease in VAS scores was statistically significant after the evaluation at 12th h in all groups. Total morphine consumption (morphine concentration = 0.2 mg/ml) in group paracetamol (72.3 ± 38.0 ml) and dexketoprofen trometamol (69.3 ± 24.1 ml) was significantly lower than group placebo (129.3 ± 22.6 ml) (P < 0.001). Global satisfaction scores of the patients in group placebo was significantly lower than group dexketoprofen trometamol after surgery and the increase in global satisfaction score was significant only in group placebo. Conclusion: Dexketoprofen trometamol and Paracetamol didn’t cause significant change on pain scores, but increased patients’ comfort. Although total morphine consumption was significantly decreased by both drugs, the incidence of nausea and vomiting were similar among the groups. According to results of the present study routine addition of dexketoprofen trometamol and paracetamol to patient controlled analgesia morphine after hysterectomies is not recommended. PMID

  1. [Intravenous drug users and contact with the health care system].

    PubMed

    Skretting, A

    1990-08-20

    Intravenous drug users in the Oslo area seem to have rather limited contact with treatment programmes (outpatient or inpatient). The data are taken from a survey of intravenous drug use among arrestees at Oslo Central Police Station. 1,394 intravenous drug users were examined. Less than one third reported having had any contact with a treatment programme during the last six months, and less than 50% reported such contact during the last two years. More than 50% said that they had never been admitted to an inpatient treatment institution.

  2. Therapeutic potential of ghrelin in restricting-type anorexia nervosa.

    PubMed

    Hotta, Mari; Ohwada, Rina; Akamizu, Takashi; Shibasaki, Tamotsu; Kangawa, Kenji

    2012-01-01

    Anorexia nervosa (AN) is an eating disorder characterized by a decrease in caloric intake and malnutrition. It is associated with a variety of medical morbidities as well as significant mortality. Nutritional support is of paramount importance to prevent impaired quality of life later in life in affected patients. Some patients with restricting-type AN who are fully motivated to gain body weight cannot increase their food intake because of malnutrition-induced gastrointestinal dysfunction. Chronicity of AN prevents participation in social activities and leads to increased medical expenses. Therefore, there is a pressing need for effective appetite-stimulating therapies for patients with AN. Ghrelin is the only orexigenic hormone that can be given intravenously. Intravenous infusion of ghrelin is reported to increase food intake and body weight in healthy subjects as well as in patients with poor nutritional status. Here, we introduce the results of a pilot study that investigated the effects of ghrelin on appetite, energy intake, and nutritional parameters in five patients with restricting-type AN, who are fully motivated to gain body weight but could not increase their food intake because of malnutrition-induced gastrointestinal dysfunction.

  3. Applications of intravenous immunoglobulin in haematology.

    PubMed

    Todd, A A; Yap, P L

    1992-06-01

    Intravenous immunoglobulin (IVIgG) has many potential applications in haematology both as antibody replacement therapy and as an immune-modulater in autoimmune disorders. Antibody replacement appears to be of value in the prophylaxis of infection in low-grade B-cell malignancies, in bone marrow transplant recipients and in children with AIDS, although optimal treatment strategies have not been assessed and determining which patients are likely to derive greatest benefit has been problematic. IVIgG appears to be effective in the prevention or amelioration of CMV-related pathology if given frequently and has also dramatically improved the survival of patients with established interstitial pneumonia when used in combination with ganciclovir. Intriguingly, IVIgG appears to moderate the severity of GVHD in adult transplant recipients. IVIgG has short term efficacy in most patients with ITP but, as long term remissions are uncommon, it has become necessary to be more selective in the use of IVIgG in this disorder. The response to IVIgG in other immune-mediated cytopenias is similar with generally transient improvement but also with occasional spectacular cures. The treatment of the acquired haemophilias with IVIgG has yielded in vivo and vitro evidence to support the idiotype-antiidiotype theory of IVIgG immune-modulation and has also demonstrated significant differences in the sensitivity of coagulation factor autoantibodies and alloantibodies to IVIgG therapy. IVIgG has several roles in pregnancy related disorders, including the management of both mother and fetus in ITP during pregnancy, the antenatal and postnatal management of platelet alloimmunisation and also in the management of severe rhesus isoimmunisation. IVIgG is safe and well tolerated. The expense of this therapy should be balanced against the likely gains and the overall costs of alternative approaches.

  4. Fluid Shifts

    NASA Technical Reports Server (NTRS)

    Stenger, Michael; Hargens, A.; Dulchavsky, S.; Ebert, D.; Lee, S.; Sargsyan, A.; Martin, D.; Lui, J.; Macias, B.; Arbeille, P.; Platts, S.

    2014-01-01

    NASA is focusing on long-duration missions on the International Space Station (ISS) and future exploration-class missions beyond low Earth orbit. Visual acuity changes observed after short-duration missions were largely transient, but more than 30% of ISS astronauts experience more profound, chronic changes with objective structural and functional findings such as papilledema and choroidal folds. Globe flattening, optic nerve sheath dilation, and optic nerve tortuosity also are apparent. This pattern is referred to as the visual impairment and intracranial pressure (VIIP) syndrome. VIIP signs and symptoms, as well as postflight lumbar puncture data, suggest that elevated intracranial pressure (ICP) may be associated with the space flight-induced cephalad fluid shifts, but this hypothesis has not been tested. The purpose of this study is to characterize fluid distribution and compartmentalization associated with long-duration space flight, and to correlate these findings with vision changes and other elements of the VIIP syndrome. We also seek to determine whether the magnitude of fluid shifts during space flight, as well as the VIIP-related effects of those shifts, is predicted by the crewmember's pre-flight condition and responses to acute hemodynamic manipulations (such as head-down tilt). Lastly, we will evaluate the patterns of fluid distribution in ISS astronauts during acute reversal of fluid shifts through application of lower body negative pressure (LBNP) interventions to characterize and explain general and individual responses. We will examine a variety of physiologic variables in 10 long-duration ISS crewmembers using the test conditions and timeline presented in the Figure below. Measures include: (1) fluid compartmentalization (total body water by D2O, extracellular fluid by NaBr, intracellular fluid by calculation, plasma volume by CO rebreathe, interstitial fluid by calculation); (2) forehead/eyelids, tibia, calcaneus tissue thickness (by ultrasound

  5. Cost of post-operative intravenous iron therapy in total lower limb arthroplasty: a retrospective, matched cohort study

    PubMed Central

    Muñoz, Manuel; Gómez-Ramírez, Susana; Martín-Montañez, Elisa; Naveira, Enrique; Seara, Javier; Pavía, José

    2014-01-01

    Background Requirements for allogeneic red cell transfusion after total lower limb arthroplasty are still high (20–50%), and post-operative intravenous iron has been shown to reduce transfusion requirements for this surgery. We performed a cost analysis to ascertain whether this alternative is also likely to be cost-effective. Materials and methods Data from 182 matched-pairs of total lower limb arthroplasty patients, managed with a restrictive transfusion protocol and without (control group) or with post-operative intravenous iron (iron group), were retrospectively reviewed. Acquisition and administration costs of iron (iron sucrose or ferric carboxymaltose) and allogeneic red cell concentrates, haemoglobin measurements, and prolonged stay in hospital were used for blood management cost analysis. Results Patients in the iron group received 600 mg intravenous iron, without clinically relevant incidents, and had a lower allogeneic transfusion rate (11.5% vs 26.4% for the iron and control groups, respectively; p=0.001). The reduction in transfusion rate was more pronounced in anaemic patients (17% vs 40%; p=0.015) than in non-anaemic ones (9.6% vs 21.2%; p=0.011). There were no differences with respect to post-operative infection rate. Patients receiving allogeneic transfusion stayed in hospital longer (+1.9 days [95% CI: 1.2–2.6]). As intravenous iron reduces the allogeneic transfusion rate, both iron formulations were cost-neutral in the different cost scenarios (−25.5 to 62.1 €/patient for iron sucrose, and −51.1 to 64.4 €/patient for ferric carboxymaltose). Discussion In patients presenting with or without pre-operative anaemia, post-operative intravenous iron after total lower limb arthroplasty seems to be safe and is associated with reduced transfusion rates, without incremental costs. For anaemic patients, its efficacy could be increased by associating some other blood-saving method. PMID:24120595

  6. Plasma volume expansion from the intravenous glucose tolerance test before and after hip replacement surgery

    PubMed Central

    2013-01-01

    Background Hyperosmotic glucose is injected intravenously when an intravenous glucose tolerance test (IVGTT) is initiated. The extent and time period of plasma volume expansion that occurs in response to the glucose load has not been studied in the perioperative setting. Methods Twenty-two non-diabetic patients aged between 57 and 76 years (mean 68) underwent an IVGTT, during which 0.3 g/kg of glucose 30% (1 ml/kg) was injected as a bolus over one minute, one day before and two days after hip replacement surgery. Twelve blood samples were collected over 75 minutes from each patient. The turnover of both the exogenous glucose and the injected fluid volume was calculated by means of mass balance and volume kinetic analysis. Results The IVGTT raised plasma glucose by 9 mmol/L and the plasma volume by 8%. The extracellular fluid volume increased by 320 (SD 60) ml of which 2/3 could be accounted for in the plasma. The half-life of the exogenous glucose averaged 30 minutes before surgery and 36 minutes postoperatively (P < 0.02). The glucose elimination governed 86% of the decay of the plasma volume expansion, which occurred with a half-life of 12 minutes before to 21 minutes after the surgery (median, P < 0.001). Conclusion Hyperosmotic glucose translocated intracellular water to the plasma volume rather than to the entire extracellular fluid volume. The preferential re-distribution acts to dilute the plasma concentrations used to quantify insulin sensitivity and ß-cell function from an IVGTT. The greater-than-expected plasma dilution lasted longer after than before surgery. PMID:23978219

  7. Intravenous injection of elemental mercury: A report of two cases

    PubMed Central

    Gopalakrishna, A.; Pavan Kumar, T.V.

    2008-01-01

    Two cases of intravenous injection of elemental mercury are described in this report. One patient succumbed and the other remains asymptomatic two years after the surgical removal of all the injected mercury. Management of intravenous injection of elemental mercury (intended to be an aphrodisiac in these two cases) is discussed here and the need for surgical removal of all accessible mercury has been emphasized. PMID:19753268

  8. Monitoring of propofol and its metabolite during total intravenous anesthesia

    NASA Astrophysics Data System (ADS)

    Elizarov, A. Yu.; Ershov, T. D.; Levshankov, A. I.

    2011-12-01

    Intravenous hypnotic propofol and its metabolite are detected in real time during total intravenous anesthesia by an electron ionization mass spectrometer. The mass spectrometer is connected directly to the breathing circuit of an apparatus for inhalational anesthesia. Ratios between the propofol concentrations in expired air and blood serum are measured. It is concluded that real-time noninvasive monitoring of the propofol concentration in blood using electron ionization mass spectrometry is feasible.

  9. Dietary restriction with and without caloric restriction for healthy aging

    PubMed Central

    Lee, Changhan; Longo, Valter

    2016-01-01

    Caloric restriction is the most effective and reproducible dietary intervention known to regulate aging and increase the healthy lifespan in various model organisms, ranging from the unicellular yeast to worms, flies, rodents, and primates. However, caloric restriction, which in most cases entails a 20–40% reduction of food consumption relative to normal intake, is a severe intervention that results in both beneficial and detrimental effects. Specific types of chronic, intermittent, or periodic dietary restrictions without chronic caloric restriction have instead the potential to provide a significant healthspan increase while minimizing adverse effects. Improved periodic or targeted dietary restriction regimens that uncouple the challenge of food deprivation from the beneficial effects will allow a safe intervention feasible for a major portion of the population. Here we focus on healthspan interventions that are not chronic or do not require calorie restriction. PMID:26918181

  10. Dietary restriction with and without caloric restriction for healthy aging.

    PubMed

    Lee, Changhan; Longo, Valter

    2016-01-01

    Caloric restriction is the most effective and reproducible dietary intervention known to regulate aging and increase the healthy lifespan in various model organisms, ranging from the unicellular yeast to worms, flies, rodents, and primates. However, caloric restriction, which in most cases entails a 20-40% reduction of food consumption relative to normal intake, is a severe intervention that results in both beneficial and detrimental effects. Specific types of chronic, intermittent, or periodic dietary restrictions without chronic caloric restriction have instead the potential to provide a significant healthspan increase while minimizing adverse effects. Improved periodic or targeted dietary restriction regimens that uncouple the challenge of food deprivation from the beneficial effects will allow a safe intervention feasible for a major portion of the population. Here we focus on healthspan interventions that are not chronic or do not require calorie restriction. PMID:26918181

  11. Restrictive vs. non-restrictive composition: a magnetoencephalography study

    PubMed Central

    Leffel, Timothy; Lauter, Miriam; Westerlund, Masha; Pylkkänen, Liina

    2014-01-01

    Recent research on the brain mechanisms underlying language processing has implicated the left anterior temporal lobe (LATL) as a central region for the composition of simple phrases. Because these studies typically present their critical stimuli without contextual information, the sensitivity of LATL responses to contextual factors is unknown. In this magnetoencephalography (MEG) study, we employed a simple question-answer paradigm to manipulate whether a prenominal adjective or determiner is interpreted restrictively, i.e., as limiting the set of entities under discussion. Our results show that the LATL is sensitive to restriction, with restrictive composition eliciting higher responses than non-restrictive composition. However, this effect was only observed when the restricting element was a determiner, adjectival stimuli showing the opposite pattern, which we hypothesise to be driven by the special pragmatic properties of non-restrictive adjectives. Overall, our results demonstrate a robust sensitivity of the LATL to high level contextual and potentially also pragmatic factors. PMID:25379512

  12. Relationship between intravenous use and achieving initial cocaine abstinence.

    PubMed

    Budney, A J; Higgins, S T; Bickel, W; Kent, L

    1993-04-01

    This study assessed whether route of cocaine administration (intravenous vs. intranasal) influences cocaine abstinence during the first 6 weeks of outpatient treatment. Fifty-nine persons received behavioral treatment or standard drug counselling in an outpatient clinic. Based on information collected at intake, intravenous users had fewer years of education, were employed in less skilled jobs, were less likely to be married, reported more negative consequences from cocaine use, reported using more cocaine per occasion and spent more money on cocaine per week than intranasal users. Intravenous and intranasal users did not differ significantly in the average duration of continuous cocaine abstinence (mean = 2.6 vs. mean = 3.3 weeks achieved during 6 weeks of treatment). The duration of abstinence between intravenous and intranasal users was equal in the behavioral treatment (mean = 4.2). In standard treatment the average duration was less among intravenous than intranasal users (mean = 0.9 vs. mean = 2.4), but that difference did not achieve statistical significance. Hepatitis and employment instability were associated with shorter periods of cocaine abstinence among intravenous users, whereas employment instability, lower job skill level, drug use severity and reports of memory loss were associated with shorter periods of cocaine abstinence among intranasal users. These results indicate that i.v. cocaine users can achieve a period of initial abstinence in an outpatient setting comparable to the duration of typical inpatient hospitalizations, although special types of outpatient treatment may be necessary to obtain a positive outcome.

  13. Intravenous lidocaine as a suppressant of coughing during tracheal intubation.

    PubMed

    Yukioka, H; Yoshimoto, N; Nishimura, K; Fujimori, M

    1985-12-01

    Effects of intravenously administered lidocaine on cough suppression during tracheal intubation under general anesthesia were evaluated in two studies. In study 1, 100 patients received either a placebo or 0.5, 1.0, 1.5, or 2.0 mg/kg lidocaine intravenously 1 min before tracheal intubation. All visible coughs were classified as coughing. The incidence of coughing decreased as the dose of lidocaine increased. A dose of 1 mg/kg or more of intravenous lidocaine suppressed the cough reflex significantly (P less than 0.01). Coughing was suppressed completely by 2 mg/kg of intravenous lidocaine. In study 2, 108 patients received 2 mg/kg lidocaine intravenously or a placebo 1, 3, 5, 7, 10, or 15 min before intubation. The same criteria for determining whether a patient did or did not cough during tracheal intubation were used as in study 1. The incidence of coughing decreased significantly (P less than 0.01) when 2 mg/kg of lidocaine was injected intravenously between 1 and 5 min before our attempting intubation. Cough reflex was suppressed completely by plasma concentrations of lidocaine in excess of 3 micrograms/ml. PMID:4061901

  14. Relationship between intravenous use and achieving initial cocaine abstinence.

    PubMed

    Budney, A J; Higgins, S T; Bickel, W; Kent, L

    1993-04-01

    This study assessed whether route of cocaine administration (intravenous vs. intranasal) influences cocaine abstinence during the first 6 weeks of outpatient treatment. Fifty-nine persons received behavioral treatment or standard drug counselling in an outpatient clinic. Based on information collected at intake, intravenous users had fewer years of education, were employed in less skilled jobs, were less likely to be married, reported more negative consequences from cocaine use, reported using more cocaine per occasion and spent more money on cocaine per week than intranasal users. Intravenous and intranasal users did not differ significantly in the average duration of continuous cocaine abstinence (mean = 2.6 vs. mean = 3.3 weeks achieved during 6 weeks of treatment). The duration of abstinence between intravenous and intranasal users was equal in the behavioral treatment (mean = 4.2). In standard treatment the average duration was less among intravenous than intranasal users (mean = 0.9 vs. mean = 2.4), but that difference did not achieve statistical significance. Hepatitis and employment instability were associated with shorter periods of cocaine abstinence among intravenous users, whereas employment instability, lower job skill level, drug use severity and reports of memory loss were associated with shorter periods of cocaine abstinence among intranasal users. These results indicate that i.v. cocaine users can achieve a period of initial abstinence in an outpatient setting comparable to the duration of typical inpatient hospitalizations, although special types of outpatient treatment may be necessary to obtain a positive outcome. PMID:8508724

  15. Total intravenous anesthesia for major burn surgery

    PubMed Central

    Cancio, Leopoldo C; Cuenca, Phillip B; Walker, Stephen C; Shepherd, John M

    2013-01-01

    Total intravenous anesthesia (TIVA) is frequently used for major operations requiring general anesthesia in critically ill burn patients. We reviewed our experience with this approach. Methods: During a 22-month period, 547 major burn surgeries were performed in this center’s operating room and were staffed by full-time burn anesthesiologists. The records of all 123 TIVA cases were reviewed; 112 records were complete and were included. For comparison, 75 cases were selected at random from a total of 414 non-TIVA general anesthetics. Some patients had more than one operation during the study: as appropriate for the analysis in question, each operation or each patient was entered as an individual case. For inter-patient analysis, exposure to 1 or more TIVAs was used to categorize a patient as member of the TIVA group. Results: Excision and grafting comprised 78.2% of the operations. 14 TIVA regimens were used, employing combinations of 4 i.v. drugs: ketamine (K, 91 cases); i.v. methadone (M, 62); fentanyl (F, 58); and propofol (P, 21). The most common regimens were KM (34 cases); KF (26); KMF (16); and K alone (8). Doses used often exceeded those used in non-burn patients. TIVA was preferred for those patients who were more critically ill prior to surgery, with a higher ASA score (3.87 vs. 3.11). Consistent with this, inhalation injury (26.7 vs. 1.6%), burn size (TBSA, 36.3 vs. 15.8%), and full-thickness burn size (FULL, 19.8 vs. 6.5%) were higher in TIVA than in non-TIVA patients. Despite this, intraoperative pressor use was as common in TIVA as in non-TIVA cases (23.9 vs. 22.7%). Conclusions: TIVA was used in patients whose inhalation injury rate and TBSA were greater than those of non-TIVA patients. TIVA cases were not associated with increased hemodynamic instability. TIVA is a viable approach to general anesthesia in critically ill burn patients. PMID:23638329

  16. Recovery of fibrinogen concentrate after intraosseous application is equivalent to the intravenous route in a porcine model of hemodilution

    PubMed Central

    Schlimp, Christoph J.; Solomon, Cristina; Keibl, Claudia; Zipperle, Johannes; Nürnberger, Sylvia; Öhlinger, Wolfgang; Redl, Heinz; Schöchl, Herbert

    2014-01-01

    BACKGROUND Fibrinogen concentrate is increasingly considered as a hemostatic agent for trauma patients experiencing bleeding. Placing a venous access is sometimes challenging during severe hemorrhage. Intraosseous access may be considered instead. Studies of intraosseous infusion of coagulation factor concentrates are limited. We investigated in vivo recovery following intraosseous administration of fibrinogen concentrate and compared the results with intravenous administration. METHODS This study was performed on 12 pigs (mean [SD] body weight, 34.1 [2.8] kg). Following controlled blood loss (35 mL/kg) and fluid replacement with balanced crystalloid solution, intraosseous (n = 6) administration of fibrinogen concentrate (80 mg per kilogram of bodyweight) in the proximal tibia was compared with intravenous (n = 6) administration of the same dose (fibrinogen infusion time approximately 5 minutes in both groups). The following laboratory parameters were assessed: blood cell count, prothrombin time index, activated partial thromboplastin time, and plasma fibrinogen concentration (Clauss assay). Coagulation status was also assessed by thromboelastometry. RESULTS All tested laboratory parameters were comparable between the intraosseous and intravenous groups at baseline, hemodilution, and 30 minutes after fibrinogen concentrate administration. In vivo recovery of fibrinogen was also similar in the two groups (89% [23%] and 91% [22%], respectively). There were no significant between-group differences in any of the thromboelastometric parameters. Histologic examination indicated no adverse effects on the tissue surrounding the intraosseous administration site. CONCLUSION This study suggests that intraosseous administration of fibrinogen concentrate results in a recovery of fibrinogen similar to that of intravenous administration. The intraosseous route of fibrinogen concentrate could be a valuable alternative in situations where intravenous access is not feasible or would

  17. Restricting retrotransposons: a review.

    PubMed

    Goodier, John L

    2016-01-01

    Retrotransposons have generated about 40 % of the human genome. This review examines the strategies the cell has evolved to coexist with these genomic "parasites", focussing on the non-long terminal repeat retrotransposons of humans and mice. Some of the restriction factors for retrotransposition, including the APOBECs, MOV10, RNASEL, SAMHD1, TREX1, and ZAP, also limit replication of retroviruses, including HIV, and are part of the intrinsic immune system of the cell. Many of these proteins act in the cytoplasm to degrade retroelement RNA or inhibit its translation. Some factors act in the nucleus and involve DNA repair enzymes or epigenetic processes of DNA methylation and histone modification. RISC and piRNA pathway proteins protect the germline. Retrotransposon control is relaxed in some cell types, such as neurons in the brain, stem cells, and in certain types of disease and cancer, with implications for human health and disease. This review also considers potential pitfalls in interpreting retrotransposon-related data, as well as issues to consider for future research. PMID:27525044

  18. Improving the usability of intravenous medication labels to support safe medication delivery

    PubMed Central

    Bauer, David T.; Guerlain, Stephanie

    2011-01-01

    Medication label design is frequently a contributing factor to medication errors. Design regulations and recommendations have been predominantly aimed at manufacturers’ product labels. Pharmacy-generated labels have received less scrutiny despite being an integral artifact throughout the medication use process. This article is an account of our efforts to improve the design of a hospital’s intravenous (IV) medication labels. Our analysis revealed a set of interrelated processes and stakeholders that restrict the range of feasible label designs. The technological and system constraints likely vary among hospitals and represent significant barriers to developing and implementing specific design standards. We propose both an ideal IV label design and one that adheres to the current constraints of the hospital under study. PMID:21731156

  19. Antiretroviral restriction factors in mice.

    PubMed

    Nair, Smita; Rein, Alan

    2014-11-26

    One of the most exciting areas in contemporary retrovirus research is the discovery of "restriction factors". These are cellular proteins that act after virus entry to inhibit infection by or replication of retroviruses (and other viruses and intracellular pathogens). We briefly discuss here three antiretroviral restriction factors in mice: Fv1, APOBEC3, and tetherin, touching on both biological and molecular aspects of these restriction systems.

  20. A Kinetic-fluid Model

    SciTech Connect

    First Author = C.Z. Cheng; Jay R. Johnson

    1998-07-10

    A nonlinear kinetic-fluid model for high-beta plasmas with multiple ion species which can be applied to multiscale phenomena is presented. The model embeds important kinetic effects due to finite ion Larmor radius (FLR), wave-particle resonances, magnetic particle trapping, etc. in the framework of simple fluid descriptions. When further restricting to low frequency phenomena with frequencies less than the ion cyclotron frequency the kinetic-fluid model takes a simpler form in which the fluid equations of multiple ion species collapse into single-fluid density and momentum equations and a low frequency generalized Ohm's law. The kinetic effects are introduced via plasma pressure tensors for ions and electrons which are computed from particle distribution functions that are governed by the Vlasov equation or simplified plasma dynamics equations such as the gyrokinetic equation. The ion FLR effects provide a finite parallel electric field, a perpendicular velocity that modifies the ExB drift, and a gyroviscosity tensor, all of which are neglected in the usual one-fluid MHD description. Eigenmode equations are derived which include magnetosphere-ionosphere coupling effects for low frequency waves (e.g., kinetic/inertial Alfven waves and ballooning-mirror instabilities).

  1. Improved Arterial Blood Oxygenation Following Intravenous Infusion of Cold Supersaturated Dissolved Oxygen Solution

    PubMed Central

    Grady, Daniel J; Gentile, Michael A; Riggs, John H; Cheifetz, Ira M

    2014-01-01

    BACKGROUND One of the primary goals of critical care medicine is to support adequate gas exchange without iatrogenic sequelae. An emerging method of delivering supplemental oxygen is intravenously rather than via the traditional inhalation route. The objective of this study was to evaluate the gas-exchange effects of infusing cold intravenous (IV) fluids containing very high partial pressures of dissolved oxygen (>760 mm Hg) in a porcine model. METHODS Juvenile swines were anesthetized and mechanically ventilated. Each animal received an infusion of cold (13 °C) Ringer’s lactate solution (30 mL/kg/hour), which had been supersaturated with dissolved oxygen gas (39.7 mg/L dissolved oxygen, 992 mm Hg, 30.5 mL/L). Arterial blood gases and physiologic measurements were repeated at 15-minute intervals during a 60-minute IV infusion of the supersaturated dissolved oxygen solution. Each animal served as its own control. RESULTS Five swines (12.9 ± 0.9 kg) were studied. Following the 60-minute infusion, there were significant increases in PaO2 and SaO2 (P < 0.05) and a significant decrease in PaCO2 (P < 0.05), with a corresponding normalization in arterial blood pH. Additionally, there was a significant decrease in core body temperature (P < 0.05) when compared to the baseline preinfusion state. CONCLUSIONS A cold, supersaturated dissolved oxygen solution may be intravenously administered to improve arterial blood oxygenation and ventilation parameters and induce a mild therapeutic hypothermia in a porcine model. PMID:25249764

  2. Fluid Mechanics

    NASA Astrophysics Data System (ADS)

    Pnueli, David; Gutfinger, Chaim

    1997-01-01

    This text is intended for the study of fluid mechanics at an intermediate level. The presentation starts with basic concepts, in order to form a sound conceptual structure that can support engineering applications and encourage further learning. The presentation is exact, incorporating both the mathematics involved and the physics needed to understand the various phenomena in fluid mechanics. Where a didactical choice must be made between the two, the physics prevails. Throughout the book the authors have tried to reach a balance between exact presentation, intuitive grasp of new ideas, and creative applications of concepts. This approach is reflected in the examples presented in the text and in the exercises given at the end of each chapter. Subjects treated are hydrostatics, viscous flow, similitude and order of magnitude, creeping flow, potential flow, boundary layer flow, turbulent flow, compressible flow, and non-Newtonian flows. This book is ideal for advanced undergraduate students in mechanical, chemical, aerospace, and civil engineering. Solutions manual available.

  3. Fluid extraction

    DOEpatents

    Wai, Chien M.; Laintz, Kenneth E.

    1999-01-01

    A method of extracting metalloid and metal species from a solid or liquid material by exposing the material to a supercritical fluid solvent containing a chelating agent is described. The chelating agent forms chelates that are soluble in the supercritical fluid to allow removal of the species from the material. In preferred embodiments, the extraction solvent is supercritical carbon dioxide and the chelating agent is a fluorinated .beta.-diketone. In especially preferred embodiments the extraction solvent is supercritical carbon dioxide, and the chelating agent comprises a fluorinated .beta.-diketone and a trialkyl phosphate, or a fluorinated .beta.-diketone and a trialkylphosphine oxide. Although a trialkyl phosphate can extract lanthanides and actinides from acidic solutions, a binary mixture comprising a fluorinated .beta.-diketone and a trialkyl phosphate or a trialkylphosphine oxide tends to enhance the extraction efficiencies for actinides and lanthanides. The method provides an environmentally benign process for removing contaminants from industrial waste without using acids or biologically harmful solvents. The method is particularly useful for extracting actinides and lanthanides from acidic solutions. The chelate and supercritical fluid can be regenerated, and the contaminant species recovered, to provide an economic, efficient process.

  4. Intravenous magnesium sulfate does not increase ventricular CSF ionized magnesium concentration of patients with intracranial hypertension.

    PubMed

    Brewer, R P; Parra, A; Borel, C O; Hopkins, M B; Reynolds, J D

    2001-01-01

    Magnesium sulfate has attracted interest as a potential neuroprotectant but passage of magnesium ion into the central nervous system has not been well documented. For this study, we quantified plasma and cerebrospinal fluid (CSF) ionized magnesium concentration after systemic magnesium sulfate infusion in patients with intracranial hypertension. Patients ( N = 9) received an intravenous infusion of 5 g/20 mmol magnesium sulfate (125 mL of a 4% wt/vol solution) over 30 minutes. Before and after dosing, CSF (from an indwelling ventricular catheter) and blood samples were collected at hourly intervals. Ionized magnesium concentration in all samples was determined using an electrolyte analyzer. Baseline plasma and CSF ionized magnesium concentrations were 0.58 +/- 0.05 and 0.82 +/- 0.06 mmol/L, respectively. Intravenous magnesium sulfate infusion significantly increased plasma ionized magnesium concentration (peak, 0.89 +/- 0.11 mmol/L), but CSF magnesium levels did not change during the 4-hour study. Systemic administration of magnesium sulfate failed to increase CSF ionized magnesium concentration in patients with intracranial hypertension despite increasing plasma magnesium levels by >50%.

  5. Children's Restrictive Disclosure to Friends.

    ERIC Educational Resources Information Center

    Rotenberg, Ken J.; Sliz, Dave

    1988-01-01

    Children's restrictive disclosure to friends, which is a facet of intimate friendship, was investigated. It was found that children in kindergarten, second, and fourth grade showed restrictive disclosure to friends, and that greater disclosure of positive personal information to friends than to nonfriends was exhibited with age. (PCB)

  6. Long-Term Efficacy of Postpartum Intravenous Iron Therapy

    PubMed Central

    Zimmermann, Roland

    2014-01-01

    Background. The potential benefits of administering a dose of intravenous iron in patients with moderate postpartum anaemia rather than oral iron alone remains unproven. Aims. To determine whether a single injection of intravenous iron followed by a 6-week course of oral iron is as effective over 6 months in restoring normal haemoglobin levels and replenishing iron stores in women with moderate postpartum anaemia as a course of oral iron alone in women with mild postpartum anaemia. Materials and Methods. Retrospective two-arm cohort study in women with mild postpartum anaemia (haemoglobin 9.6–10.5 g/dL) prescribed iron daily for 6 weeks (N = 150) and women with moderate postpartum anaemia (haemoglobin 8.5–9.5 g/dL), given a single 500 mg injection of intravenous iron followed by iron daily for 6 weeks (N = 75). Haemoglobin and ferritin were measured 6 months postpartum. Results. Haemoglobin returned to similar mean levels in both groups. Ferritin levels were statistically significantly higher in the intravenous + oral group (57.7 ± 49.3 μg/L versus 32.9 ± 20.1 μg/L). Conclusions. Despite lower baseline haemoglobin, intravenous iron carboxymaltose was superior to oral iron alone in replenishing iron stores in moderate postpartum anaemia and may prove similarly beneficial in mild postpartum anaemia. PMID:25431768

  7. Is intravenous urography still used in patients with prostatism?

    PubMed

    Boelaert, I; Oyen, R; Baert, A L; Baert, L V

    1997-08-01

    The value of intravenous urography in patients with prostatism was retrospectively evaluated. One thousand four hundred ninety five intravenous urograms of male patients referred by the department of urology were reviewed. Based on the clinical information, only patients with complaints of prostatism as a single symptom were selected. Patients with associated symptoms (i.e. hematuria, urinary infection) were excluded. Forty seven patients could be included based on these criteria. In 29 of 47 cases (61.7%) no abnormalities were found. Abnormalities found in 18 cases included dilatation of the excretory system, urinary calculi, congenital anomaly, acquired small kidney, renal cysts and retroperitoneal fibrosis. In 5 cases (10.1%) the intravenous urography necessitated further treatment and/or follow up. In 3.1% prostatism was the indication for the examination. The number of relevant abnormalities at intravenous urography performed for prostatism is low and this is in accordance with results reported in literature. These results provide further evidence for the continuously changing indications for intravenous urography.

  8. Intravenous ferric carboxymaltose for the treatment of iron deficiency anemia

    PubMed Central

    Friedrisch, João Ricardo; Cançado, Rodolfo Delfini

    2015-01-01

    Nutritional iron deficiency anemia is the most common deficiency disorder, affecting more than two billion people worldwide. Oral iron supplementation is usually the first choice for the treatment of iron deficiency anemia, but in many conditions, oral iron is less than ideal mainly because of gastrointestinal adverse events and the long course needed to treat the disease and replenish body iron stores. Intravenous iron compounds consist of an iron oxyhydroxide core, which is surrounded by a carbohydrate shell made of polymers such as dextran, sucrose or gluconate. The first iron product for intravenous use was the high molecular weight iron dextran. However, dextran-containing intravenous iron preparations are associated with an elevated risk of anaphylactic reactions, which made physicians reluctant to use intravenous iron for the treatment of iron deficiency anemia over many years. Intravenous ferric carboxymaltose is a stable complex with the advantage of being non-dextran-containing and a very low immunogenic potential and therefore not predisposed to anaphylactic reactions. Its properties permit the administration of large doses (15 mg/kg; maximum of 1000 mg/infusion) in a single and rapid session (15-minute infusion) without the requirement of a test dose. The purpose of this review is to discuss some pertinent issues in relation to the history, pharmacology, administration, efficacy, and safety profile of ferric carboxymaltose in the treatment of patients with iron deficiency anemia. PMID:26670403

  9. Time Varying Apparent Volume of Distribution and Drug Half-Lives Following Intravenous Bolus Injections.

    PubMed

    Wesolowski, Carl A; Wesolowski, Michal J; Babyn, Paul S; Wanasundara, Surajith N

    2016-01-01

    We present a model that generalizes the apparent volume of distribution and half-life as functions of time following intravenous bolus injection. This generalized model defines a time varying apparent volume of drug distribution. The half-lives of drug remaining in the body vary in time and become longer as time elapses, eventually converging to the terminal half-life. Two example fit models were substituted into the general model: biexponential models from the least relative concentration error, and gamma variate models using adaptive regularization for least relative error of clearance. Using adult population parameters from 41 studies of the renal glomerular filtration marker 169Yb-DTPA, simulations of extracellular fluid volumes of 5, 10, 15 and 20 litres and plasma clearances of 40 and 100 ml/min were obtained. Of these models, the adaptively obtained gamma variate models had longer times to 95% of terminal volume and longer half-lives.

  10. Time Varying Apparent Volume of Distribution and Drug Half-Lives Following Intravenous Bolus Injections

    PubMed Central

    Wesolowski, Carl A.; Wesolowski, Michal J.; Babyn, Paul S.

    2016-01-01

    We present a model that generalizes the apparent volume of distribution and half-life as functions of time following intravenous bolus injection. This generalized model defines a time varying apparent volume of drug distribution. The half-lives of drug remaining in the body vary in time and become longer as time elapses, eventually converging to the terminal half-life. Two example fit models were substituted into the general model: biexponential models from the least relative concentration error, and gamma variate models using adaptive regularization for least relative error of clearance. Using adult population parameters from 41 studies of the renal glomerular filtration marker 169Yb-DTPA, simulations of extracellular fluid volumes of 5, 10, 15 and 20 litres and plasma clearances of 40 and 100 ml/min were obtained. Of these models, the adaptively obtained gamma variate models had longer times to 95% of terminal volume and longer half-lives. PMID:27403663

  11. Time Varying Apparent Volume of Distribution and Drug Half-Lives Following Intravenous Bolus Injections.

    PubMed

    Wesolowski, Carl A; Wesolowski, Michal J; Babyn, Paul S; Wanasundara, Surajith N

    2016-01-01

    We present a model that generalizes the apparent volume of distribution and half-life as functions of time following intravenous bolus injection. This generalized model defines a time varying apparent volume of drug distribution. The half-lives of drug remaining in the body vary in time and become longer as time elapses, eventually converging to the terminal half-life. Two example fit models were substituted into the general model: biexponential models from the least relative concentration error, and gamma variate models using adaptive regularization for least relative error of clearance. Using adult population parameters from 41 studies of the renal glomerular filtration marker 169Yb-DTPA, simulations of extracellular fluid volumes of 5, 10, 15 and 20 litres and plasma clearances of 40 and 100 ml/min were obtained. Of these models, the adaptively obtained gamma variate models had longer times to 95% of terminal volume and longer half-lives. PMID:27403663

  12. Efficacy and Tolerability of Intravenous Levetiracetam in Children

    PubMed Central

    Aceves, Jose; Khan, Owais; Mungall, Diana; Fonkem, Ekokobe; Wright, Chanin; Wenner, Andrea; Kirmani, Batool

    2013-01-01

    Intractable epilepsy in children poses a serious medical challenge. Acute repetitive seizures and status epilepticus leads to frequent emergency room visits and hospital admissions. Delay of treatment may lead to resistance to the first-line anticonvulsant therapies. It has been shown that these children continue to remain intractable even after acute seizure management with approved Food and Drug Administration (FDA) agents. Intravenous levetiracetam, a second-generation anticonvulsant was approved by the FDA in 2006 in patients 16 years and older as an alternative when oral treatment is not an option. Data have been published showing that intravenous levetiracetam is safe and efficacious, and can be used in an acute inpatient setting. This current review will discuss the recent data about the safety and tolerability of intravenous levetiracetam in children and neonates, and emphasize the need for a larger prospective multicenter trial to prove the efficacy of this agent in acute seizure management. PMID:23966977

  13. Peritoneal Fluid Analysis

    MedlinePlus

    ... limited. Home Visit Global Sites Search Help? Peritoneal Fluid Analysis Share this page: Was this page helpful? Formal name: Peritoneal Fluid Analysis Related tests: Pleural Fluid Analysis , Pericardial Fluid ...

  14. Pleural Fluid Analysis Test

    MedlinePlus

    ... limited. Home Visit Global Sites Search Help? Pleural Fluid Analysis Share this page: Was this page helpful? Formal name: Pleural Fluid Analysis Related tests: Pericardial Fluid Analysis , Peritoneal Fluid ...

  15. Asymmetric generalization and interaction profiles in rhesus monkeys discriminating intravenous cocaine or intravenous heroin from vehicle.

    PubMed

    Platt, Donna M; Rowlett, James K; Spealman, Roger D

    2010-03-01

    Many polydrug abusers combine cocaine with heroin in the form of a "speedball." This study investigated the discriminative stimulus (DS) effects of speedballs in rhesus monkeys trained to discriminate either intravenous cocaine or intravenous heroin from vehicle. Initial substitution tests revealed an asymmetry in the generalization profile of dopamine and opioid agonists such that mu agonists partially substituted for cocaine, but direct and indirect dopamine agonists did not substitute for heroin. Subsequent speedball tests in which drug mixtures were administered by coinjecting the component drugs while keeping the dose-ratio constant revealed an additional asymmetry. In cocaine-trained monkeys, coadministration of cocaine and heroin produced leftward shifts in the cocaine dose-response function. Heroin's cocaine-enhancing effects were mimicked by the mu agonists fentanyl and methadone and less consistently by the delta agonist (+)-4-[(alphaR)-alpha-((2S,5R)-4-allyl-2,5-dimethyl-1-piperazinyl)-3-methoxybenzyl]-N,N-diethylbenzamide (SNC 80) and reversed by the mu antagonist naltrexone and the delta antagonist naltrindole. In heroin-trained monkeys, coadministration of cocaine and heroin attenuated the DS effects of heroin. Cocaine's heroin-attenuating effects were mimicked by the D1-like agonist 6-chloro-7,8-dihydroxy-1-phenyl-2,3,4,5-tetrahydro-(1H)-3-benzazepine (SKF 81297) and the D2-like agonist R-(-)-propylnorapomorphine and reversed by the D1-like antagonist (6aS-trans)-11-chloro-6,6a,7,8,9,13b-hexahydro-7-methyl-5H- benzo[d] aphtha[2,1-b]azepin-12-ol hydrobromide (SCH 39166) and the D2-like antagonist raclopride. Attenuation of the effects of heroin was accompanied by decreases in response rate. These results suggest that heroin enhances the DS effects of cocaine via mu, and to a lesser extent delta, receptor mechanisms; whereas cocaine-induced inhibition of the DS effects of heroin probably was due at least in part to masking of the heroin DS presumably

  16. Intramuscular versus Intravenous Therapy for Prehospital Status Epilepticus

    PubMed Central

    Silbergleit, Robert; Durkalski, Valerie; Lowenstein, Daniel; Conwit, Robin; Pancioli, Arthur; Palesch, Yuko; Barsan, William

    2012-01-01

    BACKGROUND Early termination of prolonged seizures with intravenous administration of benzodiazepines improves outcomes. For faster and more reliable administration, paramedics increasingly use an intramuscular route. METHODS This double-blind, randomized, noninferiority trial compared the efficacy of intramuscular midazolam with that of intravenous lorazepam for children and adults in status epilepticus treated by paramedics. Subjects whose convulsions had persisted for more than 5 minutes and who were still convulsing after paramedics arrived were given the study medication by either intramuscular autoinjector or intravenous infusion. The primary outcome was absence of seizures at the time of arrival in the emergency department without the need for rescue therapy. Secondary outcomes included endotracheal intubation, recurrent seizures, and timing of treatment relative to the cessation of convulsive seizures. This trial tested the hypothesis that intramuscular midazolam was noninferior to intravenous lorazepam by a margin of 10 percentage points. RESULTS At the time of arrival in the emergency department, seizures were absent without rescue therapy in 329 of 448 subjects (73.4%) in the intramuscular-midazolam group and in 282 of 445 (63.4%) in the intravenous-lorazepam group (absolute difference, 10 percentage points; 95% confidence interval, 4.0 to 16.1; P<0.001 for both noninferiority and superiority). The two treatment groups were similar with respect to need for endotracheal intubation (14.1% of subjects with intramuscular midazolam and 14.4% with intravenous lorazepam) and recurrence of seizures (11.4% and 10.6%, respectively). Among subjects whose seizures ceased before arrival in the emergency department, the median times to active treatment were 1.2 minutes in the intramuscular-midazolam group and 4.8 minutes in the intravenous-lorazepam group, with corresponding median times from active treatment to cessation of convulsions of 3.3 minutes and 1.6 minutes

  17. [Transition from intravenous to subcutaneous prostacyclin in pulmonary hypertension].

    PubMed

    Escribano Subías, Pilar; Cea-Calvo, Luis; Tello de Menesses, Rocío; Gómez Sánchez, Miguel A; Delgado Jiménez, Juan F; Sáenz de la Calzada, Carlos

    2003-08-01

    Treatment of arterial pulmonary hypertension with epoprostenol (intravenous prostacyclin) improves survival and quality of life, but the need for an implanted central venous catheter is associated with frequent complications, that often (as in the case of infection or dislodgment) are serious and require catheter replacement. Treprostinil is a prostacyclin analogue suitable for continuous subcutaneous administration. We report the successful transition from intravenous epoprostenol to subcutaneuos treprostinil in four patients with severe pulmonary hypertension who suffered from serious complications associated with the epoprostenol infusion system.

  18. [The development of multifunction intravenous infusion quantitative packaging device].

    PubMed

    Zhao, Shufang; Li, Ruihua; Shen, Lianhong

    2012-11-01

    Aimed at tackling the compatibility issues arising from the drug reaction in intravenous infusion tube, we developed a simple, suitable and multi-function intravenous infusion tube for the special use for rescuing critical patients, the elderly, children etc. Each drug in a transfusion process can be filtered to realize quantitative packet and packet delivery. Thus, the drugs in the infusion tube are prevented from meeting with each other. No overlap, no particle pollution occurred. Stable performance and accurate dosage are maintained. As a result safety is ensured during drug delivery. PMID:23461118

  19. Rationale for Use of Intravenous Acetaminophen in Special Operations Medicine.

    PubMed

    Vokoun, Edward Scott

    2015-01-01

    Use of intravenous acetaminophen has increased recently as an opioid-sparing strategy for patients undergoing major surgery. Its characteristics and efficacy suggest that it would a useful adjunct in combat trauma medicine. This article reviews those characteristics, which include rapid onset, high peak plasma concentration, and favorable side-effect profile. Also discussed is the hepatotoxicity risk of acetaminophen in a combat trauma patient. It concludes that intravenous acetaminophen should be considered as an addition to the US Special Operations Command Tactical Trauma Protocols and supplied to medics for use in field care.

  20. Relapsing thrombotic microangiopathy and intravenous sustained-release oxycodone

    PubMed Central

    Nataatmadja, Melissa; Divi, Dakshinamurthy

    2016-01-01

    Thrombotic microangiopathy (TMA) associated with injecting sustained-release oxymorphone, an opioid intended for oral use, has previously been reported. We report a case of TMA secondary to intravenous use of sustained-release oxycodone, and the first case to demonstrate relapsing disease due to persistent intravenous opioid use. In cases such as these, TMA is suspected to be due to a polyethylene oxide (PEO) coating found on these drugs, and the disease is likely due to a directly toxic effect of PEO to endothelial cells. We hypothesize that there are unidentified genetic predispositions causing some persons to be susceptible to developing this disease. PMID:27478601

  1. [Tricuspid valve infective endocarditis in intravenous drug abuser].

    PubMed

    Rataj, O; Martinkovičová, L; Šetina, M

    2013-10-01

    Infective endocarditis can be divided from practical point of view into native valve endocarditis and prosthetic valve endocarditis. With regard to aquired endocarditis, endocarditis in intravenous drug abusers can be separetly differentiated. Echocardiography and microbio-logical cultures are essential for dia-gnosis. Treatment consists of antibio-tic therapy and often surgical procedure is required. We present a case report of an intravenous drug abuser with a tricuspid valve endocarditis, successfully treated with antibio-tic therapy and a following surgical valve repair. PMID:24164370

  2. AGU Sonar Data Restriction Panel

    NASA Astrophysics Data System (ADS)

    The AGU Council accepted the report of the panel set up in February to study the issue of restriction by the U.S. Navy of access to high-resolution sonar data for the U.S. Exclusive Economic Zone. Panel chairman John Bossier announced that “the Navy has acted in the best interests of the nation” in lifting the restriction order. Only two areas, egress routes to two submarine bases (see “Navy Defines Areas Under Sonar Ban,” in News, this issue), remain restricted.Panel members were Bruce Douglas, Alexander Malahoff, Donald Piepgras, Paul Richards, David Smith and Manik Talwani.

  3. A comparative study of intravenous paracetamol and intravenous tramadol for postoperative analgesia in laparotomies

    PubMed Central

    Shahid, Mohammed; Manjula, B. P.; Sunil, B. V.

    2015-01-01

    Background: Pain in the perioperative setting or thereafter plays a significant role in delaying an otherwise successful recovery. Hence, mitigation of such postoperative pain assumes importance. Among the various agents employed for such mitigation, opioids and non-steroidal anti-inflammatory drugs have for some time taken center stage. However, alas they are not without their share of adverse effects. This study was undertaken with the purpose of elucidating the efficacy of intravenous (IV) paracetamol as compared to IV tramadol in mitigating postoperative pain while observing its effect on hemodynamic stability and the presence of adverse drug reactions, if any. Materials and Methods: A total of 60 randomized cases aged ranges from 20 to 60 years of both sexes divided into two groups (each for paracetamol and tramadol) scheduled for laparotomies were administered IV paracetamol and tramadol for postoperative pain relief and assessed with visual analog scale (VAS) score and variations in vital parameters to ascertain extent of pain relief and post-operative nausea vomiting (PONV). Results: Data so collected was statistically interpreted, and observations extrapolated. Save for a perceptible decline in PONV with paracetamol group compared with tramadol group with a statistically significant P < 0.001, nothing statistically significant was observed in any other parameter, including VAS scores between either group. Conclusion: IV paracetamol is a safer alternative to tramadol with lesser PONV in the postoperative period translates into the lesser duration of hospitalization and hence earlier discharge. PMID:26712966

  4. Measuring intravenous cannulation skills of practical nursing students using rubber mannequin intravenous training arms.

    PubMed

    Jones, Robert S; Simmons, Angela; Boykin, Gary L; Stamper, David; Thompson, Jennifer C

    2014-11-01

    This study examined the effectiveness of two training methods for peripheral intravenous (IV) cannulation; one using rubber mannequin IV training arms, and the other consisting of students performing the procedure on each other. Two hundred-sixty Phase II Army Practical Nursing students were randomized into two groups and trained to perform an IV cannulation procedure. All students watched a 12-minute training video covering standard IV placement procedures. Afterward, both groups practiced the procedure for an hour according to their assigned group. Students were then tested on IV placement in a live human arm using a 14-item testing instrument in three trials that were scored pass/fail. There was no difference in the groups' performance of the IV procedure on the first attempt: 51.7% (n = 92) of the human arm group passed the test, and 48.3% (n = 86) of the rubber mannequin group passed the test (p = 0.074). These data suggest that using rubber mannequin IV arms for IV skills training may be just as effective as training students using traditional methods. In addition, using simulation provides an extra benefit of reducing risks associated with learning the procedure on a fellow student. PMID:25373067

  5. MR imaging of Ménière's disease after combined intratympanic and intravenous injection of gadolinium using HYDROPS2.

    PubMed

    Naganawa, Shinji; Yamazaki, Masahiro; Kawai, Hisashi; Bokura, Kiminori; Iida, Tatsuo; Sone, Michihiko; Nakashima, Tsutomu

    2014-01-01

    Endolymphatic hydrops (EH) in Ménière's disease is currently evaluated by 3-dimensional (3D)-real inversion recovery (IR) sequence after intratympanic (IT) administration of gadolinium (Gd) or by heavily T2-weighted (hT2W)-3D-fluid-attenuated IR (FLAIR) sequence after intravenous (IV) injection of Gd. Unilateral IT injection is usually performed. We employed a method in which we simultaneously administered contrast into one ear intravenously (IV side) and into the other ear both intravenously and intratympanically (IT + IV side) to evaluate EH in 10 patients with Ménière's disease. We then compared a HYDROPS2 image obtained by subtracting magnetic resonance cisternography from hT2W-3D-FLAIR with an image obtained by 3D-real IR and found that we could evaluate EH in all ears on the HYDROPS2 image but only in the IT + IV side on the 3D-real IR image.

  6. Oxygen supersaturated fluid using fine micro/nanobubbles.

    PubMed

    Matsuki, Noriaki; Ishikawa, Takuji; Ichiba, Shingo; Shiba, Naoki; Ujike, Yoshihito; Yamaguchi, Takami

    2014-01-01

    Microbubbles show peculiar properties, such as shrinking collapse, long lifetime, high gas solubility, negative electric charge, and free radical production. Fluids supersaturated with various gases can be easily generated using microbubbles. Oxygen microbubble fluid can be very useful for oxygen delivery to hypoxic tissues. However, there have been no reports of comparative investigations into adding fluids containing oxygen fine micro/nanobubbles (OFM-NBs) to common infusion solutions in daily medical care. In this study, it was demonstrated that OFMNBs can generate oxygen-supersaturated fluids, and they may be sufficiently small to infuse safely into blood vessels. It was found that normal saline solution is preferable for generating an oxygen-rich infusion fluid, which is best administered as a 30-minute intravenous infusion. It was also concluded that dextran solution is suitable for drug delivery substances packing oxygen gas over a 1-hour intravenous infusion. In addition, normal saline solution containing OFMNBs was effective for improving blood oxygenation. Thus, the use of OFMNB-containing fluids is a potentially effective novel method for improving blood oxygenation in cases involving hypoxia, ischemic diseases, infection control, and anticancer chemoradiation therapies. PMID:25285003

  7. Influence of Rapid Fluid Loading on Airway Structure and Function in Healthy Humans

    PubMed Central

    CERIDON, MAILE L.; SNYDER, ERIC M.; STROM, NICHOLAS A.; TSCHIRREN, JUERG; JOHNSON, BRUCE D.

    2010-01-01

    Background The present study examined the influence of rapid intravenous fluid loading (RFL) on airway structure and pulmonary vascular volumes using computed tomography imaging and the subsequent impact on pulmonary function in healthy adults (n = 16). Methods and Results Total lung capacity (ΔTLC = −6%), forced vital capacity (ΔFVC = −14%), and peak expiratory flow (ΔPEF = −19%) decreased, and residual volume (ΔRV = +38%) increased post-RFL (P < .05). Airway luminal cross-sectional area (CSA) decreased at the trachea, and at airway generation 3 (P < .05), wall thickness changed minimally with a tendency for increasing in generation five (P = .13). Baseline pulmonary function was positively associated with airway luminal CSA; however, this relationship deteriorated after RFL. Lung tissue volume and pulmonary vascular volumes increased 28% (P < .001) post-RFL, but did not fully account for the decline in TLC. Conclusions These data suggest that RFL results in obstructive/restrictive PF changes that are most likely related to structural changes in smaller airways or changes in extrapulmonary vascular beds. PMID:20142030

  8. Methionine restriction and lifespan control

    PubMed Central

    Lee, Byung Cheon; Kaya, Alaattin; Gladyshev, Vadim N.

    2016-01-01

    Dietary restriction (DR) without malnutrition is associated with longevity in various organisms. However, it has also been shown that reduced calorie intake is often ineffective in extending lifespan. Selecting optimal dietary regimens for DR studies is complicated, as the same regimen may lead to different outcomes depending on genotype and environmental factors. Recent studies suggested that interventions such as moderate protein restriction with/without adequate nutrition (e.g. particular amino acids or carbohydrates) may have additional beneficial effects mediated by certain metabolic and hormonal factors implicated in the biology of aging, regardless of total calorie intake. In particular, it was shown that restriction of a single amino acid, methionine, can mimic the effects of DR and extend lifespan in various model organisms. We discuss beneficial effects of methionine-restricted (MR) diet, the molecular pathways involved, and the use of this regimen in longevity interventions. PMID:26663138

  9. Gyroelastic fluids

    SciTech Connect

    Kerbel, G.D.

    1981-01-20

    A study is made of a scale model in three dimensions of a guiding center plasma within the purview of gyroelastic (also known as finite gyroradius-near theta pinch) magnetohydrodynamics. The (nonlinear) system sustains a particular symmetry called isorrhopy which permits the decoupling of fluid modes from drift modes. Isorrhopic equilibria are analyzed within the framework of geometrical optics resulting in (local) dispersion relations and ray constants. A general scheme is developed to evolve an arbitrary linear perturbation of a screwpinch equilibrium as an invertible integral transform (over the complete set of generalized eigenfunctions defined naturally by the equilibrium). Details of the structure of the function space and the associated spectra are elucidated. Features of the (global) dispersion relation owing to the presence of gyroelastic stabilization are revealed. An energy principle is developed to study the stability of the tubular screwpinch.

  10. Intravenous Immunoglobulin in the Treatment of Severe Clostridium Difficile Colitis

    PubMed Central

    Shah, Nihar; Shaaban, Hamid; Spira, Robert; Slim, Jihad; Boghossian, Jack

    2014-01-01

    Intravenous immunoglobulin (IVIG) has been utilized in patients with recurrent and refractory Clostridium difficile colitis. It is increasingly being used in patients with initial clinical presentation of severe colitis. Herein, we report a case of severe C. Difficile colitis successfully treated with IVIG with a review of the medical literature to identify the optimal timing and clinical characteristics for this treatment strategy. PMID:24926170

  11. Intravenous Cocaine Priming Reinstates Cocaine-Induced Conditioned Place Preference

    ERIC Educational Resources Information Center

    Lombas, Andres S.; Freeman, Kevin B.; Roma, Peter G.; Riley, Anthony L.

    2007-01-01

    Separate groups of rats underwent an unbiased conditioned place preference (CPP) procedure involving alternate pairings of distinct environments with intravenous (IV) injections of cocaine (0.75 mg/kg) or saline immediately or 15 min after injection. A subsequent extinction phase consisted of exposure to both conditioning environments preceded by…

  12. Intravenous Therapy Instruction for Licensed Practical Nurses. Instructor's Guide.

    ERIC Educational Resources Information Center

    Springer, Pam; Carey, Jean

    This Idaho instructor's guide lists tasks and enabling objectives, outlines instruction, and provides handout masters, overhead masters, and tests for intravenous therapy (IV) instruction for licensed practical nurses. Following an introduction and a list of criteria for successful completion of IV therapy courses, the document lists tasks and…

  13. Intravenous Sedation for Dental Patients with Intellectual Disability

    ERIC Educational Resources Information Center

    Miyawaki, T.; Kohjitani, A.; Maeda, S.; Egusa, M.; Mori, T.; Higuchi, H.; Kita, F.; Shimada, M.

    2004-01-01

    The poor quality of oral health care for people with intellectual disability (ID) has been recognized, and the strong fears about dental treatment suggested as a major reason for disturbances of visits to dentists by such patients. Intravenous sedation is a useful method for relieving the anxiety and fear of such patients about dental treatment,…

  14. Saccharomyces cerevisiae boulardii transient fungemia after intravenous self-inoculation.

    PubMed

    Cohen, Lola; Ranque, Stéphane; Raoult, Didier

    2013-02-14

    We report the case of a young psychotic intravenous drug user injecting herself with Saccharomyces cervisiae (boulardii). She experienced a 24 h fever, resolving spontaneously confirming, quasi experimentally, the inocuity of this yeast in a non-immunocompromised host. PMID:24432219

  15. Candida costochondritis associated with recent intravenous drug use.

    PubMed

    Crawford, Simeon J; Swan, Christopher D; Boutlis, Craig S; Reid, Alistair B

    2016-01-01

    Candida osteoarticular infections are being reported with increasing frequency, possibly due to an expanding population at risk. However, Candida costochondritis is uncommon. We report two cases of Candida costochondritis in patients who presented with subacute-onset chest wall swelling and whose only identifiable risk factor was a history of recent intravenous drug use. PMID:27182491

  16. Fluid and electrolyte therapy in ruminants.

    PubMed

    Constable, Peter

    2003-11-01

    Five important questions always must be asked and answered regarding fluid and electrolyte therapy in ruminants: (1) Is therapy needed? (2) What type of therapy? (3) What route of administration? (4) How much should be administered? and (5) How fast should the solution be administered? Food animal veterinarians routinely should carry the following commercially available crystalloid solutions and have the knowledge of how to use the products appropriately: Ringer's solution, 1.3% NaHCO3, acetated Ringer's solution, HS (7.2% NaCl), 8% NaHCO3, 23% calcium gluconate, calcium-magnesium solutions, and 50% dextrose. Ruminants with a blood pH less than 7.20 should be treated intravenously with 1.3% or 8.0% NaHCO3, and those animals with a blood pH greater than 7.45 should be treated intravenously with Ringer's solution. Oral electrolyte solutions or intravenous acetated Ringer's solution should be administered to ruminants with a blood pH greater than 7.20 but less than 7.45, and acetated Ringer's solution is preferred to lactated Ringer's solution. HS solution should be administered whenever rapid resuscitation is required. Oral administration of electrolyte solutions is underused in neonatal and adult ruminants. The optimal solution for oral administration to neonatal ruminants has a sodium concentration between 90 and 130 mmol/L; a potassium concentration between 10 and 20 mmol/L; a chloride concentration between 40 and 80 mmol/L; 40 to 80 mmol/L of metabolizable (nonbicarbonate) base, such as acetate or propionate; and glucose as an energy source. The optimal formulation for adult ruminants is unknown, but such a solution should contain sodium, potassium, calcium, magnesium, phosphate, and propionate to facilitate sodium absorption and to provide an additional source of energy to the animal. Acidemia is treated best by intravenous or oral administration of NaHCO3. Alkalemia is treated best by intravenous administration of Ringer's solution and oral administration of

  17. Fluid channeling system

    NASA Technical Reports Server (NTRS)

    Davis, Donald Y. (Inventor); Hitch, Bradley D. (Inventor)

    1994-01-01

    A fluid channeling system includes a fluid ejector, a heat exchanger, and a fluid pump disposed in series flow communication The ejector includes a primary inlet for receiving a primary fluid, and a secondary inlet for receiving a secondary fluid which is mixed with the primary fluid and discharged therefrom as ejector discharge. Heat is removed from the ejector discharge in the heat exchanger, and the heat exchanger discharge is compressed in the fluid pump and channeled to the ejector secondary inlet as the secondary fluid In an exemplary embodiment, the temperature of the primary fluid is greater than the maximum operating temperature of a fluid motor powering the fluid pump using a portion of the ejector discharge, with the secondary fluid being mixed with the primary fluid so that the ejector discharge temperature is equal to about the maximum operating temperature of the fluid motor.

  18. Fluid dispersal from safety cannulas: an in vitro comparative test.

    PubMed

    Rosenthal, Victor D; Hughes, Gavin

    2015-03-01

    We report a comparative laboratory study between 2 peripheral intravenous catheters equipped with a passive fully automatic safety mechanism to assess generation of blood droplets during withdrawal. One presented no fluid droplets, whereas the other presented droplets in 48% and 60% for the best and worst case, with analysis of variance showing positive effects on the number of droplets generated (P < .001). Safety devices can introduce hazards if health care workers are at risk from blood splatter. PMID:25728160

  19. Intravenous non-opioid analgesia for peri- and postoperative pain management: a scientific review of intravenous acetaminophen and ibuprofen

    PubMed Central

    Koh, Wonuk; Nguyen, Kimngan Pham

    2015-01-01

    Pain is a predictable consequence following operations, but the management of postoperative pain is another challenge for anesthesiologists and inappropriately controlled pain may lead to unwanted outcomes in the postoperative period. Opioids are indeed still at the mainstream of postoperative pain control, but solely using only opioids for postoperative pain management may be connected with risks of complications and adverse effects. As a consequence, the concept of multimodal analgesia has been proposed and is recommended whenever possible. Acetaminophen is one of the most commonly used analgesic and antipyretic drug for its good tolerance and high safety profiles. The introduction of intravenous form of acetaminophen has led to a wider flexibility of its use during peri- and postoperative periods, allowing the early initiation of multimodal analgesia. Many studies have revealed the efficacy, safety and opioid sparing effects of intravenous acetaminophen. Intravenous ibuprofen has also shown to be well tolerated and demonstrated to have significant opioid sparing effects during the postoperative period. However, the number of randomized controlled trials confirming the efficacy and safety is small and should be used in caution in certain group of patients. Intravenous acetaminophen and ibuprofen are important options for multimodal postoperative analgesia, improving pain and patient satisfaction. PMID:25664148

  20. Isotonic is better than hypotonic saline for intravenous rehydration of children with gastroenteritis: a prospective randomised study

    PubMed Central

    Neville, K A; Verge, C F; Rosenberg, A R; O'Meara, M W; Walker, J L

    2006-01-01

    Aims To determine whether the risk of hyponatraemia in children with gastroenteritis receiving intravenous (IV) fluids is decreased by the use of 0.9% saline. Methods A prospective randomised study was carried out in a tertiary paediatric hospital. A total of 102 children with gastroenteritis were randomised to receive either 0.9% saline + 2.5% dextrose (NS) or 0.45% saline + 2.5% dextrose (N/2) at a rate determined by their treating physician according to hospital guidelines and clinical judgement. Plasma electrolytes, osmolality, and plasma glucose were measured before (T0) and 4 hours after (T4) starting IV fluids, and subsequently if clinically indicated. Electrolytes and osmolality were measured in urine samples. Results were analysed according to whether children were hyponatraemic (plasma sodium <135 mmol/l) or normonatraemic at T0. Results At T0, mean (SD) plasma sodium was 135 (3.3) mmol/l (range 124–142), with 37/102 (36%) hyponatraemic. At T4, mean plasma sodium in children receiving N/2 remained unchanged in those initially hyponatraemic (n = 16), but fell 2.3 (2.2) mmol/l in the normonatraemic group. In contrast, among children receiving NS, mean plasma sodium was 2.4 (2.0) mmol/l higher in those hyponatraemic at baseline (n = 21) and unchanged in the initially normonatraemic children. In 16 children who were still receiving IV fluids at 24 hours, 3/8 receiving N/2 were hyponatraemic compared with 0/8 receiving NS. No child became hypernatraemic. Conclusions In gastroenteritis treated with intravenous fluids, normal saline is preferable to hypotonic saline because it protects against hyponatraemia without causing hypernatraemia. PMID:16352625

  1. Thermophysical Properties of Fluids and Fluid Mixtures

    SciTech Connect

    Sengers, Jan V.; Anisimov, Mikhail A.

    2004-05-03

    The major goal of the project was to study the effect of critical fluctuations on the thermophysical properties and phase behavior of fluids and fluid mixtures. Long-range fluctuations appear because of the presence of critical phase transitions. A global theory of critical fluctuations was developed and applied to represent thermodynamic properties and transport properties of molecular fluids and fluid mixtures. In the second phase of the project, the theory was extended to deal with critical fluctuations in complex fluids such as polymer solutions and electrolyte solutions. The theoretical predictions have been confirmed by computer simulations and by light-scattering experiments. Fluctuations in fluids in nonequilibrium states have also been investigated.

  2. Magnetized drive fluids

    SciTech Connect

    Rosensweig, R.E.; Zahn, M.

    1986-04-01

    A process is described for recovering a first fluid from a porous subterranean formation which comprises injecting a displacement fluid in an effective amount to displace the first fluid, injecting a ferrofluid, applying a magnetic field containing a gradient of field intensity within the formation, driving the displacement fluid through the formation with the ferrofluid and recovering first fluid.

  3. Fluid sampling tool

    DOEpatents

    Garcia, Anthony R.; Johnston, Roger G.; Martinez, Ronald K.

    2000-01-01

    A fluid-sampling tool for obtaining a fluid sample from a container. When used in combination with a rotatable drill, the tool bores a hole into a container wall, withdraws a fluid sample from the container, and seals the borehole. The tool collects fluid sample without exposing the operator or the environment to the fluid or to wall shavings from the container.

  4. Cellular Biotechnology Operations Support System Fluid Dynamics Investigation

    NASA Technical Reports Server (NTRS)

    2003-01-01

    Aboard the International Space Station (ISS), the Tissue Culture Medium (TCM) is the bioreactor vessel in which cell cultures are grown. With its two syringe ports, it is much like a bag used to administer intravenous fluid, except it allows gas exchange needed for life. The TCM contains cell culture medium, and when frozen cells are flown to the ISS, they are thawed and introduced to the TCM through the syringe ports. In the Cellular Biotechnology Operations Support System-Fluid Dynamics Investigation (CBOSS-FDI) experiment, several mixing procedures are being assessed to determine which method achieves the most uniform mixing of growing cells and culture medium.

  5. [Maternal pulmonary edema as an anesthesia complication after intravenous tocolysis and stimulating of lung maturation].

    PubMed

    Beer, P; Passweg, D

    1992-01-01

    Maternal lung edema due to the use of beta-mimetic tocolytic agents is a well-documented complication. The risk increases if several other factors are present: infectious diseases, the use of inhaled anesthetics, EPH gestosis, hydramnios, twin gestation and preexisting cardiovascular disease. The complications induced by beta-mimetic tocolytic agents can be reduced by remembering their side effects and contraindications and restricting fluid intake. During obstetric general anesthesia in patients undergoing tocolysis, the infusion of large amounts of saline, as is widely practised today, is strictly contraindicated. PMID:1356538

  6. Telomere Restriction Fragment (TRF) Analysis

    PubMed Central

    Mender, Ilgen; Shay, Jerry W.

    2016-01-01

    While telomerase is expressed in ~90% of primary human tumors, most somatic tissue cells except transiently proliferating stem-like cells do not have detectable telomerase activity (Shay and Wright, 1996; Shay and Wright, 2001). Telomeres progressively shorten with each cell division in normal cells, including proliferating stem-like cells, due to the end replication (lagging strand synthesis) problem and other causes such as oxidative damage, therefore all somatic cells have limited cell proliferation capacity (Hayflick limit) (Hayflick and Moorhead, 1961; Olovnikov, 1973). The progressive telomere shortening eventually leads to growth arrest in normal cells, which is known as replicative senescence (Shay et al., 1991). Once telomerase is activated in cancer cells, telomere length is stabilized by the addition of TTAGGG repeats to the end of chromosomes, thus enabling the limitless continuation of cell division (Shay and Wright, 1996; Shay and Wright, 2001). Therefore, the link between aging and cancer can be partially explained by telomere biology. There are many rapid and convenient methods to study telomere biology such as Telomere Restriction Fragment (TRF), Telomere Repeat Amplification Protocol (TRAP) (Mender and Shay, 2015b) and Telomere dysfunction Induced Foci (TIF) analysis (Mender and Shay, 2015a). In this protocol paper we describe Telomere Restriction Fragment (TRF) analysis to determine average telomeric length of cells. Telomeric length can be indirectly measured by a technique called Telomere Restriction Fragment analysis (TRF). This technique is a modified Southern blot, which measures the heterogeneous range of telomere lengths in a cell population using the length distribution of the terminal restriction fragments (Harley et al., 1990; Ouellette et al., 2000). This method can be used in eukaryotic cells. The description below focuses on the measurement of human cancer cells telomere length. The principle of this method relies on the lack of

  7. Pediatric Acute Respiratory Distress Syndrome: Fluid Management in the PICU

    PubMed Central

    Ingelse, Sarah A.; Wösten-van Asperen, Roelie M.; Lemson, Joris; Daams, Joost G.; Bem, Reinout A.; van Woensel, Job B.

    2016-01-01

    The administration of an appropriate volume of intravenous fluids, while avoiding fluid overload, is a major challenge in the pediatric intensive care unit. Despite our efforts, fluid overload is a very common clinical observation in critically ill children, in particular in those with pediatric acute respiratory distress syndrome (PARDS). Patients with ARDS have widespread damage of the alveolar–capillary barrier, potentially making them vulnerable to fluid overload with the development of pulmonary edema leading to prolonged course of disease. Indeed, studies in adults with ARDS have shown that an increased cumulative fluid balance is associated with adverse outcome. However, age-related differences in the development and consequences of fluid overload in ARDS may exist due to disparities in immunologic response and body water distribution. This systematic review summarizes the current literature on fluid imbalance and management in PARDS, with special emphasis on potential differences with adult patients. It discusses the adverse effects associated with fluid overload and the corresponding possible pathophysiological mechanisms of its development. Our intent is to provide an incentive to develop age-specific fluid management protocols to improve PARDS outcomes. PMID:27047904

  8. Ciliary fluid transport enhanced by viscoelastic fluid

    NASA Astrophysics Data System (ADS)

    Guo, Hanliang; Kanso, Eva

    2015-11-01

    Motile cilia encounter complex, non-Newtonian fluids as they beat to gain self-propulsion of cells, transport fluids, and mix particles. Recently there have been many studies on swimming in complex fluids, both experimentally and theoretically. However the role of the non-Newtonian fluid in the ciliary transport system remains largely unknown. Here we use a one-way-coupled immersed boundary method to evaluate the impacts of viscoelastic fluid (Oldroyd-B fluid) on the fluid transport generated by an array of rabbit tracheal cilia beating in a channel at low Reynolds number. Our results show that the viscoelasticity could enhance the fluid transport generated by the rabbit tracheal cilia beating pattern and the flow is sensitive to the Deborah number in the range we investigate.

  9. 78 FR 58318 - Clinical Trial Design for Intravenous Fat Emulsion Products; Public Workshop

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-23

    ... HUMAN SERVICES Food and Drug Administration Clinical Trial Design for Intravenous Fat Emulsion Products... ``Clinical Trial Design for Intravenous Fat Emulsion Products.'' This workshop will provide a forum to discuss trial design of clinical trials intended to support registration of intravenous fat...

  10. Fluid Inclusion Gas Analysis

    DOE Data Explorer

    Dilley, Lorie

    2013-01-01

    Fluid inclusion gas analysis for wells in various geothermal areas. Analyses used in developing fluid inclusion stratigraphy for wells and defining fluids across the geothermal fields. Each sample has mass spectrum counts for 180 chemical species.

  11. Synovial fluid analysis

    MedlinePlus

    Joint fluid analysis; Joint fluid aspiration ... El-Gabalawy HS. Synovial fluid analysis, synovial biopsy, and synovial pathology. In: Firestein GS, Budd RC, Gabriel SE, McInnes IB, O'Dell JR, eds. Kelly's Textbook of ...

  12. Pleural fluid Gram stain

    MedlinePlus

    Gram stain of pleural fluid ... lungs fill a person's chest with air. If fluid builds up in the space outside the lungs ... chest, it can cause many problems. Removing the fluid can relieve a person's breathing problems and help ...

  13. Pericardial fluid culture

    MedlinePlus

    Culture - pericardial fluid ... the heart (the pericardium). A small amount of fluid is removed. You may have an ECG and ... x-ray after the test. Sometimes the pericardial fluid is taken during open heart surgery. The sample ...

  14. Pleural fluid culture

    MedlinePlus

    Culture - pleural fluid ... is used to get a sample of pleural fluid. The sample is sent to a laboratory and ... the chest wall into the pleural space. As fluid drains into a collection bottle, you may cough ...

  15. Candida glabrata olecranon bursitis treated with bursectomy and intravenous caspofungin.

    PubMed

    Skedros, John G; Keenan, Kendra E; Trachtenberg, Joel D

    2013-01-01

    Orthopedic surgeons are becoming more involved in the care of patients with septic arthritis and bursitis caused by yeast species. This case report involves a middle-aged immunocompromised female who developed a Candida glabrata septic olecranon bursitis that developed after she received a corticosteroid injection in the olecranon bursa for presumed aseptic bursitis. Candida (Torulopsis) glabrata is the second most frequently isolated Candida species from the bloodstream in the United States. Increased use of fluconazole and other azole antifungal agents as a prophylactic treatment for recurrent Candida albicans infections in immunocompromised individuals is one reason why there appears to be increased resistance of C. glabrata and other nonalbicans Candida (NAC) species to fluconazole. In this patient, this infection was treated with surgery (bursectomy) and intravenous caspofungin, an echinocandin. This rare infectious etiology coupled with this intravenous antifungal treatment makes this case novel among cases of olecranon bursitis caused by yeasts. PMID:23628576

  16. Intravenous leiomyomatosis disguised as a large deep vein thrombosis

    PubMed Central

    Gunderson, Camille C; Parsons, Blake; Penaroza, Shyla; Peyton, Marvin D; Landrum, Lisa M.

    2016-01-01

    Intravenous leiomyomatosis is a benign smooth muscle tumor which despite its histology can have devastating consequences. Furthermore, the clinical manifestations are variable and nonspecific, typically leading to delayed or missed diagnosis. Thus, it is critical for clinicians to be aware of this condition and have a high index of suspicion in a middle-aged woman with a history of uterine leiomyoma presenting with an inferior vena cava mass to enable early diagnosis and treatment. We report a case of a large intravenous leiomyoma which was initially considered to be a very large deep venous thrombosis; with thorough preoperative planning, it was successfully removed intact and in entirety with a single-stage operation.

  17. Intravenous human immunoglobulin for treatment of folliculitis decalvans.

    PubMed

    Ismail, Nuriah; Ralph, Nicola; Murphy, Gillian

    2015-10-01

    We report a case of folliculitis decalvans (FD) successfully treated with intravenous human immunoglobulin (HIG). Many conventional treatments with topical agents and oral antibiotics had failed to achieve disease remission, treatment with HIG at a dose of 2 g/kg for the first month, reduced to 1 g/kg for second to fourth months was therefore started, which resulted in rapid improvement and ultimately complete resolution of FD. Clinical improvement was noted after the first infusion of HIG and remission of inflammation was achieved after the fourth infusion. Disease remission was sustained for six months following the last HIG infusion. The exact mechanism of action of HIG is poorly understood. However, it is thought to act as an immunomodulatory agent by altering different components of immune functions. To our knowledge, this is the first case reported in the literature of FD successfully treated with intravenous HIG.

  18. Successful intravenous thrombolysis for acute stroke in a child.

    PubMed

    Ortiz, Gustavo A; Koch, Sebastian; Wallace, Douglas M; Lopez-Alberola, Robert

    2007-06-01

    We report an 8-year-old white girl with no previous medical history who developed sudden onset right hemiplegia, left gaze preference, and global aphasia. An acute left middle cerebral artery stroke syndrome was diagnosed. She was treated with intravenous recombinant tissue plasminogen activator, 2 hours after the onset of symptoms. A magnetic resonance image demonstrated an acute left middle cerebral artery stroke, and a magnetic resonance angiography showed a patent left middle cerebral artery. At discharge, she was able to speak normally and walk without support. She was also able to raise the right arm up to the level of the shoulder and showed increased motility of the hand and fingers. No treatment-related complications happened. To the best of our knowledge, this is, so far, the youngest child successfully treated with intravenous recombinant tissue plasminogen activator for acute ischemic stroke.

  19. [Toxicity of prilocaine and bupivacaine in intravenous regional anesthesia].

    PubMed

    Tryba, M; Hausmann, E; Zenz, M; Wellhöner, H H

    1982-08-01

    In a prospective randomized study plasma levels of prilocaine and bupivacaine were analyzed after intravenous regional analgesia (IVRA). 20 patients respectively received either 1 mg/kg bupivacaine or 4 mg/kg prilocaine in an equipotent dosis. Prilocaine proved to be significantly less toxic than bupivacaine. Plasma levels of bupivacaine, expressed as percentage of the toxic limit, were threefold higher than those of prilocaine. In one case the maximum level of bupivacaine reached even 85% of the toxic limit. This demonstrates the possibility of dangerous side effects when exceeding the bupivacaine dose of 1 mg/kg. Methaemoglobin formation following use of prilocaine was of no clinical importance. Prilocaine is the agent of choice for intravenous regional analgesia. The use of bupivacaine for IVRA should be limited to special indications.

  20. Titration of vaccinia virus by intravenous injection of chick embryos.

    PubMed

    KAPLAN, C

    1960-01-01

    The final test of a smallpox vaccine is its capacity to prevent the disease from developing in inoculated individuals. This capacity, however, cannot be measured directly, so that other methods of assessing the efficacy of vaccine have had to be developed. A laboratory method-pock counting on the chorio-allantoic membrane of chick embryos-has recently been shown to provide a reasonably reliable estimate of the number of infective units in a given vaccine. In this paper, the author compares this pock-counting method with another method-titration by intravenous injection of chick embryos. He concludes that, although the reproducibility of titrations by intravenous injection compares very favourably with that obtained by chorio-allantoic inoculation, the former method would not be advantageous for the assay of vaccines, since it is very time-consuming and since differences in virulence might obscure comparisons between the efficacy of vaccines.

  1. Successful treatment of refractory Trichomonas vaginalis infection using intravenous metronidazole.

    PubMed

    Hawkins, Isobel; Carne, Christopher; Sonnex, Christopher; Carmichael, Andrew

    2015-08-01

    Trichomonas vaginalis is a sexually transmitted protozoan infection resulting in a vulvo-vaginitis and altered vaginal discharge in symptomatic women. Since its introduction in the 1960 s, metronidazole has been the first-line drug for trichomonal infection. Other nitroimidazoles, such as tinidazole, are used as alternative regimens with similar activity but at a greater expense. Treatment failure usually represents patient non-compliance or reinfection, although metronidazole resistance has previously been documented. Sensitivity testing is currently not available in the UK. Patients with disease unresponsive to first-line treatments pose a major challenge, as therapeutic options are limited. This case looks at a patient with refractory disease over an 18-month period, where intravenous infusion of metronidazole resulted in cure after multiple previous therapy failures. There is limited evidence to endorse the use of intravenous metronidazole, and this case report provides further support for its efficacy.

  2. Symptomatic sinus bradycardia: A rare adverse effect of intravenous ondansetron

    PubMed Central

    Moazzam, Md Shahnawaz; Nasreen, Farah; Bano, Shahjahan; Amir, Syed Hussain

    2011-01-01

    Ondansetron is a serotonin receptor antagonist which has been used frequently to reduce the incidence of post-operative nausea and vomiting in laparoscopic surgery. It has become very popular drug for the prevention of post-operative nausea and vomiting due to its superiority in-terms of efficacy as well as lack of side effects and drug interactions. Although cardiovascular adverse effects of this drug are rare, we found a case of symptomatic sinus bradycardia in a 43-year-old female patient, going for laparoscopic cholecystectomy, who developed the same after she was given intravenous ondansetron in operation theater during premedication. Hence, we report this case, as the rare possibility of encountering bradycardia effect after intravenous administration of ondansetron should be born in mind. PMID:21655029

  3. Intravenous Medication Administration in Intensive Care: Opportunities for Technological Solutions

    PubMed Central

    Moss, Jacqueline; Berner, Eta; Bothe, Olaf; Rymarchuk, Irina

    2008-01-01

    Medication administration errors have been shown to be frequent and serious. Error is particularly prevalent in highly technical specialties such as critical care. The purpose of this study was to describe the characteristics of intravenous medication administration in five intensive care units. These data were used within the context of a larger study to design information system decision support to decrease medication administration errors in these settings. Nurses were observed during the course of their work and their intravenous medication administration process, medication order source, references used, calculation method, number of medications prepared simultaneously, and any interruptions occurring during the preparation and delivery phases of the administration event were recorded. In addition, chart reviews of medication administration records were completed and nurses were asked to complete an anonymous drop-box questionnaire regarding their experiences with medication administration error. The results of this study are discussed in terms of potential informatics solutions for reducing medication administration error. PMID:18998790

  4. Scurvy in an alcoholic patient treated with intravenous vitamins.

    PubMed

    Ong, John; Randhawa, Rabinder

    2014-01-01

    Vitamin C deficiency is rare in developed countries but there is an increased prevalence in chronic alcohol abusers. In the UK, it is common practice to treat patients with chronic alcoholism who are admitted to hospital with intravenous vitamins B1, B2, B3, B6 and C for 2-3 days, followed by oral thiamine and vitamin B-compound tablets. This is a case of a 57-year-old man with a history of chronic alcoholism and chronic obstructive lung disease who was admitted to the intensive care unit for pneumonia requiring ventilatory support. He was given high doses of intravenous vitamins B1, B2, B3, B6 and C for 3 days then oral thiamine and vitamin B compound tablets but developed scurvy 4 days later. He was restarted on oral vitamin C supplementation and showed signs of improvement within 3 days of treatment. PMID:24728889

  5. Scurvy in an alcoholic patient treated with intravenous vitamins.

    PubMed

    Ong, John; Randhawa, Rabinder

    2014-04-11

    Vitamin C deficiency is rare in developed countries but there is an increased prevalence in chronic alcohol abusers. In the UK, it is common practice to treat patients with chronic alcoholism who are admitted to hospital with intravenous vitamins B1, B2, B3, B6 and C for 2-3 days, followed by oral thiamine and vitamin B-compound tablets. This is a case of a 57-year-old man with a history of chronic alcoholism and chronic obstructive lung disease who was admitted to the intensive care unit for pneumonia requiring ventilatory support. He was given high doses of intravenous vitamins B1, B2, B3, B6 and C for 3 days then oral thiamine and vitamin B compound tablets but developed scurvy 4 days later. He was restarted on oral vitamin C supplementation and showed signs of improvement within 3 days of treatment.

  6. Sphingomonas paucimobilis bloodstream infections associated with contaminated intravenous fentanyl.

    PubMed

    Maragakis, Lisa L; Chaiwarith, Romanee; Srinivasan, Arjun; Torriani, Francesca J; Avdic, Edina; Lee, Andrew; Ross, Tracy R; Carroll, Karen C; Perl, Trish M

    2009-01-01

    Nationally distributed medications from compounding pharmacies, which typically adhere to less stringent quality-control standards than pharmaceutical manufacturers, can lead to multistate outbreaks. We investigated a cluster of 6 patients in a Maryland hospital who had Sphingomonas paucimobilis bloodstream infections in November 2007. Of the 6 case-patients, 5 (83%) had received intravenous fentanyl within 48 hours before bacteremia developed. Cultures of unopened samples of fentanyl grew S. paucimobilis; the pulsed-field gel electrophoresis pattern was indistinguishable from that of the isolates of 5 case-patients. The contaminated fentanyl lot had been prepared at a compounding pharmacy and distributed to 4 states. Subsequently, in California, S. paucimobilis bacteremia was diagnosed for 2 patients who had received intravenous fentanyl from the same compounding pharmacy. These pharmacies should adopt more stringent quality-control measures, including prerelease product testing, when compounding and distributing large quantities of sterile preparations.

  7. Intravenous leiomyomatosis: a rare cause of intracardiac mass.

    PubMed

    Cruz, Inês; João, Isabel; Stuart, Bruno; Iala, Mário; Bento, Luísa; Cotrim, Carlos; Nobre, Angelo; Pereira, Hélder

    2014-11-01

    Intravenous leiomyomatosis is an unusual clinical condition characterized by histologically benign smooth muscle lesions extending from the uterus into pelvic and systemic veins and, more rarely, into the right cardiac chambers. We report the case of a 45-year-old woman who presented with a three-week history of dyspnea on exertion, shortness of breath and fatigue. Echocardiography showed a large mobile mass in the right atrium prolapsing into the right ventricle and extending to the inferior vena cava. A computed tomography scan revealed a large mass extending from the right atrium to the inferior vena cava and through the systemic veins as far as the popliteal veins. A presumptive diagnosis of large thrombus was made; the correct diagnosis of intravenous leiomyomatosis with intracardiac involvement was obtained only after surgical resection and histologic examination.

  8. Successful treatment of refractory Trichomonas vaginalis infection using intravenous metronidazole.

    PubMed

    Hawkins, Isobel; Carne, Christopher; Sonnex, Christopher; Carmichael, Andrew

    2015-08-01

    Trichomonas vaginalis is a sexually transmitted protozoan infection resulting in a vulvo-vaginitis and altered vaginal discharge in symptomatic women. Since its introduction in the 1960 s, metronidazole has been the first-line drug for trichomonal infection. Other nitroimidazoles, such as tinidazole, are used as alternative regimens with similar activity but at a greater expense. Treatment failure usually represents patient non-compliance or reinfection, although metronidazole resistance has previously been documented. Sensitivity testing is currently not available in the UK. Patients with disease unresponsive to first-line treatments pose a major challenge, as therapeutic options are limited. This case looks at a patient with refractory disease over an 18-month period, where intravenous infusion of metronidazole resulted in cure after multiple previous therapy failures. There is limited evidence to endorse the use of intravenous metronidazole, and this case report provides further support for its efficacy. PMID:25161176

  9. Neuroprotective Effects of Intravenous Anesthetics: A New Critical Perspective

    PubMed Central

    Bilotta, Federico; Stazi, Elisabetta; Zlotnik, Alexander; Gruenbaum, Shaun E.; Rosa, Giovanni

    2015-01-01

    Perioperative cerebral damage can result in various clinical sequela ranging from minor neurocognitive deficits to catastrophic neurological morbidity with permanent impairment and death. The goal of neuroprotective treatments is to reduce the clinical effects of cerebral damage through two major mechanisms: increased tolerance of neurological tissue to ischemia and changes in intra-cellular responses to energy supply deprivation. In this review, we present the clinical evidence of intravenous anesthetics on perioperative neuroprotection, and we also provide a critical perspective for future studies. The neuroprotective efficacy of the intravenous anesthetics thiopental, propofol and etomidate is unproven. Lidocaine may be neuroprotective in non-diabetic patients who have undergoing cardiac surgery with cardiopulmonary bypass (CBP) or with a 48-hour infusion, but conclusive data are lacking. There are several limitations of clinical studies that evaluate postoperative cognitive dysfunction (POCD), including difficulties in identifying patients at high-risk and a lack of consensus for defining the “gold-standard” neuropsychological testing. Although a battery of neurocognitive tests remains the primary method for diagnosing POCD, recent evidence suggests a role for novel biomarkers and neuroimaging to preemptively identify patients more susceptible to cognitive decline in the perioperative period. Current evidence, while inconclusive, suggest that intravenous anesthetics may be both neuroprotective and neurotoxic in the perioperative period. A critical analysis on data recorded from randomized control trials (RCTs) is essential in identifying patients who may benefit or be harmed by a particular anesthetic. RCTs will also contribute to defining methodologies for future studies on the neuroprotective effects of intravenous anesthetics. PMID:24669972

  10. Intravenous fish oil in adult intensive care unit patients.

    PubMed

    Heller, Axel R

    2015-01-01

    Omega-3 fatty acids contained in fish oils have shown efficacy in the treatment of chronic and acute inflammatory diseases due to their pleiotropic effects on inflammatory cell signalling pathways. In a variety of experimental and clinical studies, omega-3 fatty acids attenuated hyperinflammatory conditions and induced faster recovery. This chapter will shed light on the effects of intravenous fish oil in adult intensive care unit (ICU) patients and will discuss clinical data and recent meta-analyses on the topic. While significant beneficial effects on infection rates and the lengths of ICU and hospital stays have concordantly been identified in three recent meta-analyses on non-ICU surgical patients, the level of evidence is not so clear for critically ill patients. Three meta-analyses published in 2012 or 2013 explored data on the ICU population. Although the present data suggest the consideration of enteral nutrition enriched with fish oil, borage oil and antioxidants in mild to severe acute respiratory distress syndrome, only one of the three meta-analyses found a trend (p = 0.08) of lower mortality in ICU patients receiving intravenous omega-3 fatty acids. Two of the meta-analyses indicated a significantly shorter hospital stay (5.17-9.49 days), and one meta-analysis found a significant reduction in ICU days (1.92). As a result of these effects, cost savings were postulated. Unlike in surgical patients, the effects of fish oil on infection rates were not found to be statistically significant in ICU patients, and dose-effect relationships were not established for any cohort. Thus, obvious positive secondary outcome effects with intravenous fish oil have not yet been shown to transfer to lower mortality in critically ill patients. There is a need for adequately powered, well-planned and well-conducted randomized trials to give clear recommendations on the individual utility and dosage of intravenous omega-3 fatty acids in critical illness. PMID:25471809

  11. Distribution of creatinine following intravenous and oral administration to rats.

    PubMed

    Watanabe, J; Hirate, J; Iwamoto, K; Ozeki, S

    1981-05-01

    To evaluate the distribution of creatinine in rats, urinary, fecal and expiratory excretion, plasma levels and whole-body autoradiography following intravenous or oral administration of [carbonyl-14C]creatinine was investigated. More than 90% of the exogeneous creatinine was excreted in the urine in 24 hr following intravenous administration, and both fecal and expiratory excretion were only about 1%. In case of oral administration, however, it was found that expiratory excretion could not be neglected, ranging from about 1 to 30%. Plasma creatinine concentration-time curves following the intravenous administration (70.4 micrograms/kg or 400 mg/kg as creatinine) were analyzed according to a two-compartment open model. There were significant but very small differences in the pharmacokinetic parameters for these two doses. When these parameters were compared with those of urea, k12 and k21, which are transfer rate constants between compartment 1 and 2, for creatinine were significantly smaller than those of urea. On the other hand, k10 was larger in creatinine. Furthermore, (V'd)extrap for creatinine was about three times that of urea. Whole-body autoradiograms at 5 minutes following intravenous administration showed that exogeneous creatinine distributes with higher concentrations in liver, lung and kidney than in muscle and fat. This results was remarkably different from that of urea which distributes almost uniformly throughout the body at the same time. This difference observed in the autoradiograms would be the consequence of the fact that urea has larger k12 and k21 than creatinine.

  12. Infective endocarditis in intravenous drug users: a review article.

    PubMed

    Colville, Thomas; Sharma, Vishal; Albouaini, Khaled

    2016-02-01

    Approximately 10% of infective endocarditis (IE) involves the right side of the heart with the majority of these cases occurring in intravenous drug users. Patients are less likely to present with classical IE signs of a new murmur and peripheral stigmata, are more frequently immunocompromised and often have significant social difficulties. These factors result in both diagnostic and therapeutic challenges in this patient group that are not often seen in other patient populations with IE.

  13. Intravenous thrombolysis is unsafe in stroke due to infective endocarditis.

    PubMed

    Brownlee, W J; Anderson, N E; Barber, P A

    2014-02-01

    Embolic stroke is the most common neurological complication of infective endocarditis and a major source of morbidity and mortality. Septic embolism is considered a contraindication to intravenous thrombolysis in patients with ischaemic stroke because of concerns over an increased risk of intracranial haemorrhage. We describe a patient with occult endocarditis who was treated with thrombolysis for acute stroke and review other cases reported in the literature.

  14. Generalized Pump-restriction Theorem

    SciTech Connect

    Sinitsyn, Nikolai A; Chernyak, Vladimir Y

    2008-01-01

    We formulate conditions under which periodic modulations of parameters on a finite graph with stochastic transitions among its nodes do not lead to overall pump currents through any given link. Our theorem unifies previously known results with the new ones and provides a universal approach to explore futher restrictions on stochastic pump effect in non-adiabatically driven systems with detailed balance.

  15. Backscattering measuring system for optimization of intravenous laser irradiation dose

    NASA Astrophysics Data System (ADS)

    Rusina, Tatyana V.; Popov, V. D.; Melnik, Ivan S.; Dets, Sergiy M.

    1996-11-01

    Intravenous laser blood irradiation as an effective method of biostimulation and physiotherapy becomes a more popular procedure. Optimal irradiation conditions for each patient are needed to be established individually. A fiber optics feedback system combined with conventional intravenous laser irradiation system was developed to control of irradiation process. The system consists of He-Ne laser, fiber optics probe and signal analyzer. Intravenous blood irradiation was performed in 7 healthy volunteers and 19 patients with different diseases. Measurements in vivo were related to in vitro blood irradiation which was performed in the same conditions with force-circulated venous blood. Comparison of temporal variations of backscattered light during all irradiation procedures has shown a strong discrepancy on optical properties of blood in patients with various health disorders since second procedure. The best cure effect was achieved when intensity of backscattered light was constant during at least five minutes. As a result, the optical irradiation does was considered to be equal 20 minutes' exposure of 3 mW He-Ne laser light at the end of fourth procedure.

  16. Intravenous lidocaine for fibromyalgia syndrome: an open trial.

    PubMed

    Schafranski, Marcelo Derbli; Malucelli, Tiago; Machado, Fabíola; Takeshi, Hélcio; Kaiber, Flávia; Schmidt, Carolina; Harth, Fabielle

    2009-07-01

    Fibromyalgia is a disorder characterized by chronic widespread pain. In this study, we investigated the effect of intravenous infusions of lidocaine in pain and quality of life of patients with fibromyalgia. Twenty-three consecutive patients were included in the study, which consisted on five sequential intravenous 2% lidocaine infusions with rising dosages (2-5 mg/kg, days 1-5). Fibromyalgia Impact Questionnaire (FIQ), Health Assessment Questionnaire, and a visual analog scale (VAS) for pain were applied before the first lidocaine infusion, immediately after the fifth infusion and 30 days after the fifth infusion. A significant improvement was observed in the FIQ scores after the fifth infusion (73.52 +/- 16.56 vs 63.29 +/- 21.21, p = 0.02), which was maintained after 30 days (73.52 +/- 16.56 vs 63.85 +/- 24.59, p = 0.04). Similar results were seen concerning the VAS: 8.19 +/- 1.76 vs 6.84 +/- 2.44, p = 0.01 and 8.19 +/- 1.76 vs 7.17 +/- 2.35, p = 0.05, respectively. Intravenous lidocaine infusions are safe and effective in the management of fibromyalgia.

  17. Wound contraction decreases with intravenously injected substance P in rabbits.

    PubMed

    Lee, Jun Yong; Kim, Woo Seob; Kim, Wonyong; Kim, Han Koo; Bae, Tae Hui; Park, Jeong Ae

    2014-02-01

    Substance P is an injury-inducible endogenous factor for the mobilization of CD29+ stromal-like cells into circulation and that are major effectors of accelerated healing. In this study, we evaluated the effect of intravenously injected substance P on full-thickness skin wound healing as a secondary intention wound model. We made circular full-thickness skin wounds on the ears of 28 New Zealand white rabbits. They were treated with phosphate-buffered saline, or intravenous 5, 50, or 250 n mole/kg substance P at days 0 and 1. All substance P-treated groups showed a 2.6-5.4-fold higher CD29 expression and resulted in greatly decreased wound contraction and early maturation of the stroma. However, a significant decrease in wound contraction was measured only in the 5 n mole/kg treatment group. We conclude that intravenously injected substance P at 5 n mole/kg decreases wound contraction and promotes wound maturation in full-thickness skin wounds in a rabbit ear model.

  18. Cardiovascular effects of intravenous administration of tetracycline in cattle.

    PubMed

    Gyrd-Hansen, N; Rasmussen, F; Smith, M

    1981-03-01

    Tetracycline chloride dissolved in saline was injected intravenously to seven cows. Two doses of tetracycline were used: 5 and 10 mg/kg b.wt, and the injections were given over a period of either 10, 60 or 300 sec. A number of the cows collapsed shortly after the injection was completed, usually when the 10 mg dosage was given in 60 sec. When the same dose was given over a period of 5 min none of the cows collapsed. A more or less pronounced drop in blood pressure could be detected during or shortly after the injection; in those cows which collapsed the blood pressure fell almost to zero. The predominant change in pulse rate in connection with the tetracycline administration was a decrease which could be quite marked, pulse rates falling as low as 10-20 per min. Simultaneously with these changes in blood pressure and pulse rate severe abnormalities in ECG could be observed. Pre-treatment with a normal therapeutic dose of calcium borogluconate intravenously prevented collapse in the cows and diminished the drop in blood pressure associated with an ensuing tetracycline injection. It is concluded that intravenous injection of tetracycline is hazardous, but that collapse can be avoided by giving the injection very slowly over a period of no less than 5 min.

  19. Intravenous linezolid administered orally: a novel desensitization strategy.

    PubMed

    Cawley, Michael J; Lipka, Ozana

    2006-04-01

    A 41-year-old woman with a history of myasthenia gravis was admitted to a local hospital because of severe muscle weakness, ptosis, shortness of breath, nausea and vomiting, and fever. Blood cultures revealed Enterococcus faecium resistant to several antimicrobial agents. The organism had minimum inhibitory concentrations above 16 microg/ml for vancomycin and above 2 microg/ml for quinupristin-dalfopristin. In the absence of therapeutic alternatives, treatment with linezolid was required (minimum inhibitory concentration 1.5 microg/ml). The first dose of linezolid resulted in a hypersensitivity reaction consistent with an immunoglobulin E-mediated response requiring medical intervention. Because of a lack of intravenous access and because of limited availability of the oral suspension from the manufacturer, a desensitization protocol was implemented in which the intravenous formulation of linezolid was given orally. The patient was successfully desensitized by using an escalating, 14-dose procedure. We believe this is the first case in the English language literature to describe successful desensitization with the oral administration of intravenous linezolid in a patient with E. faecium bacteremia who was allergic to oxazolidinone. PMID:16553517

  20. A History of Intravenous Anesthesia in War (1656-1988).

    PubMed

    Roberts, Matthew; Jagdish, S

    2016-01-01

    The practice of anesthesia in war places significant restraints on the choice of anesthetic technique used; these include, but are not limited to, safety, simplicity, and portability. Ever since intravenous anesthesia became a practical alternative, there have been military doctors who felt that this technique was particularly suited to this environment. The challenge, as in civilian practice, has been to find the appropriate drugs as well as simple and safe delivery systems. The urgency of war has always stimulated innovation in medicine to counteract the ongoing development of weapons of war and their effects on the human body and to achieve improved survival as public expectations rise. This article traces the development of and the use of intravenous anesthesia by military physicians for battle casualties. The story starts long before the era of modern anesthesia, and the discussion concludes in the dog days of the cold war. The rapidly increasing interest in intravenous anesthesia in both civilian and military practice since the early 1990s is left for other authors to examine.

  1. A History of Intravenous Anesthesia in War (1656-1988).

    PubMed

    Roberts, Matthew; Jagdish, S

    2016-01-01

    The practice of anesthesia in war places significant restraints on the choice of anesthetic technique used; these include, but are not limited to, safety, simplicity, and portability. Ever since intravenous anesthesia became a practical alternative, there have been military doctors who felt that this technique was particularly suited to this environment. The challenge, as in civilian practice, has been to find the appropriate drugs as well as simple and safe delivery systems. The urgency of war has always stimulated innovation in medicine to counteract the ongoing development of weapons of war and their effects on the human body and to achieve improved survival as public expectations rise. This article traces the development of and the use of intravenous anesthesia by military physicians for battle casualties. The story starts long before the era of modern anesthesia, and the discussion concludes in the dog days of the cold war. The rapidly increasing interest in intravenous anesthesia in both civilian and military practice since the early 1990s is left for other authors to examine. PMID:26898141

  2. Fluid flow monitoring device

    DOEpatents

    McKay, Mark D.; Sweeney, Chad E.; Spangler, Jr., B. Samuel

    1993-01-01

    A flow meter and temperature measuring device comprising a tube with a body centered therein for restricting flow and a sleeve at the upper end of the tube to carry several channels formed longitudinally in the sleeve to the appropriate axial location where they penetrate the tube to allow pressure measurements and temperature measurements with thermocouples. The high pressure measurement is made using a channel penetrating the tube away from the body and the low pressure measurement is made at a location at the widest part of the body. An end plug seals the end of the device and holes at its upper end allow fluid to pass from the interior of the tube into a plenum. The channels are made by cutting grooves in the sleeve, the grooves widened at the surface of the sleeve and then a strip of sleeve material is welded to the grooves closing the channels. Preferably the sleeve is packed with powdered graphite before cutting the grooves and welding the strips.

  3. Fluid flow monitoring device

    DOEpatents

    McKay, M.D.; Sweeney, C.E.; Spangler, B.S. Jr.

    1993-11-30

    A flow meter and temperature measuring device are described comprising a tube with a body centered therein for restricting flow and a sleeve at the upper end of the tube to carry several channels formed longitudinally in the sleeve to the appropriate axial location where they penetrate the tube to allow pressure measurements and temperature measurements with thermocouples. The high pressure measurement is made using a channel penetrating the tube away from the body and the low pressure measurement is made at a location at the widest part of the body. An end plug seals the end of the device and holes at its upper end allow fluid to pass from the interior of the tube into a plenum. The channels are made by cutting grooves in the sleeve, the grooves widened at the surface of the sleeve and then a strip of sleeve material is welded to the grooves closing the channels. Preferably the sleeve is packed with powdered graphite before cutting the grooves and welding the strips. 7 figures.

  4. 5 CFR 300.604 - Restrictions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS EMPLOYMENT (GENERAL) Time-In-Grade Restrictions § 300.604 Restrictions. The following time-in-grade restrictions must be met unless... may be advanced without time restriction to positions up to GS-5 if the position to be filled is...

  5. 5 CFR 300.604 - Restrictions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS EMPLOYMENT (GENERAL) Time-In-Grade Restrictions § 300.604 Restrictions. The following time-in-grade restrictions must be met unless... may be advanced without time restriction to positions up to GS-5 if the position to be filled is...

  6. 5 CFR 300.604 - Restrictions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS EMPLOYMENT (GENERAL) Time-In-Grade Restrictions § 300.604 Restrictions. The following time-in-grade restrictions must be met unless... may be advanced without time restriction to positions up to GS-5 if the position to be filled is...

  7. 5 CFR 300.604 - Restrictions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS EMPLOYMENT (GENERAL) Time-In-Grade Restrictions § 300.604 Restrictions. The following time-in-grade restrictions must be met unless... may be advanced without time restriction to positions up to GS-5 if the position to be filled is...

  8. 5 CFR 300.604 - Restrictions.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS EMPLOYMENT (GENERAL) Time-In-Grade Restrictions § 300.604 Restrictions. The following time-in-grade restrictions must be met unless... may be advanced without time restriction to positions up to GS-5 if the position to be filled is...

  9. 49 CFR 215.203 - Restricted cars.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Restricted cars. 215.203 Section 215.203..., DEPARTMENT OF TRANSPORTATION RAILROAD FREIGHT CAR SAFETY STANDARDS Restricted Equipment § 215.203 Restricted cars. (a) This section restricts the operation of any railroad freight car that is— (1) More than...

  10. 49 CFR 215.203 - Restricted cars.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Restricted cars. 215.203 Section 215.203..., DEPARTMENT OF TRANSPORTATION RAILROAD FREIGHT CAR SAFETY STANDARDS Restricted Equipment § 215.203 Restricted cars. (a) This section restricts the operation of any railroad freight car that is— (1) More than...

  11. 49 CFR 215.203 - Restricted cars.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Restricted cars. 215.203 Section 215.203..., DEPARTMENT OF TRANSPORTATION RAILROAD FREIGHT CAR SAFETY STANDARDS Restricted Equipment § 215.203 Restricted cars. (a) This section restricts the operation of any railroad freight car that is— (1) More than...

  12. 49 CFR 215.203 - Restricted cars.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Restricted cars. 215.203 Section 215.203..., DEPARTMENT OF TRANSPORTATION RAILROAD FREIGHT CAR SAFETY STANDARDS Restricted Equipment § 215.203 Restricted cars. (a) This section restricts the operation of any railroad freight car that is— (1) More than...

  13. 49 CFR 215.203 - Restricted cars.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Restricted cars. 215.203 Section 215.203..., DEPARTMENT OF TRANSPORTATION RAILROAD FREIGHT CAR SAFETY STANDARDS Restricted Equipment § 215.203 Restricted cars. (a) This section restricts the operation of any railroad freight car that is— (1) More than...

  14. A randomized trial of dietary sodium restriction in CKD.

    PubMed

    McMahon, Emma J; Bauer, Judith D; Hawley, Carmel M; Isbel, Nicole M; Stowasser, Michael; Johnson, David W; Campbell, Katrina L

    2013-12-01

    There is a paucity of quality evidence regarding the effects of sodium restriction in patients with CKD, particularly in patients with pre-end stage CKD, where controlling modifiable risk factors may be especially important for delaying CKD progression and cardiovascular events. We conducted a double-blind placebo-controlled randomized crossover trial assessing the effects of high versus low sodium intake on ambulatory BP, 24-hour protein and albumin excretion, fluid status (body composition monitor), renin and aldosterone levels, and arterial stiffness (pulse wave velocity and augmentation index) in 20 adult patients with hypertensive stage 3-4 CKD as phase 1 of the LowSALT CKD study. Overall, salt restriction resulted in statistically significant and clinically important reductions in BP (mean reduction of systolic/diastolic BP, 10/4 mm Hg; 95% confidence interval, 5 to 15 /1 to 6 mm Hg), extracellular fluid volume, albuminuria, and proteinuria in patients with moderate-to-severe CKD. The magnitude of change was more pronounced than the magnitude reported in patients without CKD, suggesting that patients with CKD are particularly salt sensitive. Although studies with longer intervention times and larger sample sizes are needed to confirm these benefits, this study indicates that sodium restriction should be emphasized in the management of patients with CKD as a means to reduce cardiovascular risk and risk for CKD progression.

  15. Effect of preoperative intravenous methocarbamol and intravenous acetaminophen on opioid use after primary total hip and knee replacement.

    PubMed

    Looke, Thomas D; Kluth, Cameron T

    2013-02-01

    Between 2010 and 2011, a perioperative pain protocol for primary total hip and knee replacement at one Florida medical center replaced preoperative oral analgesics with intravenous methocarbamol and intravenous acetaminophen. This is a retrospective cohort study of 300 patients, with 150 patients using the new pain protocol and 150 patients using a 2008 pain protocol that did not include these medications. The 2 cohorts were similar in patient gender, age, and body mass index. Opioid consumption was evaluated for a period of 48 hours after incision and was divided into 3 separate time intervals, as well as total 48-hour consumption. Mean opiate use decreased significantly from 2008 to 2011 in all time intervals and total consumption (7.5±3.4 mg to 6.1±3.0 mg; P<.01). Subgroup analysis suggested that changes to the hip protocol were responsible for decreased opioid use in the operating room and the postanesthesia care unit, and changes to the knee protocol were responsible for decreased opioid use on the hospital floor and total consumption. The difference between the 2 protocol groups was not due to differences in individual surgeon practice patterns. Physical therapy progress of knee flexion, average walking distance, and maximum walking distance were significantly improved. Hospital discharge was shorter in the 2011 group (4.0±1.1 days in 2008 group and 3.6±1.0 days in 2011 group). This study shows significant improvement in patient care from 2008 to 2011 that is at least partially due to the change to the use of preoperative intravenous methocarbamol and intravenous acetaminophen. PMID:23379573

  16. Fluid mechanics in fluids at rest.

    PubMed

    Brenner, Howard

    2012-07-01

    Using readily available experimental thermophoretic particle-velocity data it is shown, contrary to current teachings, that for the case of compressible flows independent dye- and particle-tracer velocity measurements of the local fluid velocity at a point in a flowing fluid do not generally result in the same fluid velocity measure. Rather, tracer-velocity equality holds only for incompressible flows. For compressible fluids, each type of tracer is shown to monitor a fundamentally different fluid velocity, with (i) a dye (or any other such molecular-tagging scheme) measuring the fluid's mass velocity v appearing in the continuity equation and (ii) a small, physicochemically and thermally inert, macroscopic (i.e., non-Brownian), solid particle measuring the fluid's volume velocity v(v). The term "compressibility" as used here includes not only pressure effects on density, but also temperature effects thereon. (For example, owing to a liquid's generally nonzero isobaric coefficient of thermal expansion, nonisothermal liquid flows are to be regarded as compressible despite the general perception of liquids as being incompressible.) Recognition of the fact that two independent fluid velocities, mass- and volume-based, are formally required to model continuum fluid behavior impacts on the foundations of contemporary (monovelocity) fluid mechanics. Included therein are the Navier-Stokes-Fourier equations, which are now seen to apply only to incompressible fluids (a fact well-known, empirically, to experimental gas kineticists). The findings of a difference in tracer velocities heralds the introduction into fluid mechanics of a general bipartite theory of fluid mechanics, bivelocity hydrodynamics [Brenner, Int. J. Eng. Sci. 54, 67 (2012)], differing from conventional hydrodynamics in situations entailing compressible flows and reducing to conventional hydrodynamics when the flow is incompressible, while being applicable to both liquids and gases.

  17. Overcoming Communication Restrictions in Collectives

    NASA Technical Reports Server (NTRS)

    Tumer, Kagan; Agogino, Adrian K.

    2004-01-01

    Many large distributed system are characterized by having a large number of components (eg., agents, neurons) whose actions and interactions determine a %orld utility which rates the performance of the overall system. Such collectives are often subject to communication restrictions, making it difficult for components which try to optimize their own private utilities, to take actions that also help optimize the world utility. In this article we address that coordination problem and derive four utility functions which present different compromises between how aligned a component s private utility is with the world utility and how readily that component can determine the actions that optimize its utility. The results show that the utility functions specifically derived to operate under communication restrictions outperform both traditional methods and previous collective-based methods by up to 75%.

  18. Temperature based Restricted Boltzmann Machines.

    PubMed

    Li, Guoqi; Deng, Lei; Xu, Yi; Wen, Changyun; Wang, Wei; Pei, Jing; Shi, Luping

    2016-01-13

    Restricted Boltzmann machines (RBMs), which apply graphical models to learning probability distribution over a set of inputs, have attracted much attention recently since being proposed as building blocks of multi-layer learning systems called deep belief networks (DBNs). Note that temperature is a key factor of the Boltzmann distribution that RBMs originate from. However, none of existing schemes have considered the impact of temperature in the graphical model of DBNs. In this work, we propose temperature based restricted Boltzmann machines (TRBMs) which reveals that temperature is an essential parameter controlling the selectivity of the firing neurons in the hidden layers. We theoretically prove that the effect of temperature can be adjusted by setting the parameter of the sharpness of the logistic function in the proposed TRBMs. The performance of RBMs can be improved by adjusting the temperature parameter of TRBMs. This work provides a comprehensive insights into the deep belief networks and deep learning architectures from a physical point of view.

  19. Temperature based Restricted Boltzmann Machines

    NASA Astrophysics Data System (ADS)

    Li, Guoqi; Deng, Lei; Xu, Yi; Wen, Changyun; Wang, Wei; Pei, Jing; Shi, Luping

    2016-01-01

    Restricted Boltzmann machines (RBMs), which apply graphical models to learning probability distribution over a set of inputs, have attracted much attention recently since being proposed as building blocks of multi-layer learning systems called deep belief networks (DBNs). Note that temperature is a key factor of the Boltzmann distribution that RBMs originate from. However, none of existing schemes have considered the impact of temperature in the graphical model of DBNs. In this work, we propose temperature based restricted Boltzmann machines (TRBMs) which reveals that temperature is an essential parameter controlling the selectivity of the firing neurons in the hidden layers. We theoretically prove that the effect of temperature can be adjusted by setting the parameter of the sharpness of the logistic function in the proposed TRBMs. The performance of RBMs can be improved by adjusting the temperature parameter of TRBMs. This work provides a comprehensive insights into the deep belief networks and deep learning architectures from a physical point of view.

  20. Effects of irrigation fluid in shoulder arthroscopy

    PubMed Central

    Gupta, Surbhi; Manjuladevi, M; Vasudeva Upadhyaya, KS; Kutappa, AM; Amaravathi, Rajkumar; Arpana, J

    2016-01-01

    Background and Aims: Extravasation of irrigation fluid used in shoulder arthroscopy can lead to life-threatening airway and systemic complications. This study was conducted to assess the effect of irrigation fluid absorption on measurable anthropometric parameters and to identify whether these parameters predict airway/respiratory compromise. Methods: Thirty six American Society of Anaesthesiologists physical status one or two patients aged 15–60 years undergoing shoulder arthroscopy under general anaesthesia were recruited. Measured variables preoperatively (baseline) and at the end of surgery were neck, chest, midarm and midthigh circumferences, weight, haemoglobin and serum sodium. Temperature, endotracheal tube cuff pressure, airway pressure, duration of surgery, amount of irrigation fluid and intravenous fluid used were also noted. Measured parameters were correlated with the duration of surgery and the amount of irrigation fluid used. Results: Postoperatively, the changes in variables showed a significant increase in the mean values (cm) for neck, chest, midarm and midthigh circumference (mean ± standard deviation: 2.35 ± 1.9, P < 0.001; 2.9 ± 3.88 cm, P < 0.001; 3.28 ± 2.44, P < 0.001 and 0.39 ± 0.71, P = 0.002, respectively) and weight (kg) (1.17 ± 1.24, P < 0.001). The post-operative haemoglobin (g/dL) levels decreased significantly (0.89 ± 1.23, P < 0.001) as compared to the baseline. No significant change was found in the serum sodium levels (P = 0.92). No patient experienced airway/respiratory compromise. Conclusion: Regional and systemic absorption of irrigation fluid in arthroscopic shoulder surgery is reflected in the degree of change in the measured anthropometric variables. However, this change was not significant enough to cause airway/respiratory compromise. PMID:27053783

  1. Fluid transport container

    DOEpatents

    DeRoos, Bradley G.; Downing, Jr., John P.; Neal, Michael P.

    1995-01-01

    An improved fluid container for the transport, collection, and dispensing of a sample fluid that maintains the fluid integrity relative to the conditions of the location at which it is taken. More specifically, the invention is a fluid sample transport container that utilizes a fitment for both penetrating and sealing a storage container under controlled conditions. Additionally, the invention allows for the periodic withdrawal of portions of the sample fluid without contamination or intermixing from the environment surrounding the sample container.

  2. Fluid transport container

    DOEpatents

    DeRoos, B.G.; Downing, J.P. Jr.; Neal, M.P.

    1995-11-14

    An improved fluid container for the transport, collection, and dispensing of a sample fluid that maintains the fluid integrity relative to the conditions of the location at which it is taken. More specifically, the invention is a fluid sample transport container that utilizes a fitting for both penetrating and sealing a storage container under controlled conditions. Additionally, the invention allows for the periodic withdrawal of portions of the sample fluid without contamination or intermixing from the environment surrounding the sample container. 13 figs.

  3. Efficacy of Intravenous Infusion of Acetaminophen for Intrapartum Analgesia

    PubMed Central

    Zutshi, Vijay; Rani, Kumari Usha; Patel, Madhumita

    2016-01-01

    Introduction The intensity of pain experienced by women in labour, has been found to affect the progress of labour, foetal well-being and maternal psychology. Adverse effects associated with commonly used opioids for providing intrapartum analgesia have created a need for an alternative non-opioid drug. Aim To evaluate the efficacy of an intravenous infusion of 1000 mg of acetaminophen as an intrapartum analgesic. Materials and Methods The present prospective single-centre, single blind, placebo-controlled randomized interventional study was conducted in Department of Obstetrics and Gynaecology in Vardhaman Mahavir Medical College & Safdarjung Hospital over a period of six months from September 2014 to March 2015. After receiving the ethical clearance and written informed consent. The first 200 consecutive parturients fulfilling the inclusion criteria were recruited into the study. Women were then randomised to receive either intravenous 1000 mg (100ml) of acetaminophen (Group A, n=100) or 100 ml normal saline (Group B, n=100). Primary outcome assessed was effectiveness of acetaminophen to provide an adequate amount of analgesia, as measured by a change in Visual Analogue Scale (VAS) pain intensity score at various times after drug administration. Secondary outcomes measured were duration of labour, need for additional rescue analgesia and presence of adverse maternal or foetal effect. Results There was pain reduction at 1 and 2 hours in both groups (p<0.001). However, it was more significant in the acetaminophen group, especially at 1 hour. Duration of labour was shortened in both the groups, without any maternal and foetal adverse effects. Conclusion Intravenous acetaminophen is an efficacious non-opioid drug for relieving labour pain without any significant maternal and foetal adverse effects. PMID:27656511

  4. ECMO for Cardiac Rescue after Accidental Intravenous Mepivacaine Application

    PubMed Central

    Froehle, Michael; Haas, Nikolaus A.; Kirchner, Guenther; Kececioglu, Deniz; Sandica, Eugen

    2012-01-01

    Mepivacaine is a potent local anaesthetic and used for infiltration and regional anaesthesia in adults and pediatric patients. Intoxications with mepivacaine affect mainly the CNS and the cardiovascular system. We present a case of accidental intravenous mepivacaine application and intoxication of an infant resulting in seizure, broad complex bradyarrhythmia, arterial hypotension and finally cardiac arrest. The patient could be rescued by prolonged resuscitations and a rapid initiation of ECMO and survived without neurological damage. The management strategies of this rare complication including promising other treatment options with lipid emulsions are discussed. PMID:22966472

  5. Orthomolecular oncology: a mechanistic view of intravenous ascorbate's chemotherapeutic activity.

    PubMed

    González, Michael J; Miranda-Massari, Jorge R; Mora, Edna M; Jiménez, Ivonne Z; Matos, María Isabel; Riordan, Hugh D; Casciari, Joseph J; Riordan, Neil H; Rodríguez, Marielys; Guzmán, Angelik

    2002-03-01

    The effect of vitamin C in cancer has been a subject of great controversy; mainly because of the inconsistent results obtained by oral intakes of ascorbate when used as an anticancer agent. We believe the intravenous application of ascorbate will provide more consistent results in cancer patients since Vitamin C blood levels attained are substantially higher in a range proven cytotoxic to malignant cells. In this article we will present and discuss our proposed mechanism on the chemotherapeutic activity exhibited by ascorbate. PMID:12013679

  6. The groin hit: complications of intravenous drug abuse.

    PubMed

    Roszler, M H; McCarroll, K A; Donovan, K R; Rashid, T; Kling, G A

    1989-05-01

    We are seeing an increased number of complications in intravenous drug abusers who resort to injecting the groin for vascular access (the "groin hit"). Vascular complications include venous thrombosis, arteriovenous fistula, mycotic aneurysm, ruptured pseudoaneurysm, and dissecting hematoma. Soft tissue complications include cellulitis and abscess. The latter may dissect into the extraperitoneal space. Skeletal complications include osteomyelitis and septic arthritis. This paper illustrates the radiographic spectrum of these complications. An algorithm will illustrate the radiographic evaluation of a groin mass in a drug addict. PMID:2727357

  7. Inversion-based propofol dosing for intravenous induction of hypnosis

    NASA Astrophysics Data System (ADS)

    Padula, F.; Ionescu, C.; Latronico, N.; Paltenghi, M.; Visioli, A.; Vivacqua, G.

    2016-10-01

    In this paper we propose an inversion-based methodology for the computation of a feedforward action for the propofol intravenous administration during the induction of hypnosis in general anesthesia. In particular, the typical initial bolus is substituted with a command signal that is obtained by predefining a desired output and by applying an input-output inversion procedure. The robustness of the method has been tested by considering a set of patients with different model parameters, which is representative of a large population.

  8. Pharmacokinetics as applied to total intravenous anaesthesia. Practical implications.

    PubMed

    Schüttler, J; Schwilden, H; Stoekel, H

    1983-07-01

    In six patients undergoing gynaecological surgery computer assisted total intravenous anaesthesia (CATIA) was performed using etomidate and alfentanil. Constant plasma levels of etomidate (0.3 microgram/ml) from the very beginning onwards were achieved using the so called B.E.T. infusion scheme. Alfentanil plasma concentrations of 0.45 microgram/ml were maintained by the same infusion scheme beginning with skin incision until 20 minutes prior to the end of surgery. The proposed concept of CATIA provided an adequate analgesic and hypnotic effect during anaesthesia for abdominal surgery with a recovery period of short duration.

  9. Intravenous zoledronate for osteoporosis: less might be more

    PubMed Central

    Grey, Andrew

    2016-01-01

    Annual administration of 5 mg intravenous zoledronate is moderately effective in reducing fracture risk in older adults, decreasing the relative risk of clinical fracture by 33%. However, almost 10 years after its approval for use in clinical practice there remain very substantial uncertainties about the optimal treatment regimen, that is, the lowest dose and/or longest dosing interval that is efficacious. Several pieces of clinical research suggest that the current recommendation for annual administration of 5 mg zoledronate might represent overtreatment. Clinical trials to clarify the optimal use of zoledronate for reduction of fracture risk should be undertaken. PMID:27493690

  10. Cholescintigraphy in acute cholecystitis: use of intravenous morphine

    SciTech Connect

    Choy, D.; Shi, E.C.; McLean, R.G.; Hoschl, R.; Murray, I.P.C.; Ham, J.M.

    1984-04-01

    Conventional cholescintigraphy (60 patients) and a modified protocol (59 patients) were compared in 74 females and 45 males with acute cholecystitis. In the modified protocol, intravenous morphine was administered whenever the gallbladder was not seen 40 minutes after injection of Tc-99m-pyroxylidene-glutamate. Accuracy was 98% with morphine, compared with 88% for the conventional protocol; specificity improved from 83% to 100% with no loss of sensitivity. Low doses of morphine are well tolerated and can result in a highly accurate diagnosis of acute cholecystitis without the need for delayed imaging.

  11. Intravenous regional analgesia in a patient with Glanzmann thrombastenia.

    PubMed

    Goksu, Sitki; Gul, Rauf; Ozen, Onder; Yilmaz, Mehmet; Buyukbebeci, Orhan; Oner, Unsal

    2010-02-01

    Glanzmann thrombastenia (GT) is a rare condition of an inherited autosomal recessive gene characterized with bleeding tendency. The condition is rarely met in the OR. and therefore it is essential that anesthesiologist be cognizant of the risk involved and be prepared with all necessary precautionary measures. We present a GT case in a 27-year-old male with a mass in the anticubital region of right wrist that was successfully excised using the non-invasive intravenous regional analgesia (IVRA). The use of platelet transfusion and the recombinant factor VIIa, are stressed.

  12. Intravenous dipyridamole thallium-201 SPECT imaging methodology, applications, and interpretations

    SciTech Connect

    Rockett, J.F.; Magill, H.L.; Loveless, V.S.; Murray, G.L. )

    1990-10-01

    Dipyridamole TI-201 imaging is an ideal alternative to exercise TI-201 scintigraphy in patients who are unwilling or unable to perform maximum exercise stress. The use of intravenous dipyridamole, alone or in combination with exercise, has not been approved for clinical practice by the Food and Drug Administration. Once approval is granted, the test will become a widely used and important component of the cardiac work-up. The indications, methodology, side effects, and utility of dipyridamole cardiac imaging in the clinical setting are discussed and a variety of examples presented.59 references.

  13. Stability analysis of restricted non-static axial symmetry

    SciTech Connect

    Sharif, M.; Bhatti, M. Zaeem Ul Haq E-mail: mzaeem.math@gmail.com

    2013-11-01

    This paper aims to investigate the instability of very restricted class of non-static axially symmetric spacetime with anisotropic matter configuration. The perturbation scheme is established for the Einstein field equations and conservation laws. The instability range in the Newtonian and post-Newtonian regions are explored by constructing the collapse equation in this scenario. It is found that the adiabatic index plays an important role in the stability analysis which depends upon the physical parameters i.e., energy density and anisotropic pressure of the fluid distribution.

  14. Subcutaneous fluid administration in elderly subjects: Validation of an under-used technique

    SciTech Connect

    Lipschitz, S.; Campbell, A.J.; Roberts, M.S.; Wanwimolruk, S.; McQueen, E.G.; McQueen, M.; Firth, L.A. )

    1991-01-01

    In a crossover study in six volunteers over the age of 65, absorption of 500 mL of normal saline given subcutaneously was compared with that given intravenously. Tritiated water and technetium pertechnetate were used as water tracers. Tritium radioisotope levels in the blood increased in a smooth curve during subcutaneous infusion, reaching equilibrium levels within 60 minutes. The area under the curve after subcutaneous infusion was almost identical to that after intravenous infusion in all subjects. Radioactivity could not be demonstrated at the subcutaneous site 1 hour after completion of the infusion. Subcutaneous infusion is an effective method of giving fluid to elderly people and deserves more widespread use.

  15. Increased dietary sodium alters Fos expression in the lamina terminalis during intravenous angiotensin II infusion.

    PubMed

    Bealer, Steven L; Metcalf, Cameron S; Heyborne, Ryan

    2007-03-01

    These studies examined the effects of increased dietary sodium on expression of Fos, the protein product of c-fos, in forebrain structures in the rat following intravenous infusion with angiotensin II (AngII). Animals were provided with either tap water (Tap) or isotonic saline solution (Iso) as their sole drinking fluid for 3-5 weeks prior to testing. Rats were then implanted with catheters in a femoral artery and vein. The following day, the conscious, unrestrained animals received iv infusion of either isotonic saline (Veh), AngII, or phenylephrine (Phen) for 2 h. Blood pressure and heart rate were monitored continuously throughout the procedure. Brains were subsequently processed for evaluation of Fos-like immunoreactivity (Fos-Li IR) in the organum vasculosum of the lamina terminalis (OVLT), the subfornical organ (SFO), and the median preoptic nucleus (MnPO). Fos-Li IR was significantly increased in the SFO and OVLT of animals consuming both Tap and Iso following AngII, but not Phen, compared to Veh infusions. Furthermore, Fos-Li IR in the MnPO was increased following AngII infusion in rats consuming a high sodium diet, but not in animals drinking Tap. These data suggest that increased dietary sodium sensitizes the MnPO neurons to excitatory input from brain areas responding to circulating AngII.

  16. REBASE - restriction enzymes and methylases.

    PubMed Central

    Roberts, R J; Macelis, D

    1998-01-01

    REBASE is a comprehensive database of information about restriction enzymes and their associated methylases, including their recognition and cleavage sites and their commercial availability. Also included is a listing of homing endonucleases. Information from REBASE is available via monthly electronic mailings as well as via anonymous ftp and through the World Wide Web. The REBASE web site, http://www. neb.com/rebase , is where we maintain a web page for every enzyme, reference and supplier. Additionally, there is a search facility, help and NEWS pages, and a complete description of our various services. Specialized files are available that can be used directly by many software packages. PMID:9399870

  17. Histamine-induced airway mucosal exudation of bulk plasma and plasma-derived mediators is not inhibited by intravenous bronchodilators.

    PubMed

    Svensson, C; Alkner, U; Pipkorn, U; Persson, C G

    1994-01-01

    Experimental data suggest the possibility that common bronchodilators, such as the xanthines and beta 2-adrenoceptor agonists, may produce microvascular anti-permeability effects in the subepithelial microcirculation of the airways. In this study, we have examined the effect of bronchodilators given intravenously on exudation of different-sized plasma proteins (albumin and fibrinogen) and the generation of plasma-derived peptides (bradykinins) in human nasal airways challenged with histamine. In a double-blind, crossover, placebo-controlled and randomised trial, 12 normal volunteers were given i.v.infusions of terbutaline sulphate, theophylline and enprofylline to produce therapeutic drug levels. The effect of topical nasal provocation with histamine was closely followed by frequently nasal lavage with saline. The lavage fluid levels of albumin, fibrinogen and bradykinins increased significantly after each histamine provocation. The ratio of albumin-to-fibrinogen in plasma and the lavage fluid was 24 and 56, respectively, indicating that topical histamine provocation induced a largely non-sieved flux of macromolecules across the endothelial-epithelial barriers. The systemically administered drugs did not affect the nasal symptoms (sneezing, secretion and blockage), nor did they significantly reduce the levels of plasma proteins and plasma-derived mediators in the nasal lavage fluids. The present data suggest that systemic xanthines and beta 2-adrenoceptor agonists, at clinically employed plasma levels, may not affect the microvascular (and epithelial) exudative permeability and the bradykinin forming capacity of human airways. PMID:8005188

  18. 9 CFR 78.20 - General restrictions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS BRUCELLOSIS Restrictions on Interstate Movement of Bison Because of Brucellosis § 78.20 General restrictions. Bison may not be...

  19. 9 CFR 78.5 - General restrictions.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS BRUCELLOSIS Restrictions on Interstate Movement of Cattle Because of Brucellosis § 78.5 General restrictions. Cattle may not be...

  20. Avoidant/Restrictive Food Intake Disorder

    MedlinePlus

    ... Professional Version Eating Disorders Definition of Eating Disorders Anorexia Nervosa Avoidant/Restrictive Food Intake Disorder Binge Eating ... they eat. Eating Disorders Definition of Eating Disorders Anorexia Nervosa Avoidant/Restrictive Food Intake Disorder Binge Eating ...

  1. 9 CFR 78.5 - General restrictions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS BRUCELLOSIS Restrictions on Interstate Movement of Cattle Because of Brucellosis § 78.5 General restrictions. Cattle may not be...

  2. 9 CFR 78.20 - General restrictions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS BRUCELLOSIS Restrictions on Interstate Movement of Bison Because of Brucellosis § 78.20 General restrictions. Bison may not be...

  3. Pulmonary effects of intravenous atropine induce ventilation perfusion mismatch.

    PubMed

    Gaspari, Romolo J; Paydarfar, David

    2014-05-01

    Atropine is used for a number of medical conditions, predominantly for its cardiovascular effects. Cholinergic nerves that innervate pulmonary smooth muscle, glands, and vasculature may be affected by anticholinergic medications. We hypothesized that atropine causes alterations in pulmonary gas exchange. We conducted a prospective interventional study with detailed physiologic recordings in anesthetized, spontaneously breathing rats (n = 8). Animals breathing a normoxic gas mixture titrated to a partial arterial pressure of oxygen of 110-120 were exposed to an escalating dose of intravenous atropine (0.001, 0.01, 0.1, 5.0, and 20.0 mg/kg body mass). Arterial blood gas measurements were recorded every 2 min (×5) at baseline, and following each of the 5 doses of atropine. In addition, the animals regional pulmonary blood flow was measured using neutron-activated microspheres. Oxygenation decreased immediately following intravenous administration of atropine, despite a small increase in the volume of inspired air with no change in respiratory rate. Arterial blood gas analysis showed an increase in pulmonary dysfunction, characterized by a widening of the alveolar-arteriole gradient (p < 0.003 all groups except for the lowest dose of atropine). The microsphere data demonstrates an abrupt and marked heterogeneity of pulmonary blood flow following atropine treatment. In conclusion, atropine was found to decrease pulmonary gas exchange in a dose-dependent fashion in this rat model.

  4. Fluoropolymer-Based Emulsions for the Intravenous Delivery of Sevoflurane

    PubMed Central

    Fast, Jonathan P.; Perkins, Mark G.; Pearce, Robert A.; Waters, Ralph M.; Mecozzi, Sandro

    2009-01-01

    Background The intravenous delivery of halogenated volatile anesthetics has been previously achieved using phospholipid-stabilized emulsions, e.g. Intralipid. However, fluorinated volatile anesthetics, such as sevoflurane, are partially fluorophilic and do not mix well with classic non-fluorinated lipids. This effect limits the maximum amount of sevoflurane that can be stably emulsified in Intralipid to 3.5% v/v. This is a significant limitation to the potential clinical use of Intralipid-based emulsions. Methods The authors prepared a 20% v/v sevoflurane emulsion using a novel fluorinated surfactant and tested its effectiveness and therapeutic index by administering it to male Sprague-Dawley rats via intravenous injection into the jugular vein. The median effective dose to induce anesthesia (ED50), median lethal dose (LD50), and therapeutic index (LD50 / ED50) were determined. Anesthesia was measured by loss of the forepaw righting reflex. Results The ED50 and LD50 values were found to be 0.41 and 1.05 mL emulsion / kg body weight, respectively. These lead to a therapeutic index of 2.6, which compares favorably to previously determined values of emulsified isoflurane, as well as values for propofol and thiopental. Conclusions A novel semi-fluorinated surfactant was able to considerably increase the maximum amount of stably emulsified sevoflurane compared to Intralipid. These formulations can be used to rapidly induce anesthesia with bolus dosing from which recovery is smooth and rapid. PMID:18813044

  5. Electrophysiological study of intravenous pinaverium bromide in cardiology.

    PubMed

    Guerot, C; Khemache, A; Sebbah, J; Noel, B

    1988-01-01

    Pinaverium bromide is a musculotropic spasmolytic agent which acts by inhibiting transmembrane calcium movements, an effect similar to that of verapamil. Because of this, an investigation was carried out to see if it had any electrophysiological effects in patients with various cardiac disorders. In an open study, 10 patients received 2 mg pinaverium bromide intravenously. In a double-blind study, 10 patients received 4 mg pinaverium bromide intravenously and 10 patients placebo. Patients included those with either normal or pathological basal conduction, such as bundle-branch block and 1st degree atrioventricular block. Measurements were made of electrophysiological parameters before and 10 minutes after injection. The results showed that neither of the two doses of pinaverium bromide had any effect on atrial excitability, sino-atrial conduction, node and trunk atrioventricular conduction or on intraventricular conduction. No significant difference was seen in comparison with placebo. Pinaverium bromide had no anti-arrhythmic properties in these studies. Local, cardiac and general clinical tolerability was good in all patients. PMID:3219882

  6. Hepatitis delta virus in intravenous drug users in Kuala Lumpur.

    PubMed

    Duraisamy, G; Zuridah, H; Ariffin, Y; Kek, C S

    1994-09-01

    The hepatitis delta virus (HDV) is an RNA containing virus that requires hepatitis B virus (HBV) to supply the envelope proteins. HDV only infect man in the presence of HBV, either as a coinfection or as superinfection in HBV carriers. In the presence of hepatitis B infection, the HDV may cause more severe liver damage than that caused by the hepatitis B virus alone. HDV infection was studied in 44 HBsAg positive serum samples collected from male intravenous drug users sent for screening to the Blood Services Centre (BSC), Hospital Kuala Lumpur (HKL) between 1990 and 1992. The majority (39) were in the 20 to 39 age group. The youngest was 19 years old and the oldest was 61 years old. There were 25 Malays, 13 Chinese, five Indians and one Albanian. Anti hepatitis delta antibody (Anti-HDV) was detected in 15 out of 44 (34%) of the drug addicts. These results shows an increased in delta infection in HBsAg positive intravenous drug addicts compared to the surveillance results in 1985 when no delta antibodies were detected, and the 1986 and 1989 surveillance which showed 17.8% and 20% delta antibody positivity respectively.

  7. Potential of nanoemulsions for intravenous delivery of rifampicin.

    PubMed

    Ahmed, M; Ramadan, W; Rambhu, D; Shakeel, F

    2008-11-01

    The aim of the present study was to develop, characterize and evaluate nanoemulsion formulations for intravenous delivery of rifampicin (RIF). Different oil-in-water (o/w) nanoemulsions were prepared by the aqueous phase titration method. Prepared nanoemulsions were subjected to thermodynamic stability tests for phase separation, creaming, cracking, coalescence or phase inversion and dispersibility test for dilution capacity. Nanoemulsion formulations which passed these tests were characterized in terms of droplet size, viscosity, entrapment efficiency, homogeneity and pH. The selected formulations were subjected to in vitro dissolution studies using a dissolution apparatus-XXIII in dialysis bag. Best results were obtained with the formulation which consisted of 150 mg of RIF, 15% w/w of Sefsol 218, 18.75% w/w of Tween 80, 6.25% w/w of Tween 85 and 60% w/w of normal saline. The optimized formulation was also subjected to stability studies according to the ICH guidelines. The formulation was found to be stable for more than19 months. These results indicated the potential of nanoemulsions for intravenous delivery of RIF.

  8. Preparation of intravenous cholesterol tracer using current good manufacturing practices.

    PubMed

    Lin, Xiaobo; Ma, Lina; Racette, Susan B; Swaney, William P; Ostlund, Richard E

    2015-12-01

    Studies of human reverse cholesterol transport require intravenous infusion of cholesterol tracers. Because insoluble lipids may pose risk and because it is desirable to have consistent doses of defined composition available over many months, we investigated the manufacture of cholesterol tracer under current good manufacturing practice (CGMP) conditions appropriate for phase 1 investigation. Cholesterol tracer was prepared by sterile admixture of unlabeled cholesterol or cholesterol-d7 in ethanol with 20% Intralipid(®). The resulting material was filtered through a 1.2 micron particulate filter, stored at 4°C, and tested at time 0, 1.5, 3, 6, and 9 months for sterility, pyrogenicity, autoxidation, and particle size and aggregation. The limiting factor for stability was a rise in thiobarbituric acid-reacting substances of 9.6-fold over 9 months (P < 0.01). The emulsion was stable with the Z-average intensity-weighted mean droplet diameter remaining at 60 nm over 23 months. The zeta potential (a measure of negative surface charge protecting from aggregation) was unchanged at -36.2. Rapid cholesterol pool size was 25.3 ± 1.3 g. Intravenous cholesterol tracer was stable at 4°C for 9 months postproduction. CGMP manufacturing methods can be achieved in the academic setting and need to be considered for critical components of future metabolic studies.

  9. Risk factors with intravenous sedation for patients with disabilities.

    PubMed

    Yoshikawa, Fumihiro; Tamaki, Yoh; Okumura, Hisa; Miwa, Zenzo; Ishikawa, Masaaki; Shimoyama, Kazuhiro; Nakamura, Zenkou; Kunimori, Hitomi; Jinno, Shigeharu; Kohase, Hikaru; Fukayama, Haruhisa

    2013-01-01

    The purpose of this study was to identify the risk factors associated with low peripheral oxygen saturation (SpO2) and delayed recovery of dental patients with disabilities after intravenous sedation. A total of 1213 patients with disabilities were retrospectively investigated with respect to demographic parameters and sedation conditions. Multivariate logistic analyses were conducted for patients with an SpO2 <90% and a recovery period of >60 minutes to identify the risk factors for poor sedation conditions. A significant odds ratio related to decreased SpO2 was observed for age, sex, midazolam and propofol levels, concurrent use of nitrous oxide, cerebral palsy, Down syndrome, and mental retardation. The most problematic patients were those diagnosed with Down syndrome (odds ratio, 3.003-7.978; 95% confidence interval; P < .001). Decision tree analysis showed an increased risk of decreased SpO2 in males with Down syndrome or after administration of >0.493 mg/kg propofol in combination with midazolam. An increased risk of delayed awakening was seen in patients aged less than 21 years and in males administered >0.032 mg/kg of midazolam. Intravenous sedation for dental patients with disabilities, particularly those with cerebral palsy, Down syndrome, or mental retardation, increases the risk of decreased SpO2. In addition, delayed recovery is expected after midazolam administration. PMID:24423418

  10. Preparation of intravenous cholesterol tracer using current good manufacturing practices.

    PubMed

    Lin, Xiaobo; Ma, Lina; Racette, Susan B; Swaney, William P; Ostlund, Richard E

    2015-12-01

    Studies of human reverse cholesterol transport require intravenous infusion of cholesterol tracers. Because insoluble lipids may pose risk and because it is desirable to have consistent doses of defined composition available over many months, we investigated the manufacture of cholesterol tracer under current good manufacturing practice (CGMP) conditions appropriate for phase 1 investigation. Cholesterol tracer was prepared by sterile admixture of unlabeled cholesterol or cholesterol-d7 in ethanol with 20% Intralipid(®). The resulting material was filtered through a 1.2 micron particulate filter, stored at 4°C, and tested at time 0, 1.5, 3, 6, and 9 months for sterility, pyrogenicity, autoxidation, and particle size and aggregation. The limiting factor for stability was a rise in thiobarbituric acid-reacting substances of 9.6-fold over 9 months (P < 0.01). The emulsion was stable with the Z-average intensity-weighted mean droplet diameter remaining at 60 nm over 23 months. The zeta potential (a measure of negative surface charge protecting from aggregation) was unchanged at -36.2. Rapid cholesterol pool size was 25.3 ± 1.3 g. Intravenous cholesterol tracer was stable at 4°C for 9 months postproduction. CGMP manufacturing methods can be achieved in the academic setting and need to be considered for critical components of future metabolic studies. PMID:26416797

  11. Quantum cosmological perturbations of multiple fluids

    NASA Astrophysics Data System (ADS)

    Peter, Patrick; Pinto-Neto, N.; Vitenti, Sandro D. P.

    2016-01-01

    The formalism to treat quantization and evolution of cosmological perturbations of multiple fluids is described. We first construct the Lagrangian for both the gravitational and matter parts, providing the necessary relevant variables and momenta leading to the quadratic Hamiltonian describing linear perturbations. The final Hamiltonian is obtained without assuming any equations of motions for the background variables. This general formalism is applied to the special case of two fluids, having in mind the usual radiation and matter mix which made most of our current Universe history. Quantization is achieved using an adiabatic expansion of the basis functions. This allows for an unambiguous definition of a vacuum state up to the given adiabatic order. Using this basis, we show that particle creation is well defined for a suitable choice of vacuum and canonical variables, so that the time evolution of the corresponding quantum fields is unitary. This provides constraints for setting initial conditions for an arbitrary number of fluids and background time evolution. We also show that the common choice of variables for quantization can lead to an ill-defined vacuum definition. Our formalism is not restricted to the case where the coupling between fields is small, but is only required to vary adiabatically with respect to the ultraviolet modes, thus paving the way to consistent descriptions of general models not restricted to single-field (or fluid).

  12. Role of the glycocalyx in fluid management: Small things matter.

    PubMed

    Chappell, Daniel; Jacob, Matthias

    2014-09-01

    Intravenous fluid therapy and perception of volume effects are often misunderstood. The pharmacokinetical difference between colloids and crystalloids depends on the condition of the vascular permeability barrier. Its functioning is still largely based on Starling's principle from 1896, realising that transport of fluid to and from the interstitial space follows the balance between opposing oncotic and hydrostatic pressures. In the past decade, the endothelial glycocalyx, located on the luminal side of healthy vasculature, has increasingly been taken into consideration around models of transvascular fluid filtration. While crystalloids can freely pass through the glycocalyx, colloids are held back in the vasculature by this structure. This is reflected by a markedly higher intravascular persistence of isooncotic colloids (80-100%) versus crystalloids (around 20%), at least as long as the glycocalyx is intact. Protecting this structure in surgical practice means limiting the surgical trauma and avoiding intravascular hypervolemia.

  13. Comparative evaluation of prophylactic single-dose intravenous antibiotic with postoperative antibiotics in elective urologic surgery

    PubMed Central

    Moslemi, Mohammad K; Movahed, Seyed M Moosavi; Heidari, Akram; Saghafi, Hossein; Abedinzadeh, Mehdi

    2010-01-01

    Background Unrestricted antibiotic use is very common in Iran. As a result, emergence of resistant organisms is commonplace. Antibiotic prophylaxis in surgery consists of a short antibiotic course given immediately before the procedure in order to prevent development of a surgical site infection. The basic principle of prophylaxis is to maintain effective concentrations of an antibiotic active against the commonest pathogens during the entire surgery. Materials and methods We prospectively investigated 427 urologic surgery cases in our department between August 2008 and September 2009 (Group1). As reference cases, we retrospectively reviewed 966 patients who underwent urologic surgery between May 2004 and May 2008 (Group 2) who were administered antibiotics without any restriction. Prophylactic antibiotics such as cefazolin were administered intravenously according to our protocol. Postoperative body temperature, peripheral white blood cell counts, urinalysis, and urine culture were checked. Results To judge perioperative infections, wound condition and general condition were evaluated in terms of surgical site infection, as well as remote infection and urinary tract infection, up to postoperative day 30. Surgical site infection was defined as the presence of swelling, tenderness, redness, or drainage of pus from the wound, superficially or deeply. Remote infection was defined as occurrence of pneumonia, sepsis, or urinary tract infection. Perioperative infection rates (for surgical site and remote infection) in Group 1 and Group 2 were nine of 427 (2.6%) and 24 of 966 (2.5%), respectively. Surgical site infection rates of categories A and B in Group 1 were 0 and two (0.86%), respectively, while those in Group 2 were 0 and five (0.92%), respectively. There was no significant difference in infection rates in terms of remote infection and surgical site infection between Group 1 and Group 2 (P = 0.670). The amounts, as well as the prices, for intravenously

  14. Restricted sample variance reduces generalizability.

    PubMed

    Lakes, Kimberley D

    2013-06-01

    One factor that affects the reliability of observed scores is restriction of range on the construct measured for a particular group of study participants. This study illustrates how researchers can use generalizability theory to evaluate the impact of restriction of range in particular sample characteristics on the generalizability of test scores and to estimate how changes in measurement design could improve the generalizability of the test scores. An observer-rated measure of child self-regulation (Response to Challenge Scale; Lakes, 2011) is used to examine scores for 198 children (Grades K through 5) within the generalizability theory (GT) framework. The generalizability of ratings within relatively developmentally homogeneous samples is examined and illustrates the effect of reduced variance among ratees on generalizability. Forecasts for g coefficients of various D study designs demonstrate how higher generalizability could be achieved by increasing the number of raters or items. In summary, the research presented illustrates the importance of and procedures for evaluating the generalizability of a set of scores in a particular research context. PMID:23205627

  15. Temperature based Restricted Boltzmann Machines.

    PubMed

    Li, Guoqi; Deng, Lei; Xu, Yi; Wen, Changyun; Wang, Wei; Pei, Jing; Shi, Luping

    2016-01-01

    Restricted Boltzmann machines (RBMs), which apply graphical models to learning probability distribution over a set of inputs, have attracted much attention recently since being proposed as building blocks of multi-layer learning systems called deep belief networks (DBNs). Note that temperature is a key factor of the Boltzmann distribution that RBMs originate from. However, none of existing schemes have considered the impact of temperature in the graphical model of DBNs. In this work, we propose temperature based restricted Boltzmann machines (TRBMs) which reveals that temperature is an essential parameter controlling the selectivity of the firing neurons in the hidden layers. We theoretically prove that the effect of temperature can be adjusted by setting the parameter of the sharpness of the logistic function in the proposed TRBMs. The performance of RBMs can be improved by adjusting the temperature parameter of TRBMs. This work provides a comprehensive insights into the deep belief networks and deep learning architectures from a physical point of view. PMID:26758235

  16. Temperature based Restricted Boltzmann Machines

    PubMed Central

    Li, Guoqi; Deng, Lei; Xu, Yi; Wen, Changyun; Wang, Wei; Pei, Jing; Shi, Luping

    2016-01-01

    Restricted Boltzmann machines (RBMs), which apply graphical models to learning probability distribution over a set of inputs, have attracted much attention recently since being proposed as building blocks of multi-layer learning systems called deep belief networks (DBNs). Note that temperature is a key factor of the Boltzmann distribution that RBMs originate from. However, none of existing schemes have considered the impact of temperature in the graphical model of DBNs. In this work, we propose temperature based restricted Boltzmann machines (TRBMs) which reveals that temperature is an essential parameter controlling the selectivity of the firing neurons in the hidden layers. We theoretically prove that the effect of temperature can be adjusted by setting the parameter of the sharpness of the logistic function in the proposed TRBMs. The performance of RBMs can be improved by adjusting the temperature parameter of TRBMs. This work provides a comprehensive insights into the deep belief networks and deep learning architectures from a physical point of view. PMID:26758235

  17. 7 CFR 982.14 - Restricted hazelnuts.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Restricted hazelnuts. 982.14 Section 982.14... Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE HAZELNUTS GROWN IN OREGON AND WASHINGTON Order Regulating Handling Definitions § 982.14 Restricted hazelnuts. Restricted hazelnuts...

  18. 7 CFR 982.14 - Restricted hazelnuts.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 8 2014-01-01 2014-01-01 false Restricted hazelnuts. 982.14 Section 982.14... AGREEMENTS AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE HAZELNUTS GROWN IN OREGON AND WASHINGTON Order Regulating Handling Definitions § 982.14 Restricted hazelnuts. Restricted hazelnuts...

  19. 7 CFR 982.14 - Restricted hazelnuts.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 8 2011-01-01 2011-01-01 false Restricted hazelnuts. 982.14 Section 982.14... Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE HAZELNUTS GROWN IN OREGON AND WASHINGTON Order Regulating Handling Definitions § 982.14 Restricted hazelnuts. Restricted hazelnuts...

  20. 7 CFR 982.14 - Restricted hazelnuts.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 8 2012-01-01 2012-01-01 false Restricted hazelnuts. 982.14 Section 982.14... Agreements and Orders; Fruits, Vegetables, Nuts), DEPARTMENT OF AGRICULTURE HAZELNUTS GROWN IN OREGON AND WASHINGTON Order Regulating Handling Definitions § 982.14 Restricted hazelnuts. Restricted hazelnuts...

  1. 7 CFR 982.14 - Restricted hazelnuts.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 8 2013-01-01 2013-01-01 false Restricted hazelnuts. 982.14 Section 982.14... AGREEMENTS AND ORDERS; FRUITS, VEGETABLES, NUTS), DEPARTMENT OF AGRICULTURE HAZELNUTS GROWN IN OREGON AND WASHINGTON Order Regulating Handling Definitions § 982.14 Restricted hazelnuts. Restricted hazelnuts...

  2. 14 CFR 1203.305 - Restricted data.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Restricted data. 1203.305 Section 1203.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INFORMATION SECURITY PROGRAM Classification Principles and Considerations § 1203.305 Restricted data. Restricted Data or Formerly...

  3. 14 CFR 1203.305 - Restricted data.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Restricted data. 1203.305 Section 1203.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INFORMATION SECURITY PROGRAM Classification Principles and Considerations § 1203.305 Restricted data. Restricted Data or Formerly...

  4. 14 CFR 1203.305 - Restricted data.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Restricted data. 1203.305 Section 1203.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INFORMATION SECURITY PROGRAM Classification Principles and Considerations § 1203.305 Restricted data. Restricted Data or Formerly...

  5. 50 CFR 648.23 - Gear restrictions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Mackerel, Squid, and Butterfish Fisheries § 648.23 Gear restrictions. (a) Mesh restrictions and exemptions...°45.0′ 74°53.0′ M24 35°28.0′ 74°52.0′ (4) Mackerel, squid, and butterfish bottom trawling restricted areas. (i) Oceanographer Canyon. No permitted mackerel, squid, or butterfish vessel may fish with...

  6. 36 CFR 13.1176 - Speed restrictions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Speed restrictions. 13.1176... Operating Restrictions § 13.1176 Speed restrictions. (a) From May 15 through September 30, in designated whale waters the following are prohibited: (1) Operating a motor vessel at more than 20 knots...

  7. 36 CFR 13.1176 - Speed restrictions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 1 2013-07-01 2013-07-01 false Speed restrictions. 13.1176... Operating Restrictions § 13.1176 Speed restrictions. (a) From May 15 through September 30, in designated whale waters the following are prohibited: (1) Operating a motor vessel at more than 20 knots...

  8. 36 CFR 13.1176 - Speed restrictions.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Speed restrictions. 13.1176... Operating Restrictions § 13.1176 Speed restrictions. (a) From May 15 through September 30, in designated whale waters the following are prohibited: (1) Operating a motor vessel at more than 20 knots...

  9. 36 CFR 13.1176 - Speed restrictions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 1 2012-07-01 2012-07-01 false Speed restrictions. 13.1176... Operating Restrictions § 13.1176 Speed restrictions. (a) From May 15 through September 30, in designated whale waters the following are prohibited: (1) Operating a motor vessel at more than 20 knots...

  10. 36 CFR 13.1176 - Speed restrictions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 1 2014-07-01 2014-07-01 false Speed restrictions. 13.1176... Operating Restrictions § 13.1176 Speed restrictions. (a) From May 15 through September 30, in designated whale waters the following are prohibited: (1) Operating a motor vessel at more than 20 knots...

  11. Restriction Enzyme Mapping: A Simple Student Practical.

    ERIC Educational Resources Information Center

    Higgins, Stephen J.; And Others

    1990-01-01

    An experiment that uses the recombinant plasmid pX1108 to illustrate restriction mapping is described. The experiment involves three restriction enzymes and employs single and double restriction enzyme digestions. A list of needed materials, procedures, safety precautions, results, and discussion are included. (KR)

  12. Restricted Schur polynomials and finite N counting

    SciTech Connect

    Collins, Storm

    2009-01-15

    Restricted Schur polynomials have been posited as orthonormal operators for the change of basis from N=4 SYM to type IIB string theory. In this paper we briefly expound the relationship between the restricted Schur polynomials and the operators forwarded by Brown, Heslop, and Ramgoolam. We then briefly examine the finite N counting of the restricted Schur polynomials.

  13. 50 CFR 648.163 - Gear restrictions.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 50 Wildlife and Fisheries 10 2011-10-01 2011-10-01 false Gear restrictions. 648.163 Section 648... Atlantic Bluefish Fishery § 648.163 Gear restrictions. Link to an amendment published at 76 FR 60640, Sept... gear restrictions are necessary to assure that the fishing mortality rate is not exceeded, or to...

  14. 50 CFR 648.163 - Gear restrictions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Gear restrictions. 648.163 Section 648.163... Bluefish Fishery § 648.163 Gear restrictions. If the Council determines through its annual review or framework adjustment process that gear restrictions are necessary to assure that the fishing mortality...

  15. Problem-Solving Test: Restriction Endonuclease Mapping

    ERIC Educational Resources Information Center

    Szeberenyi, Jozsef

    2011-01-01

    The term "restriction endonuclease mapping" covers a number of related techniques used to identify specific restriction enzyme recognition sites on small DNA molecules. A method for restriction endonuclease mapping of a 1,000-basepair (bp)-long DNA molecule is described in the fictitious experiment of this test. The most important fact needed to…

  16. 21 CFR 203.20 - Sales restrictions.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 4 2012-04-01 2012-04-01 false Sales restrictions. 203.20 Section 203.20 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL PRESCRIPTION DRUG MARKETING Sales Restrictions § 203.20 Sales restrictions. Except as provided in § 203.22...

  17. 21 CFR 203.20 - Sales restrictions.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 4 2013-04-01 2013-04-01 false Sales restrictions. 203.20 Section 203.20 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL PRESCRIPTION DRUG MARKETING Sales Restrictions § 203.20 Sales restrictions. Except as provided in § 203.22...

  18. 21 CFR 203.20 - Sales restrictions.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 4 2011-04-01 2011-04-01 false Sales restrictions. 203.20 Section 203.20 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL PRESCRIPTION DRUG MARKETING Sales Restrictions § 203.20 Sales restrictions. Except as provided in § 203.22...

  19. 21 CFR 203.20 - Sales restrictions.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 4 2014-04-01 2014-04-01 false Sales restrictions. 203.20 Section 203.20 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL PRESCRIPTION DRUG MARKETING Sales Restrictions § 203.20 Sales restrictions. Except as provided in § 203.22...

  20. 14 CFR 1203.305 - Restricted data.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Restricted data. 1203.305 Section 1203.305 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION INFORMATION SECURITY PROGRAM Classification Principles and Considerations § 1203.305 Restricted data. Restricted Data or Formerly...

  1. [Infection of cerebrospinal fluid shunt systems].

    PubMed

    Jiménez-Mejías, Manuel E; García-Cabrera, Emilio

    2008-04-01

    Cerebrospinal fluid (CSF) shunt infection is a cause of considerable morbidity and mortality. Shunt infection is produced mainly during surgery and by surgical wound infection. Staphylococcus spp. (> 50% methicillin-resistant) are the most common causative bacteria, although gram-negative bacilli (10%-25%) and Propionibacterium acnes are becoming increasingly implicated. Shunt malfunction syndrome and fever are the most frequent clinical manifestations, whereas signs of meningeal irritation are uncommon. Other clinical manifestations depend on the location of the distal catheter. CSF should be obtained by puncture of the shunt reservoir or the distal catheter and processed for biochemical analyses, cell count, Gram stain, and aerobic and anaerobic cultures (lengthy incubation). Because of biofilm formation and to avoid recurrences, the recommended treatment is intravenous antibiotics plus removal of all components of the infected shunt, followed by placement of an external drainage catheter and a new shunt. Prophylaxis is important and can include antimicrobial prophylaxis and/or antibiotic-impregnated catheters.

  2. Electric fluid pump

    SciTech Connect

    Van Dam, Jeremy Daniel; Turnquist, Norman Arnold; Raminosoa, Tsarafidy; Shah, Manoj Ramprasad; Shen, Xiaochun

    2015-09-29

    An electric machine is presented. The electric machine includes a hollow rotor; and a stator disposed within the hollow rotor, the stator defining a flow channel. The hollow rotor includes a first end portion defining a fluid inlet, a second end portion defining a fluid outlet; the fluid inlet, the fluid outlet, and the flow channel of the stator being configured to allow passage of a fluid from the fluid inlet to the fluid outlet via the flow channel; and wherein the hollow rotor is characterized by a largest cross-sectional area of hollow rotor, and wherein the flow channel is characterized by a smallest cross-sectional area of the flow channel, wherein the smallest cross-sectional area of the flow channel is at least about 25% of the largest cross-sectional area of the hollow rotor. An electric fluid pump and a power generation system are also presented.

  3. Peritoneal fluid culture

    MedlinePlus

    Culture - peritoneal fluid ... sent to the laboratory for Gram stain and culture. The sample is checked to see if bacteria ... based on more than just the peritoneal fluid culture (which may be negative even if you have ...

  4. Amniotic fluid (image)

    MedlinePlus

    Amniotic fluid surrounds the growing fetus in the womb and protects the fetus from injury and temperature changes. ... of fetal movement and permits musculoskeletal development. The amniotic fluid can be withdrawn in a procedure called amniocentsis ...

  5. Fluid sampling tool

    DOEpatents

    Johnston, Roger G.; Garcia, Anthony R. E.; Martinez, Ronald K.

    2001-09-25

    The invention includes a rotatable tool for collecting fluid through the wall of a container. The tool includes a fluid collection section with a cylindrical shank having an end portion for drilling a hole in the container wall when the tool is rotated, and a threaded portion for tapping the hole in the container wall. A passageway in the shank in communication with at least one radial inlet hole in the drilling end and an opening at the end of the shank is adapted to receive fluid from the container. The tool also includes a cylindrical chamber affixed to the end of the shank opposite to the drilling portion thereof for receiving and storing fluid passing through the passageway. The tool also includes a flexible, deformable gasket that provides a fluid-tight chamber to confine kerf generated during the drilling and tapping of the hole. The invention also includes a fluid extractor section for extracting fluid samples from the fluid collecting section.

  6. Environmentally safe fluid extractor

    DOEpatents

    Sungaila, Zenon F.

    1993-07-06

    An environmentally safe fluid extraction device for use in mobile laboratory and industrial settings comprising a pump, compressor, valving system, waste recovery tank, fluid tank, and a exhaust filtering system.

  7. Environmentally safe fluid extractor

    DOEpatents

    Sungaila, Zenon F.

    1993-01-01

    An environmentally safe fluid extraction device for use in mobile laboratory and industrial settings comprising a pump, compressor, valving system, waste recovery tank, fluid tank, and a exhaust filtering system.

  8. The fluids in salt.

    USGS Publications Warehouse

    Roedder, E.

    1984-01-01

    The characteristics of fluid inclusions in salt, the geological processes through which these fluids evolve, and the possible problems such inclusions pose for nuclear waste disposal in salt beds or domes are reviewed.-J.A.Z.

  9. Pleural fluid analysis

    MedlinePlus

    ... of fluid that has collected in the pleural space. This is the space between the lining of the outside of the ... the chest. When fluid collects in the pleural space, the condition is called pleural effusion .

  10. Pleural fluid smear

    MedlinePlus

    ... the fluid that has collected in the pleural space. This is the space between the lining of the outside of the ... the chest. When fluid collects in the pleural space, the condition is called pleural effusion .

  11. In-flight demonstration of the Space Station Freedom Health Maintenance Facility fluid therapy system (E300/E05)

    NASA Technical Reports Server (NTRS)

    Lloyd, Charles W.

    1993-01-01

    The Space Station Freedom (SSF) Health Maintenance Facility (HMF) will provide medical care for crew members for up to 10 days. An integral part of the required medical care consists of providing intravenous infusion of fluids, electrolyte solutions, and nutrients to sustain an ill or injured crew member. In terrestrial health care facilities, intravenous solutions are normally stored in large quantities. However, due to the station's weight and volume constraints, an adequate supply of the required solutions cannot be carried onboard SSF. By formulating medical fluids onboard from concentrates and station water as needed, the Fluid Therapy System (FTS) eliminates weight and volume concerns regarding intravenous fluids. The first full-system demonstration of FTS is continuous microgravity will be conducted in Spacelab-Japan (SL-J). The FTS evaluation consists of two functional objectives and an in-flight demonstration of intravenous administration of fluids. The first is to make and store sterile water and IV solutions onboard the spacecraft. If intravenous fluids are to be produced in SSF, successful sterilization of water and reconstituting of IV solutions must be achieved. The second objective is to repeat the verification of the FTS infusion pump, which had been performed in Spacelab Life Sciences - 1 (SLS-1). during SLS-1, the FTS IV pump was operated in continuous microgravity for the first time. The pump functioned successfully, and valuable knowledge on its performance in continuous microgravity was obtained. Finally, the technique of starting an IF in microgravity will be demonstrated. The IV technique requires modifications in microgravity, such as use of restraints for equipment and crew members involved.

  12. Titration of intravenous synthetic oxytocin post vaginal birth following induction or augmentation.

    PubMed

    Lewis, Lucy; Hauck, Yvonne L; Pemberton, Alissa; Crichton, Caroline; Conwell, Marion

    2016-10-01

    Evidence exists for titration of intravenous oxytocin during induction and augmentation, whereas no evidence was identified for titration of intravenous oxytocin following vaginal birth, where management excluded oxytocin for postpartum haemorrhage (PPH). This retrospective cohort study explored this issue through patient case notes and computerised perinatal data. Analysis included 335 women comparing induction (n = 226, 67%) to augmentation (n = 109, 33%). The two groups differed in terms of: parity; oxytocin dosage; length of time on intravenous oxytocin; and the length of first and second stage labour. They had similar rates of PPH and titration of intravenous oxytocin following birth was rarely recorded.

  13. Titration of intravenous synthetic oxytocin post vaginal birth following induction or augmentation.

    PubMed

    Lewis, Lucy; Hauck, Yvonne L; Pemberton, Alissa; Crichton, Caroline; Conwell, Marion

    2016-10-01

    Evidence exists for titration of intravenous oxytocin during induction and augmentation, whereas no evidence was identified for titration of intravenous oxytocin following vaginal birth, where management excluded oxytocin for postpartum haemorrhage (PPH). This retrospective cohort study explored this issue through patient case notes and computerised perinatal data. Analysis included 335 women comparing induction (n = 226, 67%) to augmentation (n = 109, 33%). The two groups differed in terms of: parity; oxytocin dosage; length of time on intravenous oxytocin; and the length of first and second stage labour. They had similar rates of PPH and titration of intravenous oxytocin following birth was rarely recorded. PMID:27634662

  14. Fluid force transducer

    DOEpatents

    Jendrzejczyk, Joseph A.

    1982-01-01

    An electrical fluid force transducer for measuring the magnitude and direction of fluid forces caused by lateral fluid flow, includes a movable sleeve which is deflectable in response to the movement of fluid, and a rod fixed to the sleeve to translate forces applied to the sleeve to strain gauges attached to the rod, the strain gauges being connected in a bridge circuit arrangement enabling generation of a signal output indicative of the magnitude and direction of the force applied to the sleeve.

  15. Fluid Movement and Creativity

    ERIC Educational Resources Information Center

    Slepian, Michael L.; Ambady, Nalini

    2012-01-01

    Cognitive scientists describe creativity as fluid thought. Drawing from findings on gesture and embodied cognition, we hypothesized that the physical experience of fluidity, relative to nonfluidity, would lead to more fluid, creative thought. Across 3 experiments, fluid arm movement led to enhanced creativity in 3 domains: creative generation,…

  16. Outbreak of bacteremia due to Burkholderia contaminans linked to intravenous fentanyl from an institutional compounding pharmacy.

    PubMed

    Moehring, Rebekah W; Lewis, Sarah S; Isaacs, Pamela J; Schell, Wiley A; Thomann, Wayne R; Althaus, Mary M; Hazen, Kevin C; Dicks, Kristen V; Lipuma, John J; Chen, Luke F; Sexton, Daniel J

    2014-04-01

    IMPORTANCE Many health care facilities compound medications on site to fulfill local demands when customized formulations are needed, national supply is critically low, or costs for manufactured pharmaceuticals are excessive. Small, institutional compounding facilities may perform the same high-risk procedures as large distributors of compounded medications. OBJECTIVES To investigate an outbreak related to contamination of compounded sterile preparations and to determine processes to prevent future outbreaks. DESIGN, SETTING, AND PARTICIPANTS We performed an outbreak investigation of inpatients at Duke University Hospital from August 31 through September 6, 2012. The investigation included a case-control study, compounding facility inspection and environmental sampling, observation of a mock compounding demonstration, and microbiologic and molecular testing of sequestered medication. EXPOSURES Intravenous fentanyl prepared by an institutional compounding pharmacy. MAIN OUTCOMES AND MEASURES Microbiologic and molecular evidence of contamination of a compounded sterile preparation and failure of routine sterility testing. RESULTS Blood cultures of 7 patients during a 7-day period at Duke University Hospital yielded pan-susceptible Burkholderia cepacia complex bacteria. The risk factor common to all patients was receipt of continuous fentanyl infusion prepared by our institutional compounding pharmacy (odds ratio, 11.22; 95% CI, 2.09-∞; P = .01). The outbreak was terminated after sequestration of compounded fentanyl. An intensive evaluation of the compounding facility, its practice, and its procedures was completed. Investigators evaluated the clean room, collected targeted microbiologic samples within the compounding pharmacy environment, and observed a mock demonstration of compounding practice. The B cepacia complex was found in the anteroom sink drain and pH probe calibration fluid from the compounding clean room. Multiple microbiologic analyses of

  17. Stillbirth and fetal growth restriction.

    PubMed

    Bukowski, Radek

    2010-09-01

    The association between stillbirth and fetal growth restriction is strong and supported by a large body of evidence and clinically employed for the stillbirth prediction. However, although assessment of fetal growth is a basis of clinical practice, it is not trivial. Essentially, fetal growth is a result of the genetic growth potential of the fetus and placental function. The growth potential is the driving force of fetal growth, whereas the placenta as the sole source of nutrients and oxygen might become the rate limiting element of fetal growth if its function is impaired. Thus, placental dysfunction may prevent the fetus from reaching its full genetically determined growth potential. In this sense fetal growth and its aberration provides an insight into placental function. Fetal growth is a proxy for the test of the effectiveness of placenta, whose function is otherwise obscured during pregnancy.

  18. Assessment of the pharmacodynamics of intranasal, intravenous and oral scopolamine

    NASA Technical Reports Server (NTRS)

    Tietze, Karen J.

    1990-01-01

    Space motion sickness is an important issue in the space medical sciences program. One of the objectives of the ongoing clinical experimental protocol Pharmacokinetics of Intranasal Scopolamine in Normal Subjects is to evaluate the pharmacodynamics of scopolamine using salivary flow rate and pH profiles and cognitive performance tests as pharmacodynamic parameters. Normal volunteers collected saliva and performed the NTI Multiresource Performance Battery tests at designed time intervals to establish control saliva flow rates, salivary pH profiles, and the characteristics of the learning curve for the performance program under normal conditions. In the clinical part of the study, saliva samples and performance test scores are collected from healthy nonsmoking subjects after receiving a single 0.4 mg dose of either intranasal, intravenous, or oral scopolamine.

  19. Intravenous ampicillin pharmacokinetics in the third trimester of pregnancy.

    PubMed

    Kubacka, R T; Johnstone, H E; Tan, H S; Reeme, P D; Myre, S A

    1983-01-01

    The pharmacokinetics of a single dose of intravenous ampicillin were studied in nine patients during their third trimester of pregnancy. Each volunteer was given either 500 mg (5.7-8.8 mg/kg) or 1 g (15.4-21.4 mg/kg) of sodium ampicillin by rapid infusion. Postinfusion plasma concentration-time curves followed biexponential decay in all subjects. Calculated parameters included a mean plasma distribution volume of 177.1 +/- 97.5 ml/kg, tissue or peripheral distribution volume of 246.2 +/- 143.9 ml/kg, elimination half-life of 1.60 +/- 0.51 h, and total body clearance of 4.59 +/- 1.48 ml/min/kg. Dose-dependent disposition was not observed. Gestation-specific drug therapy research during pregnancy is discussed. PMID:6845399

  20. Intravenously administered nanoparticles increase survival following blast trauma

    PubMed Central

    Lashof-Sullivan, Margaret M.; Shoffstall, Erin; Atkins, Kristyn T.; Keane, Nickolas; Bir, Cynthia; VandeVord, Pamela; Lavik, Erin B.

    2014-01-01

    Explosions account for 79% of combat-related injuries, leading to multiorgan hemorrhage and uncontrolled bleeding. Uncontrolled bleeding is the leading cause of death in battlefield traumas as well as in civilian life. We need to stop the bleeding quickly to save lives, but, shockingly, there are no treatments to stop internal bleeding. A therapy that halts bleeding in a site-specific manner and is safe, stable at room temperature, and easily administered is critical for the advancement of trauma care. To address this need, we have developed hemostatic nanoparticles that are administered intravenously. When tested in a model of blast trauma with multiorgan hemorrhaging, i.v. administration of the hemostatic nanoparticles led to a significant improvement in survival over the short term (1 h postblast). No complications from this treatment were apparent out to 3 wk. This work demonstrates that these particles have the potential to save lives and fundamentally change trauma care. PMID:24982180

  1. Intravenous immunoglobulins in peripheral neuropathy associated with vasculitis

    PubMed Central

    Levy, Y; Uziel, Y; Zandman, G; Amital, H; Sherer, Y; Langevitz, P; Goldman, B; Shoenfeld, Y

    2003-01-01

    Objective: To present patients who exhibited various inflammatory diseases accompanied with vasculitic peripheral neuropathies for which intravenous immunoglobulin (IVIg) was used for treatment. Methods: Six patients with Sjögren's syndrome, systemic lupus erythematosus (SLE), vaccination induced vasculitis, Churg-Strauss vasculitis, mixed cryoglobulinaemia associated with hepatitis C infection, or sarcoidosis were included. All developed vasculitic peripheral neuropathy, and were treated with high dose IVIg (2 g/kg body weight). The patients were followed up for 1–5 years after this treatment. Results: In four patients (Sjögren's syndrome, Churg-Strauss vasculitis, SLE, and vaccination induced vasculitis) the neuropathy resolved after IVIg treatment. Conclusion: IVIg may be beneficial in cases of resistant vasculitic peripheral neuropathy. IVIg should probably be considered as a sole or adjuvant treatment for patients with contraindications to conventional treatment, or alternatively, for patients in whom conventional treatment has failed. PMID:14644864

  2. Survey of nursing practice related to decanting intravenous solutions.

    PubMed

    Sulzbach, L M; Munro, B H

    1991-11-01

    A survey instrument was mailed to a stratified random sample of 1000 nurses from the membership list of the American Association of Critical-Care Nurses to determine whether there are generally accepted standards for decanting intravenous (IV) solutions before the addition of medication. Four hundred seventy-eight surveys were returned from 47 states and the District of Columbia. Of those, 475 were usable. Seventy-one percent of the respondents did not decant. Of those who did decant (29%), 79% used a needle and syringe to withdraw a volume equal to that of the medication to be added. The results of this study indicate that no generally accepted standards of practice exist for the preparation of IV solutions. Patients may not, therefore, be receiving the dose prescribed by the physician. Nurses need to develop standards for accurate administration of IV solutions.

  3. Treatment of pieris ingestion in goats with intravenous lipid emulsion.

    PubMed

    Bischoff, Karyn; Smith, Mary C; Stump, Samuel

    2014-12-01

    Seven goats and one ram presented with clinical signs including regurgitation, obtundation, anorexia, apparent pain, and bloat. The animals had escaped from their barn, and it was discovered that they had ingested leaves of Pieris japonica, Japanese pieris, a grayanotoxin-containing plant. Animals were treated with antibiotics, calcium borogluconate, B vitamins, and activated charcoal within the first 24-h postexposure, which was followed by the recovery of the ram and two goats and the death of two goats. Approximately 36 h after Japanese pieris ingestion, one of the three remaining anorectic goats was dosed with intravenous lipid emulsion (ILE). This goat recovered within a few hours. The remaining two goats were given ILE the next day and appeared to recover, but one died a week later of aspiration pneumonia.

  4. A new apparatus for chronic intravenous infusion in unrestrained rats.

    PubMed

    Takeyama, H; Yura, J; Miyaike, H; Ishikawa, M; Mizuno, H; Taniguchi, M; Hanai, T; Mizuno, A; Shinagawa, N; Kato, F

    1988-01-01

    A new apparatus incorporating a unique type of swivel device was devised for chronic intravenous infusion in unrestrained rats. The swivel requires very little torque for rotation, ie, one-fourth that of the standard swivel, yet is 1/30 as expensive. A coil spring tube, located between the swivel and the catheter, allows the rat unhampered movement within the metabolic cage. Because the catheter follows the rats' movements freely, only two silk sutures are required to secure it to the animal. No statistically significant differences between experimental and control rats were observed in terms of body weight gain, food intake, nitrogen balance, or caloric efficiency. This apparatus should prove useful in many areas of research.

  5. Intravenous immunoglobulin in neurological disease: a specialist review

    PubMed Central

    Wiles, C; Brown, P; Chapel, H; Guerrini, R; Hughes, R; Martin, T; McCrone, P; Newsom-Davis, J; Palace, J; Rees, J; Rose, M; Scolding, N; Webster, A

    2002-01-01

    Treatment of neurological disorders with intravenous immunoglobulin (IVIg) is an increasing feature of our practice for an expanding range of indications. For some there is evidence of benefit from randomised controlled trials, whereas for others evidence is anecdotal. The relative rarity of some of the disorders means that good randomised control trials will be difficult to deliver. Meanwhile, the treatment is costly and pressure to "do something" in often distressing disorders considerable. This review follows a 1 day meeting of the authors in November 2000 and examines current evidence for the use of IVIg in neurological conditions and comments on mechanisms of action, delivery, safety and tolerability, and health economic issues. Evidence of efficacy has been classified into levels for healthcare interventions (tables 1 and 2). PMID:11909900

  6. Intravenous immunoglobulin treatment in a patient with adrenomyeloneuropathy

    PubMed Central

    2012-01-01

    Background Adrenomyeloneuropathy (AMN) is one of several phenotypes of the adrenoleukodystrophy spectrum caused by mutations in the ABCD1 gene on the X chromosome. An inflammatory component is part of the disease complex ranging from severe childhood CNS demyelination to spinal cord and peripheral nerve degeneration. Case presentation We present a patient with clinical progressive AMN and severe lower limb pain. Longitudinal brain magnetic resonance spectroscopy showed a constant slightly elevated myoinositol/total creatine ratio during the five year treatment period, probably reflecting demyelination, microglial activation and gliosis, indicating an inflammatory response. The pain was refractory to conventional therapy but intravenous immunoglobulin (IVIG) treatment was highly efficient. Conclusion IVIG may be considered as a last resort for treatment of refractory pain in AMN patients with indications of an inflammatory component. PMID:23009600

  7. Clinical perspectives of intravenous ketamine anaesthesia in peafowl (Pavo cristatus).

    PubMed

    Athar, M; Shakoor, A; Muhammad, G; Sarwar, M N; Chaudhry, N I

    1996-01-01

    A total of 29 peafowl (Pavo cristatus), rectified surgically for infraorbital abscesses (n = 22), lacerated wounds (n = 4), and fractures of tibia (n = 2) and radius (n = 1), were anaesthetized by the intravenous administration of ketamine hydrochloride (Inj. Calypsol, Gedeon Richter, Hungary) in a dose of 15 20 mg/kg body weight. Divided doses (10 mg + 5 mg + 5 mg) were used with an interval of 1-2 min. No premedication was undertaken in any of the birds. Anaesthesia lasted for about 15 min and the birds gained their feet completely after 30 min to 3 hours. The respiration rate was markedly depressed (8-10/min) and the respiratory pattern was deep abdominal. Only a slight increase was observed in the heart rate. Analgesia was incomplete and muscle relaxation was not satisfactory. Mild salivation was also noticed in some of the birds (n = 3). Recovery, although not smooth, was uneventful.

  8. [Experiences with intravenous sulprostone administration in massive postpartal hemorrhage].

    PubMed

    Schönegg, W; Wessel, J; Schmidt-Gollwitzer, K

    1987-11-01

    Forty-three patients at the University Gynecology Clinic in Charlottenburg were given the prostaglandin E2 derivative sulprostone for severe postpartal hemorrhage. It was administered intravenously in a dose of 1.7 mcg/min (100 mcg/100 ml/h), with short-term increases to three times this amount in isolated cases. The drug proved highly efficacious (rapid onset and lasting effect). In 80% of the cases there were no side effects. Rises in body temperature occurred in six patients and in one patient a venous irritation developed in the arm into which the drug was infused. An RDS occurred, though it was considered that there was not necessarily a causal connection between this and the sulprostone infusion. In the authors' experience this drug has an established place in the treatment of atonic postpartal hemorrhage emergencies.

  9. Quinine-induced thrombocytopenia following intravenous use of heroin

    SciTech Connect

    Christie, D.J.; Walker, R.H.; Kolins, M.D.; Wilner, F.M.; Aster, R.H.

    1983-06-01

    Profound thrombocytopenia developed in a 22-year-old man after intravenous use of heroin. A high-titer, quinine-dependent, platelet-specific antibody was detected in his serum using lysis of normal platelets labeled with chromium 51 and an electroimmunoassay for measurement of platelet-associated IgG. The antibody was specific for quinine and failed to react with platelets in the presence of quinidine hydrochloride or two structural analogues of heroin. Quinine, a common adulterant found in heroin, was detected in the patient's blood and urine. On the basis of these observations, the patient was judged to have quinine-induced immunologic thrombocytopenia. To our knowledge, this report is the first to confirm that quinine used as an adulterant can induce immunologic thrombocytopenia following an injection of heroin.

  10. Myocardial ischemia during intravenous DSA in patients with cardiac disease

    SciTech Connect

    Hesselink, J.R.; Hayman, L.A.; Chung, K.J.; McGinnis, B.D.; Davis, K.R.; Taveras, J.M.

    1984-12-01

    A prospective study was performed for 48 patients who had histories of angina and were referred for digital subtraction angiography (DSA). Cardiac disease was graded according to the American Heart Association (AHA) functional classification system. Each patient received 2-5 injections of 40-ml diatrizoate meglumine and diatrizoate sodium at 15 ml per second in the superior vena cava. Of the 28 patients in functional Classes I or II, 11% had angina and 32% had definite ischemic ECG changes after the DSA injections. Of the patients in functional Class III 63% had angina, and 58% had definite ischemic ECG changes after the injections. These observed cardiac effects following bolus injections of hypertonic ionic contrast media indicate that special precautions are necessary when performing intravenous DSA examinations on this group of high risk patients.

  11. Mucormycosis infection following intravenous access in the forearm

    PubMed Central

    Wollstein, Ronit; Palekar, Alka

    2010-01-01

    Mucormycosis is an opportunistic infection that is often fatal, requiring aggressive local control as well as systemic therapy. A rare case of a forearm infection originating in a traumatic intravenous access portal is described in the present study. The Mucor species infection prevented liver transplant, and the patient passed away. In the present case, it was decided to limit the resection to the skin and subcutaneous tissue based on a frozen section and the viability of the biopsied tissue. With consistently rising numbers of immunocompromised patients, awareness and familiarity with mucormycosis in the extremities is important. Knowing that a minimal traumatic event may precede the infection could assist in prevention and early diagnosis. Guidelines for pathological and clinical diagnosis and treatment need to be further clarified. PMID:21629620

  12. Management of Intravenous Leiomyomatosis of Uterus with Extension to Heart.

    PubMed

    Alizade, Kambiz; Maddah, Godratollah; Jafarian, Amir Hosein; Khamene Bagheri, Arash; Jafarzadeh Esfehani, Reza; Mirzaeian, Sara

    2016-02-01

    Leiomyoma is a benign smooth muscle tumor. Intra-venous extensions of these tumors occur due to tumor growth within uterine vein or lymphatic vessels. In rare cases, intracaval and intracardiac extension can also be seen. Clinical suspicion of this disease should become certain by use of imaging techniques. While the treatment is complete resection of the tumor, one or two-stage surgery can be planned for patient depending on tumor extension and patient's condition. In this report, a 52-year-old woman with a rare presentation of uterine leiomyoma will be discussed. While the tumor was extended toward right atrium, the patient had nonspecific symptoms. By use of two-stage surgery, separated laparotomy and cardiopulmonary bypass, the tumor was completely removed. PMID:26838087

  13. Control of light backscattering in blood during intravenous laser irradiation

    NASA Astrophysics Data System (ADS)

    Melnik, Ivan S.; Popov, V. D.; Rusina, Tatyana V.; Dets, Sergiy M.

    1997-02-01

    One of the most important problems in modern laser medicine is the determination of system response on laser treatment. Reaction of living system is significant during many kinds of laser procedures like surgery, therapy and biostimulation. Our study was aimed to optimize laser exposure using feed-back fiber system for intravenous laser irradiation of blood (ILIB). This system consisted of helium-neon laser (633 nm, 5 mW) with coupled fiber unit, photodetector and PC interface. Photodetector signals produced due to light backscattering were storaged and processed during all blood irradiation procedure. Significant time-dependent variations were observed within 9-15 min after beginning of treatment procedure and were correlated with number of trials, stage and character of disease. The designed feed-back system allows us to register a human blood response on laser irradiation to achieve better cure effect.

  14. Clinical perspectives of intravenous ketamine anaesthesia in peafowl (Pavo cristatus).

    PubMed

    Athar, M; Shakoor, A; Muhammad, G; Sarwar, M N; Chaudhry, N I

    1996-01-01

    A total of 29 peafowl (Pavo cristatus), rectified surgically for infraorbital abscesses (n = 22), lacerated wounds (n = 4), and fractures of tibia (n = 2) and radius (n = 1), were anaesthetized by the intravenous administration of ketamine hydrochloride (Inj. Calypsol, Gedeon Richter, Hungary) in a dose of 15 20 mg/kg body weight. Divided doses (10 mg + 5 mg + 5 mg) were used with an interval of 1-2 min. No premedication was undertaken in any of the birds. Anaesthesia lasted for about 15 min and the birds gained their feet completely after 30 min to 3 hours. The respiration rate was markedly depressed (8-10/min) and the respiratory pattern was deep abdominal. Only a slight increase was observed in the heart rate. Analgesia was incomplete and muscle relaxation was not satisfactory. Mild salivation was also noticed in some of the birds (n = 3). Recovery, although not smooth, was uneventful. PMID:9055460

  15. Modelling Framework and Assistive Device for Peripheral Intravenous Injections

    NASA Astrophysics Data System (ADS)

    Kam, Kin F.; Robinson, Martin P.; Gilbert, Mathew A.; Pelah, Adar

    2016-02-01

    Intravenous access for blood sampling or drug administration that requires peripheral venepuncture is perhaps the most common invasive procedure practiced in hospitals, clinics and general practice surgeries.We describe an idealised mathematical framework for modelling the dynamics of the peripheral venepuncture process. Basic assumptions of the model are confirmed through motion analysis of needle trajectories during venepuncture, taken from video recordings of a skilled practitioner injecting into a practice kit. The framework is also applied to the design and construction of a proposed device for accurate needle guidance during venepuncture administration, assessed as consistent and repeatable in application and does not lead to over puncture. The study provides insights into the ubiquitous peripheral venepuncture process and may contribute to applications in training and in the design of new devices, including for use in robotic automation.

  16. Intravenous Immunoglobulin in the Management of Lupus Nephritis

    PubMed Central

    Wenderfer, Scott E.; Thacker, Trisha

    2012-01-01

    The occurrence of nephritis in patients with systemic lupus erythematosus is associated with increased morbidity and mortality. The pathogenesis of lupus nephritis is complex, involving innate and adaptive cellular and humoral immune responses. Autoantibodies in particular have been shown to be critical in the initiation and progression of renal injury, via interactions with both Fc-receptors and complement. One approach in the management of patients with lupus nephritis has been the use of intravenous immunoglobulin. This therapy has shown benefit in the setting of many forms of autoantibody-mediated injury; however, the mechanisms of efficacy are not fully understood. In this paper, the data supporting the use of immunoglobulin therapy in lupus nephritis will be evaluated. In addition, the potential mechanisms of action will be discussed with respect to the known involvement of complement and Fc-receptors in the kidney parenchyma. Results are provocative and warrant additional clinical trials. PMID:23056926

  17. Dietary Restrictions in Dialysis Patients: Is There Anything Left to Eat?

    PubMed Central

    Kalantar-Zadeh, Kamyar; Brown, Amanda; Chen, Joline L. T.; Kamgar, Mohammad; Lau, Wei-Ling; Moradi, Hamid; Rhee, Connie M.; Streja, Elani; Kovesdy, Csaba P.

    2015-01-01

    A significant number of dietary restrictions are imposed traditionally and uniformly on maintenance dialysis patients, whereas there is very little data to support their benefits. Recent studies indicate that dietary restrictions of phosphorus may lead to worse survival and poorer nutritional status. Restricting dietary potassium may deprive dialysis patients of heart-healthy diets and lead to intake of more atherogenic diets. There is little data about the survival benefits of dietary sodium restriction, and limiting fluid intake may inherently lead to lower protein and calorie consumption, when in fact dialysis patients often need higher protein intake to prevent and correct protein-energy wasting. Restricting dietary carbohydrates in diabetic dialysis patients may not be beneficial in those with burnt-out diabetes. Dietary fat including omega-3 fatty acids may be important caloric sources and should not be restricted. Data to justify other dietary restrictions related to calcium, vitamins and trace elements are scarce and often contradictory. The restriction of eating during hemodialysis treatment is likely another incorrect practice that may worsen hemodialysis induced hypoglycemia and nutritional derangements. We suggest careful relaxation of most dietary restrictions and adoption of a more balanced and individualized approach, thereby easing some of these overzealous restrictions that have not been proven to offer major advantages to patients and their outcomes and which may in fact worsen patients’ quality of life and satisfaction. This manuscript critically reviews the current paradigms and practices of recommended dietary regimens in dialysis patients including those related to dietary protein, carbohydrate, fat, phosphorus, potassium, sodium, and calcium, and discusses the feasibility and implications of adherence to ardent dietary restrictions. PMID:25649719

  18. Comparison of Intrapulmonary and Systemic Pharmacokinetics of Colistin Methanesulfonate (CMS) and Colistin after Aerosol Delivery and Intravenous Administration of CMS in Critically Ill Patients

    PubMed Central

    Boisson, Matthieu; Jacobs, Matthieu; Grégoire, Nicolas; Gobin, Patrice; Marchand, Sandrine; Mimoz, Olivier

    2014-01-01

    Colistin is an old antibiotic that has recently gained a considerable renewal of interest for the treatment of pulmonary infections due to multidrug-resistant Gram-negative bacteria. Nebulization seems to be a promising form of administration, but colistin is administered as an inactive prodrug, colistin methanesulfonate (CMS); however, differences between the intrapulmonary concentrations of the active moiety as a function of the route of administration in critically ill patients have not been precisely documented. In this study, CMS and colistin concentrations were measured on two separate occasions within the plasma and epithelial lining fluid (ELF) of critically ill patients (n = 12) who had received 2 million international units (MIU) of CMS by aerosol delivery and then intravenous administration. The pharmacokinetic analysis was conducted using a population approach and completed by pharmacokinetic-pharmacodynamic (PK-PD) modeling and simulations. The ELF colistin concentrations varied considerably (9.53 to 1,137 mg/liter), but they were much higher than those in plasma (0.15 to 0.73 mg/liter) after aerosol delivery but not after intravenous administration of CMS. Following CMS aerosol delivery, typically, 9% of the CMS dose reached the ELF, and only 1.4% was presystemically converted into colistin. PK-PD analysis concluded that there was much higher antimicrobial efficacy after CMS aerosol delivery than after intravenous administration. These new data seem to support the use of aerosol delivery of CMS for the treatment of pulmonary infections in critical care patients. PMID:25267660

  19. Comparison of intrapulmonary and systemic pharmacokinetics of colistin methanesulfonate (CMS) and colistin after aerosol delivery and intravenous administration of CMS in critically ill patients.

    PubMed

    Boisson, Matthieu; Jacobs, Matthieu; Grégoire, Nicolas; Gobin, Patrice; Marchand, Sandrine; Couet, William; Mimoz, Olivier

    2014-12-01

    Colistin is an old antibiotic that has recently gained a considerable renewal of interest for the treatment of pulmonary infections due to multidrug-resistant Gram-negative bacteria. Nebulization seems to be a promising form of administration, but colistin is administered as an inactive prodrug, colistin methanesulfonate (CMS); however, differences between the intrapulmonary concentrations of the active moiety as a function of the route of administration in critically ill patients have not been precisely documented. In this study, CMS and colistin concentrations were measured on two separate occasions within the plasma and epithelial lining fluid (ELF) of critically ill patients (n = 12) who had received 2 million international units (MIU) of CMS by aerosol delivery and then intravenous administration. The pharmacokinetic analysis was conducted using a population approach and completed by pharmacokinetic-pharmacodynamic (PK-PD) modeling and simulations. The ELF colistin concentrations varied considerably (9.53 to 1,137 mg/liter), but they were much higher than those in plasma (0.15 to 0.73 mg/liter) after aerosol delivery but not after intravenous administration of CMS. Following CMS aerosol delivery, typically, 9% of the CMS dose reached the ELF, and only 1.4% was presystemically converted into colistin. PK-PD analysis concluded that there was much higher antimicrobial efficacy after CMS aerosol delivery than after intravenous administration. These new data seem to support the use of aerosol delivery of CMS for the treatment of pulmonary infections in critical care patients. PMID:25267660

  20. Potential intravenous drug incompatibilities in a pediatric unit

    PubMed Central

    Leal, Karla Dalliane Batista; Leopoldino, Ramon Weyler Duarte; Martins, Rand Randall; Veríssimo, Lourena Mafra

    2016-01-01

    ABSTRACT Objective To investigate potential intravenous drug incompatibilities and related risk factors in a pediatric unit. Methods A cross-sectional analytical study conducted in the pediatric unit of a university hospital in Brazil. Data on prescriptions given to children aged 0-15 years from June to October 2014 were collected. Prescriptions that did not include intravenous drugs and prescriptions with incomplete dosage regimen or written in poor handwriting were excluded. Associations between variables and the risk of potential incompatibility were investigated using the Student’s t test and ANOVA; the level of significance was set at 5% (p<0.05). Relative risks were calculated for each drug involved in potential incompatibility with 95% confidence interval. Results A total of 222 children participated in the study; 132 (59.5%) children were male and 118 (53.2%) were aged between 0 and 2 years. The mean length of stay was 7.7±2.3 days. Dipyrone, penicillin G and ceftriaxona were the most commonly prescribed drugs. At least one potential incompatibility was detected in about 85% of children (1.2 incompatibility/patient ratio). Most incompatibilities detected fell into the non-tested (93.4%), precipitation (5.5%), turbidity (0.7%) or chemical decomposition (0.4%) categories. The number of drugs and prescription of diazepam, phenytoin, phenobarbital or metronidazole were risk factors for potential incompatibility. Conclusion Most pediatric prescriptions involved potential incompatibilities, with higher prevalence of non-tested incompatibilities. The number of drugs and prescription of diazepam, phenobarbital, phenytoin or metronidazole were risk factors for potential incompatibilities. PMID:27462891

  1. Pharmacokinetics of intravenous and subcutaneous cefovecin in alpacas.

    PubMed

    Cox, S; Sommardahl, C; Seddighi, R; Videla, R; Hayes, J; Pistole, N; Hamill, M; Doherty, T

    2015-08-01

    The purpose of this study was to determine the pharmacokinetics of cefovecin after intravenous and subcutaneous dose of 8 mg/kg to alpacas. Bacterial infections requiring long-term antibiotic therapy such as neonatal bacteremia, pneumonia, peritonitis, dental, and uterine infections are a significant cause of morbidity and mortality in this species. However, few antimicrobials have been evaluated and proven to have favorable pharmacokinetics for therapeutic use. Most antimicrobials that are currently used require daily injections for many days. Cefovecin is a long-acting cephalosporin that is formulated for subcutaneous administration, and its long-elimination half-life allows for 14-day dosing intervals in dogs and cats. The properties of cefovecin may be advantageous for medical treatment of camelids due to its broad spectrum, route of administration, and long duration of activity. Pharmacokinetic evaluation of antimicrobial drugs in camelids is essential for the proper treatment and prevention of bacterial disease, and to minimize development of antibiotic resistant bacterial strains due to inadequate antibiotic concentrations. Cefovecin mean half-life, volume of distribution at steady-state, and clearance after intravenous administration were 10.3 h, 86 mL/kg, and 7.07 mL·h/kg. The bioavailability was 143%, while half-life, C(max), and T(max) were 16.9 h, 108 μg/mL, and 2.8 h following subcutaneous administration. In the absence of additional microbial susceptibility data for alpaca pathogens, the current cefovecin dosage regimen prescribed for dogs (8 mg/kg SC every 14 days) may need to be optimized for the treatment of infections in this species.

  2. Fluid cooled electrical assembly

    DOEpatents

    Rinehart, Lawrence E.; Romero, Guillermo L.

    2007-02-06

    A heat producing, fluid cooled assembly that includes a housing made of liquid-impermeable material, which defines a fluid inlet and a fluid outlet and an opening. Also included is an electrical package having a set of semiconductor electrical devices supported on a substrate and the second major surface is a heat sink adapted to express heat generated from the electrical apparatus and wherein the second major surface defines a rim that is fit to the opening. Further, the housing is constructed so that as fluid travels from the fluid inlet to the fluid outlet it is constrained to flow past the opening thereby placing the fluid in contact with the heat sink.

  3. Spinning fluids reactor

    DOEpatents

    Miller, Jan D; Hupka, Jan; Aranowski, Robert

    2012-11-20

    A spinning fluids reactor, includes a reactor body (24) having a circular cross-section and a fluid contactor screen (26) within the reactor body (24). The fluid contactor screen (26) having a plurality of apertures and a circular cross-section concentric with the reactor body (24) for a length thus forming an inner volume (28) bound by the fluid contactor screen (26) and an outer volume (30) bound by the reactor body (24) and the fluid contactor screen (26). A primary inlet (20) can be operatively connected to the reactor body (24) and can be configured to produce flow-through first spinning flow of a first fluid within the inner volume (28). A secondary inlet (22) can similarly be operatively connected to the reactor body (24) and can be configured to produce a second flow of a second fluid within the outer volume (30) which is optionally spinning.

  4. Sleep restriction acutely impairs glucose tolerance in rats.

    PubMed

    Jha, Pawan K; Foppen, Ewout; Kalsbeek, Andries; Challet, Etienne

    2016-06-01

    Chronic sleep curtailment in humans has been related to impairment of glucose metabolism. To better understand the underlying mechanisms, the purpose of the present study was to investigate the effect of acute sleep deprivation on glucose tolerance in rats. A group of rats was challenged by 4-h sleep deprivation in the early rest period, leading to prolonged (16 h) wakefulness. Another group of rats was allowed to sleep during the first 4 h of the light period and sleep deprived in the next 4 h. During treatment, food was withdrawn to avoid a postmeal rise in plasma glucose. An intravenous glucose tolerance test (IVGTT) was performed immediately after the sleep deprivation period. Sleep deprivation at both times of the day similarly impaired glucose tolerance and reduced the early-phase insulin responses to a glucose challenge. Basal concentrations of plasma glucose, insulin, and corticosterone remained unchanged after sleep deprivation. Throughout IVGTTs, plasma corticosterone concentrations were not different between the control and sleep-deprived group. Together, these results demonstrate that independent of time of day and sleep pressure, short sleep deprivation during the resting phase favors glucose intolerance in rats by attenuating the first-phase insulin response to a glucose load. In conclusion, this study highlights the acute adverse effects of only a short sleep restriction on glucose homeostasis. PMID:27354542

  5. Oral fluids prior to day surgery. The effect of shortening the pre-operative fluid fast on postoperative morbidity.

    PubMed

    Goodwin, A P; Rowe, W L; Ogg, T W; Samaan, A

    1991-12-01

    One hundred day surgical patients undergoing first trimester termination of pregnancy were randomly allocated to receive either 150 ml of clear fluid 1.5-2 hours before anaesthesia or to remain fasted from midnight the night before. Patients were anaesthetised using a total intravenous technique which consisted of propofol and alfentanil. No adverse intra-operative events were noted in either group. There were no significant differences in immediate recovery time, or pain, nausea and headache scores at 30 or 120 minutes following recovery. The fasted group had less pain (p less than 0.05) at 60 minutes after recovery than the fluid group, although the mean pain scores in both groups were low. Eighty two per cent of the patients returned questionnaires about pain, nausea and headache scores on arriving home, and at 12 and 24 hours after surgery. There were no significant differences between the two groups. In conclusion, pain, nausea and headache scores are low following total intravenous anaesthesia with propofol and alfentanil for termination of pregnancy and these were unaffected by the administration of 150 ml of clear fluid given approximately 1.5 hours pre-operatively.

  6. Bolus intravenous 0.9% saline, but not 4% albumin or 5% glucose, causes interstitial pulmonary edema in healthy subjects.

    PubMed

    Bihari, Shailesh; Wiersema, Ubbo F; Schembri, David; De Pasquale, Carmine G; Dixon, Dani-Louise; Prakash, Shivesh; Lawrence, Mark D; Bowden, Jeffrey J; Bersten, Andrew D

    2015-10-01

    Rapid intravenous (iv) infusion of 0.9% saline alters respiratory mechanics in healthy subjects. However, the relative cardiovascular and respiratory effects of bolus iv crystalloid vs. colloid are unknown. Six healthy male volunteers were given 30 ml/kg iv 0.9% saline, 4% albumin, and 5% glucose at a rate of 100 ml/min on 3 separate days in a double-blinded, randomized crossover study. Impulse oscillometry, spirometry, lung volumes, diffusing capacity (DLCO), and blood samples were measured before and after fluid administration. Lung ultrasound B-line score (indicating interstitial pulmonary edema) and Doppler echocardiography indices of cardiac preload were measured before, midway, immediately after, and 1 h after fluid administration. Infusion of 0.9% saline increased small airway resistance at 5 Hz (P = 0.04) and lung ultrasound B-line score (P = 0.01) without changes in Doppler echocardiography measures of preload. In contrast, 4% albumin increased DLCO, decreased lung volumes, and increased the Doppler echocardiography mitral E velocity (P = 0.001) and E-to-lateral/septal e' ratio, estimated blood volume, and N-terminal pro B-type natriuretic peptide (P = 0.01) but not lung ultrasound B-line score, consistent with increased pulmonary blood volume without interstitial pulmonary edema. There were no significant changes with 5% glucose. Plasma angiopoietin-2 concentration increased only after 0.9% saline (P = 0.001), suggesting an inflammatory mechanism associated with edema formation. In healthy subjects, 0.9% saline and 4% albumin have differential pulmonary effects not attributable to passive fluid filtration. This may reflect either different effects of these fluids on active signaling in the pulmonary circulation or a protective effect of albumin.

  7. Fulminant hepatic failure after intravenous injection of sublingual buprenorphine in a patient with hepatitis C.

    PubMed

    French, Janine; Mujumdar, Avik; Angus, Peter; Gow, Paul

    2015-08-01

    A 20-year-old indigenous Australian male was admitted to the intensive care unit with fulminant hepatic failure secondary to intravenous use of buprenorphine, which had been prescribed sublingually for opioid dependence. Intravenous buprenorphine-induced hepatitis is well recognized, however, life-threatening fulminant hepatic failure has not previously been reported.

  8. Development of an Intravenous Therapy Module for Second Year Registered Nursing Students.

    ERIC Educational Resources Information Center

    Balint, Marilyn

    A study aimed at developing an intravenous therapy module for second-year registered nursing students is described in this practicum report. The report's five chapters define the underlying problem and purpose of the study; discuss the history of intravenous therapy and the significance of the module to the host institution; review the relevant…

  9. Thermodynamic Model for Fluid-Fluid Interfacial Areas in Porous Media for Arbitrary Drainage-Imbibition Sequences

    SciTech Connect

    Schroth, Martin H.; Oostrom, Mart; Dobson, Richard; Zeyer, Josef

    2008-08-01

    Fluid/fluid interfacial areas are important in controlling the rate of mass and energy transfer between fluid phases in porous media. We present a modified thermodynamically based model (TBM) to predict fluid/fluid interfacial areas in porous media for arbitrary drainage/imbibition sequences. The TBM explicitly distinguishes between interfacial areas associated with continuous (free) and isolated (entrapped) nonwetting fluids. The model is restricted to two-fluid systems in which (1) no significant conversion of mechanical work into heat occurs, (2) the wetting fluid completely wets the porous medium’s solid surfaces, and (3) no changes in interfacial area due to mass transfer between phases occur. We show example calculations for two different drainage/imbibition sequences in two porous media: a highly uniform silica sand and a well-graded silt. The TBM’s predictions for interfacial area associated with free nonwetting-fluid are identical to those of a previously published geometry-based model (GBM). However, predictions for interfacial area associated with entrapped nonwetting-fluid are consistently larger in the TBM than in the GBM. Although a comparison of model predictions with experimental data is currently only possible to a limited extent, good general agreement was found for the TBM. As required model parameters are commonly used as inputs for or tracked during multifluid-flow simulations, the modified TBM may be easily incorporated in numerical codes.

  10. Meta-analysis of depression and substance use and impairment among intravenous drug users (IDUs)

    PubMed Central

    Conner, Kenneth R.; Pinquart, Martin; Duberstein, Paul R.

    2016-01-01

    Aims To evaluate, among intravenous drug users (IDUs), the hypothesized positive association of depression with substance-related behaviors including concurrent drug use and impairment, future drug use and impairment, alcohol use and impairment, needle sharing and substance use treatment participation, and to identify moderators of these associations. Design Meta-analysis of reports on IDUs published in English in peer-reviewed journals since 1986 that contained data on depression and substance use outcome(s) with no restrictions on range of depression scores to select the sample. Setting Fifty-five reports containing 55 samples met criteria, including 42 (76%) samples from clinical venues and 13 (24%) that were community-based. Participants Mean age was 34.3 (standard deviation = 4.5) years, comprising approximately 68% men and 43% white, non-Hispanic subjects. Measurements Depression was assessed with the Beck Depression Inventory, Center for Epidemiological Studies Depression Scale (CES-D) and other validated scales or diagnostic interviews. The Addiction Severity Index was the most frequently used measure of substance-related outcomes. Findings A priori hypotheses pertaining to depression and the substance-related variables were supported, with the exception of the predicted association of depression and future drug use and impairment. Effect sizes were small. Moderating effects of gender were identified, including greater associations of depression with substance use treatment participation and needle sharing among women and a greater association of depression with future drug use and impairment among men. Effect sizes of moderators were large. Conclusions Depression is associated with several substance-related behaviors, and select associations are stronger according to gender. Prospective associations of depression with future drug use and impairment are not immediately evident, but could be examined in subsequent research. PMID:18261192

  11. Feasibility of Modified Surviving Sepsis Campaign Guidelines in a Resource-Restricted Setting Based on a Cohort Study of Severe S. Aureus Sepsis

    PubMed Central

    Srisomang, Pramot; Teparrukkul, Prapit; Lorvinitnun, Pichet; Wongyingsinn, Mingkwan; Chierakul, Wirongrong; Hongsuwan, Maliwan; West, T. Eoin; Day, Nicholas P.; Limmathurotsakul, Direk; Peacock, Sharon J.

    2012-01-01

    Background The Surviving Sepsis Campaign (SSC) guidelines describe best practice for the management of severe sepsis and septic shock in developed countries, but most deaths from sepsis occur where healthcare is not sufficiently resourced to implement them. Our objective was to define the feasibility and basis for modified guidelines in a resource-restricted setting. Methods and Findings We undertook a detailed assessment of sepsis management in a prospective cohort of patients with severe sepsis caused by a single pathogen in a 1,100-bed hospital in lower-middle income Thailand. We compared their management with the SSC guidelines to identify care bundles based on existing capabilities or additional activities that could be undertaken at zero or low cost. We identified 72 patients with severe sepsis or septic shock associated with S. aureus bacteraemia, 38 (53%) of who died within 28 days. One third of patients were treated in intensive care units (ICUs). Numerous interventions described by the SSC guidelines fell within existing capabilities, but their implementation was highly variable. Care available to patients on general wards covered the fundamental principles of sepsis management, including non-invasive patient monitoring, antimicrobial administration and intravenous fluid resuscitation. We described two additive care bundles, one for general wards and the second for ICUs, that if consistently performed would be predicted to improve outcome from severe sepsis. Conclusion It is feasible to implement modified sepsis guidelines that are scaled to resource availability, and that could save lives prior to the publication of international guidelines for developing countries. PMID:22363410

  12. A comparison between intravenous paracetamol plus fentanyl and intravenous fentanyl alone for postoperative analgesia during laparoscopic cholecystectomy

    PubMed Central

    Choudhuri, Anirban Hom; Uppal, Rajeev

    2011-01-01

    Purpose: our study compared the effect of fentanyl alone with fentanyl plus intravenous Paracetamol for analgesic efficacy, opioid sparing effects, and opioid-related side effects after laparoscopic cholecystectomy. Materials and Methods: eighty patients undergoing laparoscopic cholecystectomy were randomized into two groups, who were given either an IV placebo or an IV injection of 1g paracetamol just before induction. Both groups received fentanyl during induction and IM diclofenac for pain relief every 8 hourly for 24 h after surgery. The postoperative pain relief was evaluated by a visual analog scale (VAS) and consumption of fentanyl as rescue analgesic in the postoperative period for 24 h after surgery was measured. The incidence of PONV and sedation scores was also measured in the postoperative period. Results: the mean VAS score in first and second hour after surgery was less in the group receiving IV Paracetamol (3.3±0.4* vs. 5.2±0.9; 3.1±0.4* vs. 4.3±0.3); the fentanyl consumption over first 24 h was also less in the group receiving IV paracetamol (50±14.9 vs. 150±25.8). The time requirement of first dose of rescue analgesic in the postoperative period was also significantly prolonged in the group receiving IV paracetamol (76±24.7 vs. 48±15.8). There was no difference in the sedation scores and in the incidence of PONV in the two groups. Conclusion: The study demonstrates the usefulness of intravenous paracetamol as pre-emptive analgesic in the treatment of postoperative pain after laparoscopic cholecystectomy. PMID:25885388

  13. Simple and rapid human papillomavirus genotyping method by restriction fragment length polymorphism analysis with two restriction enzymes.

    PubMed

    Chen, Linghan; Watanabe, Ken; Haruyama, Takahiro; Kobayashi, Nobuyuki

    2013-07-01

    Cervical cancer, the third most common cancer that affects women worldwide, is caused by the human papillomavirus (HPV) and is treatable when detected at an early stage. To date, more than 100 different HPV types have been described, and the development of simple, low-cost, and accurate methods to distinguish HPV genotypes is highly warranted. In this study, an HPV genotyping assay based on polymerase chain reaction (PCR) was evaluated. This method involved the use of MY09/11 primers followed by restriction fragment length polymorphism (RFLP) analysis with the restriction enzymes HpyCH4V and NlaIII. Cervical specimens preserved using CytoRich Blue fluid were collected from 1,134 female volunteers for HPV detection, and 1,111 valid samples were amplified using PCR. The PCR method was sensitive enough to detect 25 copies of HPV18, and three copies of HPV16. Out of 202 PCR-positive samples, HPV genotypes were determined in 189 samples (93.6%) by this RFLP method. Results were then evaluated further by capillary sequencing method. Concordant results between the two tests were as high as 96.0%. Thirteen samples, which tested negative with RFLP, were verified as non-specific amplifications with PCR. In conclusion, this PCR-RFLP method using restriction enzymes HpyCH4V and NlaIII is simple, non-labor intensive, and is applicable for the inexpensive determination of HPV genotypes in clinical samples.

  14. Isotonic solutions of mannitol, sorbitol and glycine and distilled water as irrigating fluids during transurethral resection of the prostate and calculation of irrigating fluid influx.

    PubMed

    Norlén, H

    1985-01-01

    The aim of the study was to evaluate the clinical properties of some irrigating fluids used in transurethral resection of the prostate, to study humoral changes and disposition of the various fluids and solutes on intravenous absorption and, finally, to draw conclusions concerning a suitable composition of irrigation fluid. 60 patients undergoing transurethral resection of the prostate were included in the study. Plasma concentrations of mannitol, sorbitol and glycine were determined (during and after operation) as indicators of intravenous irrigation fluid influx. The serum concentration of prostatic acid phosphatase and, in patients irrigated with distilled water, the postoperative increase in plasma haemoglobin and the serum lactate dehydrogenase increase were used as semiquantitative estimates of fluid influx. A wide-ranging series of biochemical analyses was performed on blood in all cases before, during and after the resection (inter alia, sodium, albumin, haptoglobin in serum). The half-lives in plasma were estimated for mannitol, sorbitol and glycine. Fluid absorption was calculated in several ways. Haemodilution occurred with all iso-osmolar solutions on absorption but not with distilled water. The dilution effect of glycine solution was the most pronounced. Calculation of absorbed fluid volumes gave values up to 3.0 litres. Plasma osmolality was unchanged with all irrigating fluids used. The half-life in plasma for sorbitol was about 30 min, for glycine about 90 min and for mannitol about 120 min. Glycine entered muscle cells and changed the amino acid pattern. There was an increase in the serine and ammonia concentrations in plasma postoperatively. On absorption of distilled water there was an increase in the concentration of plasma haemoglobin and in erythrocyte-derived enzymes. The immediate postoperative concentration of glycine, mannitol and sorbitol in plasma was used to calculate fluid absorption. These concentrations showed good correlation with

  15. Placental Adaptations in Growth Restriction

    PubMed Central

    Zhang, Song; Regnault, Timothy R.H.; Barker, Paige L.; Botting, Kimberley J.; McMillen, Isabella C.; McMillan, Christine M.; Roberts, Claire T.; Morrison, Janna L.

    2015-01-01

    The placenta is the primary interface between the fetus and mother and plays an important role in maintaining fetal development and growth by facilitating the transfer of substrates and participating in modulating the maternal immune response to prevent immunological rejection of the conceptus. The major substrates required for fetal growth include oxygen, glucose, amino acids and fatty acids, and their transport processes depend on morphological characteristics of the placenta, such as placental size, morphology, blood flow and vascularity. Other factors including insulin-like growth factors, apoptosis, autophagy and glucocorticoid exposure also affect placental growth and substrate transport capacity. Intrauterine growth restriction (IUGR) is often a consequence of insufficiency, and is associated with a high incidence of perinatal morbidity and mortality, as well as increased risk of cardiovascular and metabolic diseases in later life. Several different experimental methods have been used to induce placental insufficiency and IUGR in animal models and a range of factors that regulate placental growth and substrate transport capacity have been demonstrated. While no model system completely recapitulates human IUGR, these animal models allow us to carefully dissect cellular and molecular mechanisms to improve our understanding and facilitate development of therapeutic interventions. PMID:25580812

  16. Caloric restriction and genomic stability

    PubMed Central

    Heydari, Ahmad R.; Unnikrishnan, Archana; Lucente, Lisa Ventrella; Richardson, Arlan

    2007-01-01

    Caloric restriction (CR) reduces the incidence and progression of spontaneous and induced tumors in laboratory rodents while increasing mean and maximum life spans. It has been suggested that CR extends longevity and reduces age-related pathologies by reducing the levels of DNA damage and mutations that accumulate with age. This hypothesis is attractive because the integrity of the genome is essential to a cell/organism and because it is supported by observations that both cancer and immunological defects, which increase significantly with age and are delayed by CR, are associated with changes in DNA damage and/or DNA repair. Over the last three decades, numerous laboratories have examined the effects of CR on the integrity of the genome and the ability of cells to repair DNA. The majority of studies performed indicate that the age-related increase in oxidative damage to DNA is significantly reduced by CR. Early studies suggest that CR reduces DNA damage by enhancing DNA repair. With the advent of genomic technology and our increased understanding of specific repair pathways, CR has been shown to have a significant effect on major DNA repair pathways, such as NER, BER and double-strand break repair. PMID:17942423

  17. Prenatal Depression Restricts Fetal Growth

    PubMed Central

    Diego, Miguel A.; Field, Tiffany; Hernandez-Reif, Maria; Schanberg, Saul; Kuhn, Cynthia; Gonzalez-Quintero, Victor Hugo

    2009-01-01

    Objective To identify whether prenatal depression is a risk factor for fetal growth restriction. Methods Midgestation (18-20 weeks GA) estimated fetal weight and urine cortisol and birth weight and gestational age at birth data were collected on a sample of 40 depressed and 40 non-depressed women. Estimated fetal weight and birthweight data were then used to compute fetal growth rates. Results Depressed women had a 13% greater incidence of premature delivery (Odds Ratio (OR) = 2.61) and 15% greater incidence of low birthweight (OR = 4.75) than non-depressed women. Depressed women also had elevated prenatal cortisol levels (p = .006) and fetuses who were smaller (p = .001) and who showed slower fetal growth rates (p = .011) and lower birthweights (p = .008). Mediation analyses further revealed that prenatal maternal cortisol levels were a potential mediator for the relationship between maternal symptoms of depression and both gestational age at birth and the rate of fetal growth. After controlling for maternal demographic variables, prenatal maternal cortisol levels were associated with 30% of the variance in gestational age at birth and 14% of the variance in the rate of fetal growth. Conclusion Prenatal depression was associated with adverse perinatal outcomes, including premature delivery and slower fetal growth rates. Prenatal maternal cortisol levels appear to play a role in mediating these outcomes. PMID:18723301

  18. [Clinical study of severe anorexia nervosa: the role of intravenous hyperalimentation therapy].

    PubMed

    Denda, K; Kitagawa, N; Shimanaka, S

    1997-01-01

    In order to understand the psychopathology of severe anorexia nervosa (AN), and determine appropriate therapeutic approaches, a clinical study was conducted on 13 patients with severe AN who were hospitalized and were treated with intravenous hyperalimentation (IVH). The patients were divided into three types based on their clinical symptoms and initiating factors: Type I (Restricting Type; "Non-dieters"), Type II (Restricting Type: "Dieters"). Type III (Binge-eating/Purging Type). The clinical features of each type were evaluated. Based on this evaluation, the basic approach and the role of IVH in the treatment of each type are described as follows. Type I: The patients experience loss of appetite and subsequently, suffer involuntary weight loss as a result of psychological or physical stresses at school and/or home. Since the patients do not intentionally restrict food intake, they cannot explain the loss of appetite. The age at onset of this type is the youngest among the three groups. The patients are introverted, passive and not good at expressing their emotions. Therefore, it is often difficult to deepen the emotional commitment further. It is possible to understand the pathology of Type I through the psychosomatic model. IVH therapy promotes benign regression for Type I patients, so that the mother-child relationship may be restored. As the therapeutic progress, the mother child relationship occasionally become ambivalent. In such a case, it is important for the treatment team to support independent activities of the patients. Type II: The patients lose weight by intentionally restricting necessary food intake for reasons such as beauty or sports. Any experience of failure in studies or sports or trouble in complex personal relations can trigger the onset of AN. Weight loss is looked as a great achievement, whereas weight gain is recognized as a serious failure of self-control. Since type II patients understand the necessity of receiving treatment, it is

  19. Body fluid identification by integrated analysis of DNA methylation and body fluid-specific microbial DNA.

    PubMed

    Choi, Ajin; Shin, Kyoung-Jin; Yang, Woo Ick; Lee, Hwan Young

    2014-01-01

    Identification of body fluids found at crime scenes provides important information that can support a link between sample donors and actual criminal acts. Previous studies have reported that DNA methylation analysis at several tissue-specific differentially methylated regions (tDMRs) enables successful identification of semen, and the detection of certain bacterial DNA can allow for identification of saliva and vaginal fluid. In the present study, a method for detecting bacterial DNA was integrated into a previously reported multiplex methylation-sensitive restriction enzyme-polymerase chain reaction. The developed multiplex PCR was modified by the addition of a new semen-specific marker and by including amplicons for the 16S ribosomal RNA gene of saliva- and vaginal fluid-specific bacteria to improve the efficacy to detect a specific type of body fluid. Using the developed multiplex system, semen was distinguishable by unmethylation at the USP49, DACT1, and PFN3 tDMRs and by hypermethylation at L81528, and saliva could be identified by detection of saliva-specific bacteria, Veillonella atypica and/or Streptococcus salivarius. Additionally, vaginal fluid and menstrual blood were differentiated from other body fluids by hypomethylation at the PFN3 tDMR and the presence of vaginal fluid-specific bacteria, Lactobacillus crispatus and/or Lactobacillus gasseri. Because the developed multiplex system uses the same biological source of DNA for individual identification profiling and simultaneously analyses various types of body fluid in one PCR reaction, this method will facilitate more efficient body fluid identification in forensic casework.

  20. Protection against chronic cadmium toxicity by caloric restriction.

    PubMed

    Shaikh, Z A; Jordan, S A; Tang, W

    1999-04-15

    Exposure to cadmium (Cd) can result in nephrotoxicity and osteotoxicity. Because Cd-induced nephrotoxicity involves oxidative stress and caloric restriction decreases oxidative stress, we examined whether reduced caloric intake will protect against Cd-induced nephrotoxicity. In addition, the protection against the osteotoxicity was also examined. Male and female Sprague-Dawley rats were provided drinking water containing 100 mg Cd/l. Since fluid intake relative to the body weight was higher in females as compared to the males, the Cd concentration in their water was reduced to 80 mg/l after 3 months and 65 mg/l after 6.5 months. During the 27 month exposure period the males and females consumed a total of about 5 g Cd/kg body weight. Food was restricted to 20 g/day after the first 3 months. During the unrestricted food intake period Cd exposure reduced the bone density in females by 23%, with a partial recovery and stabilization during the caloric restriction phase. Hepatic and renal Cd accumulation and corresponding metallothionein (MT) levels were very similar in both sexes. The reported critical Cd concentration for nephrotoxicity was reached by 9 months. Renal MT levels were maximum at this time. Despite a 1.5-fold increase in renal Cd concentration over the next 18 months, there was no significant increase in renal MT levels. In spite of high renal Cd levels and lack of availability of sufficient MT, there was no sign of nephrotoxicity, as measured by urinary protein and glucose excretion. It is concluded that caloric restriction prevents Cd-induced nephrotoxicity and also appears to control the osteotoxicity of Cd.

  1. Sleep in patients with restrictive lung disease.

    PubMed

    Won, Christine H J; Kryger, Meir

    2014-09-01

    Restrictive lung disease leads to ventilatory defects and diffusion impairments. These changes may contribute to abnormal nocturnal pathophysiology, including sleep architecture disruption and impaired ventilation and oxygenation. Patients with restrictive lung disease may suffer significant daytime fatigue and dysfunction. Hypercarbia and hypoxemia during sleep may impact progression of lung disease and related symptoms. Little is known about the impact of treatment of sleep disruption on sleep quality and overall prognosis in restrictive lung disease. This review discusses the pathophysiology of sleep and comorbid sleep disorders in restrictive lung diseases including interstitial lung disease, neuromuscular disease, and obesity hypoventilation syndrome.

  2. 42 CFR 73.13 - Restricted experiments.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...) Restricted experiments: (1) Experiments utilizing recombinant DNA that involve the deliberate transfer of a... agriculture. (2) Experiments involving the deliberate formation of recombinant DNA containing genes for...

  3. 42 CFR 73.13 - Restricted experiments.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...) Restricted experiments: (1) Experiments utilizing recombinant DNA that involve the deliberate transfer of a... agriculture. (2) Experiments involving the deliberate formation of recombinant DNA containing genes for...

  4. 42 CFR 73.13 - Restricted experiments.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...) Restricted experiments: (1) Experiments utilizing recombinant DNA that involve the deliberate transfer of a... agriculture. (2) Experiments involving the deliberate formation of recombinant DNA containing genes for...

  5. Fiber optic fluid detector

    DOEpatents

    Angel, S.M.

    1987-02-27

    Particular gases or liquids are detected with a fiber optic element having a cladding or coating of a material which absorbs the fluid or fluids and which exhibits a change of an optical property, such as index of refraction, light transmissiveness or fluoresence emission, for example, in response to absorption of the fluid. The fluid is sensed by directing light into the fiber optic element and detecting changes in the light, such as exit angle changes for example, that result from the changed optical property of the coating material. The fluid detector may be used for such purposes as sensing toxic or explosive gases in the atmosphere, measuring ground water contamination or monitoring fluid flows in industrial processes, among other uses. 10 figs.

  6. Fiber optic fluid detector

    DOEpatents

    Angel, S. Michael

    1989-01-01

    Particular gases or liquids are detected with a fiber optic element (11, 11a to 11j) having a cladding or coating of a material (23, 23a to 23j) which absorbs the fluid or fluids and which exhibits a change of an optical property, such as index of refraction, light transmissiveness or fluoresence emission, for example, in response to absorption of the fluid. The fluid is sensed by directing light into the fiber optic element and detecting changes in the light, such as exit angle changes for example, that result from the changed optical property of the coating material. The fluid detector (24, 24a to 24j) may be used for such purposes as sensing toxic or explosive gases in the atmosphere, measuring ground water contamination or monitoring fluid flows in industrial processes, among other uses.

  7. Microwave fluid flow meter

    DOEpatents

    Billeter, Thomas R.; Philipp, Lee D.; Schemmel, Richard R.

    1976-01-01

    A microwave fluid flow meter is described utilizing two spaced microwave sensors positioned along a fluid flow path. Each sensor includes a microwave cavity having a frequency of resonance dependent upon the static pressure of the fluid at the sensor locations. The resonant response of each cavity with respect to a variation in pressure of the monitored fluid is represented by a corresponding electrical output which can be calibrated into a direct pressure reading. The pressure drop between sensor locations is then correlated as a measure of fluid velocity. In the preferred embodiment the individual sensor cavities are strategically positioned outside the path of fluid flow and are designed to resonate in two distinct frequency modes yielding a measure of temperature as well as pressure. The temperature response can then be used in correcting for pressure responses of the microwave cavity encountered due to temperature fluctuations.

  8. On-line fast response device and method for measuring dissolved gas in a fluid

    DOEpatents

    Tutu, Narinder Kumar

    2011-01-11

    A method and device for the measurement of dissolved gas within a fluid. The fluid, substantially a liquid, is pumped into a pipe. The flow of the fluid is temporally restricted, creating one or more low pressure regions. A measurement indicative of trapped air is taken before and after the restriction. The amount of dissolved air is calculated from the difference between the first and second measurements. Preferably measurements indicative of trapped air is obtained from one or more pressure transducers, capacitance transducers, or combinations thereof. In the alternative, other methods such as those utilizing x-rays or gamma rays may also be used to detect trapped air. Preferably, the fluid is a hydraulic fluid, whereby dissolved air in the fluid is detected.

  9. Increased lactulose/rhamnose ratio during fluid load is caused by increased urinary lactulose excretion.

    PubMed

    Hallemeesch, M M; Lamers, W H; Soeters, P B; Deutz, N E

    2000-01-01

    Noninvasive assessment of intestinal permeability in vivo is based on the measurement of urinary excretion of orally administered sugar probes. It is expressed as a ratio, usually lactulose/rhamnose or 3-O-methyl-D-glucose (3-OMG)/rhamnose. In both endotoxemic and control rats that were receiving fluid, we observed an increase in the recovery of lactulose and 3-OMG but not rhamnose in both groups, suggesting an enhancement of intestinal permeability. In the measurement of intestinal permeability, all pre- and postmucosal factors are considered equal for all sugars. We hypothesized that postmucosal factors and not changes in intestinal permeability caused the increased urinary lactulose and 3-OMG recoveries observed during fluid loading. Therefore, the effects of fluid loading on urinary excretion of the sugar probes were studied in healthy rats receiving the sugars intravenously. After intravenous injection, fluid loading increased urinary lactulose recovery threefold but not that of 3-OMG and rhamnose. In conclusion, fluid loading increases the lactulose/rhamnose ratio independent of changes in intestinal permeability. The 3-OMG/rhamnose ratio is not influenced by fluid loading.

  10. Solar heat transport fluid

    NASA Technical Reports Server (NTRS)

    1978-01-01

    The progress made on the development and delivery of noncorrosive fluid subsystems is reported. These subsystems are to be compatible with closed-loop solar heating or combined heating and hot water systems. They are also to be compatible with both metallic and non-metallic plumbing systems. At least 100 gallons of each type of fluid recommended by the contractor will be delivered under the contract. The performance testing of a number of fluids is described.

  11. Fluid movement and creativity.

    PubMed

    Slepian, Michael L; Ambady, Nalini

    2012-11-01

    Cognitive scientists describe creativity as fluid thought. Drawing from findings on gesture and embodied cognition, we hypothesized that the physical experience of fluidity, relative to nonfluidity, would lead to more fluid, creative thought. Across 3 experiments, fluid arm movement led to enhanced creativity in 3 domains: creative generation, cognitive flexibility, and remote associations. Alternative mechanisms such as enhanced mood and motivation were also examined. These results suggest that creativity can be influenced by certain types of physical movement.

  12. Metalworking and machining fluids

    DOEpatents

    Erdemir, Ali; Sykora, Frank; Dorbeck, Mark

    2010-10-12

    Improved boron-based metal working and machining fluids. Boric acid and boron-based additives that, when mixed with certain carrier fluids, such as water, cellulose and/or cellulose derivatives, polyhydric alcohol, polyalkylene glycol, polyvinyl alcohol, starch, dextrin, in solid and/or solvated forms result in improved metalworking and machining of metallic work pieces. Fluids manufactured with boric acid or boron-based additives effectively reduce friction, prevent galling and severe wear problems on cutting and forming tools.

  13. Intravenous administration of alpha-1-proteinase inhibitor in patients of PiZ and PiM phenotype. Preliminary report

    SciTech Connect

    Moser, K.M.; Smith, R.M.; Spragg, R.G.; Tisi, G.M.

    1988-06-24

    Nine patients with moderate pulmonary emphysema, six of PiZ phenotype and three of PiM phenotype, have received a single intravenous infusion of alpha-1-proteinase inhibitor (human) (A1PI), in a dose of 60 mg/kg over a 30-minute period. They also received a tracer dose (300 microCi) of /sup 131/I-labeled A1PI. No active or passive immunization against hepatitis was given. No acute toxicity was observed. Compared with baseline data, significant elevations of serum A1PI (measured both antigenically and as anti-elastase activity) occurred, with a serum half-life approximating 110 hours. Bronchoalveolar lavage fluid, obtained 48 hours after infusion, reflected a significant increase in A1PI concentration versus baseline bronchoalveolar lavage fluid values. Serial gamma camera images of the lungs confirmed persistence of enhanced lung radioactivity for several days. Urinary desmosine excretion did not change following A1PI infusion. During the period of follow-up thus far, no patient has had chronic toxicity, results of liver function tests have been stable, and there has been no development of hepatitis B antigen or antibodies to hepatitis B surface or core antigens.

  14. Intravenous alcohol self-administration in the P rat.

    PubMed

    Windisch, Kyle A; Kosobud, Ann E K; Czachowski, Cristine L

    2014-08-01

    Alcohol consumption produces a complex array of effects that can be divided into two types: the explicit pharmacological effects of ethanol (which can be temporally separate from time of intake) and the more temporally "relevant" effects (primarily olfactory and taste) that bridge the time from intake to onset of the pharmacological effects. Intravenous (IV) self-administration of ethanol limits the confounding "non-pharmacological" effects associated with oral consumption, allows for controlled and precise dosing, and bypasses first order absorption kinetics, allowing for more direct and better-controlled assessment of alcohol's effect on the brain. IV ethanol self-administration has been reliably demonstrated in mouse and human experimental models; however, models of IV self-administration have been historically problematic in the rat. An operant multiple-schedule study design was used to elucidate the role of each component of a compound IV-ethanol plus oral-sucrose reinforcer. Male alcohol-preferring P rats had free access to both food and water during all IV self-administration sessions. Animals were trained to press a lever for orally delivered 1% sucrose (1S) on a fixed ratio 4 schedule, and then surgically implanted with an indwelling jugular catheter. Animals were then trained to respond on a multiple FR4-FR4 schedule composed of alternating 2.5-min components across 30-min sessions. For the multiple schedule, two components were used: an oral 1S only and an oral 1S plus IV 20% ethanol (25 mg/kg/injection). Average total ethanol intake was 0.47 ± 0.04 g/kg. We found significantly higher earning of sucrose-only reinforcers and greater sucrose-lever error responding relative to the compound oral-sucrose plus IV-ethanol reinforcer. These response patterns suggest that sucrose, not ethanol, was responsible for driving overall responding. The work with a compound IV ethanol-oral sucrose reinforcer presented here suggests that the existing intravenous ethanol

  15. Peripheral intravenous and central catheter algorithm: a proactive quality initiative.

    PubMed

    Wilder, Kerry A; Kuehn, Susan C; Moore, James E

    2014-12-01

    Peripheral intravenous (PIV) infiltrations causing tissue damage is a global issue surrounded by situations that make vascular access decisions difficult. The purpose of this quality improvement project was to develop an algorithm and assess its effectiveness in reducing PIV infiltrations in neonates. The targeted subjects were all infants in our neonatal intensive care unit (NICU) with a PIV catheter. We completed a retrospective chart review of the electronic medical record to collect 4th quarter 2012 baseline data. Following adoption of the algorithm, we also performed a daily manual count of all PIV catheters in the 1st and 2nd quarters 2013. Daily PIV days were defined as follows: 1 patient with a PIV catheter equals 1 PIV day. An infant with 2 PIV catheters in place was counted as 2 PIV days. Our rate of infiltration or tissue damage was determined by counting the number of events and dividing by the number of PIV days. The rate of infiltration or tissue damage was reported as the number of events per 100 PIV days. The number of infiltrations and PIV catheters was collected from the electronic medical record and also verified manually by daily assessment after adoption of the algorithm. To reduce the rate of PIV infiltrations leading to grade 4 infiltration and tissue damage by at least 30% in the NICU population. Incidence of PIV infiltrations/100 catheter days. The baseline rate for total infiltrations increased slightly from 5.4 to 5.68/100 PIV days (P = .397) for the NICU. We attributed this increase to heightened awareness and better reporting. Grade 4 infiltrations decreased from 2.8 to 0.83/100 PIV catheter days (P = .00021) after the algorithm was implemented. Tissue damage also decreased from 0.68 to 0.3/100 PIV days (P = .11). Statistical analysis used the Fisher exact test and reported as statistically significant at P < .05. Our findings suggest that utilization of our standardized decision pathway was instrumental in providing guidance for

  16. Symptomatic intravenous antipyretic therapy: efficacy of metamizol, diclofenac, and propacetamol.

    PubMed

    Oborilová, Andrea; Mayer, Jirí; Pospísil, Zdenek; Korístek, Zdenek

    2002-12-01

    Fever is a common symptom in cancer patients. The most frequent causes of fever are infections, malignancy itself, various medications, transfusions, and allergy. Although it is necessary to treat the cause of fever, if possible, symptomatic fever management is also important. Surprisingly, little attention is paid to this topic in the medical literature, despite the fact that it is a very frequent problem. In order to support symptomatic fever therapy, we wanted to study the patients' discomfort accompanying fever and the beneficial effects of the symptomatic fever management. To the best of our knowledge, there is an absence of studies in this area, despite the fever discomfort can be an important reason for the antipyretic treatment, mainly in cancer patients. In this non-randomized open label pilot study, three intravenous antipyretics were tested in five groups of patients: diclofenac (75 mg, brief intravenous [IV] infusion) vs. metamizol (2500 mg or 1000 mg, brief IV infusion) vs. propacetamol (2000 mg or 1000 mg, slow IV injection or brief IV infusion). The study included 254 febrile episodes mainly in hemato-oncological patients with axillary temperature at least 38 degrees C. The main study endpoints were: changes in axillary temperature, improvement in patient comfort, and number and nature of adverse events. To support justification for symptomatic fever management in febrile patients, we asked the first 45 study subjects to fill in a questionnaire concerning their opinions about fever, fever-associated discomfort, and relief upon antipyretic therapy. All study medications had a significant antipyretic effect. However, metamizol at the dose 2500 mg was considered as the most effective, while propacetamol at the dose 1000 mg showed the lowest antipyretic efficacy. Concerning tolerability and adverse events, there were significant differences among the treatment groups. Diclofenac and metamizol (both 2500 mg and 1000 mg) were tolerated at best. All tested

  17. Formulation of hydrophobic therapeutics with self-assembling peptide and amino acid: A new platform for intravenous drug delivery.

    PubMed

    Pacheco, Shaun; Kanou, Takashi; Fung, Shan-Yu; Chen, Kenny; Lee, Daiyoon; Bai, Xiaohui; Keshavjee, Shaf; Liu, Mingyao

    2016-10-10

    Clinical application of hydrophobic therapeutics is restricted by lack of an efficient vehicle which permits their solubility in aqueous environments. We have previously developed a novel formulation strategy to deliver a hydrophobic Src inhibitor, PP2, involving combinations of one self-assembling peptide (SAP) and one of 4 selected amino acids (AAs). The present study aims to develop a generalized drug delivery platform for intravenous application of hydrophobic drugs by combining self-assembling peptide, amino acid and low concentration of co-solvent. A multi-step screening pipeline is established which includes assessment of drug solubility and physicochemical characteristics, as well as functional efficacy and safety in vitro and in vivo. Using PP2 as an exemplary hydrophobic compound, 480 different combinations of 6 SAPs, 20 naturally existing AAs at 2 concentrations, and 2 co-solvents were evaluated. Among the combinations, 60 formulae dissolved PP2; 10 of which significantly reduced thrombin-induced IL-8 production, a sign of inflammatory response, in normal human lung epithelial BEAS2B cells. These formulations did not show cytotoxicity alone, but 2 reduced cell viability with presence of thrombin. We then performed a double-blinded test in a rat model of pulmonary ischemia-reperfusion. PP2 formulated with EAK16-I peptide plus methionine and 2% ethanol were administrated intravenously, significantly reducing severity of lung injury. The SAP-AA formulation strategy was also successfully applied to other hydrophobic compounds, suggesting this strategy could be applicable to other hydrophobics for a variety of clinical applications. PMID:27586187

  18. Restrictions placed on constitutive relations by angular momentum balance and Galilean invariance

    NASA Astrophysics Data System (ADS)

    Rajagopal, K. R.; Srinivasa, A. R.

    2013-04-01

    In this note, we will show that for describing the response of a wide class of bodies, it is sufficient to invoke only the balance of angular momentum to obtain the restrictions on the constitutive functions that one obtains by appealing to frame indifference. While this result is known for hyperelastic materials (although it is not found in any standard text on the subject), we extend this result to classes of elasto-plastic and viscoelastic materials as well as for a class of implicit constitutive equations for viscous fluids. In particular, we show that for a class of bodies capable of instantaneous elastic response that is dictated by a stored energy function, the symmetry of the Cauchy stress alone is enough to obtain all the necessary restrictions. The result is related to Noether's theorem; if we know that there is a conserved quantity (i.e., angular momentum), we can then show that the energy function must be invariant under a group of transformations. For a class of generalized Newtonian fluids (including the Navier Stokes fluid and the Bingham fluid), the symmetry of the stress and Galilean invariance of the response functions are all that are required to obtain restrictions that are usually obtained by enforcing frame indifference.

  19. Effect of whole and fractionated intravenous immunoglobulin on complement in vitro.

    PubMed

    Mollnes, T E; Andreassen, I H; Høgåsen, K; Hack, C E; Harboe, M

    1997-07-01

    Intravenous immunoglobulins (IVIG) are increasingly used for treatment of inflammatory diseases, and the modulation of complement may contribute to some of its beneficial effects. IVIG may bind C1q and activated C3 and C4, and enhance inactivation of C3b. We have previously shown that IVIG inhibited complement-mediated lysis solely via its Fc part through interaction with the classical pathway. In the present study we have investigated whole IVIG (Octagam, and Sandoglobulin) and the monomer, dimer and multimer fractions of Octagam with respect to complement activation in serum and inhibition of complement lysis of red cells. The isolated fractions were found to be stable, homogeneous (monomer, dimer or multimer) and pure (virtually only IgG). Both whole IVIG and its fractions significantly activated complement in serum and inhibited hemolysis compared with human albumin. These effects were most pronounced in the monomer, less in the multimer and least in the dimer fraction. The complement activation was shown to be mediated through the classical pathway since formation of C1rs-C1inh complexes and C4bc were increased, in contrast to Bb. Surprisingly, heat aggregation of Octagam was not followed by a corresponding increase in complement activation, as would be expected, unless it was dialysed before heating, suggesting that it is stabilized to avoid excess activation. In conclusion, the results support the hypothesis that IVIG causes a mild activation of complement in vitro. We suggest that this effect may contribute to the complement inhibitory properties of IVIG by diverting complement deposition from the target to the fluid phase.

  20. Population pharmacokinetic model of canrenone after intravenous administration of potassium canrenoate to paediatric patients

    PubMed Central

    Suyagh, Maysa; Hawwa, Ahmed F; Collier, Paul S; Millership, Jeffrey S; Kole, Prashant; Millar, Muriel; Shields, Mike D; Halliday, Henry L; McElnay, James C

    2012-01-01

    AIMS To characterize the population pharmacokinetics of canrenone following administration of potassium canrenoate to paediatric patients. METHODS Data were collected prospectively from 23 paediatric patients (2 days to 10 years of age; median weight 4 kg, range 2.16–28.0 kg) who received intravenous potassium canrenoate (K-canrenoate) as part of their intensive care therapy for removal of retained fluids, e.g. in pulmonary oedema due to chronic lung disease and for the management of congestive heart failure. Plasma samples were analyzed by HPLC for determination of canrenone (the major metabolite and pharmacologically active moiety) and the data subjected to pharmacokinetic analysis using NONMEM. RESULTS A one compartment model best described the data. The only significant covariate was weight (WT). The final population models for canrenone clearance (CL/F) and volume of distribution (V/F) were CL/F (l h−1) = 11.4 × (WT/70.0)0.75 and V/F (l) = 374.2 × (WT/70) where WT is in kg. The values of CL/F and V/F in a 4 kg child would be 1.33 l h−1 and 21.4 l, respectively, resulting in an elimination half-life of 11.2 h. CONCLUSIONS The range of estimated CL/F in the study population was 0.67–7.38 l h−1. The data suggest that adjustment of K-canrenoate dosage according to body weight is appropriate in paediatric patients. PMID:22376078

  1. Spiral fluid separator

    NASA Technical Reports Server (NTRS)

    Robertson, Glen A. (Inventor)

    1993-01-01

    A fluid separator for separating particulate matter such as contaminates is provided which includes a series of spiral tubes of progressively decreasing cross sectional area connected in series. Each tube has an outlet on the outer curvature of the spiral. As fluid spirals down a tube, centrifugal force acts to force the heavier particulate matter to the outer wall of the tube, where it exits through the outlet. The remaining, and now cleaner, fluid reaches the next tube, which is smaller in cross sectional area, where the process is repeated. The fluid which comes out the final tube is diminished of particulate matter.

  2. Electrodeposition from supercritical fluids.

    PubMed

    Bartlett, P N; Cook, D A; George, M W; Hector, A L; Ke, J; Levason, W; Reid, G; Smith, D C; Zhang, W

    2014-05-28

    Recent studies have shown that it is possible to electrodeposit a range of materials, such as Cu, Ag and Ge, from various supercritical fluids, including hydrofluorocarbons and mixtures of CO2 with suitable co-solvents. In this perspective we discuss the relatively new field of electrodeposition from supercritical fluids. The perspective focuses on some of the underlying physical chemistry and covers both practical and scientific aspects of electrodeposition from supercritical fluids. We also discuss possible applications for supercritical fluid electrodeposition and suggest some key developments that are required to take the field to the next stage.

  3. Electrorheological fluids and methods

    SciTech Connect

    Green, Peter F.; McIntyre, Ernest C.

    2015-06-02

    Electrorheological fluids and methods include changes in liquid-like materials that can flow like milk and subsequently form solid-like structures under applied electric fields; e.g., about 1 kV/mm. Such fluids can be used in various ways as smart suspensions, including uses in automotive, defense, and civil engineering applications. Electrorheological fluids and methods include one or more polar molecule substituted polyhedral silsesquioxanes (e.g., sulfonated polyhedral silsesquioxanes) and one or more oils (e.g., silicone oil), where the fluid can be subjected to an electric field.

  4. Sphere based fluid systems

    NASA Technical Reports Server (NTRS)

    Elleman, Daniel D. (Inventor); Wang, Taylor G. (Inventor)

    1989-01-01

    Systems are described for using multiple closely-packed spheres. In one system for passing fluid, a multiplicity of spheres lie within a container, with all of the spheres having the same outside diameter and with the spheres being closely nested in one another to create multiple interstitial passages of a known size and configuration and smooth walls. The container has an inlet and outlet for passing fluid through the interstitial passages formed between the nested spheres. The small interstitial passages can be used to filter out material, especially biological material such as cells in a fluid, where the cells can be easily destroyed if passed across sharp edges. The outer surface of the spheres can contain a material that absorbs a constitutent in the flowing fluid, such as a particular contamination gas, or can contain a catalyst to chemically react the fluid passing therethrough, the use of multiple small spheres assuring a large area of contact of these surfaces of the spheres with the fluid. In a system for storing and releasing a fluid such as hydrogen as a fuel, the spheres can include a hollow shell containing the fluid to be stored, and located within a compressable container that can be compressed to break the shells and release the stored fluid.

  5. How to Avoid Fluid Overload

    PubMed Central

    Ogbu, Ogbonna C.; Murphy, David J.; Martin, Greg S.

    2015-01-01

    Purpose of the review This review highlights recent evidence describing the outcomes associated with fluid overload in critically ill patients and provides an overview of fluid management strategies aimed at preventing fluid overload during the resuscitation of patients with shock. Recent findings Fluid overload is a common complication of fluid resuscitation and is associated with increased hospital costs, morbidity and mortality. Summary Fluid management goals differ during the resuscitation, optimization, stabilization and evacuation phases of fluid resuscitation. To prevent fluid overload, strategies that reduce excessive fluid infusions and emphasize the removal of accumulated fluids should be implemented. PMID:26103147

  6. Absorption of bacampicillin and ampicillin and penetration into body fluids (skin blister fluid, saliva, tears) in healthy volunteers.

    PubMed

    Simon, C; Malerczyk, V; Klaus, M

    1978-01-01

    Equimolar doses of bacampicillin, which is rapidly converted to ampicillin in the body by hydrolysis, and ampicillin were administered orally, in the case of ampicillin also by intravenous injection, to 10 healthy subjects (cross-over study). Comparison of the areas under the serum concentrations curves after intravenous and oral administration showed that bacampillin was absorbed to 95% and orally given ampicillin to 35%. The mean peak serum levels (Cmax) after 0.8 g of oral bacampicillin were higher (15.9 microgram/ml) and appeared earlier (tmax 60 min) than after 0.556 g of oral ampicillin (3.2 microgram/ml, tmax 150 min). One and three hours after oral administration skin blister fluid contained four times more ampicillin after doses of bacampicillin than after oral ampicillin. One hour after intravenous injection of ampicillin the skin blister concentrations were 20 times higher than after oral administration of this antibiotic and three to four times higher than after oral administration of bacampicillin. The levels in saliva and tears were also determined and showed similar relationships. Since higher peaks serum levels resulted in higher and longer lasting concentrations in the extravascular space, bacampicillin is to be preferred for oral therapy.

  7. Selected topics of fluid mechanics

    USGS Publications Warehouse

    Kindsvater, Carl E.

    1958-01-01

    the Euler, Froude, Reynolds, Weber, and Cauchy numbers are defined as essential tools for interpreting and using experimental data. The derivations of the energy and momentum equations are treated in detail. One-dimensional equations for steady nonuniform flow are developed, and the restrictions applicable to the equations are emphasized. Conditions of uniform and gradually varied flow are discussed, and the origin of the Chezy equation is examined in relation to both the energy and the momentum equations. The inadequacy of all uniform-flow equations as a means of describing gradually varied flow is explained. Thus, one of the definitive problems of river hydraulics is analyzed in the light of present knowledge. This report is the outgrowth of a series of short schools conducted during the spring and summer of 1953 for engineers of the Surface Water Branch, Water Resources Division, U. S. Geological Survey. The topics considered are essentially the same as the topics selected for inclusion in the schools. However, in order that they might serve better as a guide and outline for informal study, the arrangement of the writer's original lecture notes has been considerably altered. The purpose of the report, like the purpose of the schools which inspired it, is to build a simple but strong framework of the fundamentals of fluid mechanics. It is believed that this framework is capable of supporting a detailed analysis of most of the practical problems met by the engineers of the Geological Survey. It is hoped that the least accomplishment of this work will be to inspire the reader with the confidence and desire to read more of the recent and current technical literature of modern fluid mechanics.

  8. Intravenous Leiomyomatosis with Intracardiac Extension: Echocardiographic Study and Literature Review

    PubMed Central

    Li, Rongjuan; Shen, Yanguang; Sun, Yan; Zhang, Chuanchen; Yang, Jiao; Su, Ruijuan; Jiang, Bo

    2014-01-01

    Uterine leiomyomatosis is a common disease in women; however, intravenous leiomyomatosis with intracaval and intracardiac tumor extension is rare. We sought to analyze the clinical and echocardiographic features of intracardiac leiomyomatosis. From January 2003 through July 2012, 7 women (age range, 24–59 yr) underwent surgical resection of histopathologically diagnosed intracardiac leiomyomas at our hospital. Most of the patients had histories of hysterectomy or uterine leiomyoma. We retrospectively analyzed their preoperative echocardiograms. We found that the tumors had no stalks, did not adhere to the wall of the right side of the heart, were highly mobile, and moved back and forth in the right atrium near the tricuspid orifice. All tumors originated from the inferior vena cava and had borders well demarcated from that structure's wall. Most of the masses extended into the inferior vena cava and right atrium through the right internal and common iliac veins. Computed tomograms revealed pelvic tumors and contiguous filling defects in 6 patients. When echocardiograms reveal a right-sided cardiac mass that originates from the inferior vena cava, particularly in women who have a history of hysterectomy or uterine leiomyoma, intracardiac leiomyomatosis should be suspected. If the mass has no stalk and freely moves within the inferior vena cava and right-sided cardiac chambers without attachment to the endothelial surface or endocardium, intracardiac leiomyomatosis should be diagnosed. We discuss our findings and briefly review the relevant medical literature. PMID:25425982

  9. Intravenous self-administration of cocaine and norcocaine by dogs.

    PubMed

    Risner, M E; Jones, B E

    1980-01-01

    The potency of cocaine, relative to d-amphetamine, to initiate and maintain intravenous self-administration behavior by dogs (n = 5) was determined. Response-contingent infusions of cocaine (at unit doses of 0.15, 0.30 and 0.60 mg/kg/infusion) and d-amphetamine (at unit doses of 0.05 and 0.10 mg/kg/infusion) were available during daily 4-h sessions on a FR1 reinforcement schedule. By comparing the dose-response curves of the two drugs, it was found that 1 mg of amphetamine is equivalent to 5.3 mg of cocaine (95% confidence limits = 3.8--9.1 mg). In a second experiment, pretreatment with the alpha-adrenergic antagonist phenoxybenzamine (in doses ranging from 0.125--2.0 mg/kg, IV) did not produce any appreciable changes in responding for cocaine (0.2 mg/kg/infusion) by dogs (n = 9). In contrast, when the same animals were pretreated with the dopaminergic antagonist pimozide (in doses ranging from 5--40 mg/kg, IV), subsequent responding for cocaine was increased in a dose-dependent manner. In a third experiment it was determined that norcocaine, the N-demethylated metabolite of cocaine, would maintain self-administration behavior by dogs (n = 4) when it was substituted for cocaine. As expected, when saline was substituted for cocaine, responding was not maintained.

  10. Formulation, stability and degradation kinetics of intravenous cinnarizine lipid emulsion.

    PubMed

    Shi, Shuai; Chen, Hao; Cui, Yue; Tang, Xing

    2009-05-21

    Cinnarizine was loaded in the lipid emulsion to develop an intravenous formulation with good physical and chemical stability. High-pressure homogenization was used to prepare the lipid emulsion. The factors influencing the stability of cinnarizine lipid emulsion, such as different drug loading methods, pH, temperature, sterilization methods and sterilization time were monitored by high-performance liquid chromatograph. The degradation of cinnarizine in aqueous solution and lipid emulsion both followed apparent first-order kinetics. A possible degradation mechanism was postulated by the bell-shaped pH-rate profile of cinnarizine. Localization of the drug in the interfacial lecithin layer significantly improved the chemical stability of cinnarizine and its stabilizing mechanism was thoroughly discussed and proved. The activation energy of cinnarizine in lipid emulsion was calculated to be 51.27 kJ/mol which was similar to that in aqueous solution. This indicates that the stabilizing effect of the drug carrier on cinnarizine was not an alteration of the degradation reaction. In addition, shelf-life of cinnarizine in lipid emulsion was estimated to be 1471.6 days at 4 degrees C, which is much longer compared with 19.8 days in aqueous solution. The final products were stable enough to resist a 121 degrees C rotating steam sterilization for 15 min. PMID:19429300

  11. Intravenous ascorbic acid as an adjuvant to interleukin-2 immunotherapy

    PubMed Central

    2014-01-01

    Interleukin-2 (IL-2) therapy has been demonstrated to induce responses in 10-20% of advanced melanoma and renal cell carcinoma patients, which translates into durable remissions in up to half of the responsers. Unfortunately the use of IL-2 has been associated with severe toxicity and death. It has been previously observed and reported that IL-2 therapy causes a major drop in circulating levels of ascorbic acid (AA). The IL-2 induced toxicity shares many features with sepsis such as capillary leakage, systemic complement activation, and a relatively non-specific rise in inflammatory mediators such as TNF-alpha, C-reactive protein, and in advanced cases organ failure. Animal models and clinical studies have shown rapid depletion of AA in conditions of sepsis and amelioration associated with administration of AA (JTM 9:1-7, 2011). In contrast to other approaches to dealing with IL-2 toxicity, which may also interfere with therapeutic effects, AA possesses the added advantage of having direct antitumor activity through cytotoxic mechanisms and suppression of angiogenesis. Here we present a scientific rationale to support the assessment of intravenous AA as an adjuvant to decrease IL-2 mediated toxicity and possibly increase treatment efficacy. PMID:24884532

  12. Evidence for opponent-process actions of intravenous cocaine.

    PubMed

    Ettenberg, A; Raven, M A; Danluck, D A; Necessary, B D

    1999-11-01

    The present experiment was devised to test a prediction of the Opponent-Process Theory of drug action. This theory presumes that the initial affective experience of a subject treated with cocaine would be diametrically different immediately after administration compared to some point later in time when the positive impact of the drug had subsided. A conditioned place-preference procedure was employed in which a novel environment was paired with the effects of cocaine either immediately after, 5 min after, or 15 min after an intravenous injection of 0.75 mg/kg cocaine. It was hypothesized that animals would come to prefer environments associated with the immediate positive effects of cocaine and avoid environments associated with the drug's subsequent negative effects. The results confirmed this hypothesis. While the 0-min delay and 5-min delay groups exhibited conditioned preferences for the cocaine-paired environment, the 15-min delay group came to avoid the side of the preference apparatus paired with cocaine. These data, therefore, serve as additional support for an Opponent-Process account of cocaine's actions.

  13. The Production Processes and Biological Effects of Intravenous Immunoglobulin

    PubMed Central

    Barahona Afonso, Ana Filipa; João, Cristina Maria Pires

    2016-01-01

    Immunoglobulin is a highly diverse autologous molecule able to influence immunity in different physiological and diseased situations. Its effect may be visible both in terms of development and function of B and T lymphocytes. Polyclonal immunoglobulin may be used as therapy in many diseases in different circumstances such as primary and secondary hypogammaglobulinemia, recurrent infections, polyneuropathies, cancer, after allogeneic transplantation in the presence of infections and/or GVHD. However, recent studies have broadened the possible uses of polyclonal immunoglobulin showing that it can stimulate certain sub-populations of T cells with effects on T cell proliferation, survival and function in situations of lymphopenia. These results present a novel and considerable impact of intravenous immunoglobulin (IVIg) treatment in situations of severe lymphopenia, a situation that can occur in cancer patients after chemo and radiotherapy treatments. In this review paper the established and experimental role of polyclonal immunoglobulin will be presented and discussed as well as the manufacturing processes involved in their production. PMID:27005671

  14. Incorrect Prescription of Intravenous Paracetamol in a Pediatric Patient

    PubMed Central

    Örün, E; Polat, A; Andan, H; Çizmeci, N; Tufan, N

    2013-01-01

    Intravenous (IV) paracetamol is widely used for the treatment of pain and fever, when there is a clinical indication for an IV route. A 16-month-old girl weighing 12 kg had undergone anterior open reduction for developmental dysplasia of the hip. Twenty-four hours after the operation, IV paracetamol (Perfalgan® 10 mg/ml) infusion was started for the postoperative pain management. After 12 hours’ infusion, she has developed nausea, vomiting and agitation. The liver function tests were found to be more than 10-fold elevated on the laboratory results. When the medication order was checked, it was shown that she had been administered paracetamol 5 times at a dose of 42 mg/kg (total: 2.5 g/30 hours or 168 mg/kg/24 hours). The patient was started on N-acetyl cysteine (NAC) therapy immediately. She was asymptomatic at the 36th hour of the NAC treatment and the liver function tests completely recovered over 15 days. Since the errors in the calculation of the dosage of IV paracetamol may lead to serious complications or even death, physicians should be careful not to miscalculate when preferring the IV form of the drug. PMID:23935350

  15. Incorrect prescription of intravenous paracetamol in a pediatric patient.

    PubMed

    Orün, E; Polat, A; Andan, H; Cizmeci, N; Tufan, N

    2013-01-01

    Intravenous (IV) paracetamol is widely used for the treatment of pain and fever, when there is a clinical indication for an IV route. A 16-month-old girl weighing 12 kg had undergone anterior open reduction for developmental dysplasia of the hip. Twenty-four hours after the operation, IV paracetamol (Perfalgan® 10 mg/ml) infusion was started for the postoperative pain management. After 12 hours' infusion, she has developed nausea, vomiting and agitation. The liver function tests were found to be more than 10-fold elevated on the laboratory results. When the medication order was checked, it was shown that she had been administered paracetamol 5 times at a dose of 42 mg/kg (total: 2.5 g/30 hours or 168 mg/kg/24 hours). The patient was started on N-acetyl cysteine (NAC) therapy immediately. She was asymptomatic at the 36th hour of the NAC treatment and the liver function tests completely recovered over 15 days. Since the errors in the calculation of the dosage of IV paracetamol may lead to serious complications or even death, physicians should be careful not to miscalculate when preferring the IV form of the drug. PMID:23935350

  16. The use of ultrasound for placement of intravenous catheters.

    PubMed

    Aponte, Hector; Acosta, Said; Rigamonti, Donald; Sylvia, Barbara; Austin, Paul; Samolitis, Timothy

    2007-06-01

    Ultrasound has been used to aid cannulation of veins of the neck, chest, antecubital fossa, and femoral vein. This investigation compared the traditional method of peripheral intravenous (IV) cannulation of veins of the hands and forearms with ultrasound-guided IV cannulation of these veins. After obtaining institutional review board approval and written informed consent, 35 adult subjects with a history or suspicion of difficult IV cannulation were prospectively enrolled with 16 subjects randomly assigned to the traditional group and 19 to the ultrasound group. Time taken for successful venous cannulation and number of attempts between the groups were compared using a Mann-Whitney U test. The number of subjects in whom IV cannulation was successful on the first attempt was compared between the groups using the Fisher exact test. No significant differences were noted between groups in demographics, time to successful cannulation, number of attempts, and number of subjects in whom IV cannulation was successful on the first attempt. Ultrasound was as efficacious as the traditional method of IV cannulation in this subset of patients. Future investigations should examine the efficacy of the ultrasound-guided technique of IV cannulation of these veins in patients in whom the traditional method failed.

  17. Safety of intravenous iron use in chronic kidney disease

    PubMed Central

    Kalra, Philip A.; Bhandari, Sunil

    2016-01-01

    Purpose of review Iron deficiency anaemia (IDA) is common and associated with fatigue, reduced quality of life and poorer clinical outcomes. Treatment with oral iron is often inadequate and international guidelines recommend intravenous (i.v.) iron as the preferred option for the treatment of IDA in certain clinical situations. In this review, we assess the safety of using i.v. iron with a particular focus on patients with chronic kidney disease. Recent findings Recent publications have raised safety concerns regarding the incidence of serious reactions accompanying i.v. infusion, as well as the subsequent risk of infections and cardiovascular events. Methodological flaws influence the interpretation of these data that lack evidence from the use of modern irons. The latter have been investigated in several randomized control trials. Summary There is a need for better understanding and definition of the nature of i.v. iron reactions, as many are nonserious infusion reactions rather than true anaphylaxis. Retrospective identification of anaphylaxis is difficult and we suggest the importance of reanalysing data using fatalities or standardized terms as outcome measures. With the exception of high molecular weight iron dextran, serious or life-threatening reactions are rare with the use of i.v. irons, and they can be used safely for the treatment of IDA. PMID:27557350

  18. Pharmacokinetics of melamine in pigs following intravenous administration.

    PubMed

    Baynes, Ronald E; Smith, Geof; Mason, Sharon E; Barrett, Erica; Barlow, Beth M; Riviere, Jim E

    2008-03-01

    Melamine-contaminated pet food was recently added as a supplement to livestock feed. There is little or no information concerning the pharmacokinetics of melamine in livestock, and the aim of this study was to obtain pharmacokinetic parameters for this contaminant in pigs. Melamine was administered intravenously to five weanling pigs at a dose of 6.13 mg/kg and plasma samples were collected over 24 h, extracted for melamine, and then analyzed by HPLC-UV. The data was shown to best fit a one-compartment model with melamine's half-life of 4.04 (+/- 0.37) h, clearance of 0.11 (+/- 0.01) L/h/kg, and volume of distribution of 0.61 (+/- 0.04) L/kg. These data are comparable to the only mammalian study in rats and suggests that melamine is readily cleared by the kidney and there is unlikely to be significant tissue binding. Further tissue residue studies are required to assess the depletion kinetics of this contaminant in the pig which will determine whether residue levels in the kidney should be of public health concern if pigs were exposed to a similar dose.

  19. Natural killer cells in intravenous drug abusers with lymphadenopathy syndrome.

    PubMed Central

    Poli, G; Introna, M; Zanaboni, F; Peri, G; Carbonari, M; Aiuti, F; Lazzarin, A; Moroni, M; Mantovani, A

    1985-01-01

    We have investigated 25 intravenous drug abusers with the clinical and laboratory features of lymphadenopathy syndrome (LAS) and 10 AIDS patients for the expression of NK activity. LAS and AIDS patients had low NK cytotoxicity compared to normal donors. The defective NK cytotoxicity was analysed in the eight LAS subjects with most marked depression. NK effectors were identified by morphology (large granular lymphocytes, LGL) and monoclonal antibody-defined surface markers (B73.1, N901, HNK1). LAS patients had normal percentages of LGL and B73.1+ and N901+ cells. with the exception of two subjects with very low frequency of B73.1+ and N901+ cells. The percentage of HNK1+ cells was increased in LAS, probably because of the reactivity of this reagent with a subset of conventional OKT8+ cells, relatively augmented in LAS subjects. Depletion of monocytes did not enhance NK activity consistently. LAS patients had a normal frequency of cells capable of binding K562. In-vitro exposure to interferon beta (natural) or gamma (recombinant) augmented the defective NK activity of LAS subjects. Thus, patients with LAS have defective NK activity that cannot be accounted for by a low frequency of the relevant effector cells or by monocytic suppressors. These observations suggest a functional defect of NK cells at one or more of the post-binding steps required for the completion of killing. PMID:2415279

  20. Ultrastructural localization of intravenously injected carbon nanohorns in tumor

    PubMed Central

    Matsumura, Sachiko; Yuge, Ryota; Sato, Shigeo; Tomida, Akihiro; Ichihashi, Toshinari; Irie, Hiroshi; Iijima, Sumio; Shiba, Kiyotaka; Yudasaka, Masako

    2014-01-01

    Nanocarbons have many potential medical applications. Drug delivery, diagnostic imaging, and photohyperthermia therapy, especially in the treatment of tumors, have attracted interest. For the further advancement of these application studies, the microscopic localization of nanocarbons in tumor tissues and cells is a prerequisite. In this study, carbon nanohorns (CNHs) with sizes of about 100 nm were intravenously injected into mice having subcutaneously transplanted tumors, and the CNHs in tumor tissue were observed with optical and electron microscopy. In the tumor tissue, the CNHs were found in macrophages and endothelial cells within the blood vessels. Few CNHs were found in tumor cells or in the region away from blood vessels, suggesting that, under these study conditions, the enhanced permeability of tumor blood vessels was not effective for the movement of CNHs through the vessel walls. The CNHs in normal skin tissue were similarly observed. The extravasation of CNHs was not so obvious in tumor but was easily found in normal skin, which was probably due to their vessel wall structure difference. Proper understanding of the location of CNHs in tissues is helpful in the development of the medical uses of CNHs. PMID:25092979

  1. Treatment of Intravenous Leiomyomatosis with Cardiac Extension following Incomplete Resection.

    PubMed

    Doyle, Mathew P; Li, Annette; Villanueva, Claudia I; Peeceeyen, Sheen C S; Cooper, Michael G; Hanel, Kevin C; Fermanis, Gary G; Robertson, Greg

    2015-01-01

    Aim. Intravenous leiomyomatosis (IVL) with cardiac extension (CE) is a rare variant of benign uterine leiomyoma. Incomplete resection has a recurrence rate of over 30%. Different hormonal treatments have been described following incomplete resection; however no standard therapy currently exists. We review the literature for medical treatments options following incomplete resection of IVL with CE. Methods. Electronic databases were searched for all studies reporting IVL with CE. These studies were then searched for reports of patients with inoperable or incomplete resection and any further medical treatments. Our database was searched for patients with medical therapy following incomplete resection of IVL with CE and their results were included. Results. All studies were either case reports or case series. Five literature reviews confirm that surgery is the only treatment to achieve cure. The uses of progesterone, estrogen modulation, gonadotropin-releasing hormone antagonism, and aromatase inhibition have been described following incomplete resection. Currently no studies have reviewed the outcomes of these treatments. Conclusions. Complete surgical resection is the only means of cure for IVL with CE, while multiple hormonal therapies have been used with varying results following incomplete resection. Aromatase inhibitors are the only reported treatment to prevent tumor progression or recurrence in patients with incompletely resected IVL with CE. PMID:26783463

  2. Intravenous immunoglobulin promotes antitumor responses by modulating macrophage polarization.

    PubMed

    Domínguez-Soto, Angeles; de las Casas-Engel, Mateo; Bragado, Rafael; Medina-Echeverz, José; Aragoneses-Fenoll, Laura; Martín-Gayo, Enrique; van Rooijen, Nico; Berraondo, Pedro; Toribio, María L; Moro, María A; Cuartero, Isabel; Castrillo, Antonio; Sancho, David; Sánchez-Torres, Carmen; Bruhns, Pierre; Sánchez-Ramón, Silvia; Corbí, Angel L

    2014-11-15

    Intravenous Igs (IVIg) therapy is widely used as an immunomodulatory strategy in inflammatory pathologies and is suggested to promote cancer regression. Because progression of tumors depends on their ability to redirect the polarization state of tumor-associated macrophages (from M1/immunogenic/proinflammatory to M2/anti-inflammatory), we have evaluated whether IVIg limits tumor progression and dissemination through modulation of macrophage polarization. In vitro, IVIg inhibited proinflammatory cytokine production from M1 macrophages and induced a M2-to-M1 polarization switch on human and murine M2 macrophages. In vivo, IVIg modified the polarization of tumor-associated myeloid cells in a Fcεr1γ chain-dependent manner, modulated cytokine blood levels in tumor-bearing animals, and impaired tumor progression via FcγRIII (CD16), FcγRIV, and FcRγ engagement, the latter two effects being macrophage mediated. Therefore, IVIg immunomodulatory activity is dependent on the polarization state of the responding macrophages, and its ability to trigger a M2-to-M1 macrophage polarization switch might be therapeutically useful in cancer, in which proinflammatory or immunogenic functions should be promoted.

  3. Pharmacokinetics of marbofloxacin after intravenous and intramuscular administration to ostriches.

    PubMed

    de Lucas, José Julio; Rodríguez, Casilda; Waxman, Samanta; González, Fernando; Uriarte, Isabel; San Andrés, Manuel Ignacio

    2005-11-01

    The pharmacokinetics of marbofloxacin was investigated after intravenous (IV) and intramuscular (IM) administration, both at a dose rate of 5 mg/kg BW, in six clinically healthy domestic ostriches. Plasma concentrations of marbofloxacin was determined by a HPLC/UV method. The high volume of distribution (3.22+/-0.98 L/kg) suggests good tissue penetration. Marbofloxacin presented a high clearance value (2.19+/-0.27 L/kgh), explaining the low AUC values (2.32+/-0.30 microgh/mL and 2.25+/-0.70 microgh/mL, after IV and IM administration, respectively) and a short half life and mean residence time (t(1/2 beta)=1.47+/-0.31 h and 1.96+/-0.35 h; MRT=1.46+/-0.02 h and 2.11+/-0.30 h, IV and IM, respectively). The absorption of marbofloxacin after IM administration was rapid and complete (C(max)=1.13+/-0.29 microg/mL; T(max)=0.36+/-0.071 h; MAT=0.66+/-0.22 h and F (%)=95.03+/-16.89).

  4. The intravenous laser blood irradiation in chronic pain and fibromyalgia.

    PubMed

    Momenzadeh, Sirous; Abbasi, Mohammadzaki; Ebadifar, Asghar; Aryani, Mohammadreza; Bayrami, Jafar; Nematollahi, Fatemeh

    2015-01-01

    Intravenous laser blood irradiation was first introduced into therapy by the Soviet scientists EN.Meschalkin and VS.Sergiewski in 1981. Originally this method was developed for the treatment of cardiovascular diseases. Improvement of rheologic properties of the blood as well as improvement of microcirculation and reduction of the area of infarction has been proved. Further, reduction of dysrhythmia and sudden cardiac death was achieved. At first, only the Helium-Neon laser (632.8 nm) was used in this therapy. For that, a power of 1-3mW and a period of exposure of 20-60 minutes were applied. The treatments were carried out once or twice a day up to ten appointments in all1. In the years after, many, and for the most part Russian studies showed that helium-neon laser had various effects on many organs and on the hematologic and immunologic system. The studies were published mainly in Russian which were little known in the West because of decades of political separation, and were regarded with disapproval. Besides clinical research and application for patients, the cell biological basis was developed by the Estonian cell biologist Tiina Karu at the same time. An abstract is to be found in her work "The Science of Low-Power Laser-Therapy" PMID:25699161

  5. Ultrastructural localization of intravenously injected carbon nanohorns in tumor.

    PubMed

    Matsumura, Sachiko; Yuge, Ryota; Sato, Shigeo; Tomida, Akihiro; Ichihashi, Toshinari; Irie, Hiroshi; Iijima, Sumio; Shiba, Kiyotaka; Yudasaka, Masako

    2014-01-01

    Nanocarbons have many potential medical applications. Drug delivery, diagnostic imaging, and photohyperthermia therapy, especially in the treatment of tumors, have attracted interest. For the further advancement of these application studies, the microscopic localization of nanocarbons in tumor tissues and cells is a prerequisite. In this study, carbon nanohorns (CNHs) with sizes of about 100 nm were intravenously injected into mice having subcutaneously transplanted tumors, and the CNHs in tumor tissue were observed with optical and electron microscopy. In the tumor tissue, the CNHs were found in macrophages and endothelial cells within the blood vessels. Few CNHs were found in tumor cells or in the region away from blood vessels, suggesting that, under these study conditions, the enhanced permeability of tumor blood vessels was not effective for the movement of CNHs through the vessel walls. The CNHs in normal skin tissue were similarly observed. The extravasation of CNHs was not so obvious in tumor but was easily found in normal skin, which was probably due to their vessel wall structure difference. Proper understanding of the location of CNHs in tissues is helpful in the development of the medical uses of CNHs.

  6. The Intravenous Laser Blood Irradiation in Chronic Pain and Fibromyalgia

    PubMed Central

    Momenzadeh, Sirous; Abbasi, Mohammadzaki; Ebadifar, Asghar; Aryani, Mohammadreza; Bayrami, Jafar; Nematollahi, Fatemeh

    2015-01-01

    Intravenous laser blood irradiation was first introduced into therapy by the Soviet scientists EN.Meschalkin and VS.Sergiewski in 1981. Originally this method was developed for the treatment of cardiovascular diseases. Improvement of rheologic properties of the blood as well as improvement of microcirculation and reduction of the area of infarction has been proved. Further, reduction of dysrhythmia and sudden cardiac death was achieved. At first, only the Helium-Neon laser (632.8 nm) was used in this therapy. For that, a power of 1-3mW and a period of exposure of 20-60 minutes were applied. The treatments were carried out once or twice a day up to ten appointments in all1. In the years after, many, and for the most part Russian studies showed that helium-neon laser had various effects on many organs and on the hematologic and immunologic system. The studies were published mainly in Russian which were little known in the West because of decades of political separation, and were regarded with disapproval. Besides clinical research and application for patients, the cell biological basis was developed by the Estonian cell biologist Tiina Karu at the same time. An abstract is to be found in her work "The Science of Low-Power Laser-Therapy" PMID:25699161

  7. Pharmacokinetics and tolerability of intravenous rizatriptan in healthy females.

    PubMed

    Lee, Y; Ermlich, S J; Sterrett, A T; Goldberg, M R; Blum, R A; Brucker, M J; McLoughlin, D A; Olah, T V; Zhao, J; Rogers, J D

    1998-12-01

    The pharmacokinetics and tolerability of intravenous (i.v.) rizatriptan (MK-0462), a novel 5-HT1D/1B receptor agonist for the acute oral treatment of migraine, were examined in an open, single-dose, four-period, randomized crossover study in healthy females. Results of this study indicated that i.v. rizatriptan (0.5-5 mg) was well tolerated. The disposition kinetics of rizatriptan were linear for i.v. doses up to and including 2.5 mg. Relative to the 0.5 mg dose, geometric mean dose-adjusted AUC ratios were 1.04, 1.09, and 1.18 for 1, 2.5, and 5 mg doses, respectively. Apparent plasma clearance (Cl) ranged between 859 and 941 mL min(-1) from 0.5 to 2.5 mg, but dropped to slightly below 800 mL min(-1) for the 5 mg dose. Therefore, the elimination of rizatriptan appears somewhat dose dependent at the high end of this dose range. Mean plasma half-life (t1/2) was 1.5-2.2 h across all doses while mean residence time in the body (MRT) and steady state volume of distribution (Vss) of rizatriptan remained relatively invariant across doses. Urinary excretion of rizatriptan (Ue) ranged from 14.5 to 34.6% of dose. PMID:9872339

  8. Emotional response to intravenous delta9tetrahydrocannabinol during oral surgery.

    PubMed

    Gregg, J M; Small, E W; Moore, R; Raft, D; Toomey, T C

    1976-04-01

    The administration of delta9THC intravenously as a premedicant to oral surgery resulted in acute pronounced elevations in anxiety states, a predominance of dysphoria over euphoria, and varying degrees of psychotic-like paranoiac thought. Neural effects that appeared to promote these effects included distortions of perception with sensory delusions, and heightened sensory receptiveness including antalgesic impressions of surgery; autonomic and visceral arousal greater than control or placebo levels; lack of overt behavioral signals of distress due to depersonalization; and time disintegration leading to fear-inducing misinformation about real surgical events. Introverted subjects who generally were inclined to rely on drug solutions to their problems tended to respond poorly to surgical pain and anxiety with delta9THC. These results, obtained from subjects considered to have levels of presurgical apprehension that were average or below average, suggest that the environment in which high doses of cannabinols are experienced is a potent factor in determining the quality of the emotional response. A surgical environment containing even the mild stress of outpatient oral surgery appears to have the potential to precipitate undesirable emotional responses among cannabinol-intoxicated patients. There is continued high-level social use of cannabinols inour society, with an estimate of 40% to 55% among the college-age group seen frequently by oral surgeons. Results of this study suggest that clinicians should be prepared to detect the subtle signs of marijuana intoxication to protect their patients from further psychophysiologic complications during surgery.

  9. Measurement of anticomplementary activity in therapeutic intravenous immunoglobulin preparations.

    PubMed

    Ramasamy, I; Tran, E; Farrugia, A

    1997-03-01

    Anticomplementary activity (ACA) of aggregates in intravenous immunoglobulin preparations (IVIG) was investigated using the modified Kabat and Meyer classical complement consumption method recommended by the European Pharmacopoeia and a C1q-coated microtitre enzyme-linked immunosorbent assay (ELISA). The physical characteristics of aggregates were found to affect complement binding. Aggregates formed by heating IVIG preparations at acid pH bound complement poorly, while aggregates formed by heating IVIG at neutral pH showed high ACA. This suggests that analysis of complement binding capacity provides a level of aggregate characterization of aggregates which is additional to quantitation by High-performance liquid chromatography ((HPLC). The correlation (r = 0.98) between the two tests was good when aggregates formed at neutral pH were compared, but decreased (r = 0.57) when aggregates formed at acid pH were included. A comparison of the results showed that there were no significant differences in the classification of aggregates with acceptable/unacceptable (i.e. pass/fail outcome) values of ACA. Between assay variation (CV = 7.6%) was lower in the ELISA test compared with the complement consumption assay (where percentage binding varied from 78.9% to 100%). Both assays are justified for the evaluation of ACA in therapeutic IVIG. The ELISA had the advantage in being more precise, less dependent on reagent source and requiring less technical expertise.

  10. Unprotected anal Intercourse among Iranian Intra-Venous Drug Users

    PubMed Central

    Mirabi, Parvaneh; Yarmohmmadi Vasel, Mosaieb; Moazen, Babak; Sehat, Mahmoud; Rezazadeh, Majid; Ahmadi, Khodabakhsh

    2013-01-01

    Purpose: To assess the prevalence and associated factors of unprotected anal intercourse among Iranian male heterosexual Intra-Venous Drug Users (IDUs). Methods: In a cross-sectional study 360 male heterosexual IDUs were sampled from streets of eight different geographical parts of Iran. Variables such as socio-demographics, HIV knowledge (10 items), and HIV attitude (16 items) were entered to a logistic regression to determine the predictors of unprotected anal intercourse during the past month. Results: From all, 20.8% reported unprotected anal intercourse during the past month. HIV knowledge was not significantly different among IDUs with and without unprotected anal intercourse. High age [odds ratio (OR) = 0.954, 95% confidence intervals (CI) = 0.916–0.992] was associated with a lower likelihood of unprotected anal intercourse, while being not married (OR = 2.301, 95% CI = 1.151–4.601), and high perceived HIV risk (OR = 1.776, 95% CI = 1.376–2.290) were associated with a higher likelihood of unprotected anal intercourse. Conclusion: Although the results might not be generalizable to all Iranian IDUs, this study findings may still be helpful for design and implementation of public health programs in Iran to prevent sexual transmission of HIV through IDUs. PMID:24350203

  11. Treatment of Intravenous Leiomyomatosis with Cardiac Extension following Incomplete Resection

    PubMed Central

    Doyle, Mathew P.; Li, Annette; Villanueva, Claudia I.; Peeceeyen, Sheen C. S.; Cooper, Michael G.; Hanel, Kevin C.; Fermanis, Gary G.; Robertson, Greg

    2015-01-01

    Aim. Intravenous leiomyomatosis (IVL) with cardiac extension (CE) is a rare variant of benign uterine leiomyoma. Incomplete resection has a recurrence rate of over 30%. Different hormonal treatments have been described following incomplete resection; however no standard therapy currently exists. We review the literature for medical treatments options following incomplete resection of IVL with CE. Methods. Electronic databases were searched for all studies reporting IVL with CE. These studies were then searched for reports of patients with inoperable or incomplete resection and any further medical treatments. Our database was searched for patients with medical therapy following incomplete resection of IVL with CE and their results were included. Results. All studies were either case reports or case series. Five literature reviews confirm that surgery is the only treatment to achieve cure. The uses of progesterone, estrogen modulation, gonadotropin-releasing hormone antagonism, and aromatase inhibition have been described following incomplete resection. Currently no studies have reviewed the outcomes of these treatments. Conclusions. Complete surgical resection is the only means of cure for IVL with CE, while multiple hormonal therapies have been used with varying results following incomplete resection. Aromatase inhibitors are the only reported treatment to prevent tumor progression or recurrence in patients with incompletely resected IVL with CE. PMID:26783463

  12. Space Station fluid management logistics

    NASA Technical Reports Server (NTRS)

    Dominick, Sam M.

    1990-01-01

    Viewgraphs and discussion on space station fluid management logistics are presented. Topics covered include: fluid management logistics - issues for Space Station Freedom evolution; current fluid logistics approach; evolution of Space Station Freedom fluid resupply; launch vehicle evolution; ELV logistics system approach; logistics carrier configuration; expendable fluid/propellant carrier description; fluid carrier design concept; logistics carrier orbital operations; carrier operations at space station; summary/status of orbital fluid transfer techniques; Soviet progress tanker system; and Soviet propellant resupply system observations.

  13. Intravenous Iron Carboxymaltose as a Potential Therapeutic in Anemia of Inflammation

    PubMed Central

    Traeger, Lisa; Bäumer, Nicole; Schulze, Isabell; Kuhlmann, Tanja; Müller-Tidow, Carsten

    2016-01-01

    Intravenous iron supplementation is an effective therapy in iron deficiency anemia (IDA), but controversial in anemia of inflammation (AI). Unbound iron can be used by bacteria and viruses for their replication and enhance the inflammatory response. Nowadays available high molecular weight iron complexes for intravenous iron substitution, such as ferric carboxymaltose, might be useful in AI, as these pharmaceuticals deliver low doses of free iron over a prolonged period of time. We tested the effects of intravenous iron carboxymaltose in murine AI: Wild-type mice were exposed to the heat-killed Brucella abortus (BA) model and treated with or without high molecular weight intravenous iron. 4h after BA injection followed by 2h after intravenous iron treatment, inflammatory cytokines were upregulated by BA, but not enhanced by iron treatment. In long term experiments, mice were fed a regular or an iron deficient diet and then treated with intravenous iron or saline 14 days after BA injection. Iron treatment in mice with BA-induced AI was effective 24h after iron administration. In contrast, mice with IDA (on iron deficiency diet) prior to BA-IA required 7d to recover from AI. In these experiments, inflammatory markers were not further induced in iron-treated compared to vehicle-treated BA-injected mice. These results demonstrate that intravenous iron supplementation effectively treated the murine BA-induced AI without further enhancement of the inflammatory response. Studies in humans have to reveal treatment options for AI in patients. PMID:27404499

  14. Perineural versus intravenous dexamethasone as adjuncts to local anaesthetic brachial plexus block for shoulder surgery.

    PubMed

    Rosenfeld, D M; Ivancic, M G; Hattrup, S J; Renfree, K J; Watkins, A R; Hentz, J G; Gorlin, A W; Spiro, J A; Trentman, T L

    2016-04-01

    This randomised, double-blind, placebo-controlled study compared the effect of perineural with intravenous dexamethasone, both administered concomitantly with interscalene brachial plexus block for shoulder surgery. Patients received 8 mg dexamethasone mixed with ropivacaine in the block injection (n = 42), 8 mg dexamethasone intravenously at the time of the block (n = 37), or intravenous saline (n = 41) at the time of the block. Perineural and intravenous dexamethasone resulted in prolonged mean (SD) duration of block to 16.9 (5.2) h and 18.2 (6.4) h, respectively, compared with 13.8 (3.8) h for saline (p = 0.001). Mean (SD) opioid consumption (morphine equivalents) during the first 24 h after postanaesthesia recovery arrival was 12.2 (9.3) mg in the perineural dexamethasone, 17.1 (15.9) mg in the intravenous dexamethasone and 24.1 (14.3) mg in the saline groups (p = 0.001). Dexamethasone via either route reduced anti-emetic use (p = 0.046). There was no effect on patient satisfaction. These results suggest that both perineural and intravenous dexamethasone are useful adjuncts to ropivacaine interscalene block, with the intravenous route preferred as this avoids the possibility of neural toxicity of dexamethasone. PMID:26899862

  15. 50 CFR 216.35 - Permit restrictions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... parts is subject to the provisions of 50 CFR part 14. (d) The permit holder shall not take from the wild... ADMINISTRATION, DEPARTMENT OF COMMERCE MARINE MAMMALS REGULATIONS GOVERNING THE TAKING AND IMPORTING OF MARINE MAMMALS Special Exceptions § 216.35 Permit restrictions. The following restrictions shall apply to...

  16. 50 CFR 216.35 - Permit restrictions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... parts is subject to the provisions of 50 CFR part 14. (d) The permit holder shall not take from the wild... ADMINISTRATION, DEPARTMENT OF COMMERCE MARINE MAMMALS REGULATIONS GOVERNING THE TAKING AND IMPORTING OF MARINE MAMMALS Special Exceptions § 216.35 Permit restrictions. The following restrictions shall apply to...

  17. 40 CFR 1033.740 - Credit restrictions.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... restrictions. Use of emission credits generated under this part 1033 or 40 CFR part 92 is restricted depending on the standards against which they were generated. (a) Credits from 40 CFR part 92. NOX and PM credits generated under 40 CFR part 92 may be used under this part in the same manner as NOX and...

  18. 40 CFR 1033.740 - Credit restrictions.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... restrictions. Use of emission credits generated under this part 1033 or 40 CFR part 92 is restricted depending on the standards against which they were generated. (a) Credits from 40 CFR part 92. NOX and PM credits generated under 40 CFR part 92 may be used under this part in the same manner as NOX and...

  19. 40 CFR 1033.740 - Credit restrictions.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... restrictions. Use of emission credits generated under this part 1033 or 40 CFR part 92 is restricted depending on the standards against which they were generated. (a) Credits from 40 CFR part 92. NOX and PM credits generated under 40 CFR part 92 may be used under this part in the same manner as NOX and...

  20. 40 CFR 1033.740 - Credit restrictions.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... restrictions. Use of emission credits generated under this part 1033 or 40 CFR part 92 is restricted depending on the standards against which they were generated. (a) Credits from 40 CFR part 92. NOX and PM credits generated under 40 CFR part 92 may be used under this part in the same manner as NOX and...