A protocol for eliciting nonmaterial values through a cultural ecosystem services frame

PubMed Central

Gould, Rachelle K; Klain, Sarah C; Ardoin, Nicole M; Satterfield, Terre; Woodside, Ulalia; Hannahs, Neil; Daily, Gretchen C; Chan, Kai M

2015-01-01

Stakeholders’ nonmaterial desires, needs, and values often critically influence the success of conservation projects. These considerations are challenging to articulate and characterize, resulting in their limited uptake in management and policy. We devised an interview protocol designed to enhance understanding of cultural ecosystem services (CES). The protocol begins with discussion of ecosystem-related activities (e.g., recreation, hunting) and management and then addresses CES, prompting for values encompassing concepts identified in the Millennium Ecosystem Assessment (2005) and explored in other CES research. We piloted the protocol in Hawaii and British Columbia. In each location, we interviewed 30 individuals from diverse backgrounds. We analyzed results from the 2 locations to determine the effectiveness of the interview protocol in elucidating nonmaterial values. The qualitative and spatial components of the protocol helped characterize cultural, social, and ethical values associated with ecosystems in multiple ways. Maps and situational, or vignette-like, questions helped respondents articulate difficult-to-discuss values. Open-ended prompts allowed respondents to express a diversity of ecosystem-related values and proved sufficiently flexible for interviewees to communicate values for which the protocol did not explicitly probe. Finally, the results suggest that certain values, those mentioned frequently throughout the interview, are particularly salient for particular populations. The protocol can provide efficient, contextual, and place-based data on the importance of particular ecosystem attributes for human well-being. Qualitative data are complementary to quantitative and spatial assessments in the comprehensive representation of people's values pertaining to ecosystems, and this protocol may assist in incorporating values frequently overlooked in decision making processes. Un Protocolo para Obtener Valores No Materiales por medio de un Marco de Servicios Ambientales Culturales Resumen Los deseos, necesidades y valores no materiales de los accionistas influyen frecuentemente sobre el éxito de los proyectos de conservación. Estas consideraciones son difíciles de articular y caracterizar, lo que resulta en entendimiento limitado en el manejo y la política. Concebimos un protocolo de entrevista diseñado para mejorar el entendimiento de los servicios ambientales culturales (SAC). El protocolo inicia con la discusión de actividades relacionadas con ecosistemas (p. ej.: recreación, cacería) y manejo; después señala a los SAC, dando pie a los valores que encierran conceptos identificados en la Evaluación Ambiental del Milenio (2005) y explorado en otras investigaciones sobre SAC. Hicimos pruebas piloto del protocolo en Hawái y Columbia Británica. En cada localidad entrevistamos a 30 individuos de diversos entornos. Analizamos los resultados de las dos localidades para determinar la efectividad del protocolo de entrevista en la obtención de valores no materiales. Los componentes cualitativos y espaciales del protocolo nos ayudaron a caracterizar los valores culturales, sociales y éticos asociados con el ecosistema de múltiples maneras. Los mapas y las preguntas de situación, o de tipo viñeta, ayudaron a los encuestados a articular valores difíciles de discutir. Las preguntas abiertas permitieron a los encuestados expresar una diversidad de valores ambientales y demostraron ser suficientemente flexibles para que los encuestados comunicaran valores que el protocolo no buscaba explícitamente. Finalmente, los resultados sugieren que ciertos valores, aquellos mencionados frecuentemente en la entrevista, son particularmente prominentes para poblaciones particulares. El protocolo puede proporcionar datos eficientes, contextuales y basados en lugar sobre la importancia de atributos ambientales particulares para el bienestar humano. Los datos cualitativos son complementarios para las evaluaciones cuantitativas y espaciales en la representación comprensiva de los valores de los valores que pertenecen a los ecosistemas. Este protocolo puede ayudar a incorporar valores frecuentemente ignorados en el proceso de toma de decisiones. PMID:25354730

Barium enema (image)

MedlinePlus

A barium enema is performed to examine the walls of the colon. During the procedure, a well lubricated enema tube is inserted gently into the rectum. The barium, a radiopaque (shows up on X-ray) contrast ...

Perforation and mortality after cleansing enema for acute constipation are not rare but are preventable.

PubMed

Niv, Galia; Grinberg, Tamar; Dickman, Ram; Wasserberg, Nir; Niv, Yaron

2013-01-01

Constipation is a common complaint, frequently treated with cleansing enema. Enemas can be very effective but may cause serious adverse events, such as perforation or metabolic derangement. Our aim was to evaluate the outcome of the use of cleansing enema for acute constipation and to assess adverse events within 30 days of therapy. We performed a two-phase study: an initial retrospective and descriptive study in 2010, followed by a prospective study after intervention, in 2011. According to the results of the first phase we established guidelines for the treatment of constipation in the Emergency Department and then used these in the second phase. There were 269 and 286 cases of severe constipation in the first and second periods of the study, respectively. In the first study period, only Fleet® Enema was used, and in the second, this was changed to Easy Go enema (free of sodium phosphate). There was a 19.2% decrease in the total use of enema, in the second period of the study (P < 0.0001). Adverse events and especially, the perforation rate and the 30-day mortality in patients with constipation decreased significantly in the second phase: 3 (1.4%) versus 0 (P = 0.0001) and 8 (3.9%) versus 2 (0.7%) (P = 0.0001), for perforation and death in the first and second period of the study, respectively. Enema for the treatment of acute constipation is not without adverse events, especially in the elderly, and should be applied carefully. Perforation, hyperphosphatemia (after Fleet Enema), and sepsis may cause death in up to 4% of cases. Guidelines for the treatment of acute constipation and for enema administration are urgently needed.

Perforation and mortality after cleansing enema for acute constipation are not rare but are preventable

PubMed Central

Niv, Galia; Grinberg, Tamar; Dickman, Ram; Wasserberg, Nir; Niv, Yaron

2013-01-01

Objectives Constipation is a common complaint, frequently treated with cleansing enema. Enemas can be very effective but may cause serious adverse events, such as perforation or metabolic derangement. Our aim was to evaluate the outcome of the use of cleansing enema for acute constipation and to assess adverse events within 30 days of therapy. Methods We performed a two-phase study: an initial retrospective and descriptive study in 2010, followed by a prospective study after intervention, in 2011. According to the results of the first phase we established guidelines for the treatment of constipation in the Emergency Department and then used these in the second phase. Results There were 269 and 286 cases of severe constipation in the first and second periods of the study, respectively. In the first study period, only Fleet® Enema was used, and in the second, this was changed to Easy Go enema (free of sodium phosphate). There was a 19.2% decrease in the total use of enema, in the second period of the study (P < 0.0001). Adverse events and especially, the perforation rate and the 30-day mortality in patients with constipation decreased significantly in the second phase: 3 (1.4%) versus 0 (P = 0.0001) and 8 (3.9%) versus 2 (0.7%) (P = 0.0001), for perforation and death in the first and second period of the study, respectively. Conclusion Enema for the treatment of acute constipation is not without adverse events, especially in the elderly, and should be applied carefully. Perforation, hyperphosphatemia (after Fleet Enema), and sepsis may cause death in up to 4% of cases. Guidelines for the treatment of acute constipation and for enema administration are urgently needed. PMID:23658492

EJERCICIO Y LA DETECCION DEL MAL AGUDO DE MONTAÑA GRAVE

PubMed Central

Garófoli, Adrián; Montoya, Paola; Elías, Carlos; Benzo, Roberto

2012-01-01

El Mal Agudo de Montaña (MAM) es un conjunto de síntomas inespecíficos padecidos por sujetos que ascienden rápidamente desde baja a alta altura sin adecuada aclimatación. Usualmente es autolimitado, pero las formas graves (edema pulmonar y cerebral) pueden causar la muerte. La hipoxemia exagerada en reposo está relacionada con el desarrollo de MAM pero su valor predictivo es limitado. Dado que el ejercicio en altura se acompaña de mayor hipoxemia y síntomas, postulamos el valor predictivo de un simple test de ejercicio para pronosticar MAM grave. Se estudió el valor predictivo de la saturación de oxígeno en reposo y ejercicio submáximo a 2 700m y 4 300m en 63 sujetos que ascendían al cerro Aconcagua (6 962m). Se consideró desaturación de oxígeno con ejercicio a una disminución >=5% respecto al reposo. Se utilizó la escala de Lake-Louise para establecer la presencia de MAM grave. 6 sujetos presentaron MAM grave (9.5%) y requirieron evacuación. La saturación de oxígeno en reposo a 2 700m no fue significativa para clasificar sujetos que luego desarrollaron MAM grave. Por el contrario, la asociación de desaturación durante el ejercicio a 2 700m más la saturación inapropiada en reposo a 4 300m fue significativa para clasificar a los sujetos que desarrollaron MAM grave con un valor predictivo positivo de 80% y un valor predictivo negativo del 97%. Nuestros resultados son relevantes para el montañismo y sugieren la adición de un simple test de ejercicio en la predicción del MAM grave. PMID:20228017

Pedagogia artistica: la conceptualizacion y la creatividad en estudiantes de ciencias de sexto grado

NASA Astrophysics Data System (ADS)

Ortiz Colon, Edwin A.

Se realizo un estudio fenomenologico sobre la conceptualizacion, la creatividad y el valor del dibujo en propiciar un contexto creativo para el aprendizaje de ciencias de sexto grado. La conceptualizacion se interpreto como un proceso que ocurre en las relaciones que los estudiantes establecen entre los temas de estudio y las ideas principales, las experiencias previas, las creencias personales, el tiempo y el valor de la conservacion ambiental. La esencia de la creatividad se definio en funcion de la imaginacion, las destrezas, la intencion, la libertad de pensamiento y expresion y el contexto. El dibujo propicio un ambiente creativo de aprendizaje en las ciencias al facilitar el uso del pensamiento cientifico profundo, el inquirir artistico y la expresion libre.

21 CFR 201.304 - Tannic acid and barium enema preparations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... added to barium enemas to improve X-ray pictures. Tannic acid is capable of causing diminished liver... use in enemas. Tannic acid for rectal use to enhance X-ray visualization is regarded as a new drug...

Extreme hyperphosphatemia and hypocalcemic coma associated with phosphate enema.

PubMed

Hsu, Heng Jung; Wu, Mai-Szu

2008-01-01

Fleet enema (sodium phosphate, C.B. Fleet Co., Inc., Lynchburg, Virginia) is widely used for bowel preparation or constipation relief in the hospital and over the counter. The potential risks, including hyperphosphatemia and hypocalcemic coma should be kept in mind of primary care physician. The patients with older age, bowel obstruction, small intestinal disorders, poor gut motility, and renal disease are contraindicated or should be administered with caution. We present a patient with old age and chronic renal failure who developed severe hyperphosphatemia and hypocalcemic tetany with coma after sodium phosphate enema. We recommend the use of alternative enema preparations, such as simple tap water or saline solution enemas, which can prevent fatal complications in high risk patients.

A randomized trial of enema versus polyethylene glycol 3350 for fecal disimpaction in children presenting to an emergency department.

PubMed

Miller, Melissa K; Dowd, Mary Denise; Friesen, Craig A; Walsh-Kelly, Christine M

2012-02-01

This study aimed to compare efficacy of enema versus polyethylene glycol (PEG) 3350 for pediatric fecal impaction treatment. We conducted a prospective, randomized comparison of treatments of fecal impaction in children in a pediatric emergency department (ED). Treatment arms were a single milk and molasses enema in the ED or PEG 3350 for 3 days outpatient. Telephone follow-up was done on days 1, 3, and 5. The primary outcome was main symptom improvement. Additional outcomes were stool frequency, consistency, and ease of stool passage. Treatment failures (home enema, ED return, or hospital admission) were tracked. Seventy-nine subjects participated (39 PEG; 40 enema). At day 1, PEG subjects were less likely to have improved main symptom (odds ratio [OR], 0.3; 95% confidence interval [CI], 0.1-0.8) but no difference in other outcomes. Half (54%) in enema arm were reported as upset by ED therapy, whereas no children in PEG arm were upset (P < 0.05). At day 3, more patients in enema arm reported ideal stool consistency (74% vs 38%; P < 0.05). At day 5, no difference between groups was noted. Most treatment failures were in PEG arm (83%; P = 0.08). This pilot study suggests that disimpaction by enema may be superior to PEG for immediate relief of symptoms. Larger trials are needed to assess any advantage.

Effects of a Glutamine Enema on Anastomotic Healing in an Animal Colon Anastomosis Model

PubMed Central

Oner, Osman Zekai; Oruc, Mehmet Tahir; Bulbuller, Nurullah; Ozdem, Sebahat; Ozdemir, Sukru; Alikanooglu, Arsenal Sezgin; Karakoyun, Rojbin; Dogan, Ugur; Ongen, Ayper; Koc, Umit

2015-01-01

Purpose Anastomotic leakage in colorectal surgery is a very important issue. Although many studies have shown the positive effects of enteral glutamine (Gln) on anastomotic healing, none has assessed the effects of administering Gln via an enema for anastomotic healing. To fill this study gap, this study investigated the intraluminal effect of administration of Gln enema on the healing of colonic anastomosis in a rat model. Methods Thirty Wistar albino rats were divided into three groups containing 10 rats each and were subjected to distal left colon transection and anastomosis. Postoperatively, group I (the control group) was administered no treatment, group II was administered daily placebo enemas containing physiological saline, and group III was administered daily 2% L-Gln enemas. After sacrifice on postoperative day 5, anastomotic healing, burst pressure, tissue hydroxyproline levels, and histological parameters were measured, and group values were compared via statistical analysis. Results Group III was found to have the highest mean bursting pressure and tissue hydroxyproline levels and the lowest mean ischemia score. While the values of these parameters were not found to differ significantly among the groups, the lack of significance may have been due to the limited number of subjects examined. Conclusion Administration of a Gln enema may have a positive effect on anastomosis in terms of bursting pressure and histopathological parameters. Future research should examine administration of a preoperative Gln enema as a means of decreasing the traumatic effects of the enema and identifying its applicability in surgical practice. PMID:26817016

The Malone antegrade continence enema for neurogenic and structural fecal incontinence and constipation.

PubMed

Koyle, M A; Kaji, D M; Duque, M; Wild, J; Galansky, S H

1995-08-01

Problems of fecal elimination are commonly encountered by the pediatric urologist and surgeon. The Malone antegrade continence enema has been described as a means to administer a large volume enema via a continent catheterizable appendicocecostomy, resulting in reliable fecal elimination. Of 22 patients undergoing this procedure 16 reported total continence 4 months or longer after surgery. Complications are relatively minor and tap water appears to be a safe solution for the antegrade continence enema. A nonrefluxing, imbricated appendicocecostomy is preferable to prevent cutaneous fecal or gas leaks.

21 CFR 201.304 - Tannic acid and barium enema preparations.

Code of Federal Regulations, 2010 CFR

2010-04-01

... added to barium enemas to improve X-ray pictures. Tannic acid is capable of causing diminished liver... use in enemas. Tannic acid for rectal use to enhance X-ray visualization is regarded as a new drug within the meaning of section 201(p) of the Federal Food, Drug, and Cosmetic Act. (b) In view of the...

Quantitative distribution of radiolabeled 5-aminosalicylic acid enemas in patients with left-sided ulcerative colitis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vitti, R.A.; Meyers, F.; Knight, L.C.

1989-11-01

Rectally administered suspensions of 5-aminosalicylic acid (5-ASA) are topically effective in treating left-sided ulcerative colitis. The extent to which the contents of these enemas are distributed to inflamed mucosal linings has not previously been determined. This study was undertaken to validate a technique for labeling 5-ASA with 99mTc and to quantitate the distribution of (99mTc)5-ASA in eight patients with left-sided ulcerative colitis. Eight patients underwent three colonic scintigraphic exams within five days, receiving a 60-ml radiolabeled 5-ASA enema into the unprepared rectum for each study, with sequential anterior abdominal images obtained for 4 hr. Activity within the rectum, sigmoid, descending,more » transverse, and ascending colon was quantitated. Over 50% of the labeled enema had advanced beyond the rectum in five of eight patients and in six of eight patients by 30 min and 60 min, respectively. The distribution of (99mTc)5-ASA was quantitatively reproducible when repeated in the same patient on different days, despite apparent visual differences. By 2 hr, the amount of the enema present within the rectum decreased significantly (P less than 0.05) compared to the initial distribution. The amount of enema present within the descending colon was increased significantly at 0.5 hr (P less than 0.05) and at 2 hr (P less than 0.01). There were no significant changes in the distribution from initial values for the sigmoid, transverse, or ascending colon at any time. In each of these cases the spread of the enema to or beyond the extent of disease was documented. In patients with left-sided ulcerative colitis, small volume (99mTc)5-ASA enemas reliably reach the area of inflammation.« less

Incidence, risks and outcome of radiological leak following early contrast enema after anterior resection.

PubMed

Reilly, Frank; Burke, John P; Appelmans, Eline; Manzoor, Talha; Deasy, Joseph; McNamara, Deborah A

2014-04-01

Anastomotic leak (AL) is a major complication following anterior resection for colorectal cancer. Early contrast enema may diagnose subclinical anastomotic leakage. Knowledge of factors concerning AL is vital to its detection. The aim of this study was to define the incidence, risks and outcome of radiological leak following routine early contrast enema after anterior resection. A cohort of 129 patients who underwent anterior resection for colorectal cancer and had an early Gastrografin enema between July 2008 and December 2012 in a tertiary referral centre was identified from a prospective database. The severity of AL was defined using the International Study Group of Rectal Cancer (ISREC) grading system. Of the 129 patients, 65.1 % were male, and the mean age at surgery was 64.6 ± 1.1 years. Gastrografin enema was performed on average on post-operative day 4.8 ± 0.2. Eighteen patients (14.0 %) had a radiological leak on Gastrografin enema, and nine patients (7.0 %) had a clinical AL. On multivariate analysis, only being of male sex and having a loop ileostomy increased the risk of radiological AL. Gastrografin enema had a sensitivity of 100 % (95 % CI 66-100 %) and specificity of 93 % (95 % CI 86-97 %) for predicting clinical AL. Of the 18 patients with radiological leaks, 11 were ISREC grade A, 3 were grade B and 4 were grade C. In the current series, early Gastrografin enema following anterior resection identifies a 14 % radiological leak rate and has a high sensitivity and specificity for predicting clinical AL. The majority of radiological leaks may be managed conservatively.

A controlled trial of colostomy management by natural evacuation, irrigation and foam enema.

PubMed

Doran, J; Hardcastle, J D

1981-10-01

Twenty patients entered a prospective controlled trial of colostomy management by three techniques--natural evacuation, colostomy irrigation and foam enema. Every patient spent 2 months using each technique. The mean number of colostomy actions weekly was 17 during natural evacuation, 6 during irrigation and 10 with the enema. There was no significant difference in the time taken to manage the colostomy by each technique. Eighteen patients considered that both irrigation and the foam enema improved the quality of their life, and opted to continue with irrigation on completion of the study. There were no major complications during the trial but leakage of foam and an increase in flatus were problems with the foam enema. It is concluded that patients should be made aware of the alternative methods available for colostomy management and be encouraged to use the method of their choice.

The value of the preoperative barium-enema examination in the assessment of pelvic masses

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gedgaudas, R.K.; Kelvin, F.M.; Thompson, W.M.

1983-03-01

The value of the barium-enema examination in the assessment of pelvic masses was studied in 44 patients. Findings from those barium-enema examinations and from pathological specimens from 37 patients who had malignant tumors and seven patients who had endometriosis were retrospectively analyzed to determine if the barium-enema examination is useful in differentiating extrinsic lesions with and without invasion of the colon. None of the 12 patients who had extrinsic lesions had any of the criteria that indicated bowel-wall invasion. These criteria included fixation and serrations of the bowel wall in all patients with invasion, and ulceration and fistulizaton in thosemore » patients who had complete transmural invasion. In patients with pelvic masses, the preoperative barium-enema examination may be useful to the surgeon in planning surgery and in preparing the patient for the possibility of partial colectomy or colostomy.« less

Gas-induced susceptibility artefacts on diffusion-weighted MRI of the rectum at 1.5 T - Effect of applying a micro-enema to improve image quality.

PubMed

van Griethuysen, Joost J M; Bus, Elyse M; Hauptmann, Michael; Lahaye, Max J; Maas, Monique; Ter Beek, Leon C; Beets, Geerard L; Bakers, Frans C H; Beets-Tan, Regina G H; Lambregts, Doenja M J

2018-02-01

Assess whether application of a micro-enema can reduce gas-induced susceptibility artefacts in Single-shot Echo Planar Imaging (EPI) Diffusion-weighted imaging of the rectum at 1.5 T. Retrospective analysis of n = 50 rectal cancer patients who each underwent multiple DWI-MRIs (1.5 T) from 2012 to 2016 as part of routine follow-up during a watch-and-wait approach after chemoradiotherapy. From March 2014 DWI-MRIs were routinely acquired after application of a preparatory micro-enema (Microlax ® ; 5 ml; self-administered shortly before acquisition); before March 2014 no bowel preparation was given. In total, 335 scans were scored by an experienced reader for the presence/severity of gas-artefacts (on b1000 DWI), ranging from 0 (no artefact) to 5 (severe artefact). A score ≥3 (moderate-severe) was considered a clinically relevant artefact. A random sample of 100 scans was re-assessed by a second independent reader to study inter-observer effects. Scores were compared between the scans performed without and with a preparatory micro-enema using univariable and multivariable logistic regression taking into account potential confounding factors (age/gender, acquisition parameters, MRI-hardware, rectoscopy prior to MRI). Clinically relevant gas-artefacts were seen in 24.3% (no micro-enema) vs. 3.7% (micro-enema), odds ratios were 0.118 in univariable and 0.230 in multivariable regression (P = 0.0005 and 0.0291). Mean severity score (±SD) was 1.19 ± 1.71 (no-enema) vs 0.32 ± 0.77 (micro-enema), odds ratios were 0.321 (P < 0.0001) and 0.489 (P = 0.0461) in uni- and multivariable regression, respectively. Inter-observer agreement was excellent (κ0.85). Use of a preparatory micro-enema shortly before rectal EPI-DWI examinations performed at 1.5 T MRI significantly reduces both the incidence and severity of gas-induced artefacts, compared to examinations performed without bowel preparation. Copyright © 2017 Elsevier B.V. All rights reserved.

Colonoscopy can miss diverticula of the left colon identified by barium enema.

PubMed

Niikura, Ryota; Nagata, Naoyoshi; Shimbo, Takuro; Akiyama, Junichi; Uemura, Naomi

2013-04-21

To identify the diagnostic value of colonoscopy for diverticulosis as determined by barium enema. A total of 65 patients with hematochezia who underwent colonoscopy and barium enema were analyzed, and the diagnostic value of colonoscopy for diverticula was assessed. The receiver operating characteristic area under the curve was compared in relation to age (< 70 or ≥ 70 years), sex, and colon location. The number of diverticula was counted, and the detection ratio was calculated. Colonic diverticula were observed in 46 patients with barium enema. Colonoscopy had a sensitivity of 91% and specificity of 90%. No significant differences were found in the receiver operating characteristic area under the curve (ROC-AUC) for age group or sex. The ROC-AUC of the left colon was significantly lower than that of the right colon (0.81 vs 0.96, P = 0.02). Colonoscopy identified 486 colonic diverticula, while barium enema identified 1186. The detection ratio for the entire colon was therefore 0.41 (486/1186). The detection ratio in the left colon (0.32, 189/588) was significantly lower than that of the right colon (0.50, 297/598) (P < 0.01). Compared with barium enema, only half the number of colonic diverticula can be detected by colonoscopy in the entire colon and even less in the left colon.

Pharmacokinetics of Caffeine following a Single Administration of Coffee Enema versus Oral Coffee Consumption in Healthy Male Subjects

PubMed Central

Tosri, Nisanuch; Rojanasthien, Noppamas; Srichairatanakool, Somdet; Sangdee, Chaichan

2013-01-01

The objective of this study was to determine the pharmacokinetics of caffeine after single administration of a coffee enema versus coffee consumed orally in healthy male subjects. The study design was an open-label, randomized two-phase crossover study. Eleven healthy subjects were randomly assigned either to receive 500 mL of coffee enema for 10 minutes or to consume 180 mL of ready-to-drink coffee beverage. After a washout period of at least 10 days, all the subjects were switched to receive the alternate coffee procedure. Blood samples were collected immediately before and at specific time points until 12 hours after coffee administration in each phase. The mean caffeine content in both the coffee solution prepared for the coffee enema and the ready-to-drink coffee beverage was not statistically different. The C max and AUC of caffeine obtained from the coffee enema were about 3.5 times significantly less than those of the coffee consumed orally, despite having slightly but statistically faster T max. The t 1/2 of caffeine obtained following both coffee procedures did not statistically differ. In summary, the relative bioavailability of caffeine obtained from the coffee enema was about 3.5 times significantly less than those of the coffee consumed orally. PMID:23533801

Left-colon antegrade continence enema (LACE) procedure for fecal incontinence.

PubMed

Churchill, Bernard M; De Ugarte, Daniel A; Atkinson, James B

2003-12-01

Antegrade continence enemas (ACE) are an efficacious therapeutic option for patients with fecal incontinence. The authors review their institution's experience with a variation of the Monti-Malone ACE procedure using the left colon as a source of an intestinal conduit and enema reservoir. From 2000 to 2002, 18 patients with fecal incontinence or intractable constipation underwent left-colon ACE (LACE) procedure. Concomitant Mitrofanoff appendicovesicostomy was performed in 15 patients and bladder augmentation in 9. The majority of patients had neural tube defects. A segment of left colon was tubularized, tunneled into the muscular wall of the distal colon, and exteriorized through the left upper quadrant or midabdomen. Stomal catherization and enema installation were started one month postoperatively. Fifteen patients (83%) achieved fecal continence, 2 remain incontinent of stool, and 1 experienced stomal closure (mean follow-up was 24 +/- 9 months). Two patients had stomal stenosis that required revision. The mean enema volume in patient's achieving continence was 360 +/- 216 mL, and the mean transit time was 18 +/- 12 minutes. LACE is an efficacious procedure for fecal incontinence that can be performed safely at the time of major urologic reconstruction. Administration of enemas into the left colon has several physiologic advantages that result in predictable bowel evacuation.

Produccion Gaseosa del Cometa Halley: Erupciones Y Fotodisociacion del Radical OH

NASA Astrophysics Data System (ADS)

Silva, A. M.; Mirabel, I. F.

1990-11-01

RESUMEN:En este trabajo informamos la detecci6n de 20 erupciones en la li'nea de =18cm (1667MHz) del radical OH en el Cometa Halley.Las observaciones incluyen todos los monitoreos existentes y se extienden desde 120 dias antes del perihelio hasta 90 dias despues.Se detectan bruscos crecimientos en el flujo medido,hasta un factor 1O,seguidos por decaimientos lentos asociados con la fotodisociaci6n del OH. Se obtuvieron valores para el tiempo de vida fotoquimico del OH y del H2O basandose en el modelo desarrollado previamente por Silva(1988). Esos tiempos de vida estan de acuerdo con predicciones teoricas y con las observaciones en el Ultravioleta, y los resultados, los que son fuertemente dependientes de la velocidad heliocentrica del Coineta (variando hasta un factor 6), han sido calculados para varios rangos de velocidad entre +28 y -28 km/seg. Key wo'L :

Enemas, suppositories and rectal stimulation are not effective in accelerating enteral feeding or meconium evacuation in low-birthweight infants: a systematic review.

PubMed

Kamphorst, Kim; Sietsma, Ydelette; Brouwer, Annemieke J; Rood, Paul J T; van den Hoogen, Agnes

2016-11-01

Early full enteral feeding in preterm infants decreases morbidity and mortality. Our systematic review covered the effectiveness of rectal stimulation, suppositories and enemas on stooling patterns and feeding tolerance in low-birthweight infants born at up to 32 weeks. It comprised seven studies published between 2007 and 2014 and covered 495 infants. Suppositories were ineffective in shortening the time to reach full enteral feeding, and the evidence on enemas was contradictory. Enemas and rectal stimulation did not shorten the time until complete meconium evacuation was reached. Further research into safe, effective interventions to accelerate meconium excretion is needed. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Cost-Effectiveness Analysis of Five Competing Strategies for the Management of Multiple Recurrent Community-Onset Clostridium difficile Infection in France

PubMed Central

Galperine, Tatiana; Denies, Fanette; Lannoy, Damien; Lenne, Xavier; Odou, Pascal; Guery, Benoit; Dervaux, Benoit

2017-01-01

Background Clostridium difficile infection (CDI) is characterized by high rates of recurrence, resulting in substantial health care costs. The aim of this study was to analyze the cost-effectiveness of treatments for the management of second recurrence of community-onset CDI in France. Methods We developed a decision-analytic simulation model to compare 5 treatments for the management of second recurrence of community-onset CDI: pulsed-tapered vancomycin, fidaxomicin, fecal microbiota transplantation (FMT) via colonoscopy, FMT via duodenal infusion, and FMT via enema. The model outcome was the incremental cost-effectiveness ratio (ICER), expressed as cost per quality-adjusted life year (QALY) among the 5 treatments. ICERs were interpreted using a willingness-to-pay threshold of €32,000/QALY. Uncertainty was evaluated through deterministic and probabilistic sensitivity analyses. Results Three strategies were on the efficiency frontier: pulsed-tapered vancomycin, FMT via enema, and FMT via colonoscopy, in order of increasing effectiveness. FMT via duodenal infusion and fidaxomicin were dominated (i.e. less effective and costlier) by FMT via colonoscopy and FMT via enema. FMT via enema compared with pulsed-tapered vancomycin had an ICER of €18,092/QALY. The ICER for FMT via colonoscopy versus FMT via enema was €73,653/QALY. Probabilistic sensitivity analysis with 10,000 Monte Carlo simulations showed that FMT via enema was the most cost-effective strategy in 58% of simulations and FMT via colonoscopy was favored in 19% at a willingness-to-pay threshold of €32,000/QALY. Conclusions FMT via enema is the most cost-effective initial strategy for the management of second recurrence of community-onset CDI at a willingness-to-pay threshold of €32,000/QALY. PMID:28103289

Cost-Effectiveness Analysis of Five Competing Strategies for the Management of Multiple Recurrent Community-Onset Clostridium difficile Infection in France.

PubMed

Baro, Emilie; Galperine, Tatiana; Denies, Fanette; Lannoy, Damien; Lenne, Xavier; Odou, Pascal; Guery, Benoit; Dervaux, Benoit

2017-01-01

Clostridium difficile infection (CDI) is characterized by high rates of recurrence, resulting in substantial health care costs. The aim of this study was to analyze the cost-effectiveness of treatments for the management of second recurrence of community-onset CDI in France. We developed a decision-analytic simulation model to compare 5 treatments for the management of second recurrence of community-onset CDI: pulsed-tapered vancomycin, fidaxomicin, fecal microbiota transplantation (FMT) via colonoscopy, FMT via duodenal infusion, and FMT via enema. The model outcome was the incremental cost-effectiveness ratio (ICER), expressed as cost per quality-adjusted life year (QALY) among the 5 treatments. ICERs were interpreted using a willingness-to-pay threshold of €32,000/QALY. Uncertainty was evaluated through deterministic and probabilistic sensitivity analyses. Three strategies were on the efficiency frontier: pulsed-tapered vancomycin, FMT via enema, and FMT via colonoscopy, in order of increasing effectiveness. FMT via duodenal infusion and fidaxomicin were dominated (i.e. less effective and costlier) by FMT via colonoscopy and FMT via enema. FMT via enema compared with pulsed-tapered vancomycin had an ICER of €18,092/QALY. The ICER for FMT via colonoscopy versus FMT via enema was €73,653/QALY. Probabilistic sensitivity analysis with 10,000 Monte Carlo simulations showed that FMT via enema was the most cost-effective strategy in 58% of simulations and FMT via colonoscopy was favored in 19% at a willingness-to-pay threshold of €32,000/QALY. FMT via enema is the most cost-effective initial strategy for the management of second recurrence of community-onset CDI at a willingness-to-pay threshold of €32,000/QALY.

Intussusception reduction: Effect of air vs. liquid enema on radiation dose.

PubMed

Kaplan, Summer L; Magill, Dennise; Felice, Marc A; Edgar, J Christopher; Anupindi, Sudha A; Zhu, Xiaowei

2017-10-01

Both air and radiopaque liquid contrast are used to reduce ileocolic intussusception under fluoroscopy. Some suggest air lowers radiation dose due to shorter procedure times. However, air enema likely lowers radiation dose regardless of fluoroscopy time due to less density over the automatic exposure control cells. We test the hypothesis that air enema reduction of ileocolic intussusception results in lower radiation dose than liquid contrast enema independent of fluoroscopy time. We describe a role for automatic exposure control in this dose difference. We retrospectively evaluated air and liquid intussusception reductions performed on a single digital fluoroscopic unit during a 26-month period. We compared patient age, weight, gender, exam time of day and year, performing radiologist(s), radiographic image acquisitions, grid and magnification use, fluoroscopy time and dose area product. We compared categorical and continuous variables statistically using chi-square and Mann-Whitney U tests, respectively. The mean dose area product was 2.7-fold lower for air enema, 1.3 ± 0.9 dGy·cm 2 , than for liquid, 3.5 ± 2.5 dGy·cm 2 (P<0.005). The mean fluoroscopy time was similar between techniques. The mean dose area product/min was 2.3-fold lower for air, 0.6 ± 0.2 dGy·cm 2 /min, than for liquid, 1.4 ± 0.5 dGy·cm 2 /min (P<0.001). No group differences were identified in other measured dose parameters. Fluoroscopic intussusception reduction using air enema uses less than half the radiation dose of liquid contrast enema. Dose savings are independent of fluoroscopy time and are likely due to automatic exposure control interaction.

Colonoscopy can miss diverticula of the left colon identified by barium enema

PubMed Central

Niikura, Ryota; Nagata, Naoyoshi; Shimbo, Takuro; Akiyama, Junichi; Uemura, Naomi

2013-01-01

AIM: To identify the diagnostic value of colonoscopy for diverticulosis as determined by barium enema. METHODS: A total of 65 patients with hematochezia who underwent colonoscopy and barium enema were analyzed, and the diagnostic value of colonoscopy for diverticula was assessed. The receiver operating characteristic area under the curve was compared in relation to age (< 70 or ≥ 70 years), sex, and colon location. The number of diverticula was counted, and the detection ratio was calculated. RESULTS: Colonic diverticula were observed in 46 patients with barium enema. Colonoscopy had a sensitivity of 91% and specificity of 90%. No significant differences were found in the receiver operating characteristic area under the curve (ROC-AUC) for age group or sex. The ROC-AUC of the left colon was significantly lower than that of the right colon (0.81 vs 0.96, P = 0.02). Colonoscopy identified 486 colonic diverticula, while barium enema identified 1186. The detection ratio for the entire colon was therefore 0.41 (486/1186). The detection ratio in the left colon (0.32, 189/588) was significantly lower than that of the right colon (0.50, 297/598) (P < 0.01). CONCLUSION: Compared with barium enema, only half the number of colonic diverticula can be detected by colonoscopy in the entire colon and even less in the left colon. PMID:23613630

Thiopental Anesthesia and Tannic Acid Diagnostic Enemas

PubMed Central

Singh, Jasbir; Boyd, Eldon M.

1966-01-01

The administration to albino rats of tannic acid as a retention enema (in doses of 0.2 g./kg. body weight and over) prolonged the duration of anesthesia induced by thiopental given immediately before, or 72 hours after, the tannic acid. This dose of tannic acid corresponds, on the basis of body weight, to a radiodiagnostic enema of 2 1. of 0.25% tannic acid in barium sulfate suspension given to a child weighing 25 kg. By excluding certain hypothermic effects of tannic acid, it was concluded that thiopental potentiation was probably due to impairment by the tannic acid of the liver's ability to detoxify the barbiturate. The results suggest that a drug which is detoxified in the liver should be administered three to five days after a tannic acid-barium sulfate radiodiagnostic enema only with considerable caution. PMID:5947612

DETECTION OF SMALL LESIONS OF THE LARGE BOWEL—Barium Enema Versus Double Contrast

PubMed Central

Robinson, J. Maurice

1954-01-01

Roentgen study with the so-called opaque barium enema with some modifications is superior to double contrast study as the primary means of demonstrating polyps in the colon as well as other lesions. The method described combines fluoroscopy, high kilovoltage radiography, fluoroscopically aimed “spot films” taken with compression, suction and evacuation studies. In this way unsuspected as well as suspected polyps can be demonstrated, particularly if attention is directed to the region where polyps are most likely to be found—namely, the distal third of the large bowel. Double contrast study is quite valuable as a supplement to the modified “single contrast” barium enema, but it has not been sufficiently perfected to replace the modified opaque barium enema as a primary procedure. In many instances a combination of methods will, of course, be required. PMID:13209360

Alleviating debilitating, chronic constipation with colostomy after appendicostomy: a case study.

PubMed

Baig, Mirza K; Boyer, Mary Lou; Marquez, Helen; Wexner, Steven D

2005-12-01

Severe chronic constipation is a debilitating condition. Patients not only experience infrequent bowel movements, but also are often frustrated by the sensation of incomplete evacuation; pain; straining; daily use of enemas; and continual concerns regarding diet, fluids, and medications. Diagnostic tests are performed to rule out organic causes of the condition. Common treatment options consist of dietary fiber supplementation, dietary instruction, adequate fluid intake, enemas, and laxatives; additional noninvasive management includes biofeedback training and botulinum toxin type A injections. Surgery is rarely recommended, although a select group of patients may benefit from antegrade continence enema procedure. A female patient presented with a history of long-standing constipation. When antegrade continence enema offered no improvement and other treatment measures failed, she underwent successful laparoscopic-assisted sigmoid resection and end colostomy. This approach may provide options for patients in similar circumstances.

Small intestinal obstruction by remnants of the omphalomesenteric duct: findings on contrast enema.

PubMed

Fenton, L Z; Buonomo, C; Share, J C; Chung, T

2000-03-01

We reviewed the contrast enema examinations and medical records of six patients with small intestinal obstruction due to omphalomesenteric duct remnant to evaluate for characteristic imaging findings. In five out of the six patients the point of obstruction was demonstrated on the enema; in three patients, the characteristic "beak" of a volvulus was seen, either in the terminal ileum or cecum. In three patients, there was medial deviation of the cecum. The characteristic radiographic features of volvulus at the cecum or terminal ileum and medial deviation of the cecum should suggest persistence of an omphalomesenteric duct remnant as the etiology of obstruction in a child less than 2 years of age. The appearance of omphalomesenteric duct remnant obstruction on enema examination, though not specific, is characteristic and should be familiar to pediatric radiologists.

Development of In Situ Gelling and Bio Adhesive 5-Fluorouracil Enema

PubMed Central

Wang, Lu-Lu; Zheng, Wen-Sheng; Chen, Shao-Hua; Fang, Xia-Qin

2013-01-01

In this study, a novel 5-Fluorouracil (5-FU) enema with good bio adhesion and temperature sensitivity was developed using in situ gelling technology. The preparation was formulated as a free-flowing liquid before use, while a layer of gel film was quickly formed when administered in the rectum, with a large contact surface area. It also demonstrated good biocompatibility, appropriate gel strength and bio adhesive force with excellent adhesion to rectal mucosa and prolonged action time, allowing more effective drug absorption and diffusion to surrounding tissues. Poloxamer 407 and poloxamer 188 were applied to adjust the gelling temperature. With the addition of carbopol and polycarbophil (bio adhesive substances), the solubility of 5-FU and gel strength increased, the temperature of gelation and the surface area of drug contact on mucous epithelium decreased. Decreased adhesive force between the preparation and the mucous membrane of the rectum was demonstrated with improving carbopol and polycarbophil’s concentration. In vitro release demonstrated that 5-FU in situ gelling enema with different bases had a rapid and almost complete drug release. We used an optimized formulation of P407/P188/polycarbophil/5-FU (17/2.5/0.2/1.0) for animal experiments. The result showed that the drug evenly covered the surface of the rectum and there was no leakage in 6 hours. The in situ gelling enema showed significantly higher rectal tissue levels of 5-FU compared with suppository and intravenous administration, indicating that 5-FU could be well absorbed due to the enlarged releasing area, longer retention time and larger amount of dissolved active ingredients. Systemically, 5-FU levels in the enema group were similar to those in the suppository group and significantly lower than the intravenous group. The enema was not associated with morphological damage to rectal tissue. These results suggest that the bio adhesive and in situ gelling enema could be a more effective rectal delivery system of 5-FU. PMID:23976976

Development of in situ gelling and bio adhesive 5-Fluorouracil enema.

PubMed

Wang, Lu-Lu; Zheng, Wen-Sheng; Chen, Shao-Hua; Fang, Xia-Qin

2013-01-01

In this study, a novel 5-Fluorouracil (5-FU) enema with good bio adhesion and temperature sensitivity was developed using in situ gelling technology. The preparation was formulated as a free-flowing liquid before use, while a layer of gel film was quickly formed when administered in the rectum, with a large contact surface area. It also demonstrated good biocompatibility, appropriate gel strength and bio adhesive force with excellent adhesion to rectal mucosa and prolonged action time, allowing more effective drug absorption and diffusion to surrounding tissues. Poloxamer 407 and poloxamer 188 were applied to adjust the gelling temperature. With the addition of carbopol and polycarbophil (bio adhesive substances), the solubility of 5-FU and gel strength increased, the temperature of gelation and the surface area of drug contact on mucous epithelium decreased. Decreased adhesive force between the preparation and the mucous membrane of the rectum was demonstrated with improving carbopol and polycarbophil's concentration. In vitro release demonstrated that 5-FU in situ gelling enema with different bases had a rapid and almost complete drug release. We used an optimized formulation of P407/P188/polycarbophil/5-FU (17/2.5/0.2/1.0) for animal experiments. The result showed that the drug evenly covered the surface of the rectum and there was no leakage in 6 hours. The in situ gelling enema showed significantly higher rectal tissue levels of 5-FU compared with suppository and intravenous administration, indicating that 5-FU could be well absorbed due to the enlarged releasing area, longer retention time and larger amount of dissolved active ingredients. Systemically, 5-FU levels in the enema group were similar to those in the suppository group and significantly lower than the intravenous group. The enema was not associated with morphological damage to rectal tissue. These results suggest that the bio adhesive and in situ gelling enema could be a more effective rectal delivery system of 5-FU.

Use of Antegrade Continence Enema for the Treatment of Fecal Incontinence and Functional Constipation in Adults: A Systematic Review.

PubMed

Patel, Abhilasha S; Saratzis, Athanasios; Arasaradnam, Ramesh; Harmston, Christopher

2015-10-01

Antegrade continence enema is a proximal colonic stoma that allows antegrade lavage of the colon for the treatment of fecal incontinence and functional constipation. Its role in the treatment of these conditions in adults has not been established. This review aimed to evaluate the clinical response and complications of antegrade continence enema in the adult population. A systematic literature search of MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases from January 1980 to October 2013 was conducted. Studies reporting clinical outcomes of antegrade continence enema in adult patients were considered. Only studies with participants aged 16 years and older were selected. Use of the antegrade continence enema for the treatment of constipation and incontinence in adults was investigated. The primary outcome was the number of patients irrigating their stoma. Secondary outcomes included the incidence of stoma stenosis, assessment of functional outcome, and evaluation of quality of life. Overall, 15 studies were selected, describing outcomes in 374 patients. All of the reports were observational cross-sectional studies, and 4 were prospective. The number of participants still using their stoma ranged from 47% to 100% over a follow-up period of 6 to 55 months. Eleven studies reported achievement of full continence in 33% to 100% of patients. Four studies described functional outcomes, and 7 studies reported a wide range of patient satisfaction. The rate of stoma stenosis varied from 8% to 50%. There were considerable heterogeneities within and across studies. Most studies were of poor quality, as reflected in the Methodological Index for Nonrandomized Studies score. Antegrade continence enema has been reported as an acceptable treatment of both functional constipation and fecal incontinence in adults across several analyses. There is wide variation regarding outcome measures. Larger prospective studies are required to assess the role of antegrade continence enema in the adult population.

Tiene Arte Valor Afuera Del Barrio: The Murals of East Los Angeles and Boyle Heights

ERIC Educational Resources Information Center

Holscher, Louis M.

1976-01-01

Discusses the themes of the murals and explores the possible uses that the murals in Los Angeles have for the outsider, the non-Chicano, for those who have only a little understanding or awareness of the Chicano community. (Author/AM)

Adding a custom made pressure release valve during air enema for intussusception: A new technique.

PubMed

Ahmed, Hosni Morsi; Ahmed, Osama; Ahmed, Refaat Khodary

2015-01-01

Non-surgical reduction remains the first line treatment of choice for intussusception. The major complication of air enema reduction is bowel perforation. The authors developed a custom made pressure release valve to be added to portable insufflation devices, delivering air at pressures accepted as safe for effective reduction of intussusception in children under fluoroscopic guidance. The aim of this study was to develop a custom made pressure release valve that is suitable for the insufflation devices used for air enema reduction of intussusception and to put this valve into regular clinical practice. An adjustable, custom made pressure release valve was assembled by the authors using readily available components. The valve was coupled to a simple air enema insufflation device. The device was used for the trial of reduction of intussusception in a prospective study that included 132 patients. The success rate for air enema reduction with the new device was 88.2%. The mean pressure required to achieve complete reduction was 100 mmHg. The insufflation pressure never exceeded the preset value (120 mmHg). Of the successful cases, 58.3% were reduced from the first attempt while 36.1% required a second insufflation. Only 5.55% required a third insufflation to complete the reduction. In cases with unsuccessful pneumatic reduction attempt (18.1%), surgical treatment was required. Surgery ranged from simple reduction to resection with a primary end to end anastomosis. No complications from air enema were recorded. The authors recommend adding pressure release valves to ensure safety by avoiding pressure overshoot during the procedure.

Precisión de las velocidades radiales obtenidas con el REOSC

NASA Astrophysics Data System (ADS)

González, J. F.; Lapasset, E.

Complementando una línea de trabajo iniciada con anterioridad discutimos la estabilidad del espectrógrafo REOSC de CASLEO en DC para la medición de velocidades radiales en base al análisis de observaciones realizadas en enero y abril de 1997. En esas oportunidades obtuvimos 26 espectros de estrellas patrones y 27 espectros de 3 estrellas usadas como estrellas de referencia en nuestro programa de cúmulos abiertos. Además tomamos 26 espectros de crepúsculo con el telescopio en posiciones cubriendo el rango H=-4,+4 y δ =-90,+30. Mediante correlaciones cruzadas derivamos la velocidad de 19 órdenes en cada uno de estos espectros. En base a un análisis estadístico de los datos obtenidos discutimos la contribución de los distintos factores que afectan a la dispersión de lectura observada. En particular, la flexión del instrumento no introduciría errores significativos cuando se observa con masas de aire menores que 2.0. La dispersión de los valores de velocidad medidos para espectros de alta relación S/N de una misma estrella resultó del orden de 0.5 km/s. La comparación con los valores de velocidad publicados por distintos autores para las estrellas patrones no permite distinguir ninguna diferencia sistemática apreciable de las velocidades de CASLEO, siendo la media cuadrática de los residuos del orden de 1.0 km/s.

Sodium Phosphate Rectal

MedlinePlus

... not give the adult-size enema to a child. If you are giving the child-size enema to a child who is 2 to 5 years of age, ... eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. ...

Is knowing believing? The role of event plausibility and background knowledge in planting false beliefs about the personal past.

PubMed

Pezdek, Kathy; Blandon-Gitlin, Iris; Lam, Shirley; Hart, Rhiannon Ellis; Schooler, Jonathan W

2006-12-01

False memories are more likely to be planted for plausible than for implausible events, but does just knowing about an implausible event make individuals more likely to think that the event happened to them? Two experiments assessed the independent contributions o f plausibility a nd background knowledge to planting false beliefs. In Experiment 1, subjects rated 20 childhood events as to the likelihood of each event having happened to them. The list included the implausible target event "received an enema," a critical target event of Pezdek, Finger, and Hodge (1997). Two weeks later, subjects were presented with (1) information regarding the high prevalence rate of enemas; (2) background information on how to administer an enema; (3) neither type of information; or (4) both. Immediately or 2 weeks later, they rated the 20 childhood events again. Only plausibility significantly increased occurrence ratings. In Experiment 2, the target event was changed from "barium enema administered in a hospital" to "home enema for constipation"; significant effects of both plausibility and background knowledge resulted. The results suggest that providing background knowledge can increase beliefs about personal events, but that its impact is limited by the extent of the individual's familiarity with the context of the suggested target event.

Estudio de los Efectos Gravitomagnéticos en Cuerpos Masivos Rotantes

NASA Astrophysics Data System (ADS)

Velandia Heredia, N.; Tejeiro, J. M.

2008-03-01

A partir del estudio de los Efectos Gravitomagnéticos en cuerpos masivos rotantes, planteamos la expresión para medir el desfase en el tiempo, para diferentes observadores, que se dan cuando viajan dos rayos de luz por una guía de onda o de manera libre (geodésicas), en el plano azimutal y en el plano polar. Con lo anterior queremos abordar el experimento tipo Michelson y Morley, de forma que podamos involucrar el valor de la densidad del momento angular (a) en el retraso temporal para los dos haces de luz que viajan por los brazos del interferómetro, cuando este último es ubicado en el plano ecuatorial.

Barium enema and CT volumetry for predicting pathologic response to preoperative chemoradiotherapy in rectal cancer patients.

PubMed

Murono, Koji; Kawai, Kazushige; Tsuno, Nelson H; Ishihara, Soichiro; Yamaguchi, Hironori; Sunami, Eiji; Kitayama, Joji; Watanabe, Toshiaki

2014-06-01

Preoperative chemoradiotherapy has been widely used for the prevention of local recurrence of locally advanced rectal cancer, and the effect of chemoradiotherapy is known to be associated with overall survival. We aimed to evaluate the association of the pathologic response grade with tumor recurrence rate after chemoradiotherapy, using radiographic analysis and the Response Evaluation Criteria in Solid Tumors as the parameters. This study was conducted at a single tertiary care institution in Japan. This was a retrospective cohort study of patients undergoing preoperative chemoradiotherapy. A total of 101 low rectal cancer patients receiving preoperative chemoradiotherapy from July 2004 to August 2012 were enrolled. The tumor reduction rate was measured with the use of traditional Response Evaluation Criteria in Solid Tumors, barium enema, and CT volumetry, and the correlation between the reduction rate and the pathologic response grade was examined. The tumor reduction rate assessed according to Response Evaluation Criteria in Solid Tumors showed no association with the pathologic response grade (p =0.61). In contrast, the radiographic response rate by both barium enema and CT volumetry strongly correlated with the pathologic response grade (p < 0.0001 and p = 0.001).In terms of local tumor recurrence, those diagnosed as high responders by the pathologic response grade, Response Evaluation Criteria in Solid Tumors, barium enema, and CT volumetry had a lower recurrence rate (p =0.03, p =0.03, p =0.0002, and p =0.001). The difference between high responders and low responders was especially prominent by barium enema and CT volumetry. The study is limited by its retrospective nature. Double-contrast barium enema and CT volumetry were superior to Response Evaluation Criteria in Solid Tumors in evaluating the effect of chemoradiotherapy and predicting the likelihood of tumor recurrence.

Efficacy and Safety of Combined Oral and Enema Therapy Using Polyethylene Glycol 3350-Electrolyte for Disimpaction in Pediatric Constipation

PubMed Central

Yoo, Taeyeon

2017-01-01

Purpose We evaluated the efficacy and safety of combined oral and enema therapy using polyethylene glycol (PEG) 3350 with electrolyte solution for disimpaction in hospitalized children. Methods We retrospectively studied 28 children having functional constipation who received inpatient treatment between 2008 and 2016. The amount of oral PEG 3350 electrolyte solution administered was 50–70 mL/kg/d (PEG 3350, 3–4.1 g/kg/d), and an enema solution was administered 1–2 times a day as a single dose of 15–25 mL/kg (PEG 3350, 0.975–1.625 g/kg/d). A colon transit time (CTT) test based on the Metcalf protocol was performed in some patients. Results Administration of oral and enema doses of PEG 3350 electrolyte solution showed 2.1±0.3 times and 2.9±0.4 times, respectively. After disimpaction, the frequency of defecation increased from 2.2±0.3 per week to once a day (1.1±0.1 per day). The number of patients who complained of abdominal pain was reduced from 15 (53.6%) to 4 (14.3%). Before hospitalization, nine patients underwent a CTT test, and 5 of 9 patients (55.6%) were classified as belonging to a group showing abnormalities. And in some patients, mild adverse effects were noted. We examined electrolytes and osmolality before and after disimpaction in 16 of 28 patients, and no abnormalities were noted. Conclusion In terms of therapeutic efficacy and safety, combined oral and enema therapy using high-dose PEG 3350 with electrolytes is considered superior to conventional oral monotherapy or combined oral and enema therapy on an outpatient basis. PMID:29302506

Efficacy and Safety of Combined Oral and Enema Therapy Using Polyethylene Glycol 3350-Electrolyte for Disimpaction in Pediatric Constipation.

PubMed

Yoo, Taeyeon; Bae, Sun Hwan

2017-12-01

We evaluated the efficacy and safety of combined oral and enema therapy using polyethylene glycol (PEG) 3350 with electrolyte solution for disimpaction in hospitalized children. We retrospectively studied 28 children having functional constipation who received inpatient treatment between 2008 and 2016. The amount of oral PEG 3350 electrolyte solution administered was 50-70 mL/kg/d (PEG 3350, 3-4.1 g/kg/d), and an enema solution was administered 1-2 times a day as a single dose of 15-25 mL/kg (PEG 3350, 0.975-1.625 g/kg/d). A colon transit time (CTT) test based on the Metcalf protocol was performed in some patients. Administration of oral and enema doses of PEG 3350 electrolyte solution showed 2.1±0.3 times and 2.9±0.4 times, respectively. After disimpaction, the frequency of defecation increased from 2.2±0.3 per week to once a day (1.1±0.1 per day). The number of patients who complained of abdominal pain was reduced from 15 (53.6%) to 4 (14.3%). Before hospitalization, nine patients underwent a CTT test, and 5 of 9 patients (55.6%) were classified as belonging to a group showing abnormalities. And in some patients, mild adverse effects were noted. We examined electrolytes and osmolality before and after disimpaction in 16 of 28 patients, and no abnormalities were noted. In terms of therapeutic efficacy and safety, combined oral and enema therapy using high-dose PEG 3350 with electrolytes is considered superior to conventional oral monotherapy or combined oral and enema therapy on an outpatient basis.

The effects of acupressure on labor pains during child birth: randomized clinical trial.

PubMed

Mafetoni, Reginaldo Roque; Shimo, Antonieta Keiko Kakuda

2016-08-08

to analyze the effects of acupressure on the sanyinjiao point for pregnant women in labor at public maternity wards. single-blind controlled clinical trial, randomly done employing a pragmatic profile. We selected 156 pregnant women in their ≥ 37 week/s, who had cervical dilations of ≥ 4 cm and with two or more contractions in 10 minutes. The pregnant women were randomly divided into three groups at a university hospital in the suburbs of Sao Paulo, Brazil, in order to receive either acupressure treatment, a placebo or participate as part of a control group. The acupressure was applied on the sanyinjiao point during the contractions for 20 minutes. Then the intensity of the pain was evaluated using the Visual Analogue Scale (VAS). The averages for the pain measured using the VAS were not different for the three groups that were a part of the study (p-value=0.0929), however they were less in the acupressure groups immediately after receiving the treatment (p-value=<0.0001). This was also the case where the treatment lasted for 1 hour (p-value=0.0001). This was the case in comparison with placebo and control groups. the use of acupressure on the sanyinjiao point is a useful way to alleviate pain in a non-invasive manner. It can improve the quality of care given to pregnant women in labor. Register: RBR-9mhs8r. analisar os efeitos da acupressão no ponto sanyinjiao sobre a dor na fase ativa do trabalho de parto, em gestantes atendidas em maternidade pública. trata-se de um ensaio clínico controlado e randomizado, simples-cego e de caráter pragmático. Foram selecionadas 156 mulheres com idade gestacional ≥ 37 semanas, dilatação cervical ≥ 4 cm e com duas ou mais contrações em 10 minutos. As gestantes foram divididas aleatoriamente em três grupos em um hospital universitário do interior do estado de São Paulo, Brasil, para receber acupressão, placebo ou participar como controle. A acupressão foi aplicada no ponto sanyinjiao durante as contrações, por 20 minutos, e a intensidade da dor avaliada por meio de uma Escala Analógica Visual (EAV). as médias de dor pela EAV não foram diferentes nos três grupos na admissão (p-valor=0,0929), porém foram menores no grupo de acupressão imediatamente após (p-valor=<0,0001) e com 1 h do tratamento (p-valor=0,0001) ao se comparar com placebo e controle. a acupressão no ponto sanyinjiao se mostrou uma medida útil no alívio da dor, não invasiva e um meio de melhorar a qualidade dos cuidados a parturiente. Registro: RBR-9mhs8r. analizar los efectos de la acupresión, en el punto sanyinjiao, sobre el dolor en la fase activa del trabajo de parto, en embarazadas atendidas en maternidad pública. ensayo clínico controlado y aleatorio, simple ciego y de carácter pragmático. Fueron seleccionadas 156 mujeres con edad gestacional ≥ 37 semanas, dilatación cervical ≥ 4 cm y con dos o más contracciones en 10 minutos. Las embarazadas fueron divididas aleatoriamente en tres grupos en un hospital universitario del interior del estado de Sao Paulo, Brasil, para recibir acupresión, placebo o participar como control. La acupresión fue aplicada en el punto sanyinjiao durante las contracciones, por 20 minutos; la intensidad del dolor fue evaluada por medio de una Escala Analógica Visual (EAV). los promedios del dolor por la EAV no fueron diferentes en los tres grupos en la admisión (valor p=0,0929), sin embargo fueron menores en el grupo de acupresión inmediatamente después (valor p=<0,0001) y también después de 1 hora del tratamiento (valor p=0,0001) al compararse con el placebo y control. la acupresión en el punto sanyinjiao se mostró una medida útil en el alivio del dolor, no invasiva y un medio de mejorar la calidad de los cuidados la parturienta. Registro: RBR-9mhs8r.

21 CFR 201.307 - Sodium phosphates; package size limitation, warnings, and directions for over-the-counter sale.

Code of Federal Regulations, 2014 CFR

2014-04-01

... ingredient when marketed as described in paragraph (a) of this section is misbranded within the meaning of... can be harmful.” (ii) Rectal enema dosage forms. “Using more than one enema in 24 hours can be harmful...

21 CFR 201.307 - Sodium phosphates; package size limitation, warnings, and directions for over-the-counter sale.

Code of Federal Regulations, 2011 CFR

2011-04-01

... ingredient when marketed as described in paragraph (a) of this section is misbranded within the meaning of... can be harmful.” (ii) Rectal enema dosage forms. “Using more than one enema in 24 hours can be harmful...

21 CFR 201.307 - Sodium phosphates; package size limitation, warnings, and directions for over-the-counter sale.

Code of Federal Regulations, 2013 CFR

2013-04-01

... ingredient when marketed as described in paragraph (a) of this section is misbranded within the meaning of... can be harmful.” (ii) Rectal enema dosage forms. “Using more than one enema in 24 hours can be harmful...

21 CFR 201.307 - Sodium phosphates; package size limitation, warnings, and directions for over-the-counter sale.

Code of Federal Regulations, 2012 CFR

2012-04-01

... ingredient when marketed as described in paragraph (a) of this section is misbranded within the meaning of... can be harmful.” (ii) Rectal enema dosage forms. “Using more than one enema in 24 hours can be harmful...

Percutaneous endoscopic colostomy of the left colon: a new technique for management of intractable constipation in children.

PubMed

Rawat, David J; Haddad, Munther; Geoghegan, Niamh; Clarke, Simon; Fell, John M

2004-07-01

The antegrade colonic enema is accepted as effective for management of intractable constipation in children when conventional bowel management has failed. This study describes experience with a new, minimally invasive technique, the distal antegrade colonic enema, which involves percutaneous endoscopic colostomy of the left colon. Fifteen children with refractory constipation and soiling who had radiographic evidence of megarectum and/or distal colonic delay were selected for the procedure. The junction of the descending and the sigmoid colon was identified colonoscopically, and the percutaneous endoscopic colostomy tube, through which antegrade distal colonic enema are administered, was inserted. Fourteen children underwent distal percutaneous endoscopic colostomy insertion. The median time required for the procedure was 30 minutes (20-50 minutes). Excluding one child (technical difficulties with percutaneous endoscopic colostomy placement), median post-procedural hospital stay was 4 days (2-27 days). Thirteen children were no longer soiling, and improvement in quality of life was reported at 2 months' follow-up. At 6 months' follow-up, 90% of children were clean during intervals between enemas. All children evaluated at 12 months' follow-up remained clean. Median duration of follow-up was 12.5 months (2-51 months). The distal percutaneous endoscopic colostomy is a simple alternative to established methods for delivery of antegrade enemas. It is less invasive and on reversal leaves only minor scarring.

Oral 5-Aminosalicylate, Mesalamine Suppository, and Mesalamine Enema as Initial Therapy for Ulcerative Proctitis in Clinical Practice with Quality of Care Implications.

PubMed

Richter, James M; Arshi, Nabeela K; Oster, Gerry

2016-01-01

Background. Ulcerative proctitis (UP) is typically treated initially with oral 5-aminosalicylate ("5-ASA"), mesalamine suppository, or mesalamine enema ("UP Rx"). Little is known about their effectiveness in practice. Methods. Using a US health insurance database, we identified new-onset UP patients between January 1, 2005, and December 31, 2007, based on the following: (1) initiation of UP Rx; (2) endoscopy in prior 30 days resulting in diagnosis of UP; and (3) no prior encounters for ulcerative colitis or Crohn's disease. We examined the incidence of therapy escalation and total costs in relation to initial UP Rx. Results. We identified 548 patients: 327 received mesalamine suppository, 138 received oral 5-ASA, and 83 received mesalamine enema, as initial UP Rx. One-third receiving oral 5-ASA experienced therapy escalation over 12 months, 21% for both mesalamine suppository and enema. Mean cumulative total cost of UP Rx over 12 months was $1552, $996, and $986 for patients beginning therapy with oral 5-ASA, mesalamine enema, and mesalamine suppository, respectively. Contrary to expert recommendations the treatments were often not continued prophylactically. Conclusions. Treatment escalation was common, and total costs of therapy were higher, in patients who initiated treatment with oral 5-ASA. Further study is necessary to assess the significance of these observations.

Oral 5-Aminosalicylate, Mesalamine Suppository, and Mesalamine Enema as Initial Therapy for Ulcerative Proctitis in Clinical Practice with Quality of Care Implications

PubMed Central

Richter, James M.; Arshi, Nabeela K.; Oster, Gerry

2016-01-01

Background. Ulcerative proctitis (UP) is typically treated initially with oral 5-aminosalicylate (“5-ASA”), mesalamine suppository, or mesalamine enema (“UP Rx”). Little is known about their effectiveness in practice. Methods. Using a US health insurance database, we identified new-onset UP patients between January 1, 2005, and December 31, 2007, based on the following: (1) initiation of UP Rx; (2) endoscopy in prior 30 days resulting in diagnosis of UP; and (3) no prior encounters for ulcerative colitis or Crohn's disease. We examined the incidence of therapy escalation and total costs in relation to initial UP Rx. Results. We identified 548 patients: 327 received mesalamine suppository, 138 received oral 5-ASA, and 83 received mesalamine enema, as initial UP Rx. One-third receiving oral 5-ASA experienced therapy escalation over 12 months, 21% for both mesalamine suppository and enema. Mean cumulative total cost of UP Rx over 12 months was $1552, $996, and $986 for patients beginning therapy with oral 5-ASA, mesalamine enema, and mesalamine suppository, respectively. Contrary to expert recommendations the treatments were often not continued prophylactically. Conclusions. Treatment escalation was common, and total costs of therapy were higher, in patients who initiated treatment with oral 5-ASA. Further study is necessary to assess the significance of these observations. PMID:27446860

Fatal Liver Damage After Barium Enemas Containing Tannic Acid

PubMed Central

Lucke, Hans H.; Hodge, Kenneth E.; Patt, Norman L.

1963-01-01

Tannic acid contained in the barium enema was found to have been the sole known potential hepatotoxin in four of the five cases of fulminating fatal liver failure that occurred in a 213-bed hospital over a period of 27 months. In the other case halothane anesthesia had also been administered. Autopsies (performed on four of the cases) did not suggest viral hepatitis but showed substantially indentical hepatic changes, not unlike those reported in the past following tannic acid exposure. Proof is not claimed that tannic acid was the cause of these deaths, but further investigation regarding the safety of its administration in barium enemas is advocated. ImagesFig. 1 PMID:14079135

[Not Available].

PubMed

Zubiaga, Lorea; Ruiz-Tovar, Jaime; Giner, Lorena; González, Juan; Aguilar, María Del Mar; García, Alejandro; Calpena, Rafael; Durán, Manuel

2016-07-19

Introducción y objetivo: el IMC puede resultar engañoso para ciertas complexiones corporales, por lo que se han propuesto otros parámetros como la adiposidad (calculada a través de fórmula CUN-BAE,) el índice de Framingham de riesgo cardiovascular (IF) y el índice aterogénico (IA) (rCT/HDL-c) como predictores de riesgo cardiovascular. Se propone comparar estos factores como marcadores de éxito terapéutico tras cirugía en pacientes obesos sometidos a gastrectomía vertical laparoscópica (GVL) como procedimiento de cirugía bariátrica.Material y métodos: realizamos un estudio observacional prospectivo de pacientes sometidos a GVL y con un periodo de seguimiento mínimo de 1 año. Analizamos la evolución de IMC, adiposidad, IF e IA.Resultados: analizamos 140 pacientes. El IMC preoperatorio fue de 49,1 kg/m2, con una adiposidad del 54,8%, un IF 7,54% y un IA de 4,2. A los 12 meses el IMC era de 28,4 kg/m2, con una adiposidad del 39,4%, un IF del 3,7% y un IA de 1,64. En función de estos resultados, a los 12 meses el IMC medio está en rango de sobrepeso, la adiposidad en niveles de obesidad (obesidad: > 25% en hombres y > 35% en mujeres), el IF en rango de riesgo cardiovascular bajo (< 5%) y el IA dentro del rango de normalidad (< 3). Correlacionando estos parámetros observamos que el IMC se correlaciona con la adiposidad tanto en valores preoperatorios (Pearson 0,486; p = 0,004), posoperatorios (Pearson 0,957; p < 0,001), como en la diferencia entre ambos (Pearson 0,606; p = 0,017), lo cual es lógico, porque el IMC se incluye en la fórmula CUN-BAE para el cálculo de la adiposidad. En los valores posoperatorios se objetiva una correlación de la adiposidad con el IF (Pearson 0,814, p = 0,036) y con el IA (Pearson 0,517; p = 0,049). En los valores preoperatorios no se objetivan dichas correlaciones. El IMC no se correlacionó con la adiposidad.Conclusión: la adiposidad se correlaciona con índices de riesgo cardiovascular, como el índice de Framingham o el índice aterogénico, pero solo en las determinaciones posoperatorias. Estos elementos suponen herramientas útiles para valorar la disminución del riesgo de enfermedad cardiovascular después de cirugía bariátrica.

Effectiveness of therapeutic barium enema for diverticular hemorrhage

PubMed Central

Matsuura, Mizue; Inamori, Masahiko; Nakajima, Atsushi; Komiya, Yasuhiko; Inoh, Yumi; Kawasima, Keigo; Naitoh, Mai; Fujita, Yuji; Eduka, Akiko; Kanazawa, Noriyoshi; Uchiyama, Shiori; Tani, Rie; Kawana, Kennichi; Ohtani, Setsuya; Nagase, Hajime

2015-01-01

AIM: To evaluate the effectiveness of barium impaction therapy for patients with colonic diverticular bleeding. METHODS: We reviewed the clinical charts of patients in whom therapeutic barium enema was performed for the control of diverticular bleeding between August 2010 and March 2012 at Yokohama Rosai Hospital. Twenty patients were included in the review, consisting of 14 men and 6 women. The median age of the patients was 73.5 years. The duration of the follow-up period ranged from 1 to 19 mo (median: 9.8 mo). Among the 20 patients were 11 patients who required the procedure for re-bleeding during hospitalization, 6 patients who required it for re-bleeding that developed after the patient left the hospital, and 3 patients who required the procedure for the prevention of re-bleeding. Barium (concentration: 150 w%/v%) was administered per the rectum, and the leading edge of the contrast medium was followed up to the cecum by fluoroscopy. After confirmation that the ascending colon and cecum were filled with barium, the enema tube was withdrawn, and the patient’s position was changed every 20 min for 3 h. RESULTS: Twelve patients remained free of re-bleeding during the follow-up period (range: 1-19 mo) after the therapeutic barium enema, including 9 men and 3 women with a median age of 72.0 years. Re-bleeding occurred in 8 patients including 5 men and 3 women with a median age of 68.5 years: 4 developed early re-bleeding, defined as re-bleeding that occurs within one week after the procedure, and the remaining 4 developed late re-bleeding. The DFI (disease-free interval) decreased 0.4 for 12 mo. Only one patient developed a complication from therapeutic barium enema (colonic perforation). CONCLUSION: Therapeutic barium enema is effective for the control of diverticular hemorrhage in cases where the active bleeding site cannot be identified by colonoscopy. PMID:25987779

Pediatric constipation in the emergency department: evaluation, treatment, and outcomes.

PubMed

Freedman, Stephen B; Thull-Freedman, Jennifer; Rumantir, Maggie; Eltorki, Mohamed; Schuh, Suzanne

2014-09-01

Limited knowledge exists surrounding the pharmacologic management of pediatric constipation in the emergency department (ED) setting and the success of interventions. Our primary objective was to determine whether enema administration is associated with 7-day ED revisits for persistent symptoms. Secondary objectives focused on assessing other predictors of ED revisits. We conducted a retrospective cohort study of children <18 years old, diagnosed as having constipation (International Classification of Diseases-10 codes F98.1 nonorganic encopresis, K59.0 constipation) in a pediatric ED in Toronto, Canada, between November 2008 and October 2010. A total of 3592 visits were included; 6% (n = 225) were associated with a revisit. Children with revisits more frequently had vomiting (28% vs 17%, P = 0.001), more pain (5.7 ± 3.6 vs 4.6-3.6 of 10, P = 0.01), and underwent more blood tests (19% 05, 11%, 95% confidence interval [CI] of the difference 3%-14%] and diagnostic imaging (62% vs 47%, 95% CI of the difference 9%-22%). Children administered an enema were 1.54 times more likely to revisit the ED than those who did not receive an enema (8.6% vs 5.5%, 95% CI of the difference 1.1%-5.2%, P = 0.001). Type of enema administered varied by age (P < 0.001). Regression analysis identified the following independent predictors of revisits: diagnostic imaging (odds ratio [OR] 1.54, 95% CI 1.15-2.06), vomiting (OR 1.45, 95% CI 1.07-1.98), enema administration (OR 1.40, 95% CI 1.05-1.88), and significant medical history (OR 1.26, 95% CI 1.04-1.53). Enema administration and diagnostic imaging are associated with revisits in children diagnosed with constipation. Their role in the ED management of pediatric constipation requires further evaluation.

Post Anesthesia Care Unit Patient Classification System: The Direct Care Nursing Time Component

DTIC Science & Technology

1991-07-18

Removal 1304 Enema - Cleansing 1305 Enema - Retention 1306 Colostomy - Irrigation 1307 Colostomy - Dressing Change 1308 Lavage 1309 Paracentesis 1310...Curettage 1910 Vaginal /Pelvic Ex,.iiination 1911 Urinary Bladder Training 1912 Condom Catheter Application 1913 Peritoneal Dialysis - Initiation 1914...Hypothermia/Hyperthermia Treatment 2101 Oral Medication 2102 Intramuscular Medication 2103 Subcutaneous Medication 2104 Suppository, Rectal/ Vaginal

Poblaciones de los niveles atómicos en condiciones de no equilibrio

NASA Astrophysics Data System (ADS)

Cruzado, A.

El objetivo de este trabajo es encontrar la distribución de los átomos en los diferentes niveles de energía. Con el propósito de encontrar resultados generales y de amplia aplicación, hemos planteado las ecuaciones de equilibrio estadístico como función del número atómico del elemento a considerar y de las condiciones físicas del medio (temperatura y densidad). Así también se ha intentado tener en cuenta todos los niveles atómicos considerando explícitamente aquellos con un número cuántico principal menor que un cierto valor n y calculando una expresión aproximada para estimar la influencia de los demás.

Influencia atmosférica en la rotación terrestre

NASA Astrophysics Data System (ADS)

Fernández, L. I.; Arias, E. F.; Brunini, C. A.

Las observaciones de los parámetros de la orientación terrestre han alcanzado en estos últimos años una exactitud sin precedentes gracias al uso de modernas técnicas de geodesia espacial. Estudios previos han establecido que las variaciones en la rotación terrestre con períodos iguales o menores que dos años obedecen a cambios en la circulación atmosférica global. Para estos períodos puede comprobarse que existe un gran acuerdo entre las fluctuaciones de la longitud del día (LOD) y los cambios del momento angular atmosférico terrestre (AAM). Sin embargo, no existe un acuerdo general acerca de las causas que provocan las variaciones de largo período de la rotación de la Tierra, también conocidas como ``variaciones decenales''. En nuestro análisis examinamos las correlaciones entre las variaciones de los valores de LOD y las fluctuaciones en la componente polar del momento angular atmosférico terrestre. Con este propósito utilizamos los siguientes juegos de datos: las series de AAM, estimado siguiendo la definición de Barnes et al.(1983) para 2825 días provientes del National Meteorological Center (NMC) y del European Centre for Medium Range Weather Forecast (ECMWF); y las series de LOD que contienen valores alisados espaciados a intervalos de un día elaborados por el International Earth Rotation Service (IERS). Mostraremos que para los cambios anuales e interanuales en la rotación de la Tierra la influencia atmosférica es asombrosa, mientras que, tanto en las escalas temporales más grandes y como en las más pequeñas, ambas series, geodésica y atmosférica, parecen diverger aún cuando poseemos observaciones obtenidas con las técnicas más modernas al presente.

[Presentation of the Editor of Gaceta Médica de México].

PubMed

Treviño-Becerra, Alejandro

La Gaceta Médica de México (GMM) es nuestro órgano oficial de divulgación que muestra los valores de la Academia Nacional de Medicina de México. Sirve como identidad del médico mexicano con sus académicos y divulga los fundamentos científicos de la práctica médica nacional.

Use of butyrate or glutamine in enema solution reduces inflammation and fibrosis in experimental diversion colitis

PubMed Central

Pacheco, Rodrigo Goulart; Esposito, Christiano Costa; Müller, Lucas CM; Castelo-Branco, Morgana TL; Quintella, Leonardo Pereira; Chagas, Vera Lucia A; de Souza, Heitor Siffert P; Schanaider, Alberto

2012-01-01

AIM: To investigate whether butyrate or glutamine enemas could diminish inflammation in experimental diversion colitis. METHODS: Wistar specific pathogen-free rats were submitted to a Hartmann’s end colostomy and treated with enemas containing glutamine, butyrate, or saline. Enemas were administered twice a week in the excluded segment of the colon from 4 to 12 wk after the surgical procedure. Follow-up colonoscopy was performed every 4 wk for 12 wk. The effect of treatment was evaluated using video-endoscopic and histologic scores and measuring interleukin-1β, tumor necrosis factor-alpha, and transforming growth factor beta production in organ cultures by enzyme linked immunosorbent assay. RESULTS: Colonoscopies of the diverted segment showed mucosa with hyperemia, increased number of vessels, bleeding and mucus discharge. Treatment with either glutamine or butyrate induced significant reductions in both colonoscopic (P < 0.02) and histological scores (P < 0.01) and restored the densities of collagen fibers in tissue (P = 0.015; P = 0.001), the number of goblet cells (P = 0.021; P = 0.029), and the rate of apoptosis within the epithelium (P = 0.043; P = 0.011) to normal values. The high levels of cytokines in colon explants from rats with diversion colitis significantly decreased to normal values after treatment with butyrate or glutamine. CONCLUSION: The improvement of experimental diversion colitis following glutamine or butyrate enemas highlights the importance of specific luminal nutrients in the homeostasis of the colonic mucosa and supports their utilization for the treatment of human diversion colitis. PMID:22969190

History, evolution, and current status of radiologic imaging tests for colorectal cancer screening.

PubMed

Levine, Marc S; Yee, Judy

2014-11-01

Colorectal cancer screening is thought to be an effective tool with which to reduce the mortality from colorectal cancer through early detection and removal of colonic adenomas and early colon cancers. In this article, we review the history, evolution, and current status of imaging tests of the colon-including single-contrast barium enema, double-contrast barium enema, computed tomographic (CT) colonography, and magnetic resonance (MR) colonography-for colorectal cancer screening. Despite its documented value in the detection of colonic polyps, the double-contrast barium enema has largely disappeared as a screening test because it is widely perceived as a labor-intensive, time-consuming, and technically demanding procedure. In the past decade, the barium enema has been supplanted by CT colonography as the major imaging test in colorectal cancer screening in the United States, with MR colonography emerging as another viable option in Europe. Although MR colonography does not require ionizing radiation, the radiation dose for CT colonography has decreased substantially, and regular screening with this technique has a high benefit-to-risk ratio. In recent years, CT colonography has been validated as an effective tool for use in colorectal cancer screening that is increasingly being disseminated.

Meta-analysis: the efficacy of rectal beclomethasone dipropionate vs. 5-aminosalicylic acid in mild to moderate distal ulcerative colitis.

PubMed

Manguso, F; Balzano, A

2007-07-01

Beclomethasone dipropionate (BDP) is a second-generation steroid with topical effects and minimal systemic activity for patients with ulcerative colitis (UC). To review all available literature to assess the efficacy of enema/foam BDP compared with enema/foam 5-aminosalicylic acid (5-ASA) in the control of left-sided mild-moderate UC. We selected randomized controlled trials of enema/foam BDP compared with enema/foam 5-ASA treatment in patients with UC. Two reviewers assessed trial quality and extracted data independently. Four trials involving 428 UC patients, 209 treated with 5-ASA (1-4 g o.d.) and 219 with BDP (3 mg o.d.), were included. Intention-to-treat analysis showed that 5-ASA induced improvement/remission of UC in 146 (69.9%) patients, while BDP in 143 (65.3%). The test for heterogeneity (Cochran Q) was not significant and Mantel-Haenszel pooled estimate of odds ratio was 1.23 (95% CI = 0.82-1.85). The results did not change when analysis was performed on a per-protocol basis. The randomized controlled trials identified in this review showed that rectal BDP has equal effect as 5-ASA to control symptoms in UC.

Kangfuxinye Enema Combined with Mesalamine for Ulcerative Colitis: A Systematic Review and GRADE Approach

PubMed Central

Ren, Peng-wei; Yang, Wen-jie; Shan, Jing-yan; Hong, Qi; Wen, Shu

2017-01-01

Objectives To critically appraise the efficacy and safety of Kangfuxinye enema combined with mesalamine for the ulcerative colitis (UC) patients and in addition to grade the quality of evidence by using the GRADE (grading of recommendations, assessment, development, and evaluation) approach. Methods A literature search was performed in the Cochrane Library, MEDLINE, EMBASE, CBM, CNKI, VIP, and WanFang Databases. The search restrictions were patients with UC and RCTs. Studies including other treatments except Kangfuxinye with mesalamine were excluded. Results Nineteen studies met the inclusion criteria. We found significant benefits of Kangfuxinye combined with mesalamine against mesalamine alone in improving response rate as well as reducing the recurrence rate and inflammation rate; meanwhile, the increase of the adverse events rate was not observed. Furthermore, the symptoms remission rate and the cure time were insignificant statistically. Additionally, GRADE results indicated that the quality of evidence regarding the above 6 outcomes was rated from very low to moderate quality. Conclusions Although Kangfuxinye enema seems effective and safe for treating UC patients in this systematic review, Kangfuxinye enema combined with mesalamine was weakly recommended due to very low to moderate quality of available evidence by the GRADE approach. PMID:28848616

Renal excretion of water-soluble contrast media after enema in the neonatal period.

PubMed

Kim, Hee Sun; Je, Bo-Kyung; Cha, Sang Hoon; Choi, Byung Min; Lee, Ki Yeol; Lee, Seung Hwa

2014-08-01

When abdominal distention occurs or bowel obstruction is suspected in the neonatal period, a water-soluble contrast enema is helpful for diagnostic and therapeutic purposes. The water-soluble contrast medium is evacuated through the anus as well as excreted via the kidneys in some babies. This study was designed to evaluate the incidence of renal excretion after enemas using water-soluble contrast media and presume the causes. Contrast enemas using diluted water-soluble contrast media were performed in 23 patients under 2 months of age. After the enema, patients were followed with simple abdominal radiographs to assess the improvement in bowel distention, and we could also detect the presence of renal excretion of contrast media on the radiographs. Reviewing the medical records and imaging studies, including enemas and consecutive abdominal radiographs, we evaluated the incidence of renal excretion of water-soluble contrast media and counted the stay duration of contrast media in urinary tract, bladder, and colon. Among 23 patients, 12 patients (52%) experienced the renal excretion of water-soluble contrast media. In these patients, stay-in-bladder durations of contrast media were 1-3 days and stay-in-colon durations of contrast media were 1-10 days, while stay-in-colon durations of contrast media were 1-3 days in the patients not showing renal excretion of contrast media. The Mann-Whitney test for stay-in-colon durations demonstrated the later evacuation of contrast media in the patients with renal excretion of contrast media (p = 0.07). The review of the medical records showed that 19 patients were finally diagnosed as intestinal diseases, including Hirschsprung's disease, meconium ileum, meconium plug syndrome, and small bowel atresia or stenosis. Fisher's exact test between the presence of urinary excretion and intestinal diseases indicated a statistically significant difference (p = 0.04). The intestinal diseases causing bowel obstruction may increase the water-soluble contrast media's dwell time in the bowel and also increase urinary excretion. Copyright © 2013. Published by Elsevier B.V.

The novel appearance of low rectal anastomosis on contrast enema following laparoscopic anterior resection: discriminating anastomotic leaks from "dog-ears" on water-soluble contrast enema and flexible sigmoidoscopy.

PubMed

Katory, Mark; McLean, Ross; Osman, Khalid; Ahmad, Mukhtar; Hughes, Tracey; Newby, Mike; Dennison, Christopher; O'Loughlin, Paul

2017-02-01

Interpretation of water-soluble contrast enema following laparoscopic low anterior resection can be very challenging for both radiologists and colorectal surgeons. Discriminating the radiological appearances secondary to anastomotic configuration from those caused by actual anastomotic dehiscence is a common problem and may be made worse with the advent of laparoscopic surgery. The aim of this study is to identify potential novel appearances of the water-soluble contrast enema (WSCE) images of rectal anastomosis following laparoscopic low anterior resection to radiologists and surgeons. We enrolled 45 patients who underwent laparoscopic low anterior resection with proximal de-functioning loop ileostomy within a specialized colorectal unit. The water-soluble contrast enema reports were reviewed. Two blinded colorectal radiologists independently reviewed the images of patients suspected of anastomotic leak. All of these patients also underwent a flexible sigmoidoscopy to confirm or exclude anastomotic leak before reversal of loop ileostomy. Inter-observer concordance was calculated. Seven out of eighteen patients (38.9%) were found to have true anastomotic leaks on flexible sigmoidoscopy (15% overall leak rate). In the remaining eleven patients the image appearances were attributed to the appearance of the anastomotic 'dog-ear effect', created by the anastomotic configuration due to multiple firing of the intra-corporeal laparoscopic stapling device. Radiologist inter-observer concordance was 83%. Sensitivity was 100%, specificity 71%, positive-predictive value (38.9%) and negative-predictive value (100%). The novel appearances of laparoscopic-stapled rectal anastomoses in WSCE can be mistaken for anastomotic leak. To avoid delay in reversal of ileostomy, a flexible sigmoidoscopy can be used to confirm or exclude a leak.

Paeonol attenuates TNBS-induced colitis by inhibiting NF-{kappa}B and STAT1 transactivation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ishiguro, Kazuhiro; Ando, Takafumi; Maeda, Osamu

2006-11-15

Paeonol, a major phenolic component of Moutan Cortex, is known to have anti-inflammatory activity. However, the effect of Paeonol on colitis has not been evaluated and the molecular mechanism of its anti-inflammatory action remains unknown. The aim of this study was to determine if Paeonol enema attenuates trinitrobenzene sulfonic acid (TNBS)-induced colitis in mice. We also investigated the effects of Paeonol in colon cancer-derived CW-2 cells and T cell leukemia-derived Jurkat cells treated with tumor necrosis factor {alpha} (TNF{alpha}) and/or interferon {gamma} (IFN{gamma}), which play critical roles in TNBS-induced colitis. Paeonol enema attenuated TNBS-induced colitis judging by body weigh reduction,more » colon length and histological score. Myeloperoxidase activity and inducible nitric oxide synthase (iNOS) production in the colon were also reduced with Paeonol enema. In CW-2 cells, Paeonol inhibited iNOS protein and mRNA expression induced by costimulation of TNF{alpha} and IFN{gamma}. Furthermore, Paeonol reduced TNF{alpha}-induced NF-{kappa}B transactivation and IFN{gamma}-induced STAT1 transactivation in CW-2 cells and also in Jurkat cells. These findings suggest that Paeonol enema may be useful for the treatment of colitis.« less

No Prophylactic Antibiotic Use for Young Children's Intussusception with Low-risk Infection after Successful Air Enema Reduction.

PubMed

Zhang, Yuan; Zou, Wen; Ren, Lemeng; Zhang, Yinghui; Sun, Zhaohui; Liu, Huandi; Liu, Qian; Si, Chunfeng; Jia, Hongying

2018-04-17

The Chinese government has issued the policy of promulgating the clinical use of antibacterial drugs since 2011. Prophylactic antibiotic use is a challenging problem among young children with intussusception after successful air enema reduction. There were limited data regarding the clinical value of prophylactic antibiotics for intussusception with low-risk infections. A retrospective non-randomized comparative study was conducted among 188 young children with intussusception after successful air enema reduction between January 1, 2011 and December 30, 2013. Among these children, 51 received prophylactic antibiotics and 137 did not receive antibiotics. Our results showed that there were no significant differences in age, gender, weight, admission period, reduction interval, axillary temperature, leukocytes, neutrophils, lymphocytes, monocytes, mesenteric lymph nodes and complications between groups (P > 0.05). The national policy had significantly improved clinical use of antibiotic for young children with low-risk intussusception (OR < 0.001, P < 0.001). Inpatients days were longer for children used antibiotics than those who did not (median, 27.0 hours vs 21.0 hours, P = 0.003). Prophylactic antibiotics appeared to be of little value after the successful air enema reduction of intussusception in young children with low-risk infection. Policy intervention is effective for antibiotic use in China.

Radio-Observaciones del OH EN la Coma del Cometa Halley Desde EL Hemisferio Sur

NASA Astrophysics Data System (ADS)

Silva, A. M.; Bajaja, E.; Morras, R.; Cersosimo, J. C.; Martin, M. C.; Arnal, E. M.; Poppel, W. G. L.; Colomb, F. R.; Mazzaro, J.; Olalde, J. C.; Boriakoff, V.; Mirabel, I. F.

1987-05-01

Se utilizó una antena de 30 metros del Instituto Argentino de Radioastronomía para observaciones diarias Cf ebrero a abril de 1986) de la transición en 1667 MHz ( λ = 18 cm) del OH en la coma del cometa Halley. De las observaciones realizadas se concluye: 1) El número promedio de moléculas de OH en la coma durante 37 días de observación fue de (8.9±3.5)x1034 moléculas, lo que implica una tasa de producción promedio de OH de 1.8x1029 moléculas seg-1 y consecuentemente una pérdida de masa promedio de 17±6 toneladas seg-1 . Este valor está de acuerdo con las mediciones realizadas por las sondas Vega y Giotto. 2) El monitoreo desde el lAR revela la existencia de variaciones bruscas en los flujos de absorción del OH. Estas variaciones son consistentes con los modelos que representan la producción gaseosa a partir de ejecciones y/o desprendimientos discretos de materia congelada del núcleo. 3) Las variaciones en la densidad de flujo son consistentes con las estimaciones de los tiem- pos de vida medios del H2O y del OH en presencia del campo de radiación solar. 4) Se encuentra una correlación entre la intensidad del flujo absorbido y anisotropías en Ia dinamica de la coma.

Cambios históricos en el aporte terrígeno de la cuenca del Río de la Plata sobre la plataforma interna Uruguaya

NASA Astrophysics Data System (ADS)

Marrero, Analía; Tudurí, Adriana; Pérez, Laura; Cuña, Caroline; Muniz, Pablo; Lopes Figueira, Rubens; Michaelovitch de Mahiques, Michel; Alves de Lima Ferreira, Paulo; Pittauerová, Daniela; Hanebuth, Till; García Rodríguez, Felipe

2014-12-01

El Río de la Plata (RdlP) presenta significativas variaciones naturales (hidrodinámicas y oceanográficas) asociadas a diferentes condiciones climáticas. El propósito de este trabajo es inferir los cambios de aportes continentales de sedimentos y su relación con las variaciones hidrológicas del Río de la Plata, a través del análisis de proxies sedimentológicos y geoquímicos en testigos de sedimentos de la plataforma interna uruguaya que registran los últimos 100 años, aproximadamente. A partir de la datación por 210Pb de dos testigos de sedimentos (GeoB 13813-4 y BAR1) se reconstruyó la geocronología del ambiente, y se relacionó con datos de las forzantes climáticas Pacific Decadal Oscillation, El Niño/La Niña Southern Oscillation, Atlantic Multidecadal Oscillation, y las anomalías hidrológicas de los ríos Paraná y Uruguay. Los valores más positivos y estables del Southern Oscillation Index, los cuales corresponden a fases La Niña, se observan en el periodo correspondiente entre 1910-1970, respecto al resto de la serie, donde se aprecia una mayor variabilidad y una tendencia hacia valores más negativos (eventos El Niño). Se hicieron dendrogramas (clustering) jerárquicos para ambos testigos. Para el testigo GeoB 13813-4, se utilizó la relación Ca/Ti y la granulometría, mientras que para BAR1 se recurrió a variables granulométricas y la tasa de sedimentación. El mayor aporte continental hacia la región de la plataforma adyacente al Río de la Plata registrado a partir del año 1970, podría ser el factor principal de los agrupamientos observados en los clusters para ambos testigos. Las agrupaciones mostraron una diferenciación en la década de 1970, lo que estaría asociado al aumento de los caudales de los ríos Paraná y Uruguay, durante las últimas tres décadas del siglo XX. Por otra parte se observa que la granulometría del testigo BAR1 presentó un mayor tamaño de grano y más variabilidad que en el caso del testigo GeoB 13813-4. También se determinó una mayor acumulación de sedimentos a través del tiempo en el cinturón de barro del Río de la Plata (plataforma continental adyacente), comparado con aquel registrado en la Barra del Indio (límite entre zona intermedia y externa del estuario). Estas diferencias podrían estar relacionadas con la influencia del Río de la Plata, el cual genera un ambiente altamente dinámico sobre la Barra del Indio y un ambiente más estable sobre el cinturón de barro en la plataforma continental.

[National Academy of Medicine, one hundred and fifty-four academic year].

PubMed

Mansilla-Olivares, Armando

2017-01-01

El incalculable valor que atesora la Academia Nacional de Medicina, su enorme influencia y repercusión sobre la toma de decisiones médico-científico-epidemiológicas, radica única y exclusivamente en el dominio del conocimiento, la mente científica y el talento de todos y cada uno de sus miembros, desde su fundación en 1864 hasta nuestros días.

H3+: superficies de energía potencial, estados y transiciones rovibracionales

NASA Astrophysics Data System (ADS)

Aguado, M. Paniagua Y. A.

Hemos calculado varias superficies globales de energía potencial para el estado fundamental y excitados del sistema H3+ en más de ocho mil geometrías diferentes usando una base (9s 3p 1d)/[4s 3p 1d] en cada átomo de Hidrógeno y mediante un método de cálculo de interacción de configuraciones completa (FCI). Hemos ajustado las superficies a formas analíticas del tipo Aguado y Paniagua con un error promedio menor de 50 cm-1 y menor en el pozo de potencial del estado fundamental. Finalmente hemos calculado y analizado los niveles vibracionales para los dos estados electrónicos más bajos, siendo la desviación respecto de los mejores valores publicados, tanto experimentales como teóricos, de unos pocos números de onda.

Constipation and Outcomes of Cecostomy.

PubMed

Arya, Shruti; Gupta, Nancy; Gupta, Rahul; Aggarwal, Arun

Constipation, defined as delay or difficulty in defecation, present for 2 or more weeks, is a common problem encountered by both primary and specialty medical providers. There are no randomized controlled trials on the use of antegrade enemas in the pediatric population. Most published papers are based on the experience at a particular center. The aim of this article is to describe the pathophysiology of constipation, review the contribution of colonic manometry to the diagnosis of constipation, summarize the advancements in the management of constipation through the use of antegrade enemas, and study the outcomes of cecostomy at different centers. This study is a comprehensive literature review generated by computerized search of literature, supplemented by review of monographs and textbooks in pathology, gastroenterology, and surgery. Literature search was performed using the publications from 1997 to 2012. The search included publications of all types presenting or reviewing data on cecostomy. The antegrade continence enema is a therapeutic option for defecation disorders when maximal conventional therapy is not successful. Symptoms of defecation disorders in children with different underlying etiologies improve significantly after a cecostomy is created. In addition, there is a benefit on the patients' physical activity, healthcare utilization, and general well-being. Based on the review of published literature it seems that antegrade enemas are a successful therapeutic option in children with severe constipation and/or fecal incontinence. With the advent of cecostomy buttons, patient compliance and the overall cosmetic appearance have improved.

Colonic spread of three rectally administered mesalazine (Pentasa) dosage forms in healthy volunteers as assessed by gamma scintigraphy.

PubMed

Brown, J; Haines, S; Wilding, I R

1997-08-01

Rectal administration of enemas, foams and suppositories is the most efficient method of delivering locally-acting drugs to the distal colon, sigmoid colon and rectum. Healthy volunteers provide an effective population to compare different formulations for rectal drug delivery. However, there is still only limited comparative information available on the dispersion of such dosage forms in human subjects. Therefore, the objective of this scintigraphic study was to compare colonic spread of an enema, a rectal foam and a suppository formulation in healthy volunteers. This was a randomized, crossover study in eight healthy male volunteers. Each received Pentasa rectal formulations as either a 100 mL suspension enema (1 g mesalazine), one actuation of a non-CFC propellant rectal foam (1 g mesalazine in 5 mL concentrate, expanding to 40 mL on actuation), or one suppository (1 g mesalazine) on three separate occasions. The spread of the radiolabelled formulations was assessed over a 4-h period by gamma scintigraphy. The formulations were retained by all subjects for the whole of the 4-h imaging period. The enema spread to the splenic flexure in 7 out of 8 subjects, but was retained in the rectum and sigmoid colon in one individual. The foam spread as far as the descending colon in four subjects. In the remaining individuals the foam was retained in the rectum and sigmoid colon. The spread of the suppository was limited and confined to the rectum. The findings of this study are consistent with previous research and support the intended clinical uses of the enema, foam and suppository formulations to treat distal ulcerative colitis, proctosigmoiditis and proctitis, respectively. The results highlight the potential of gamma scintigraphy in providing in vivo 'proof of concept' data to help verify the targeting of pharmaceutical products to their intended site of delivery.

Contrast enema findings in patients presenting with poor functional outcome after primary repair for Hirschsprung disease.

PubMed

Garrett, Kevin M; Levitt, Marc A; Peña, Alberto; Kraus, Steven J

2012-09-01

The radiologic evaluation of Hirschsprung disease is well described in the literature. However, there is a paucity of literature describing the appearance of the neo-rectum and colon after repair, specifically describing findings in patients with poor functional outcome, which would suggest the need for reoperation. We describe findings on contrast enema and correlate them with surgical findings at reoperation in children with poor functional outcome after primary repair for Hirschsprung disease who suffer from bowel dysfunction that can manifest with either soiling or obstructive symptoms such as enterocolitis. Children were identified from our colorectal surgery database. At the time of abstract submission, 35 children had contrast enemas prior to reoperation. Additional children continue to present for evaluation. The majority of children included in the study had their primary repair performed elsewhere. The initial procedures included: Duhamel (n = 11), Soave (n = 20) or Swenson (n = 3). One child had undergone a primary Soave repair and subsequently had a Swenson-type reoperation but continued to have a poor outcome. One child's initial surgical repair could not be determined. Images were reviewed by a staff pediatric radiologist and a pediatric radiology fellow. Findings encountered on contrast enema in these children include a distal narrowed segment due to stricture or aganglionic/transitional zone segment (8), dilated/hypomotile distal segment (7), thickened presacral space due to compressing Soave cuff (11), dilated Duhamel pouch (8), active enterocolitis (3) and partially obstructing twist of the pull-through segment (1). Multiple anatomical and pathological complications exist that can lead to bowel dysfunction in children after repair of Hirschsprung disease. Little recent literature exists regarding the radiographic findings in children. We had the opportunity to review a substantial series of these children, describe the contrast enema findings in these difficult cases and correlate them with operative findings. Radiologic evaluation is key to assessing such patients; it defines the potential anatomical problem with the pull-through and facilitates surgical planning.

[Progress in the early diagnosis of cancer of the colon and rectum].

PubMed

Canessa, N; Roset, J; Boffi, A; Ferrara, J B; Galano, A; Albertengo, J C

1978-09-01

Our experience with the air contrast examination in the cancer of colon and rectum diagnoses is showed. The colaboration among radiologist, endoscopist, pathologist and surgeon is important. In the large bowel tumors diagnosis, the radiologic and endoscopic prodedures should be evaluated together. The double colonic contrast has showed in our experience, better results than with the barium enema. Over 31 patients with both studies, we obtained 13 false negatives (with barium enema, doing then the double colonic contrast became positive 12 (92.4%).

Estructura orbital en el Problema Restringido Rectilíneo Isósceles

NASA Astrophysics Data System (ADS)

Orellana, R. B.

Para definir problemas en Mecánica Celeste se utilizan diferentes parámetros. El conocimiento de la dinámica del problema para valores particulares de estos parámetros nos permite entender el comportamiento en casos más generales. El Problema Restringido Rectilíneo Isósceles puede ser considerado como el caso límite del Problema de Sitnikov cuando la excentricidad tiende a uno o como el Problema Isósceles cuando la masa central tiende a cero. Se ha compactificado el espacio de fases y analizado la dinámica en el límite. Esto ha permitido separar el espacio de fases en diferentes regiones dependiendo de las clases de órbitas.

Autoguía para el telescopio 2,15 mts de CASLEO

NASA Astrophysics Data System (ADS)

Aballay, J. A.; Casagrande, A. R.; Pereyra, P. F.; Marún, A. H.

Se está desarrollando un sistema de autoguía para el telescopio de 2,15 mts. El mismo se realizará aprovechando el Offset Guider. Al ocular móvil de éste se vinculará alguna cámara digital (ST4-ST7-CH250) para lograr la visión del objeto. El funcionamiento del equipo será el siguiente: primero, dadas las coordenadas del objeto a observar, se tomarán las coordenadas del telescopio para que, a través de una base de datos, se determine un campo de objetos que sirvan para la cámara de visión, luego, la PC obtendrá el offset entre la estrella de observación y la estrella seleccionada como guía, este valor será trasladado a los motores que posicionarán en forma automática el ocular. Una vez que la estrella es visualizada en la cámara (monitor de PC ) se correrá el programa que guiará el telescopio automáticamente.

Klismaphilia--a physiological perspective.

PubMed

Agnew, J

1982-10-01

Dr. Joanne Denko coined the work klismaphilia to describe the practices of some of her patients who enjoyed the use of enemas as a sexual stimulant. Since then questions occasionally appear in the professional literature asking about the relationship between enemas and sexual pleasure. This paper considers some of the physiological aspects of the human sexual apparatus that relate to anal sensitivity and explores why klismaphilia can be sexually grafifying. The paper starts with a discussion of the physiological basis for anal sensitivity and anal masturbation in both the human male and the human female. The paper then goes on to relate all this to the sexual sensations received from an enema, and discusses the similarities and differences between all these types of stimulation. Some of the psychological aspects of klismaphilia are also considered in relationship to the physiology involved. The paper concludes with a brief discussion of masked anal masturbation among the population at large. A comprehensive list of references from the literature is given to support these findings.

Clinical study on treatment of hyperuricaemia by retention enema of Chinese herbal medicine combined with allopurinol.

PubMed

Chen, Qian; Ma, Li; Akebaier, Wupu

2009-12-01

To study the effect of retention enema of Chinese herbal medicine combined with allopurinol in treating hyperuricaemia (HUE). Seventy-eight patients with HUE were assigned to two: groups, the 40 patients in the treated group were treated with retention enema of Chinese herbal medicine combined with oral intake of allopurinol, and the 38 patients in the control group were treated with allopurinol alone. The therapeutic course for all was 6 weeks. The clinical efficacy, changes of symptoms, blood levels of uric acid and lipids, renal function, and 24 h urinary micro-albumin were observed. The total effective rate was: 92.5% in the treated group, which was significantly higher than that in the control group (68.4%, P<0.05). After treatment, the score of symptoms in the treated group decreased from 9.43+/-1.15 scores to 3.25+/-0.85 scores, significantly lower than that in the control group (9.75+/-1.43 scores vs 9.25+/-0.82 scores, P<0.01). Moreover, the post-treatment improvements in blood uric acid, blood lipids, renal function and 24h urinary micro-albumin in the treated group were all better than those in the control group (P<0.05 or P<0.01). Retention enema with: Chinese herbal medicine combined with allopurinol could obviously reduce the uric acid level in blood, improve patients' renal function and lipid metabolism, and alleviate the clinical symptoms in patients with HUE.

Analysis of 777 cases with obstruction of the ureter or extrahepatic bile duct by ultrasonography after normal saline retention enema

PubMed Central

2012-01-01

Background Conventional transabdominal ultrasound usually fails to visualize parts of the ureter or extrahepatic bile duct covered by bowel gas. In this study, we propose a new method for gaining acoustic access to the ureters and extrahepatic bile duct to help determine the nature of obstruction to these structures when conventional transabdominal ultrasound fails. Methods The normal saline retention enema method, that is, using normal saline-filled colons to gain acoustic access to the bilateral ureters and extrahepatic bile duct and detecting the lesions with transabdominal ultrasonic diagnostic apparatus, was applied to 777 patients with obstructive lesions, including 603 with hydroureter and 174 with dilated common bile duct, which were not visualized by conventional ultrasonography. The follow-up data of all the patients were collected to verify the results obtained by this method. Results Of the 755 patients who successfully finished the examination after normal saline retention enema (the success rate of the enema is about 98%), the nature of obstruction in 718 patients was determined (the visualizing rate is approximately 95%), including 533 with ureteral calculus, 23 with ureteral stricture, 129 with extrahepatic bile duct calculus, and 33 with common bile duct tumor. Conclusions Colons filled fully with normal saline can surely give acoustic access to the bilateral ureters and extrahepatic bile duct so as to determine the nature of obstruction of these structures when conventional transabdominal ultrasound fails. PMID:22871226

Valores, Creencias Y Objectivos: Base del programa de la Escuela Experimental P.K. Yonge. (Values, Beliefs and Objectives: The Basis of Experimental Schools P.K. Yonge's Program.)

ERIC Educational Resources Information Center

Florida Univ., Gainesville. Coll. of Education.

The values, beliefs, and objectives that form the core of the program at the Experimental School P.K. Yonge in the University of Florida are presented in this paper which is written in Spanish. This experimental school serves approximately 900 students from grades one through twelve. The function of the school is to conduct research to solve…

Anastomotic leaks: what is the best diagnostic imaging study?

PubMed

Nicksa, G A; Dring, R V; Johnson, K H; Sardella, W V; Vignati, P V; Cohen, J L

2007-02-01

Postoperative anastomotic leaks are one of the most devastating consequences of colorectal surgery. Diagnostic imaging for upper gastrointestinal anastomotic leaks has been evaluated and reported on extensively. No study has compared the utility and effectiveness of CT scans and water-soluble enemas for the identification of postoperative lower gastrointestinal anastomotic leaks. The present study was designed to evaluate and compare these two common radiographic imaging modalities in detecting lower gastrointestinal anastomotic leaks. A retrospective chart review was performed that identified 36 patients during a seven-year period who underwent reoperative surgery for a lower gastrointestinal anastomotic leak. Patient's imaging studies were classified as positive if extravasation of contrast material was demonstrated. When negative, a study was retrospectively reviewed in an attempt to identify findings suggestive of an anastomotic leak. There were 36 patients identified with a postoperative lower gastrointestinal leak requiring surgical intervention. There were 28 of 36 patients (78 percent) re-explored on the basis of a radiologic study demonstrating an anastomotic leak. A total of 27 CT scans were performed, of which 4 (14.8 percent) were considered positive for an anastomotic leak. On review of the remaining negative CT scans, nine (33.3 percent) were considered descriptive positive with a large amount of fluid or air in the peritoneal cavity but without obvious extravasation of contrast. Eighteen patients were evaluated with a water-soluble enema and 15 (83.3 percent) demonstrated extravasation of contrast material. In the 26 patients with a distal anastomotic leak, 17 water-soluble enemas were performed, with 15 (88 percent) demonstrating a leak. In contrast, only 2 of 17 (12 percent) CT scans were positive in this group of patients (P < 0.001). There were ten patients who initially had a CT scan followed by a water-soluble enema. Of these patients, eight of nine (88 percent) initially had a negative CT scan but were considered to be clinically suspicious of having an anastomotic leak and subsequently had a leak demonstrated on a water-soluble enema. Early intervention in patients who develop an anastomotic leak can be shown to improve the ultimate outcome, especially with respect to mortality. It is usually necessary to obtain objective tests of anastomotic integrity because of the nonspecificity of clinical signs. Our study supported the superiority of water-soluble enema to CT imaging in patients in whom both modalities were used. This difference was most pronounced for distal anastomotic leaks, whereas no radiologic imaging study proved effective in evaluating proximal anastomoses.

PubMed

Martínez Carrión, José Miguel; Cámara, Antonio D; Pérez-Castroviejo, Pedro María

2016-12-12

Objetivo: analizar la geografía del estado nutricional en España y su evolución entre mediados del siglo xixy comienzos del siglo xx, etapa previa a la transición nutricional con alta prevalencia de malnutrición.Métodos: se utilizan datos antropométricos agregados (promedios provinciales de estatura) del reclutamiento militar en 1858 y 1913, así como promedios provinciales de estatura y peso procedentes de una revisión realizada entre 119.571 soldados en 1903-1906. Con estos datos se elaboran cartografía y estadísticos descriptivos.Resultados: los parámetros antropométricos de los españoles se situaban entre los valores de complexión más bajos de Europa antes de la transición nutricional. Entre 1858 y 1913, la altura media creció solo 1,43 cm. En ese periodo hubo cambios significativos en la geografía antropométrica marcados por la configuración de una polaridad nutricional a las puertas de la I Guerra Mundial: las provincias del centro y del sur de país exhiben mayor incidencia de la malnutrición crónica que las provincias del arco Noreste, que disfrutan de ventaja relativa en términos nutricionales.Conclusión:las desigualdades territoriales que configuraron una geografía polarizada del estado nutricional en España pueden asociarse en parte a los cambios ambientales del periodo, caracterizados por el inicio de la modernización y la industrialización y, asimismo, por la privación derivada de las crisis agrarias, las enfermedades y el relativo atraso tecnológico. Se destaca la relevancia de la historia antropométrica para el estudio de los niveles de vida en poblaciones del pasado y del proceso de transición nutricional.

[In Process Citation].

PubMed

Santos, Carla Adriana; Fonseca, Jorge; Carolino, Elisabete; Lopes, Teresa; Sousa Guerreiro, António

2016-03-25

Introducción y objetivos: el cobre (Cu) es un oligoelemento muy estudiado, pero poco se sabe de su evolución en los pacientes alimentados por gastrostomía endoscópica (GEP). Pretendemos evaluar la evolución del Cu sérico desde la gastrostomía hasta 12 semanas después de la intervención en estos pacientes alimentados con preparaciones domésticas.  Métodos: realizamos un estudio observacional prospectivo para evaluar el Cu sérico, la albúmina, la transferrina y el índice de masa corporal (IMC) en el momento de la GEP, tras 4 semanas y 12 semanas después de la intervención. Los datos incluyen edad, género, NRS 2002 y enfermedad subyacente: cánceres de cabeza y cuello (CCC) y disfagia neurológica (DN). Después de la intervención, estos pacientes fueron alimentados conpreparaciones domésticas. Resultados: 146 enfermos (89 hombres), entre 21-95 años: CCC-56, DN-90. Valores de Cu entre 42-160 μg/dl (normal: 70-140 μg/dl); normales 89% (n = 130); bajos 11% (n = 16), albúmina baja: 53% (n = 77), transferrina baja: 65% (n = 94), IMC bajo: 53% (n = 78). Después de 4 semanas: valores normales de Cu en 93% y bajos en 7%, albúmina baja en 34%, transferrina baja en 52%. Tras 12 semanas: valores normales de Cu en 95% y bajos en 5%, albúmina baja en 25%, transferrina baja en 32%. No encontramos diferencias significativas en el Cusérico cuando se compara edad, género, enfermedad subyacente, IMC, albúmina y transferrina. Conclusiones: la mayoría de los enfermos presentan Cu sérico normal en el momento de la gastrostomía. Para los enfermos con Cu sérico bajo antes del procedimiento, la alimentación con preparaciones domésticas parece suficiente para su normalización progresiva.

Curva de aprendizaje en la colocación de tornillos pediculares percutáneos mínimamente invasivos

PubMed Central

Landriel, Federico; Hem, Santiago; Rasmussen, Jorge; Vecchi, Eduardo; Yampolsky, Claudio

2018-01-01

Resumen Objetivo: El objetivo de este estudio fue estimar la curva de aprendizaje necesaria para la correcta colocación de tornillos transpediculares percutáneos (TTP). Introducción: Los TTP son la forma de instrumentación más utilizada en el tratamiento quirúrgico de lesiones espinales que requieren estabilización. Métodos: Evaluamos retrospectivamente la inserción de 422 TTP (T5 a S1) en 75 pacientes operados entre 2013–2016, bajo guía fluoroscópica bidimensional. El cirujano 1 colocó siempre los tornillos del lado derecho y el cirujano 2, la totalidad del lado izquierdo. El posicionamiento y ruptura pedicular fue determinando con la clasificación tomográfica de Gertzbein. Se comparó la precisión en la colocación de TTP de nuestra serie con una tasa de ruptura de 8,08% (rango de 0,67-20,83%), valor de referencia obtenido de un meta-análisis propio. Resultados: De los 422 TTP, 395 fueron insertados en el pedículo sin violación de su cortical (Grado 1 = 93,6%), 27 (6,4%) rompieron la pared pedicular, de los cuales el 3,8% fue Grado 2, el 1,65% Grado 3 y sólo el 0,9% Grado 4. El Cirujano 1, presentó una tasa se ruptura global de 6,6%, alcanzando valores estándares de precisión al colocar 74 TTP; el Cirujano 2 presentó una tasa de ruptura de 6,1%, alcanzando valores de referencia a los 64 TTP; la diferencia entre ambos no fue estadísticamente significativa (P = 0,9009). Conclusión: En la serie evaluada se evidenció que se necesitan colocar aproximadamente 70 TTP para lograr resultados en términos de exactitud intrapedicular comparables con lo reportado por cirujanos experimentados en esta técnica mínimamente invasiva. PMID:29900033

A comparison of estimated and calculated effective porosity

NASA Astrophysics Data System (ADS)

Stephens, Daniel B.; Hsu, Kuo-Chin; Prieksat, Mark A.; Ankeny, Mark D.; Blandford, Neil; Roth, Tracy L.; Kelsey, James A.; Whitworth, Julia R.

Effective porosity in solute-transport analyses is usually estimated rather than calculated from tracer tests in the field or laboratory. Calculated values of effective porosity in the laboratory on three different textured samples were compared to estimates derived from particle-size distributions and soil-water characteristic curves. The agreement was poor and it seems that no clear relationships exist between effective porosity calculated from laboratory tracer tests and effective porosity estimated from particle-size distributions and soil-water characteristic curves. A field tracer test in a sand-and-gravel aquifer produced a calculated effective porosity of approximately 0.17. By comparison, estimates of effective porosity from textural data, moisture retention, and published values were approximately 50-90% greater than the field calibrated value. Thus, estimation of effective porosity for chemical transport is highly dependent on the chosen transport model and is best obtained by laboratory or field tracer tests. Résumé La porosité effective dans les analyses de transport de soluté est habituellement estimée, plutôt que calculée à partir d'expériences de traçage sur le terrain ou au laboratoire. Les valeurs calculées de la porosité effective au laboratoire sur trois échantillons de textures différentes ont été comparées aux estimations provenant de distributions de taille de particules et de courbes caractéristiques sol-eau. La concordance était plutôt faible et il semble qu'il n'existe aucune relation claire entre la porosité effective calculée à partir des expériences de traçage au laboratoire et la porosité effective estimée à partir des distributions de taille de particules et de courbes caractéristiques sol-eau. Une expérience de traçage de terrain dans un aquifère de sables et de graviers a fourni une porosité effective calculée d'environ 0,17. En comparaison, les estimations de porosité effective de données de texture, de teneur en eau et les valeurs publiées étaient environ 50 à 90% plus fortes que la valeur calibrée sur le terrain. Ainsi, l'estimation de la porosité effective pour le transport en solution dépend fortement du modèle de transport utilisé et est préférable lorsqu'elle est obtenue à partir d'expériences de traçage de laboratoire ou de terrain. Resumen La porosidad efectiva en el análisis del transporte de solutos se suele estimar, en lugar de calcularse a partir de ensayos de trazadores en el campo o el laboratorio. Los valores calculados de la porosidad efectiva en el laboratorio en tres muestras de distintas texturas se compararon con las estimaciones realizadas a partir de las distribuciones de tamaño de partículas y de las curvas características suelo-agua. El ajuste fue bastante pobre y parece que no existe una relación clara entre los valores de la porosidad efectiva calculados mediante los tres métodos. Un ensayo de trazadores en el campo, en un acuífero formado por arenas y gravas, dio lugar a un valor de porosidad efectiva calculado de 0.17. Las estimaciones realizadas a partir de los datos de textura, humedad retenida y valores publicados eran entre un 50-90 por ciento mayores que el valor calibrado en el ensayo de campo. Así, la estimación del valor de la porosidad efectiva para el transporte químico depende mucho del modelo de transporte seleccionado y es mejor si se obtiene a partir de ensayos de laboratorio o de campo.

PubMed

Beas, Renato; Anduaga-Beramendi, Alexander; Maticorena-Quevedo, Jesus; Mayta-Tristán, Percy

2018-03-26

Objetivo: Identificar los factores asociados al Síndrome de Burnout (SB) en trabajadores de salud del Perú en el año 2014.Métodos: Estudio transversal analítico mediante un análisis secundario de la Encuesta Nacional de Usuarios de Salud del año 2014 en Perú. El SB fue medido mediante el Maslach Burnout Inventory - Human Services Survey (MBI-HSS). Se realizó un análisis descriptivo, también un análisis bivariado y multivariado calculando los valores de p y los OR crudos y ajustados mediante Regresión Logística.Resultados: La prevalencia del SB en los profesionales de la salud fue 2,8%, encontrándose asociadas las variables: género, tiempo en el sector salud, horas de trabajo e ingreso mensual total.Conclusiones: Se encontró que los factores asociados al SB en el personal de Perú en el año 2014 fueron el género, el tiempo en el sector salud, las horas de trabajo y el ingreso mensual total.

[Competence in biocentric ethics.

PubMed

Stepke, Fernando Lolas

2012-07-01

ResumenEste artículo explora el origen y la conceptualización de la bioética en tanto ética biocéntrica, definida por el pionero Fritz Jahr como un imperativo hipotético que llama a respetar la vida en todas sus formas. Tras describirla como proceso social, procedimiento técnico y producto académico, se enumeran y comentan algunas competencias que debieran presidir el empleo del discurso bioético en cualquier punto del complejo social "investigación médica": miembros de comités de ética de investigación, investigadores, empresarios, administradores. Cada uno de estos grupos, en su "cultura epistémica" propia, define y explicita los principios básicos en tanto expresión de valores y leyes generales.

Uso Del Condón en Adolescentes Nahuas, un Modelo Explicativo.

PubMed

Tirado, María de Los Ángeles Meneses; Benavides-Torres, Raquel A; Navarro, Sergio Meneses; de la Colina, Juan Antonio Doncel; Rodríguez, Dora Julia Onofre; Hernández, Francisco Javier Baéz

2018-03-01

En México, la población indígena supera los siete millones de habitantes, en Puebla el grupo más representativo es el Náhuatl. Sin embargo, las condiciones de vida, salud, educación y transporte son precarias para esta población. En los adolescentes, las responsabilidades como el matrimonio, la familia y los compromisos ante la comunidad, favorecen conductas de riesgo sexual que dificultan su desarrollo económico, social y reproductivo. El objetivo fue proponer un modelo explicativo del uso del condón en adolescentes nahuas. Método. Bajo el marco de la teoría social cognitiva, el concepto de valores culturales de Leininger y el proceso de la sustracción teórica, se desarrolló este artículo. Se muestran las relaciones del modelo con las proposiciones y los factores que influyen en el uso del condón para este grupo específico. Finalmente, el modelo explica las variables de interés, los niveles de abstracción y las relaciones entre sí en el contexto náhuatl. El siguiente paso será implementar los indicadores empíricos para conocer el grado de influencia de los factores personales y ambientales hacia el uso del condón en adolescentes nahuas. Resultados que aportarán información para el desarrollo del conocimiento en enfermería y la reducción de riesgo sexual de esta población.

Water soluble contrast enema examination of the integrity of the rectal anastomosis prior to loop ileostomy reversal may be superfluous.

PubMed

Larsson, Anna; Lindmark, Gudrun; Syk, Ingvar; Buchwald, Pamela

2015-03-01

Defunctioning loop ileostomy in low anterior resection (LAR) is routinely used to reduce consequences of anastomotic leakage. The purpose of this study was to analyze which examination technique is optimal for evaluating the integrity of the anastomosis prior to loop ileostomy reversal. Retrospective analysis of 95 patients who had been subjected to LAR at Helsingborg Hospital and Skåne University Hospital, Sweden, was undertaken between January 2007 and June 2009. The examination techniques of the rectal anastomosis prior to reversal and the clinical outcome after reversal were studied. Radiologic anastomosis control using water soluble contrast enema, digital rectal examination (DRE), and rectoscopy were performed in 53 % (50/95), 98 % (93/95), and 69 % (66/95), respectively. In two patients, no control of the anastomosis was performed before reversal. Fifty-two percent (49/95) of the patients were examined using all techniques. Six patients demonstrated leakage detected before reversal of which two were only radiological leakages. These two patients underwent loop ileostomy reversal after delay without complications. They were the only ones where the three examination techniques did not prove coherence. Four patients had symptomatic leakage; these were detected with rectoscopy and DRE and verified with enema. Three patients developed anastomotic leakage after loop ileostomy reversal despite normal preoperative examinations. Two of these patients had rectovaginal fistulas (AVFs). This retrospective study indicates that contrast enema does not provide additional information if rectoscopy and DRE are normal. Despite negative examinations, three of nine leakages were diagnosed after loop ileostomy reversal. Especially, AVFs seem difficult to diagnose.

Cost-Effectiveness Analysis of Six Strategies to Treat Recurrent Clostridium difficile Infection

PubMed Central

Lapointe-Shaw, Lauren; Tran, Kim L.; Coyte, Peter C.; Hancock-Howard, Rebecca L.; Powis, Jeff; Poutanen, Susan M.; Hota, Susy

2016-01-01

Objective To assess the cost-effectiveness of six treatment strategies for patients diagnosed with recurrent Clostridium difficile infection (CDI) in Canada: 1. oral metronidazole; 2. oral vancomycin; 3.oral fidaxomicin; 4. fecal transplantation by enema; 5. fecal transplantation by nasogastric tube; and 6. fecal transplantation by colonoscopy. Perspective Public insurer for all hospital and physician services. Setting Ontario, Canada. Methods A decision analytic model was used to model costs and lifetime health effects of each strategy for a typical patient experiencing up to three recurrences, over 18 weeks. Recurrence data and utilities were obtained from published sources. Cost data was obtained from published sources and hospitals in Toronto, Canada. The willingness-to-pay threshold was $50,000/QALY gained. Results Fecal transplantation by colonoscopy dominated all other strategies in the base case, as it was less costly and more effective than all alternatives. After accounting for uncertainty in all model parameters, there was an 87% probability that fecal transplantation by colonoscopy was the most beneficial strategy. If colonoscopy was not available, fecal transplantation by enema was cost-effective at $1,708 per QALY gained, compared to metronidazole. In addition, fecal transplantation by enema was the preferred strategy if the probability of recurrence following this strategy was below 8.7%. If fecal transplantation by any means was unavailable, fidaxomicin was cost-effective at an additional cost of $25,968 per QALY gained, compared to metronidazole. Conclusion Fecal transplantation by colonoscopy (or enema, if colonoscopy is unavailable) is cost-effective for treating recurrent CDI in Canada. Where fecal transplantation is not available, fidaxomicin is also cost-effective. PMID:26901316

Fluorescence contrast-enhanced proliferative lesion imaging by enema administration of indocyanine green in a rat model of colon carcinogenesis

PubMed Central

Onda, Nobuhiko; Mizutani-Morita, Reiko; Yamashita, Susumu; Nagahara, Rei; Matsumoto, Shinya; Yoshida, Toshinori; Shibutani, Makoto

2017-01-01

The fluorescent contrast agent indocyanine green (ICG) is approved by the Food and Drug Administration for clinical applications. We previously reported that cultured human colon tumor cells preferentially take up ICG by endocytic activity in association with disruption of their tight junctions. The present study explored ICG availability in fluorescence imaging of the colon to identify proliferative lesions during colonoscopy. The cellular uptake of ICG in cultured rat colon tumor cells was examined using live-cell imaging. Colon lesions in rats administered an ICG-containing enema were further assessed in rats with azoxymethane-induced colon carcinogenesis, using in vivo endoscopy, ex vivo microscopy, and immunofluorescence microscopy. The uptake of ICG by the cultured cells was temperature-dependent. The intracellular retention of the dye in the membrane trafficking system suggested endocytosis as the uptake mechanism. ICG administered via enema accumulated in colon proliferative lesions ranging from tiny aberrant crypt foci to adenomas and localized in proliferating cells. Fluorescence endoscopy detected these ICG-positive colonic proliferative lesions in vivo. The immunoreactivity of the tight-junction molecule occludin was altered in the proliferative lesions, suggesting the disruption of the integrity of tight junctions. These results suggest that fluorescence contrast-enhanced imaging following the administration of an ICG-containing enema can enhance the detection of mucosal proliferative lesions of the colon during colonoscopy. The tissue preference of ICG in the rat model evaluated in this study can be attributed to the disruption of tight junctions, which in turn promotes endocytosis by proliferative cells and the cellular uptake of ICG. PMID:29163827

Colon Necrosis Due to Sodium Polystyrene Sulfonate with and without Sorbitol: An Experimental Study in Rats.

PubMed

Ayoub, Isabelle; Oh, Man S; Gupta, Raavi; McFarlane, Michael; Babinska, Anna; Salifu, Moro O

2015-01-01

Based on a single rat study by Lillemoe et al, the consensus has been formed to implicate sorbitol rather than sodium polystyrene sulfonate (SPS) as the culprit for colon necrosis in humans treated with SPS and sorbitol. We tested the hypothesis that colon necrosis by sorbitol in the experiment was due to the high osmolality and volume of sorbitol rather than its chemical nature. 26 rats underwent 5/6 nephrectomy. They were divided into 6 groups and given enema solutions under anesthesia (normal saline, 33% sorbitol, 33% mannitol, SPS in 33% sorbitol, SPS in normal saline, and SPS in distilled water). They were sacrificed after 48 hours of enema administration or earlier if they were very sick. The gross appearance of the colon was visually inspected, and then sliced colon tissues were examined under light microscopy. 1 rat from the sorbitol and 1 from the mannitol group had foci of ischemic colonic changes. The rats receiving SPS enema, in sorbitol, normal saline, distilled water, had crystal deposition with colonic necrosis and mucosal erosion. All the rats not given SPS survived until sacrificed at 48 h whereas 11 of 13 rats that received SPS in sorbitol, normal saline or distilled water died or were clearly dying and sacrificed sooner. There was no difference between sorbitol and mannitol when given without SPS. In a surgical uremic rat model, SPS enema given alone or with sorbitol or mannitol seemed to cause colon necrosis and high mortality rate, whereas 33% sorbitol without SPS did not.

Colon Necrosis Due to Sodium Polystyrene Sulfonate with and without Sorbitol: An Experimental Study in Rats

PubMed Central

Ayoub, Isabelle; Oh, Man S.; Gupta, Raavi; McFarlane, Michael; Babinska, Anna; Salifu, Moro O.

2015-01-01

Introduction Based on a single rat study by Lillemoe et al, the consensus has been formed to implicate sorbitol rather than sodium polystyrene sulfonate (SPS) as the culprit for colon necrosis in humans treated with SPS and sorbitol. We tested the hypothesis that colon necrosis by sorbitol in the experiment was due to the high osmolality and volume of sorbitol rather than its chemical nature. Methods 26 rats underwent 5/6 nephrectomy. They were divided into 6 groups and given enema solutions under anesthesia (normal saline, 33% sorbitol, 33% mannitol, SPS in 33% sorbitol, SPS in normal saline, and SPS in distilled water). They were sacrificed after 48 hours of enema administration or earlier if they were very sick. The gross appearance of the colon was visually inspected, and then sliced colon tissues were examined under light microscopy. Results 1 rat from the sorbitol and 1 from the mannitol group had foci of ischemic colonic changes. The rats receiving SPS enema, in sorbitol, normal saline, distilled water, had crystal deposition with colonic necrosis and mucosal erosion. All the rats not given SPS survived until sacrificed at 48 h whereas 11 of 13 rats that received SPS in sorbitol, normal saline or distilled water died or were clearly dying and sacrificed sooner. There was no difference between sorbitol and mannitol when given without SPS. Conclusions In a surgical uremic rat model, SPS enema given alone or with sorbitol or mannitol seemed to cause colon necrosis and high mortality rate, whereas 33% sorbitol without SPS did not. PMID:26413782

Cost-Effectiveness Analysis of Six Strategies to Treat Recurrent Clostridium difficile Infection.

PubMed

Lapointe-Shaw, Lauren; Tran, Kim L; Coyte, Peter C; Hancock-Howard, Rebecca L; Powis, Jeff; Poutanen, Susan M; Hota, Susy

2016-01-01

To assess the cost-effectiveness of six treatment strategies for patients diagnosed with recurrent Clostridium difficile infection (CDI) in Canada: 1. oral metronidazole; 2. oral vancomycin; 3.oral fidaxomicin; 4. fecal transplantation by enema; 5. fecal transplantation by nasogastric tube; and 6. fecal transplantation by colonoscopy. Public insurer for all hospital and physician services. Ontario, Canada. A decision analytic model was used to model costs and lifetime health effects of each strategy for a typical patient experiencing up to three recurrences, over 18 weeks. Recurrence data and utilities were obtained from published sources. Cost data was obtained from published sources and hospitals in Toronto, Canada. The willingness-to-pay threshold was $50,000/QALY gained. Fecal transplantation by colonoscopy dominated all other strategies in the base case, as it was less costly and more effective than all alternatives. After accounting for uncertainty in all model parameters, there was an 87% probability that fecal transplantation by colonoscopy was the most beneficial strategy. If colonoscopy was not available, fecal transplantation by enema was cost-effective at $1,708 per QALY gained, compared to metronidazole. In addition, fecal transplantation by enema was the preferred strategy if the probability of recurrence following this strategy was below 8.7%. If fecal transplantation by any means was unavailable, fidaxomicin was cost-effective at an additional cost of $25,968 per QALY gained, compared to metronidazole. Fecal transplantation by colonoscopy (or enema, if colonoscopy is unavailable) is cost-effective for treating recurrent CDI in Canada. Where fecal transplantation is not available, fidaxomicin is also cost-effective.

Patient experiences of colonoscopy, barium enema and CT colonography: a qualitative study.

PubMed

Von Wagner, C; Knight, K; Halligan, S; Atkin, W; Lilford, R; Morton, D; Wardle, J

2009-01-01

Previous studies of patient experience with bowel screening tests, in particular CT colonography (CTC), have superimposed global rating scales and not explored individual experience in detail. To redress this, we performed qualitative interviews in order to characterize patient expectations and experiences in depth. Following ethical permission, 16 patients undergoing CTC, 18 undergoing colonoscopy and 15 undergoing barium enema agreed to a semi-structured interview by a health psychologist. Interviews were recorded, responses transcribed and themes extracted with the aim of assimilating individual experiences to facilitate subsequent development and interpretation of quantitative surveys of overall satisfaction with each diagnostic test. Transcript analysis identified three principal themes: physical sensations, social interactions and information provision. Physical sensations differed for each test but were surprisingly well tolerated overall. Social interactions with staff were perceived as very important in colouring the whole experience, particularly in controlling the feelings of embarrassment, which was critical for all procedures. Information provision was also an important determinant of experience. Verbal feedback was most common during colonoscopy and invariably reassuring. However, patients undergoing CTC received little visual or verbal feedback and were often confused regarding the test outcome. Barium enema had no specific advantage over other tests. Qualitative interviews provided important perspectives on patient experience. Our data demonstrated that models describing the quality of medical encounters are applicable to single diagnostic episodes. Staff interactions and information provision were particularly important. We found advantages specific to both CTC and colonoscopy but none for barium enema. CTC could benefit greatly from improved information provision following examination.

BARIUM REDUCTION OF INTUSSUSCEPTION IN INFANCY

PubMed Central

Denenholz, Edward J.; Feher, George. S.

1955-01-01

Barium enema reduction was used as the initial routine treatment in 29 infants with intussusception. In 22 of them the intussusception was reduced by this means. In three of eight patients operated upon the intussusception was found to be reduced. Four of the remaining five patients had clinical or x-ray evidence of complications before reduction by barium enema was attempted. Twenty-one of the patients, all of whom were observed in private practice, were treated without admission to the hospital. After reduction, these patients were observed closely by the clinician. None of these patients showed clinical or x-ray signs of complications before reduction. Certain clinical and roentgen criteria must be satisfied before it can be concluded that reduction by barium enema is complete. If there are clinical signs of complications with x-ray evidence of small bowel obstruction, only a very cautious attempt at hydrostatic reduction should be made. As the time factor is generally a reliable clinical guide to reducibility, the late cases should be viewed with greater caution. Long duration of symptoms, however, is not per se a contraindication to an attempt at hydrostatic reduction. PMID:13230908

[Not Available].

PubMed

De Arriba Muñoz, Antonio; López Úbeda, Marta; Rueda Caballero, Carmen; Labarta Aizpún, José Ignacio; Ferrández Longás, Ángel

2016-07-19

Introducción: saber diagnosticar y tratar la obesidad se ha convertido en el mayor reto del siglo XXI, debido al aumento de su prevalencia.Objetivos: determinar los valores de normalidad de perímetro abdominal (PA) e índice de masa corporal (IMC) según edad y sexo en población española sana.Métodos: estudio longitudinal observacional realizado entre 1980 y 2014. Se incluyeron 165 niños y 169 niñas recién nacidas, recogiendo datos de forma anual hasta los 18 años (74 varones y 92 mujeres), y posteriormente a los 28 años (42 varones y 45 mujeres). Se realizó medición de peso, longitud/talla y perímetro abdominal. Se calcularon los percentiles (P3, P10, P25, P50, P75, P90, P97) de IMC y PA según edad y sexo.Resultados: se presentan datos evolutivos de IMC y PA durante la infancia, destacando cómo aumentan los valores entre los 18 y 28 años de los percentiles superiores al p50, sobre todo en mujeres. Existe una correlación positiva en relación al PA entre el valor obtenido a los 3 años con el valor de los 18 años y de los 28 años tanto en varones (r = 0,722 y r = 0,605, p = 0,000, respectivamente) como en mujeres(r = 0,922, r = 0,857, p = 0,000, respectivamente). Y entre los 18 y 28 años (r = 0,731, p = 0,000 para varones y r = 0,961, p = 0,000 para mujeres).Conclusión: se presentan valores de normalidad de PA e IMC según edad y sexo, que podrán utilizarse como herramienta de referencia para identificar a personas con riesgo de desarrollar enfermedades cardiovasculares o diabetes.

COLOSTOMY CARE

PubMed Central

Lee Marsh, Robert

1955-01-01

Psychic preparation of the patient for the necessity of colostomy is a long first step toward his adjustment to living with an artificial anus. Proper surgical placement of the outlet will ease care of the bowel. Control of fecal consistency and peristaltic rate should ideally produce constipation responsive only to habit or enemata. The object of the enema is to produce an evacuation thorough enough to prevent soiling for a day or two. The object of dietary variations is to produce a manageable volume and consistency of fecal stream. The technique of enemas and choice of diet can be individualized when the underlying principles are understood. PMID:13230924

Acute colitis caused by caustic products.

PubMed

da Fonseca, J; Brito, M J; Freitas, J; Leal, C

1998-12-01

We report two cases of acute proctocolitis caused by rectal application of caustic products of domestic use. One 61-yr-old woman applied an ammonia solution enema; the other patient, a 63-yr-old woman, accidentally applied an enema containing lye. Both patients presented with intense anal pain, but the first patient also had abdominal pain with guarding, hematochezia, and leucocytosis. An acute proctocolitis was found at sigmoidoscopy in both patients. Only conservative and symptomatic measures were prescribed in both cases, and a clinical and endoscopic recovery was seen. In spite of persistent fibrosis in the lamina propria, no signs of stenosis were found.

?`Es necesario calcular detalladamente funciones de partición atómicas?

NASA Astrophysics Data System (ADS)

Milone, L. A.; Merlo, D. C.

Basándonos en extensos y precisos cómputos de funciones de partición realizados por nosotros para distintos átomos, se muestra que en el cálculo u obtención de ciertas magnitudes (notablemente la presión electrónica, la abundancia de un elemento deducida a partir de un estado fuertemente ionizado, etc.) el error porcentual que se comete es pequeño (inferior a 1 %) si se adopta, como valor de la función de partición, el peso estadístico del término correspondiente al estado fundamental del átomo. Esta notable simplificación acelera el cálculo, por ejemplo, de un modelo de atmósfera estelar, sin disminuir la precisión de los resultados.

Competencias en ética biocéntrica

PubMed Central

Stepke, Fernando Lolas

2013-01-01

Resumen Este artículo explora el origen y la conceptualización de la bioética en tanto ética biocéntrica, definida por el pionero Fritz Jahr como un imperativo hipotético que llama a respetar la vida en todas sus formas. Tras describirla como proceso social, procedimiento técnico y producto académico, se enumeran y comentan algunas competencias que debieran presidir el empleo del discurso bioético en cualquier punto del complejo social “investigación médica”: miembros de comités de ética de investigación, investigadores, empresarios, administradores. Cada uno de estos grupos, en su “cultura epistémica” propia, define y explicita los principios básicos en tanto expresión de valores y leyes generales. PMID:23459767

Rebamipide enema therapy for left-sided ischemic colitis patients accompanied by ulcers: Open label study

PubMed Central

Matsumoto, Satohiro; Tsuji, Kenichiro; Shirahama, Satoshi

2008-01-01

AIM: To attempt rectal administration of rebamipide in the treatment of ischemic colitis patients with ulcers, and evaluate its effects. METHODS: We compared 9 ischemic colitis patients (2 men, 7 women) with ulcers treated by bowel rest only from 2000 to 2005 (conventional therapy group), with 6 patients (2 men, 4 women) treated by rebamipide enema therapy in 2006 (rebamipide enema therapy group) and analyzed the mean duration of fasting and hospitalization, degree of ulcer healing, and decrease in WBC count for the two groups. RESULTS: The mean duration of fasting and hospitalization were 2.7 ± 1.8 d and 9.2 ± 1.5 d in the rebamipide group and 7.9 ± 4.1 d and 17.9 ± 6.8 d in the control group, respectively, and significantly reduced in the rebamipide group (t = -2.915; P = 0.0121 and t = -3.054; P = 0.0092). As for the degree of ulcer healing at 7 d after admission, the ulcer score was reduced by 3.5 ± 0.5 (points) in the rebamipide group and 2.8 ± 0.5 (points) in the control group (t = 1.975; P = 0.0797), while the decrease in WBC count was 120.0 ± 55.8 (× 102/μL) in the rebamipide group and 85.9 ± 56.8 (× 102/μL) in the control group (t = 1.006; P = 0.3360). CONCLUSION: In left-sided ischemic colitis patients with ulcers, rebamipide enema therapy significantly reduced the duration of fasting and hospitalization, recommending its use as a new and effective therapeutic alternative. PMID:18609691

HIRSCHSPRUNG'S DISEASE—The Clinical Differentiation and Treatment of Children with Hirschsprung's Disease and Pseudo-Hirschsprung's Disease

PubMed Central

Ravitch, Mark M.

1958-01-01

Hirschsprung's disease is marked by constipation from the time of birth, with the development, if uncorrected, of a protuberant abdomen and flared costal margins. The rectal ampulla is empty and the abdomen is filled with fecal masses. Pain is not prominent. Flatus is passed in large amounts. Encopresis does not occur. Barium enema shows the characteristic narrowed distal rectal segment and biopsy of the rectum shows absence of the ganglion cells of the myenteric plexus. Treatment is operative resection of the distal narrow segment and a primary anastomosis. Hirschsprung's disease may be mimicked in children with: 1. Psychogenic constipation—pseudo-Hirschsprung's disease. Unlike Hirschsprung's disease, symptoms do not appear at birth, encopresis is common, and the barium enema shows no narrow distal segment. 2. Mental retardation and cerebral defect. 3. Corrected imperforate anus—on the basis of stenosis, imperfect innervation or poor habit training. 4. Cretinism—with severe constipation and intestinal dilatation perhaps the presenting symptoms. Treatment of these four groups of children with severe constipation not due to Hirschsprung's disease is: For Group 1, open discussion with parent and child. Assumption by the physician of full control of the details of treatment, and relegation of parent to the role of the physician's agent in following the prescribed regimen. For Group 2, an enema regimen. Whereas fairly rapid restoration (and then persistence) of normal bowel habit can be expected in Group 1, the basic defects in Group 2 may require indefinite continuation of treatment. For Group 3, regular enema regimen, in the less severe cases—one identical with that used in Group 1, and dilatation of strictures or anoplasty. In Group 4, thyroid hormone therapy relieves the constipation of hypothyroidism and causes reversion of radiographic changes in the colon and rectum. PMID:13561108

Clinical and subclinical leaks after low colorectal anastomosis: a clinical and radiologic study.

PubMed

Lim, Michael; Akhtar, Saleem; Sasapu, Kishore; Harris, Keith; Burke, Dermot; Sagar, Peter; Finan, Paul

2006-10-01

This study was designed to examine the natural history of subclinical leaks and their effect on bowel function and quality of life and to evaluate water-soluble contrast enema features that predict anastomotic healing after leaks. Consecutive patients who underwent low rectal anastomosis were followed up postoperatively for leaks. All leaks were confirmed radiologically with CT scanning and water-soluble contrast enema imaging. Water-soluble contrast enemas were serially repeated to identify healing. Characteristics on initial water-soluble contrast enema were correlated with observed healing. Postoperatively, patients were required to fill in a quality of life and a bowel function questionnaire. A total of 138 patients underwent low rectal anastomosis procedures with a median follow-up period of 26 (interquartile range, 19-37) months. There were 23 documented leaks of which 13 (9 percent) presented clinically and 10 (8 percent) presented subclinically. Ileostomy closure was possible in 4 of 13 (30 percent) patients with a clinical leak and all 10 (100 percent) patients with a subclinical leak. Median quality of life scores were lower for patients with clinical leaks and no ileostomy closure (P = 0.03). Bowel function for subclinical leak patients and clinical leak patients with ileostomy closure were similarly impaired. The presence of a cavity (P = 0.01) and a stricture (P = 0.01) at the anastomotic site were unfavorable radiologic features associated with nonhealing. Subclinical leaks are more benign in their natural history compared with clinical leaks. Quality of life and bowel function is no better in patients with a subclinical leak compared with patients with a clinical leak who have ileostomy closure. Anastomotic leaks may resolve if favorable radiologic features are present.

Transrectal-ultrasound prostatic biopsy preparation: rectal enema vs. mechanical bowel preparation.

PubMed

De Nunzio, Cosimo; Lombardo, Riccardo; Presicce, Fabrizio; Bellangino, Mariangela; Finazzi Agro, Enrico; Gambrosier, Matteo Bonetto; Trucchi, Alberto; Petta, Stefano; Tubaro, Andrea

2015-01-01

Transrectal prostate biopsy (TRUSbx) is the standard for the diagnosis of prostate cancer. Different bowel preparations are used for patients undergoing TRUSbx. The aim of our study was to compare two different bowel preparations for TRUSbx. From May 2012 and onwards, a selected group of men undergoing TRUS 12-core prostate biopsy were enrolled into a prospective database. Patients were randomized 1:1 to receive a rectal enema (Group A) the night before the procedure or polyethylene glycol 34.8 grams/4 liters of water the day before the procedure (Group B). A VAS scale to evaluate the patients' discomfort according to the two preparations was collected. The same antibiotic prophylaxis was performed in both groups. All complications were prospectively recorded and graded according to the Clavien Classification System (CCS). A total of 198 patients were consecutively enrolled. Mean age was 67.5 ±7.9 years, mean body mass index (BMI) was 27.1 ±4.2 Kg/m(2), mean PSA value was 9.3 ±12.6 ng/ml and the mean prostatic volume was 60.6 ±29 ml. 97 patients were enrolled in Group A and 101 in Group B. Overall post-biopsy morbidity rate was 60%. No significant differences for low-grade and high-grade complications was observed between the two groups. Patients receiving the rectal enema presented with a significantly lower VAS score (3.1 ±1.1 vs. 5.9 ±1.7; p = 0.02). Our study confirmed that a rectal enema should be considered as the standard bowel preparation in patients undergoing a TRUS biopsy; it is as effective as PEG and associated with less discomfort.

Interfraction Prostate Movement in Bone Alignment After Rectal Enema for Radiotherapy

PubMed Central

Seo, Young Eun; Kim, Tae Hyo; Lee, Ki Soo; Cho, Won Yeol; Lee, Hyung-Sik; Hur, Won-Joo

2014-01-01

Purpose To assess the effect of a rectal enema on interfraction prostate movement in bone alignment (BA) for prostate radiotherapy (RT), we analyzed the spatial difference in prostates in a bone-matched setup. Materials and Methods We performed BA retrospectively with data from prostate cancer patients who underwent image-guided RT (IGRT). The prostate was identified with implanted fiducial markers. The setup for the IGRT was conducted with the matching of three fiducial markers on RT planning computed tomography images and those on two oblique kV x-ray images. Offline BA was performed at the same position. The coordinates of a virtual prostate in BA and a real prostate were obtained by use of the ExaxTrac/NovalisBody system, and the distance between them was calculated as the spatial difference. Interfraction prostate displacement was drawn from the comparison of the spatial differences. Results A total of 15 patients with localized prostate cancer treated with curative hypofractionated IGRT were enrolled. A total of 420 fractions were analyzed. The mean of the interfraction prostate displacements after BA was 3.12±2.00 mm (range, 0.20-10.53 mm). The directional difference was profound in the anterior-posterior and supero-inferior directions (2.14±1.73 mm and 1.97±1.44 mm, respectively) compared with the right-left direction (0.26±0.22 mm, p<0.05). The required margin around the clinical target volume was 4.97 mm with the formula of van Herk et al. Conclusions The interfraction prostate displacement was less frequent when a rectal enema was performed before the procedure. A rectal enema can be used to reduce interfraction prostate displacement and resulting clinical target volume-to-planning target volume margin. PMID:24466393

Preparation of goreisan suppository and pharmacokinetics of trans-cinnamic acid after administration to rabbits.

PubMed

Katagiri, Yukiko; Miyazaki, Yasunori; Uchino, Tomonobu; Kagawa, Yoshiyuki

2014-01-01

Goreisan suppository is prepared as a hospital preparation, and successfully used for the treatment of diarrhea and vomiting in young children with common cold. While clinical efficacy of the suppository has been reported, few studies have been carried out to clarify the preparation procedure and pharmacokinetics of the suppository. In this study, trans-cinnamic acid (CA) was used as a representative substance of goreisan constituents, and assayed by HPLC-UV. We investigated the properties of goreisan suppositories prepared using various sizes of pulverized goreisan extract granules, in vitro dissolution profiles using the reciprocating dialysis tube method, and pharmacokinetics in rabbits compared with those for goreisan enema. Mass and content uniformity tests on the suppositories of three size fractions, 0-75, 75-150, and 150-300 µm, showed good acceptance for all kinds of suppository. Storage stability at 4°C was maintained until 4 months. In vitro dissolution of CA from the suppository was proportional to time until 45 min, and slower than that from the enema. Finally, 80% of CA had dissolved at 60 min. Pharmacokinetic study in rabbits revealed that the area under the plasma concentration-time curve from 0 to 120 min (AUC0-120 min) of the suppository was twice that of the enema. Moreover, from a study in rabbits using CA injection and CA suppository, we revealed that CA was rapidly and well absorbed from the rectum, showing 84% absolute bioavailability. Thus, we illustrated the defined preparation procedure of the suppository and the superiority of the suppository over the enema. This study will support evidence that the suppository is fast-acting and efficacious in clinical use.

Meta-analysis using individual patient data: efficacy and durability of topical alicaforsen for the treatment of active ulcerative colitis.

PubMed

Vegter, S; Tolley, K; Wilson Waterworth, T; Jones, H; Jones, S; Jewell, D

2013-08-01

The antisense ICAM-1 inhibitor alicaforsen has been studied in four phase 2 studies in ulcerative colitis (UC). Recruited patients varied as to the extent of their colitis and in the severity of disease at entry. To investigate the efficacy of alicaforsen enema in specific UC populations. Efficacy was analysed for short-term (week 6-10) and long-term (week 30) outcomes compared with either placebo or a high-dose mesalazine (mesalamine) enema in patients with disease extent up to 40 cm from the anal verge in patients with moderate or severe disease, and in patients with both of these features. Individual patient data meta-analyses of 200 patients from four phase 2 studies evaluating nightly alicaforsen 240 mg enema and comparators. Patient data were pooled and analysed in a single data set. Continuous outcomes were evaluated using anova; dichotomous outcomes were evaluated using Pearson chi-square or Fisher's exact tests. Alicaforsen showed superior efficacy vs. placebo in: patients with disease extent up to 40 cm, patients with moderate and severe disease and especially when both those conditions were satisfied. In these patient groups, mesalazine also showed short-term efficacy. At week 30, however, the efficacy of mesalazine waned and alicaforsen became significantly more efficacious. This post hoc meta-analysis showed that alicaforsen is effective in patients with active UC, especially in patients with distal disease, which is of moderate/severe activity. The efficacy of alicaforsen was durable in these sub-groups, suggesting a disease-modifying effect. This analysis suggests that alicaforsen enema may offer an effective, potentially durable response in moderate/severe distal active UC. © 2013 John Wiley & Sons Ltd.

Bioavailability of the antiemetic metopimazine given as a microenema

PubMed Central

HERRSTEDT, JØRN; JØRGENSEN, MORTEN; ANGELO, HELLE RIIS; RASSING, MARGRETHE RØMER; MØLLER-SONNERGAARD, JØRN; DOMBERNOWSKY, PER

1996-01-01

The absorption of the antiemetic metopimazine (MPZ) given as a single dose of (a) 40 mg microenema, (b) 40 mg orally and (c) 10 mg as a 60 min i.v. continuous infusion was investigated in six healthy volunteers. Blood samples were drawn and the serum concentrations of MPZ and its acid metabolite were measured. The bioavailability of MPZ given orally and as enemas was 22.3 and 19.5% respectively. Partial avoidance of hepatic first pass metabolism was seen with the enemas, which in contrast to suppositories, seems to represent a reliable form of rectal administration. PMID:8799530

Neonatal sigmoid volvulus.

PubMed

Khalayleh, Harbi; Koplewitz, Benjamin Z; Kapuller, Vadim; Armon, Yaron; Abu-Leil, Sinan; Arbell, Dan

2016-11-01

Neonatal sigmoid volvulus is a rare entity. It is associated with Hirschsprung's disease. Presentation is acute abdominal distention, vomiting and obstipation. Abdominal radiograph will show the "coffee bean" sign, but this is frequently missed and the diagnosis requires a high index of suspicion. Treatment options include contrast enema, colonoscopy or laparotomy, depending on the condition of the baby and local availability. During the last 6years, 6 infants with sigmoid volvulus were treated in our department. Four presented during the first 48h since birth, and 2 presented at the age of 2 and 7weeks of age. One child was operated and 5 had primary contrast enema with radiologic de-volvulus. Rectal biopsy was performed in all cases; three children had Hirschsprung's disease. Those with normal biopsies responded well to rectal washouts. Two patients had early one stage transanal pullthrough and one had 2 further occasions of sigmoid volvulus prior to definitive surgery. All three recovered with an uneventful course. Neonatal sigmoid volvulus requires a high level of suspicion. Contrast enema is efficient for primary de-volvulus. Rectal biopsy should be performed and if positive for Hirschsprung's disease, surgery should be performed sooner rather than later. Copyright © 2016 Elsevier Inc. All rights reserved.

Un asteroide proveniente de la Luna

NASA Astrophysics Data System (ADS)

Tancredi, G.

El descubrimiento de un débil objeto en movimiento por el telescopio Spacewatch (un instrumento dedicado a la búsqueda de Asteroides Cercanos a la Tierra) en 1991, ha generado una gran controversia en la comunidad planetaria. El objeto, denominado 1991 VG, tiene elementos orbitales llamativamente similares a los de la Tierra, lo que ha llevado a B. G. Marsden a aventurar:``El objeto podría ser una nave espacial en retorno (IAUC 5387)". Luego de analizar las características dinámicas de 1991 VG y las diferentes hipótesis sobre su origen, favorecemos la alternativa de que el objeto es un gran fragmento de material eyectado de la Luna durante un reciente impacto (en las últimas decenas de miles de años). El hallazgo en 1983 en la Antártida de meteoritos con composición tipo lunar, confirma la posibilidad de que material de la superficie del satélite puede ser eyectado a velocidades superiores a la de escape del sistema Tierra-Luna y alcance órbitas heliocéntricas. Los elementos orbitales de 1991 VG corresponden a los valores alcanzados por partículas que apenas escapan de la gravedad lunar y entran en órbitas heliocéntricas a través del punto Lagrangiano exterior del sistema Tierra-Sol.

Ajuste de parámetros libres en teorías de campos camaleones a partir de espectros de nubes moleculares galácticas y experimentos terrestres

NASA Astrophysics Data System (ADS)

Teppa Pannia, F. A.; Landau, S. J.

Resultados recientes, basados en el análisis de espectros moleculares de nubes galácticas a través del método del amoníaco, han arrojado nuevos límites sobre la variación del parámetro adimensional μ=m_e /m_p. Los resultados indican Δ μ/μ = (μ_{obs}-μ_{lab})/μ_{lab}= (2.2± 0.4_{est} ±0.3_{sist}) times 10 ^{-8}, en acuerdo con una variación no nula de dicha cantidad (Levshakov et al. 2010). En este trabajo, motivado por los datos astronómicos, estudiamos la solución lineal del modelo teórico fenomenológico de campo escalar camaleón, presentado por Mota y Shaw (2007), que predice variaciones en μ. Con el fin de cotejar estas predicciones con los resultados observacionales, utilizamos datos de experimentos terrestres que testean violaciones al Principio de Equivalencia para analizar el valor de los parámetros libres presentes en el modelo. El trabajo realizado muestra que la solución estudiada no se puede ajustar a los datos experimentales, sugiriendo que el modelo lineal debe ser descartado para explicar las observaciones astronómicas. FULL TEXT IN SPANISH

PubMed

Bueno Vargas, Pilar; Manzano Martín, Manuel; López-Aliaga, Inmaculada; López Pedrosa, José M ª

2016-09-20

Introducción: la gestación y lactancia están relacionadas con pérdidas temporales en la densidad mineral ósea (DMO) materna. Una suplementación con calcio podría resultar beneficiosa para evitar la pérdida de masa ósea del esqueleto materno. Otros nutrientes como los prebióticos han sido identificados como responsables de un incremento en la absorción de minerales, pudiendo condicionar la mineralización ósea.Objetivo: estudiar el efecto de la suplementación de la dieta materna con el prebiótico inulina enriquecida con oligofructosa, durante la gestación y la lactancia sobre el contenido mineral óseo (CMO) y la DMO al final del periodo de lactancia.Métodos: las ratas gestantes fueron alimentadas con dieta estándar (grupo CC), dieta fortificada en calcio (grupo Ca) o enriquecida con el prebiótico inulina enriquecida con oligofructosa (grupo Pre) hasta el final del periodo de lactancia. Posteriormente se evaluó el CMO y DMO por absorciometría de rayos X (DEXA) y el pH del contenido cecal.Resultados:en términos generales, el grupo Pre presenta los mayores valores absolutos de CMO y DMO de entre los tres grupos, siendo en la tibia significativamente diferentes en los grupos CC y Pre frente al grupo Ca. El pH del contenido cecal del grupo Pre es significativamente inferior al de los grupos CC y Ca.Conclusión:la suplementación con inulina enriquecida con oligofructosa, en condiciones nutricionales no deficientes en calcio, durante la gestación y la lactancia, ejerce una protección del esqueleto materno en las ratas y puede ser considerada como una estrategia nutricional para proteger la masa ósea materna en el periodo perinatal.

Estudio de la fotoabsorción y fotoionización de la molécula de alta relevancia atmosférica no a través de los estados Rydberg con la metodología MQDO

NASA Astrophysics Data System (ADS)

Bustos, E.; Velasco, A. M.; Martín, I.; Lavín, C.

Los procesos de fotoionización son de una importancia fundamental [1] y encuentran aplicación en un gran número de contextos científicos: Astrofísica [2], química de las radiaciones, biología. Los investigadores de dichos campos, necesitan de valores de fiables de secciones eficaces para la fotoionización parcial, la Fotoabsorción, así como para los procesos de fotofragmentación en amplios intervalos espectrales, particularmente en estudios de modelización [3-5]. En este trabajo se ha centrado la atención sobre el oxido nítrico, que se ha considerado apropiado y relevante por varios motivos: por el trascendental papel que representa en la física y química de la alta atmosfera [6], aparte de por estar íntimamente relacionado con los problemas de contaminación. Los procesos de recombinación disociativa [7] del NO, donde los estados Rydberg se encuentran directamente implicados, son relevantes, por ejemplo, en las regiones E y F de la ionosfera [7]. En este trabajo se estudia la fotoionización del NO desde el estado fundamental con la versión molecular del método del orbital de defecto cuántico (MQDO). Para ello se calcula el diferencial de las fuerzas de oscilador parciales que constituyen los canales de fotoionización del NO desde el estado fundamental. La continuidad del diferencial de fuerza de oscilador calculada a través del umbral de fotoionización, esto es, en las regiones del espectro discreta y del continua, se adopta como criterio de calidad la escasez de datos comparativos [8].

Free fatty acid suppositories are as effective as docusate sodium and sorbitol enemas in treating constipation in children.

PubMed

Ormarsson, Orri Thor; Asgrimsdottir, Gudrun Marta; Loftsson, Thorsteinn; Stefansson, Einar; Lund, Sigrun Helga; Bjornsson, Einar Stefan

2016-06-01

A well-documented, clinically proven per rectum treatment for childhood constipation is needed. This phase two clinical trial evaluated the efficacy of suppositories containing free fatty acids (FFA) compared with Klyx docusate sodium and sorbitol enemas. A randomised, controlled, single-blind study was undertaken on 77 children aged between one and 17 who presented to an emergency department in Iceland and were diagnosed with constipation. In stage one, 23 patients were randomised to receive lower dose FFA suppositories or Klyx (n = 33). In stage two, 21 different patients were randomised to receive higher dose suppositories and compared with the same Klyx control subjects. The suppositories were effective at bowel emptying in 39% of the group who received the lower FFA doses and 81% of the group receiving higher doses, compared with 88% in the Klyx control group. Symptom relief was obtained in 30% of the group receiving the lower doses and 71% of the group receiving the higher doses, compared with 73% in the control group. The higher dose FFA suppositories were as effective as the Klyx enemas with regard to bowel emptying and symptom relief and might provide an important and less invasive alternative for childhood constipation. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Small bowel enteroclysis in surgically treated obesity.

PubMed

Coppola, V; Verrengia, D; Gatta, G; Alfinito, M; Alfano, L; D'Agostino, F

1998-11-01

To define the indications, technical limitations and diagnostic yeld of small bowel transbuccal enema in the follow-up of surgical jejunoileal shunting in patients with complicated severe essential obesity. Three patients were submitted to surgical diversion: two of them underwent an intestinal bypass after Payne-De Wind (isoperistaltic end-to-side jejunoileostomy) and the other after Scott (end-to-end jejunoileostomy). The latter refers to intestinal recanalization and antiperistaltic lower end-to-side gastroenteric restoration. Radiologic studies are the only means to depict the surgical small bowel. Radiographic follow-up needs barium sulfate administration and therefore cannot be performed any sooner than 30 days postoperatively. In the last three years the classic transbuccal enema has been performed with a Rollandi tube (with a terminal opening and a balloon). Both the anastomosis and the blind loop are difficult to demonstrate. Jejunoileal bypass can be used to treat severe obsity uncontrollable otherwise, to reduce food absorption. Different severe complications may result and small bowel studies may permit to show late local complications. Small bowel enema is also indispensable in bypass reversal. There are no alternatives to this radiologic examination which is however very difficult to perform, because of the changes made by previous operation(s), and to interpret because the anastomosis, the sutured loop and wall changes are often poorly demonstrated.

Fluoroscopy-guided hydrostatic reduction of intussusception in infancy: role of pharmacological premedication.

PubMed

Esposito, Francesco; Ambrosio, Concetta; De Fronzo, Simona; Panico, Maria Rita; D'Aprano, Marilena; Giugliano, Anna Marcella; Noviello, Domenico; Oresta, Patrizia

2015-06-01

Intussusception is one of the most common causes of paediatric emergency. Fluoroscopy-guided hydrostatic reduction is a common nonoperative management strategy for the treatment of intussusception. The role of pharmacological premedication in increasing the success rate of hydrostatic reduction is still controversial. The purpose of this study was to verify the presence of a possible correlation between pharmacological premedication and the percentage of hydrostatic reduction of intussusception in paediatric patients. This study considered children with a diagnosis of idiopathic intussusception treated at our hospital between January 2007 and June 2013. One group of patients underwent hydrostatic reduction by barium enema without any preliminary therapy. A second group of patients received pharmacological premedication with both a sedative and an anti-oedematous agent before the procedure. A total of 398 patients were treated with barium enema for therapeutic purposes. In the group of patients who received no premedication (n = 254), 165 (65 %) children achieved hydrostatic reduction of the intussusception. Among the patients who received pharmacological premedication prior to barium enema (n = 144), 122 (85 %) children achieved resolution of the intussusception. Our study shows that the use of pharmacological premedication is effective for the reduction of the intussusception, as its limit patient stress, fluoroscopic time and radiation dose.

DISYUNTIVAS EN LAS CONCEPCIONES SOBRE AUTONOMÍA Y BENEFICENCIA QUE AFECTAN LA TERAPÉUTICA DEL INTENTO SUICIDA1

PubMed Central

Mondragón, Liliana; Monroy, Zuraya; Ito, Ma. Emily; Medina-Mora, Dra. Ma. Elena

2010-01-01

El objetivo del trabajo es conocer las disyuntivas entre los principios de beneficencia y autonomía, que se presentan en la relación médico-paciente, durante la terapéutica del intento de suicidio. La investigación se realizó en dos hospitales psiquiátricos de la Ciudad de México. La muestra incluyó a tres sujetos con intento de suicidio, mayores de 18 años, que eran atendidos en consulta externa a causa de una lesión autoinfligida en el último año, y a tres psiquiatras que trataban a estos pacientes. La información se obtuvo previo consentimiento informado en entrevistas individuales. Se llevó a cabo un análisis de discurso argumentado para encontrar los significados que los participantes otorgaron a los principios bioéticos y las posibles disyuntivas entre éstos. Las discordancias entre la beneficencia y la autonomía estuvieron relacionadas con el beneficio del tratamiento, el respeto por los valores y las creencias de los pacientes, entre otros. Este trabajo presenta consideraciones éticas relevantes en el escenario clínico, al ofrecer al psiquiatra un análisis bioético que le permita actuar de acuerdo con la beneficencia y respetando la autonomía del paciente frente a casos de intento de suicidio y, de esta forma procurar una mejor atención para ellos. PMID:20830214

DISYUNTIVAS EN LAS CONCEPCIONES SOBRE AUTONOMÍA Y BENEFICENCIA QUE AFECTAN LA TERAPÉUTICA DEL INTENTO SUICIDA.

PubMed

Mondragón, Liliana; Monroy, Zuraya; Ito, Ma Emily; Medina-Mora, Dra Ma Elena

2010-06-01

El objetivo del trabajo es conocer las disyuntivas entre los principios de beneficencia y autonomía, que se presentan en la relación médico-paciente, durante la terapéutica del intento de suicidio.La investigación se realizó en dos hospitales psiquiátricos de la Ciudad de México. La muestra incluyó a tres sujetos con intento de suicidio, mayores de 18 años, que eran atendidos en consulta externa a causa de una lesión autoinfligida en el último año, y a tres psiquiatras que trataban a estos pacientes. La información se obtuvo previo consentimiento informado en entrevistas individuales. Se llevó a cabo un análisis de discurso argumentado para encontrar los significados que los participantes otorgaron a los principios bioéticos y las posibles disyuntivas entre éstos.Las discordancias entre la beneficencia y la autonomía estuvieron relacionadas con el beneficio del tratamiento, el respeto por los valores y las creencias de los pacientes, entre otros. Este trabajo presenta consideraciones éticas relevantes en el escenario clínico, al ofrecer al psiquiatra un análisis bioético que le permita actuar de acuerdo con la beneficencia y respetando la autonomía del paciente frente a casos de intento de suicidio y, de esta forma procurar una mejor atención para ellos.

Effects of modified Sanhuang decoction () enema on serum tumor necrosis factor-α and colonic mucosa interleukin-1β, interleukin-6 levels in ulcerative colitis rats.

PubMed

Wang, Shuai; Zhou, Tao; Zhai, Jun-Peng; Wang, Li-Hua; Chen, Jing

2014-11-01

To investigate the effects of Modified Sanhuang Decoction (, MSD) enema on the serum tumor necrosis factor alpha (TNF-α) and colonic mucosa interleukin-1β (IL-1β), interleukin-6 (IL-6) levels in experimental ulcerative colitis (UC) rats. Forty-five male Wistar rats were randomly divided into 4 groups: normal group (n=12), model group (n=11), salazosulfapyridine (SASP) group (n=11) and MSD group (n=11). The UC model was induced by 2,4,6-trinitrobenzene sulfonic acid (TNBS)/ethanol solution. Rats in the normal group and model group were clystered with 0.9% normal saline, while in the SASP group and MSD group were clystered with SASP and MSD enema, respectively. After drug administration (10 mL/kg body weight, for 7 days), colonic gross changes and colonic mucosa histology were observed, serum TNF-α and colonic mucosa IL-1β, IL-6 levels were tested by enzyme linked immunosorbent assay and radioimmunoassay, respectively. As compared with the normal group, the experimental UC rats, the colonic mucosal damage index scores (CMDIs), histopathological scores (HS) and the serum TNF-α and colonic mucosa IL-1β, IL-6 levels significantly increased (P<0.05 or P<0.01). In the MSD and SASP groups, the ulcer area significantly reduced, and edema disappeared. The CMDIs, HS, the serum TNF-α and colonic mucosa IL-1β, IL-6 levels in the MSD and SASP groups significantly decreased (P<0.05 or P<0.01) compared with the model group. The CMDIs in the MSD group were lower than that in the SASP group (P<0.05), but there were no significant differences in HS, serum TNF-α or colonic mucosa IL-1β, IL-6 levels between the MSD and SASP groups. MSD enema can improve colonic mucosa impairment and decrease serum TNF-α and colonic mucosa IL-1β, IL-6 levels in experimental UC.

Efectos Especiales de Anclaje (Estudio sobre Regresiones de Juicios Condicionales). Parte 2: Invariancia del Juicio No-Condicional Como Valor Estandar Para el Juicio Condicional (Special Effects of Anchoring (Study of Regression of Conditional Judgements) Part 2: Invariance of Unconditional Judgments as Standard Value for the Conditional Judgment). Publication No. 31.

ERIC Educational Resources Information Center

Lopez Alonso, A. O.

From the best-fit lines corresponding to sets of families of conditional judgements, the constant stimulus family and the constant condition family, both defined for a same scale object, the coordinate values of the point of intersection of both lines (indifference point) are obtained. These values are studied in relation to the mean values of the…

Enteroclysis

MedlinePlus

Small bowel enema; CT enteroclysis; Small bowel follow-through; Barium enteroclysis; MR enteroclysis ... radiology department. Depending on the need, x-ray, CT scan , or MRI imaging is used. The test ...

Accuracy of a pediatric early warning score in the recognition of clinical deterioration.

PubMed

Miranda, Juliana de Oliveira Freitas; Camargo, Climene Laura de; Nascimento, Carlito Lopes; Portela, Daniel Sales; Monaghan, Alan

2017-07-10

to evaluate the accuracy of the version of the Brighton Pediatric Early Warning Score translated and adapted for the Brazilian context, in the recognition of clinical deterioration. a diagnostic test study to measure the accuracy of the Brighton Pediatric Early Warning Score for the Brazilian context, in relation to a reference standard. The sample consisted of 271 children, aged 0 to 10 years, blindly evaluated by a nurse and a physician, specialists in pediatrics, with interval of 5 to 10 minutes between the evaluations, for the application of the Brighton Pediatric Early Warning Score for the Brazilian context and of the reference standard. The data were processed and analyzed using the Statistical Package for the Social Sciences and VassarStats.net programs. The performance of the Brighton Pediatric Early Warning Score for the Brazilian context was evaluated through the indicators of sensitivity, specificity, predictive values, area under the ROC curve, likelihood ratios and post-test probability. the Brighton Pediatric Early Warning Score for the Brazilian context showed sensitivity of 73.9%, specificity of 95.5%, positive predictive value of 73.3%, negative predictive value of 94.7%, area under Receiver Operating Characteristic Curve of 91.9% and the positive post-test probability was 80%. the Brighton Pediatric Early Warning Score for the Brazilian context, presented good performance, considered valid for the recognition of clinical deterioration warning signs of the children studied. avaliar a acurácia da versão traduzida e adaptada do Brighton Paediatric Early Warning Score para o contexto brasileiro, no reconhecimento da deterioração clínica. estudo de teste diagnóstico para medir a acurácia do Brighton Paediatric Early Warning Score, para o contexto brasileiro, em relação a um padrão de referência. A amostra foi composta por 271 crianças de 0 a 10 anos, avaliadas de forma cega por uma enfermeira e um médico, especialistas em pediatria, com intervalo de 5 a 10 minutos entre as avaliações, para aplicação do Brighton Paediatric Early Warning Score, para o contexto brasileiro e do padrão de referência. Os dados foram processados e analisados nos programas Statistical Package for the Social Sciences e VassarStats.net. O desempenho do Brighton Paediatric Early Warning Score para o contexto brasileiro foi avaliado por meio dos indicadores de sensibilidade, especificidade, valores preditivos, área sob a curva ROC, razões de probabilidades e probabilidade pós-teste. o Brighton Paediatric Early Warning Score para o contexto brasileiro apresentou sensibilidade de 73,9%, especificidade de 95,5%, valor preditivo positivo de 73,3%, valor preditivo negativo de 94,7%, área sob a Receiver Operating Characteristic Curve de 91,9% e a probabilidade pós-teste positivo foi de 80%. o Brighton Paediatric Early Warning Score, para o contexto brasileiro, apresentou bom desempenho, considerado válido para o reconhecimento de sinais de alerta de deterioração clínica das crianças estudadas. evaluar la precisión de la versión traducida y adaptada del Brighton Paediatric Early Warning Score para el contexto brasileño, en el reconocimiento de la deterioración clínica. estudio de test diagnóstico para medir la precisión del Brighton Paediatric Early Warning Score para el contexto brasileño, en relación a un estándar de referencia. La muestra estuvo compuesta por 271 niños de 0 a 10 años, evaluadas de forma ciega por especialistas en pediatría, una enfermera y un médico, con intervalo de 5 a 10 minutos entre las evaluaciones, para aplicación del Brighton Paediatric Early Warning Score para el contexto brasileño. Los datos fueron procesados y analizados en los programas Statistical Package for the Social Sciences y VassarStats.net. El desempeño del Brighton Paediatric Early Warning Score para el contexto brasileño fue evaluado por medio de los indicadores de sensibilidad, especificidad, valores predictivos, área debajo de la curva ROC, razones de probabilidades y probabilidad postest. el Brighton Paediatric Early Warning Score para el contexto brasileño presentó sensibilidad de 73,9%, especificidad de 95,5%, valor predictivo positivo de 73,3%, valor predictivo negativo de 94,7%, área bajo la Receiver Operating Characteristic Curve de 91,9% y la probabilidad postest positivo fue de 80%. el Brighton Paediatric Early Warning Score para el contexto brasileño, presentó buen desempeño, considerado válido para el reconocimiento de señales de alerta de deterioración clínica de los niños estudiados.

Comparación de la efectividad de ranibizumab intravítreo para el tratamiento del edema macular diabético en ojos vitrectomizados y no vitrectomizados.

PubMed

Koyanagi, Yoshito; Yoshida, Shigeo; Kobayashi, Yoshiyuki; Kubo, Yuki; Yamaguchi, Muneo; Nakama, Takahito; Nakao, Shintaro; Ikeda, Yasuhiro; Ohshima, Yuji; Ishibashi, Tatsuro; Sonoda, Kohhei

2017-07-11

Objetivo: Comparar la efectividad de ranibizumab intravítreo (RIV) para el tratamiento del edema macular diabético (EMD) en ojos con y sin vitrectomía previa. Procedimientos: Evaluamos de manera prospectiva la mejor agudeza visual corregida (MAVC) y el grosor macular central (GMC) tras el tratamiento con RIV durante 6 meses. Resultados: No se observaron diferencias significativas en la MAVC o GMC inicial en ninguno de los dos grupos. En el grupo no vitrectomizado (n = 15), los cambios medios en la MAVC y GMC hasta el sexto mes de tratamiento con respecto al valor inicial resultaron significativos (p < 0,01). En el grupo vitrectomizado (n = 10), se observó una mejora más lenta, y la mejora media en la MAVC no resultó significativa (p = 0,5), aunque la media en la disminución del GMC sí que lo fue (p < 0,05). No se observaron diferencias significativas en los cambios medios en la MAVC y el GMC entre ambos grupos a los 6 meses del tratamiento. Conclusiones: La diferencia en la efectividad de RIV entre ambos grupos no resultó significativa. Ranibizumab intravítreo puede ser una opción de tratamiento incluso en pacientes vitrectomizados con EMD. © 2017 S. Karger AG, Basel.

[In Process Citation].

PubMed

López-Fuenzalida, Antonio; Rodríguez Canales, Carolina; Reyes Ponce, Álvaro; Contreras Molina, Ángela; Fernández Quezada, Javiera; Aguirre Polanco, Carolina

2016-03-25

Introducción: dado el incremento del sobrepeso y obesidad infantil, es relevante estudiar no solo las consecuencias metabólicas, sino también aquellas de índole musculoesqueléticas que pueden afectar la funcionalidad motriz, como es el pie plano, en esta población. Objetivo: identificar la asociación entre el estado nutricional y la prevalencia de pie plano en niños y niñas chilenos de 6 a 10 años. Métodos: el z-score del índice de masa corporal (IMC) y el registro y análisis de las huellas plantares según la metodología de Hernández-Corvo fue llevado a cabo en 388 escolares (52,3% niñas). Un test de diferencia para dos proporciones fue utilizado para evaluar las diferencias entre los grupos. Se considera una significancia estadística con p ≤ 0,05. Resultados: la prevalencia del exceso de peso fue de más del 40%. Esta prevalencia fue más alta en las niñas (47,8%) que en los niños (42,7%). La prevalencia de pie plano en todos los niños fue del 17%, presentando valores más elevados el pie derecho (18,3%) que el izquierdo (15,7%). Hay un incremento significativo de la prevalencia de pie plano en los niños obesos en relación con los niños con sobrepeso y normopeso. Conclusión: el estado nutricional está asociado con incrementos en la prevalencia de pie plano en niños. En la población infantil de 6 a 10 años de edad, la obesidad está asociada con la alteración morfológica del pie.

[Elective laparoscopic right colectomy for caecal volvulus: case report and literature review].

PubMed

Ramírez-Ramírez, Moisés Marino; Villanueva-Sáenz, Eduardo; Ramírez-Wiella-Schwuchow, Gustavo

Caecal volvulus is an uncommon cause of intestinal obstruction. Its clinical presentation is non-specific, with the diagnosis usually confirmed by barium enema and abdominal computed tomography. Treatment depends on many factors, and minimally invasive approaches are becoming the treatment of choice. A 54 years old female, admitted to the Emergency Department with clinical symptoms of intestinal obstruction. On physical examination she had a palpable, firm, and tympanitic mass in the right abdomen, with peritoneal irritation. The radiographs of the abdomen, barium enema and abdominal computed tomography showed caecal volvulus. As she showed a full remission after the barium enema, with no clinical or biochemical data of systemic inflammatory response syndrome or peritoneal irritation, she was discharged to her home. Two weeks later, a laparoscopic right hemicolectomy was performed with an ileo-transverse extracorporeal anastomosis. Her progress was satisfactory, and she was discharged 4 days after surgery due to improvement. Caecal volvulus is a rare cause of intestinal obstruction, with high mortality rates, and is caused by excessive mobility of the caecum. Its incidence is increasing. Treatment depends on many factors. Early non-surgical untwisting, followed by an elective laparoscopic surgical procedure offers several advantages and reduces mortality. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

Antegrade continence enemas improve quality of life in patients with medically-refractory encopresis.

PubMed

Church, Joseph T; Simha, Sidd; Wild, Laurie C; Teitelbaum, Daniel H; Ehrlich, Peter F

2017-05-01

Fecal incontinence is a socially debilitating problem for many children. We hypothesized that in selected patients with medically-refractory encopresis, placement of an appendicostomy or cecostomy tube for administration of antegrade continence enemas (ACE) would improve quality of life (QOL). We reviewed all patients with encopresis who underwent appendicostomy or cecostomy placement from 2003 to 2014 at our institution. We contacted subjects' parents by phone and administered 3 surveys: a survey reflecting current stooling habits, a disease-specific QOL survey, and the PedsQL™ QOL survey. QOL surveys were completed twice by parents, once reflecting pre-operative QOL, then again reflecting current QOL. Pre-procedure and post-procedure scores were compared by paired t-test. Ten patients underwent appendicostomy/cecostomy for encopresis. Eight completed phone surveys. All procedures were performed laparoscopically. All patients experienced fecal soiling pre-operatively, whereas 5/8 surveyed patients (63%) noted complete resolution of soiling post-procedure (p<0.01). General and disease-specific QOL improved from pre-procedure to post-procedure in the following domains: social habits, physical activity, ability to spend the night elsewhere, feeling, and overall QOL (p<0.05). PedsQL™ scores improved significantly in physical functioning, social functioning, and overall functioning (p<0.05). Antegrade continence enemas significantly improve quality of life in patients with medically-refractory encopresis, likely related to resolution of soiling. 4. Copyright © 2017. Published by Elsevier Inc.

Improving Quality and Efficiency for Intussusception Management After Successful Enema Reduction.

PubMed

Raval, Mehul V; Minneci, Peter C; Deans, Katherine J; Kurtovic, Kelli J; Dietrich, Ann; Bates, D Gregory; Rangel, Shawn J; Moss, R Lawrence; Kenney, Brian D

2015-11-01

The purpose of this project was to implement a protocol facilitating discharge from the emergency department (ED) after successful radiologic ileocolic intussusception reduction in a pediatric referral center. A multidisciplinary team identified drivers for successful quality improvement including educational brochures, a standardized radiologic report, an observation period in the ER with oral hydration challenges, and follow-up phone calls the day after discharge. Patient outcomes were tracked, and quarterly feedback was provided. Of 80 patients identified over a 24-month period, 34 (42.5%) did not qualify for discharge home due to need for surgical intervention (n = 9), specific radiologic findings (n = 11), need for additional intravenous hydration (n = 4), or other reasons (n = 7). Of 46 patients who qualified for discharge, 30 (65.2%) were successfully sent home from the ED. One patient returned with recurrent symptoms that required repeat enema reduction. Sixteen patients were observed and discharged within 23 hours. Adherence with discharge from the ED improved over time. Discharge from the ED was associated with cost savings and improved net margins at the hospital level for each encounter. A sustainable multidisciplinary quality improvement project to discharge intussusception patients from the ED after air-contrast enema reduction was successfully integrated in a high-volume referral center through education, standardized radiologic reporting, and protocoled follow-up. Copyright © 2015 by the American Academy of Pediatrics.

Estimación de pequeñas perturbaciones en satélites geocéntricos como un problema inverso

NASA Astrophysics Data System (ADS)

Zadunaisky, P. E.

El movimiento geocéntrico de un satélite artificial es simulado automáticamente por un sistema de ecuaciones diferenciales de segundo orden que incluyen dos funciones perturbadoras. La primera representa el segundo término del potencial gravitatorio de la Tierra y la segunda corresponde al frenado atmosférico. Asumiendo como conocidas, por hipótesis o por mediciones, la posición y velocidad del satélite en instantes sucesivos se estiman las perturbaciones a intervalos sucesivos por un método determinístico. Para ilustrar el método y comprobar la precisión de nuestros resultados hemos simulado dos ejemplos incluyendo valores conocidos de las perturbaciones que luego comparamos con los resultados de nuestro método. El método puede aplicarse por ejemplo para el intervalo de una revolución satelital lo cual permitiría el diseño inmediato de una maniobra correctiva de la órbita satelital.

Reduction in oxidative stress levels in the colonic mucosa without fecal stream after the application of enemas containing aqueous Ilex paraguariensis extract.

PubMed

Cunha, Fernando Lorenzetti da; Silva, Camila Morais Gonçalves da; Almeida, Marcos Gonçalves de; Lameiro, Thais Miguel do Monte; Marques, Letícia Helena Souza; Margarido, Nelson Fontana; Martinez, Carlos Augusto Real

2011-08-01

To evaluate the antioxidant effects of enemas containing aqueous extract of Ilex paraguariensis, comparing segments with and without fecal stream and correlating the segments with the duration of intervention. Twenty-six Wistar rats were subjected to a diversion of the fecal stream in the left colon by a proximal colostomy and distal mucosal fistula. The rats were distributed randomly into two experimental groups of 13 animals each based on the time of sacrifice after surgical procedure (two or four weeks). Each group was then divided into two experimental subgroups that received either second daily enemas containing 0.9% saline solution or aqueous extract of Ilex paraguariensis at 0.2g/100g. Colitis was diagnosed by histopathological analysis and the detection of oxidative tissue damage by measuring the levels of malondialdehyde. The Mann-Whitney test was used to compare the tissue levels of malondialdehyde between colon segments with and without fecal stream in each experimental group, and the Kruskal-Wallis test was used to verify the variance between the levels of oxidative stress according the duration of the irrigation; both tests determined significance at 5% (p<0.05). The levels of malondialdehyde in the animals subjected to intervention in the colon with saline with and without fecal stream after two and four weeks of irrigation were 0.05±0.006 and 0.06±0.006, and 0.05± 0.03 and 0.08 ±0.02, respectively. The malondialdehyde levels in the animals irrigated with Ilex paraguariensis with and without fecal stream after two and four weeks of irrigation were 0.010±0.002 and 0.02±0.004, and 0.03±0.007 and 0.04±0.01, respectively. After two and four weeks of intervention, the levels of malondialdehyde were lower in the animals irrigated with Ilex paraguariensis regardless of the time of irrigation (p=0.0001 and p=0.002, respectively). The daily rectal application of enemas containing aqueous extract of Ilex paraguariensis decreases oxidative tissue damage in the colon without fecal stream regardless of the time of irrigation.

Adaptación al español y validación de criterio de una escala para la tamización de problemas emocionales y del comportamiento en la primera infancia.

PubMed

Cano, Luz Helena; Acosta, María Natalia; Pulido, Adriana

2018-05-01

Introducción. La detección temprana del riesgo de problemas emocionales y del comportamiento en niños puede contribuir al desarrollo de estrategias que promuevan la salud mental desde la primera infancia. En Colombia no existe una herramienta validada para dicha detección.Objetivos. Seleccionar, adaptar y establecer la validez de criterio de una escala de tamización de problemas emocionales y del comportamiento en niños menores de seis años.Materiales y métodos. A partir de una revisión de la literatura y un consenso de expertos, se seleccionó la herramienta Early Childhood Screening Assessment (ECSA). Posteriormente, se llevó a cabo su adaptación lingüística y se determinó la validez de criterio mediante una curva de características de recibidor-operador (Receiver Operating Characteristic, ROC), y se la comparó con el cuestionario Child Behavior Checklist (CBCL 1,5-5). En el estudio participaron 206 cuidadores de niños entre el año y medio y los seis años de edad de la ciudad de Tunja y el municipio de Sopó.Resultados. La puntuación del ECSA presentó una buena correlación con la puntuación t total del CBCL 1,5-5 (ro de Spearman=0,75; p<0,01). La escala ECSA tuvo una sensibilidad de 86 % y una especificidad de 82 % al establecer un punto de corte de 24 para la población estudiada.Conclusión. En este primer estudio de adaptación y validación de la versión en español de la escala ECSA, se detectaron buenos valores de sensibilidad y especificidad para la tamización de problemas emocionales y del comportamiento en la primera infancia.

Total proctocolectomy with ileostomy

MedlinePlus

... clear liquids, such as broth, clear juice, and water, after a certain time. Follow the instructions you have been given about when to stop eating and drinking. You may need to use enemas or laxatives ...

Total proctocolectomy and ileal - anal pouch

MedlinePlus

... clear liquids, such as broth, clear juice, and water after a certain time. Follow the instructions you have been given about when to stop eating and drinking. Your may need to use enemas or laxatives ...

Understanding Antegrade Colonic Enema (ACE) Surgery

MedlinePlus

... recognized leader in digestive diagnosis, treatments and surgical innovations. Cleveland Clinic is a non-profit academic medical ... Safety Office of Diversity & Inclusion Patient Experience Research & Innovations Government & Community Relations Careers For Employees Resources for ...

Lower GI Series (Barium Enema)

MedlinePlus

... You may be asked to change position several times to evenly coat the large intestine with the barium. If you are having a double-contrast lower GI series, the radiologist will inject air through the tube ...

21 CFR 876.5210 - Enema kit.

Code of Federal Regulations, 2010 CFR

2010-04-01

... to promote evacuation of the contents of the lower colon. The device consists of a container for... irrigation system (§ 876.5220). (b) Classification. Class I (general controls). The device is exempt from the...

Molecular and Epidemiological Characterization of Infant Botulism in Beijing, China.

PubMed

Dong, Yin Ping; Wang, Wei; Jiang, Tao; Xu, Jin; Han, Chun Hui; Yan, Shao Fei; Fanning, Séamus; Li, Ying; Ma, Xiao Chen; Zhang, Di; Zhao, Yao; Zeng, Biao; Li, Feng Qin

2017-06-01

Laboratory-based pathogen isolation, identification, and toxicity determination were performed on samples from a suspected case of infant botulism. Mice injected with cultures generated from the enema sample and ingested Powered infant formula (PIF) presented typical signs of botulism. Antitoxins to polyvalent botulinum neurotoxins (BoNTs) and monovalent BoNT type B antitoxin had protective effects. Clostridium botulinum isolated from the enema and residual PIF samples were positive for type B toxin. Pulsed-field gel electrophoresis (PFGE) revealed that the two strains of C. botulinum isolated from the two samples produced indistinguishable pulsotypes. These findings confirmed this case of type B infant botulism associated with the ingestion of PIF contaminated by type B C. botulinum spores. Copyright © 2017 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

The new Malone antegrade continence enema automatic instillation device allows independence and decreases flush times.

PubMed

Hinds, Angelique C; Baskin, Laurence S

2004-10-01

The Malone antegrade continence enema procedure has changed the lives of many school-aged children who would otherwise be in diapers. Unfortunately, our current procedures to flush the Malone antegrade continence enema are difficult to accomplish independently and require an extensive time commitment. In this study we confirm that a new device, the ACE Malone automatic instillation device (ACE-MAID) is safe and effective, will decrease the time it takes to perform the flush and will increase independence. Nine patients were prospectively enrolled for a 1-year study. Patient age ranged from 4 to 16 years, and diagnoses included spina bifida (3 cases), imperforate anus (4) and infantile meningitis (1). The study consisted of initial and followup questionnaires, an "ACE-O-Gram," quality assurance testing of the ACE-MAID and an objective observation of current flushing technique. The average objective start to finish flush time decreased from 45 minutes initially to 31 minutes using the ACE-MAID. Children who initially had more than 1 accident per month had a decrease in the number of stool accidents. When asked to compare the ACE-MAID device to the previous form of flushing 100% of patients stated that it was better. When asked if they would use the pump when the study was over 100% reported yes. The new ACE-MAID proved safe and effective, decreased flush times, may decrease stool accidents and facilitates independence for children treated with a MACE procedure.

Use of mineral oil Fleet enema for the removal of a large tar burn: a case report.

PubMed

Carta, Tricia; Gawaziuk, Justin; Liu, Song; Logsetty, Sarvesh

2015-03-01

Extensive hot tar burns are relatively uncommon. Management of these burns provides a significant clinical challenge especially with respect to tar removal involving a large total body surface area (TBSA), without causing further tissue injury. We report a case of an over 40-year old male construction worker who was removing a malfunctioning cap from broken valve. This resulted in tar spraying over the anterior surface of his body including legs, feet, chest, abdomen, arms, face and oral cavity (80% TBSA covered in tar resulting in a 50% TBSA burn injury). Initially, petrolatum-based, double antibiotic ointment was used to remove the tar, based on our previous experience with small tar burns. However, this was time-consuming and ineffective. The tar was easily removed with mineral oil without irritation. In order to meet the demand for quantity of mineral oil, the pharmacy suggested using mineral oil Fleet enema (C.B. Fleet Company, Inc., Lynchburg, Virginia, USA). The squeezable bottle and catheter tip facilitated administration of oil into the patient's construction boots and under clothing that was adhered to the patient's skin. Tar removal requires an effective, non-toxic and non-irritating agent. Mineral oil is such an agent. For patients that may present with a large surface area tar burn, using mineral oil Fleet enema is a viable option that facilitates application into difficult areas. Grant Support: The Firefighters' Burn Fund (Manitoba) supported this project. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Detection of colorectal carcinoma on double contrast barium enema when double reporting is routinely performed: an audit of current practice.

PubMed

Leslie, A; Virjee, J P

2002-03-01

To determine the sensitivity of double contrast barium enema (DCBE) in the detection of colorectal carcinoma (CRC) when double reporting is routinely performed. Over a 1-year period all patients with a diagnosis of CRC within a large teaching hospital were identified. Using computer records, any patient with CRC who had had a DCBE within 5 years of diagnosis was identified. During this time period all DCBE were double reported by the radiographer or radiology trainee who performed the enema and by a consultant radiologist specializing in gastrointestinal radiology. Over the 1-year period 169 patients were identified with a diagnosis of CRC. Seventy patients had had a DCBE within the preceding 5 years. Sixty-four patients had had CRC diagnosed on the DCBE. One patient had a sessile polyp diagnosed, which was removed at colonoscopy and found to be an invasive adenocarcinoma. In five cases (7%) the CRC was not diagnosed on DCBE. In three cases the lesions could be seen retrospectively, in one case the lesion could not be seen and in one case the examination had been incomplete. In our series the miss-rate for CRC was 7%. Previous studies have shown miss-rates of 15-24%. These studies have not routinely employed double reporting. Our results suggest that double reporting of DCBE significantly reduces the miss-rate and that this reduction is due to fewer perceptive errors. Copyright 2002 The Royal College of Radiologists.

Limited utility of preoperative studies in preparation for colostomy closure.

PubMed

Pokorny, R M; Heniford, T; Allen, J W; Tuckson, W B; Galandiuk, S

1999-04-01

Numerous diagnostic and therapeutic practices are used in an attempt to reduce the morbidity of colostomy closures. Our principal aim was to evaluate the role of preoperative studies, specifically barium enemas and endoscopic examinations, performed before colostomy closures. Additionally, we wished to identify other practices involved in the perioperative management of patients undergoing colostomy closure that influenced morbidity. The records of 100 consecutive patients who underwent elective colostomy closure at University of Louisville Hospital between January 1989 and July 1995 were reviewed. Wound infection was the most common complication (12%). Various bowel preparations were equivalent in efficacy and did not influence the complication rate. Intermittent wound irrigation with antibiotics for 3 days postoperatively, via subcutaneous drains, was associated with a low incidence of incision infection. Preoperative barium enema or sigmoidoscopy were often performed but rarely useful. Performing these examinations merely increased hospital cost without a corresponding decline in morbidity.

Subcorneal pustular dermatosis and episcleritis associated with poorly controlled ulcerative colitis.

PubMed

Wargo, Jeffrey J; Adams, Megan; Trevino, Julian

2017-01-30

A man aged 56 years with a history of ulcerative colitis (UC) status postsubtotal colectomy was hospitalised with fevers, dry cough, eye redness and a new bloody, mucoid rectal discharge. 2 months prior to admission, the dermatologist had started him on dapsone for subcorneal pustular dermatosis but did not recognise that he had recently self-discontinued mesalamine enemas, inducing a flare of his UC. After a thorough inpatient evaluation, including flexible sigmoidoscopy, active UC involving the rectal stump was determined to be driving his dermatological and ophthalmological findings. By reinstituting mesalamine enemas, control of his UC was achieved and the extraintestinal manifestations of his inflammatory bowel disease (IBD) resolved. This case illustrates the importance of careful history taking and of early recognition of extraintestinal manifestations of IBD in order to appropriately target treatment and prevent unnecessary morbidity. 2017 BMJ Publishing Group Ltd.

Variaciones seculares de período en las RR Lyrae de ω~Centauri

NASA Astrophysics Data System (ADS)

Marraco, H. G.; Milesi, G. E.

Utilizando 689 observaciones de 35 estrellas RR Lyrae del cúmulo globular ω Centauri hemos obtenido nuevas determinaciones de sus períodos y sus correspondientes variaciones seculares. Las observaciones fueron obtenidas de la literatura con la excepción de un grupo 66 determinaciones que se presentan por vez primera aquí. Utilizando el parámetro testigo σ descripto en Marraco & Muzzio (Publ. Astron. Soc. Pacific 92, 700, 1980), hemos realizado un ajuste bidimensional en P y β (donde β es la variación secular del período). Con este fin la totalidad de las 689 observaciones fueron llevadas a un sistema fotométrico común. Para esto se realizó un cuidadoso análisis de los numerosos errores en la identificación de las estrellas de las series de comparación. Los resultados de los ajustes bidimensionales fueron analizados utilizando técnicas de procesamiento de imágenes. Con este fin el parámetro de ajuste σ fue representado como función de P y β. En las imágenes resultantes se buscaron los mínimos y al menor de ellos se lo aceptó como período instantáneo verdadero y su variación secular β. La determinación precisa de cada parámetro se realizó mediante ajuste de gaussianas y se determinaron sus errores. A modo de ejemplo la variable #8 fue analizada en una matriz de 501 × 501 elementos representando el parámetro σ para valores comprendidos entre 0,521034 < P < 0,521534 dias y -150×10-10 < β < +150×10-10 dias/dia. El mejor período instantáneo (correspondiente a la época DJ=2.426.908) y su variación secular son P = 0,5212859±0,0000001 días y β 14,012±,010×10-10 días/día respectivamente. Con estos valores el parámetro testigo resulta σ= 0,127 . Si no se tiene en cuenta la variación secular del período y se busca aquél de mejor ajuste para β = 0, se obtiene P = 0,5212960 días, pero entonces el parámetro de ajuste resulta tan alto como σ = 0,23 .

Successful treatment of severe pouchitis with rebamipide refractory to antibiotics and corticosteroids: A case report

PubMed Central

Miyata, Mitsuki; Konagaya, Toshihiro; Kakumu, Shiniti; Mori, Takeshi

2006-01-01

The antibiotics, metronidazole and ciprofloxacin, are the first-line treatment for pouchitis. Patients who do not respond to antibiotics or conventional medications represent a major challenge to therapy. In this report, we have described a successful treatment of severe refractory pouchitis with a novel agent, rebamipide, known to promote epithelial cell regeneration and angiogenesis. A 27-year-old male with ileo-anal pouch surgery presented with worsening anal pain, diarrhea, and abdominal pain. The patient was diagnosed to have pouchitis and was given metronidazole together with betamethasone enema (3.95 mg/dose). However, despite this intensive therapy, the patient did not improve. On endoscopy, ulceration and inflammation were seen in the ileal pouch together with contact bleeding and mucous discharge. The patient was treated with rebamipide enema (150 mg/dose) twice a day for 8 wk without additional drug therapy. Two weeks after the rebamipide therapy, stool frequency started to decrease and fecal hemoglobin became negative at the 4th wk. At the end of the therapy, endoscopy revealed that ulcers in the ileal pouch had healed with no obvious inflammation. The effect of rebamipide enema was dramatic and was maintained throughout the 11-mo follow-up. The patient continued to be in remission. No adverse effects were observed during the treatment or the follow-up period. The sustained response seen in this case with severe and refractory pouchitis indicates that agents, which promote epithelial cell growth, angiogenesis and mucosal tissue regeneration, are potential therapeutic agents for the treatment of refractory colorectal lesions. PMID:16489687

Healing acceleration of acetic acid-induced colitis by marigold (Calendula officinalis) in male rats.

PubMed

Tanideh, Nader; Jamshidzadeh, Akram; Sepehrimanesh, Masood; Hosseinzadeh, Masood; Koohi-Hosseinabadi, Omid; Najibi, Asma; Raam, Mozhdeh; Daneshi, Sajad; Asadi-Yousefabad, Seyedeh-Leili

2016-01-01

Ulcerative colitis (UC) is a type of chronic inflammatory bowel disease with unknown etiology. Several therapeutic strategies such as consumption of medicinal plants have been used for its treatment. The aim of this study was to evaluate healing effects of Calendula officinalis hydroalcoholic extract in experimentally induced UC in rat. Ninety-six rats, weighing 200 ± 20 g, were randomly divided into eight equal groups. UC induced by 3% acetic acid and oral doses of C. officinalis extract, 1500 and 3000 mg/kg, and enema (gel 10% and 20%) were given. Two groups as positive controls were given asacol (enema) and oral mesalamine. Negative control groups were given normal saline and base gel. On days 3 and 7, intestinal histopathology and weight changes, plus oxidative stress indices including malondialdehyde (MDA) level and myeloperoxidase (MPO) activity were assayed. A significant increase in the body weight of rats was seen in the group given C. officinalis extract 3000 mg/kg orally, oral mesalamine, and 20% intracolonic gel form of marigold extract compared with negative control and base gel groups during the experimental period. Acute inflammation and granular atrophy after UC induction were resolved completely completely by both 20% intracolonic gel and 3000 mg/kg orally. An increase in MPO activity and a decrease in MDA level in response to oral and intracolonic gel form of C. officinalis were observed 3 and and 7 days after treatment (P < 0.05). Our results indicate that oral and enema forms of hydroalcoholic extract of C. officinalis can be offered as are potential therapeutic agents for UC induced in rats.

Rectal administration of propylthiouracil in hyperthyroid patients: comparison of suspension enema and suppository form.

PubMed

Jongjaroenprasert, W; Akarawut, W; Chantasart, D; Chailurkit, L; Rajatanavin, R

2002-07-01

Previous studies have described the therapeutic effects of propylthiouracil (PTU) and methimazole in normal subjects after rectal suppositories. The goal of our study was to compare the pharmacokinetic and pharmacologic effects of a suppository and suspension form of PTU given per rectum. Fifteen newly diagnosed hyperthyroid patients of both genders (ages 21 to 55 years) were randomly given the drug as follows: group 1 (n = 7), a single enema (400 mg of PTU in 90 mL of sterile water) and group 2 (n = 8), two suppositories of polyethylene glycol base (200 mg of PTU in each). The pharmacokinetic study revealed earlier time to peak levels (T(max)) and significantly greater maximal peak levels (C(max)) in group 1 than in group 2, (85.71 +/- 12.12 minutes vs. 172.5 +/- 26.24 minutes for T(max) and 3.89 +/- 0.34 vs. 2.01 +/- 0.38 microg/mL, p < 0.05 for C(max), respectively). However, the area under the curve (635.16 +/- 105.71 vs. 377.87 +/- 68.09 microg x min/mL) was not statistically different between both groups. Both forms induced a significant decrease in serum free triiodothyronine (FT(3)) levels and an increase in serum rT(3) levels shortly after administration. Four subjects reported a bitter taste 5-10 minutes after receiving the drug. PTU can be effectively absorbed via the rectal route. The enema form appeared to provide better bioavailability than the suppository form. However, both preparations exhibited comparable therapeutic effect.

Anastomotic leakage after colorectal surgery: diagnostic accuracy of CT.

PubMed

Kauv, Paul; Benadjaoud, Samir; Curis, Emmanuel; Boulay-Coletta, Isabelle; Loriau, Jerome; Zins, Marc

2015-12-01

To evaluate the diagnostic accuracy of CT in postoperative colorectal anastomotic leakage (AL). Two independent blinded radiologists reviewed 153 CTs performed for suspected AL within 60 days after surgery in 131 consecutive patients, with (n = 58) or without (n = 95) retrograde contrast enema (RCE). Results were compared to original interpretations. The reference standard was reoperation or consensus (a radiologist and a surgeon) regarding clinical, laboratory, radiological, and follow-up data after medical treatment. AL was confirmed in 34/131 patients. For the two reviewers and original interpretation, sensitivity of CT was 82 %, 87 %, and 71 %, respectively; specificity was 84 %, 84 %, and 92 %. RCE significantly increased the positive predictive value (from 40 % to 88 %, P = 0.0009; 41 % to 92 %, P = 0.0016; and 40 % to 100 %, P = 0.0006). Contrast extravasation was the most sensitive (reviewers, 83 % and 83 %) and specific (97 % and 97 %) sign and was significantly associated with AL by univariate analysis (P < 0.0001 and P < 0.0001). By multivariate analysis with recursive partitioning, CT with RCE was accurate to confirm or rule out AL with contrast extravasation. CT with RCE is accurate for diagnosing postoperative colorectal AL. Contrast extravasation is the most reliable sign. RCE should be performed during CT for suspected AL. • CT accurately diagnosed clinically suspected colorectal AL and showed good interobserver agreement • Contrast extravasation was the most sensitive and specific CT sign • Retrograde contrast enema during CT improved positive predictive value • Retrograde contrast enema decreased false-negative or indeterminate original CT interpretations.

Radiographic findings and clinical factors in dogs with surgically confirmed or presumed colonic torsion.

PubMed

Gremillion, Christine L; Savage, Mason; Cohen, Eli B

2018-05-01

Colonic torsion is a life-threatening condition in dogs and radiographic findings for this condition have not been well described. The purpose of this retrospective case series was to describe radiographic findings and clinical signs in a group of dogs with colonic torsion. Inclusion criteria were dogs presenting during the period of 2006 and 2016, and that had abdominal radiography and a surgically confirmed or presumed diagnosis of colonic torsion. For each dog, clinical data were recorded from medical records and imaging findings were recorded from retrieved plain radiographs and positive contrast radiographs in which barium enema was performed. Fourteen dogs met inclusion criteria. Of these, nine dogs had colonic torsion confirmed at surgery, with five dogs having surgical confirmation of colonic congestion or mesenteric torsion. Radiographic findings included segmental distention of the colon (14/14), focal narrowing of the colon (11/14), displacement of cecum (11/14), displacement of descending colon (14/14), and mild to no small intestinal distention (14/14). In cases where barium enema was performed, focal narrowing of the colon and longitudinal striations that course in a helical pattern were identified, termed the "torsion sign." Vomiting was the most common clinical sign observed (12/14), followed by abdominal pain in a small majority of cases (8/14). Severe abdominal pain and hypovolemic shock were uncommon in the patients reported (3/14). Colonic torsion should be considered as a differential diagnosis for dogs with radiographic segmental colonic distention with displacement of the descending colon and cecum. Barium enema is recommended for more definitive diagnosis. © 2018 American College of Veterinary Radiology.

[2000-year history of the ear syringe and its relationship to the enema. Images from the history of otorhinolaryngology, represented by instruments from the collection of the Ingolstadt Medical History Museum].

PubMed

Feldmann, H

1999-08-01

SYRINGES WITH A PISTON AND THEIR USE AS "CLYSTER ORICULARIUS" IN THE ANCIENT ROME: Syringes with a piston were already known in ancient times and have been mentioned as a device for spraying rose water (Philon of Byzantium, about 230 BC), and for fighting fires (Heron of Alexandria about 110 AD). Celsus mentions it several times in his grand opus "De Medicina" (1st century AD) in the treatment of purulent discharge from the ear and for removing foreign bodies from the external ear canal. He always calls it "clyster oricularius", i.e. ear syringe, even when he describes its use in applications other than otological, such as in urology. Later the ear syringe fell from favor for a very long time and was reinvented only at the beginning of the 19th century. IRRIGATION OF THE BOWELS, FROM THE BAG SYRINGE TO THE PISTON SYRINGE: Irrigations of the bowels, clysters, were performed from ancient times to the 18th century with a baglike syringe using the bladder of animals as a pouch. Syringes with a piston were used by barbers and surgeons only for cleansing wounds or irrigating natural cavities of the body. Irrigation of the external ear canal had completely fallen from favor. In France in the 18th century large syringes with a piston made of tin oder brass came into use for enemas and replaced the old baglike devices. THE REINVENTION OF THE EAR SYRINGE AFTER THE PROTOTYPE OF THE ENEMA SYRINGE: Itard, an otologist in France in 1821, was the first to describe irrigating the ear with a syringe to remove hard wax. He recommended using an enema syringe ("seringue à lavement") for the procedure. Soon after his publication special ear syringes of appropriate size were developed and described by Beck in Freiburg, Germany, in 1827; by Fabrizi in Modena, Italy, 1839; and Schmalz in Dresden, Germany, 1846, who also introduced the kidney-shaped bowel for catching the water. Apart from that, small baglike syringes made of rubber were devised especially for use by the patient himself (Kramer, Berlin, 1860). This historical development is described in detail and illustrated by numerous figures.

Attenuation of Ultraviolet Radiation by Dust in Interstellar Clouds

NASA Astrophysics Data System (ADS)

Escalante, V.

1994-07-01

Se han obtenido soluciones de la ecuación de transporte para la dispersión coherente, no conservativa y anisotrópica para estimar la precisión de métodos aproximados, usados en modelos de nubes en que la luz es atenuada principalmente por el polvo. En los cálculos se ha aplicado el metodo de armónicos esféricos para distintos parámetros del polvo. Se ha explorado la posibilidad de descubrir cambios en las caracterísiticas del polvo mediante observaciones de regiones fotodisociadas. Se muestra que para altos valores del albedo de dispersión simple y del parametro de asimetria de Ia función de fase que son adecuados para el polvo galáctico, no es posible determinar variaciones de más de un factor de 2 en el cociente de gas a polvo. Solutions to the transfer equation for coherent, non-conservative, anisotropic scattering have been obtained in order to estimate the accuracy of approximate methods used in models of clouds where light is attenuated mostly by dust. In the calculations the spherical harmonic method has been applied for different grain parameters. The possibility of discovering changes of dust characteristics through observations of photodissociation regions has been considered. It is shown that for the high values of the single scattering albedo and the asymmetry parameter of the phase function for redistribution that appear to be appropriate for galactic dust, it is not possible to determine variations of more than a factor of 2 in the gas to dust ratio.

Desarrollo de un instrumento para medir percepciones sobre el contexto de construccion del conocimiento cientifico de estudiantes universitarios de nuevo ingreso

NASA Astrophysics Data System (ADS)

Garcia-Ramirez, Jaime Antonio

En esta investigacion, se desarrollo un instrumento que permite medir percepciones relacionadas al contexto de constriccion del conocimiento cientifico. Se examinaron instrumentos existentes y se encontro que el VOSTS (Views on science, technology, and society), instrumento desarrollado empiricamente en Canada por Aikenhead, Ryan y Fleming, podia traducirse y validarse en el contexto cultural puertorriqueno. El instrumento es extenso, consta de 113 reactivos, cada uno con una premisa basica relacionada a la tematica ciencia, tecnologia y sociedad y un numero de alternativas relacionadas a la premisa que oscila entre siete y trece. Se delimito su utilizacion a los quince reactivos identificados por los autores como relacionados a la construccion social del conocimiento cientifico. Metodologicamente, se procedio a utilizar el modelo de adaptacion intercultural, que permite que el instrumento desarrollado satisfaga las dimensiones de equivalencia semantica, de contenido, tecnica, de criterio y conceptual, atemperado asi al instrumento original. Se cumplio con este proposito mediante la traduccion de la version original en ingles al espanol y viceversa. Se utilizaron comites para examinar la traduccion y la retro-traduccion del instrumento. Se realizo una prueba piloto con estudiantes universitarios de nuevo ingreso, utilizando el instrumento traducido para asegurar su intelegibilidad. La confiabilidad del instrumento se determino mediante la intervencion de un panel de expertos quienes clasificaron las distintas posiciones dentro de cada reactivo en: realista, con merito e ingenua; se transformaron estas opciones en valores numericos lo que permitio establecer una escala Likert para cada una. Se suministro el instrumento a una muestra de estudiantes universitarios de nuevo ingreso con caracteristicas similares a las de la poblacion puertorriquena en cuanto a ejecucion en las pruebas de aptitud verbal y matematica del College Board. Los resultados de sus contestaciones fueron transformados numericamente para poder obtener el coeficiente de correlacion de Spearman-Brown para el instrumento (0.661, p < 0.01). El analisis de las contestaciones de los estudiantes refleja percepciones diversas y, en algunos casos, contradictorias con respecto al contexto de construccion del conocimiento cientifico.

Puerto Rico, humedales [Puerto Rico, wetlands

USGS Publications Warehouse

Adams, D. Briane; Hefner, John M.; Dopazo, Teresa

1999-01-01

La isla de Puerto Rico, localizada al noreste del Mar Caribe y sus islas principales, Vieques, Culebra e Isla de Mona, poseen humedales en abundancia . El clima subtropical, la lluvia abundante y las complejas formas topográficas y geológicas de estas islas dan origen a los humedales, que varían desde los raros e inusuales bosques cubiertos por nubes en las tierras altas, hasta los extensos manglares, yerbas marinas y arrecifes de coral a lo largo de las costas Norte y Sur. Sin embargo, los humedales en Puerto Rico han disminuido en los últimos siglos como resultado del aumento en el desarrollo agrícola, poblacional y turístico. Algunos tipos de humedales como los bosques de palo de pollo (Pterocarpus officinalis) se han reducido a sólo unos pocos remanentes (figura 1).Biológicamente hablando, los humedales de las islas están entre las áreas más productivas. Los humedales asociados con el bosque pluvial en las tierras altas del interior de Puerto Rico contienen varias plantas raras y especies de animales que no se encuentran en otras partes de la Isla. El agua de escorrentía proveniente de los humedales en las partes altas de la Isla proveen una fuente de agua que utilizan varias ciudades para abasto público. Los humedales costeros como los mangles, los colchones de yerbas marinas y los arrecifes de coral proveen áreas para la reproducción y crianza de varios peces, crustáceos y otras especies en la cadena alimenticia (López y otros, 1988). De esta manera, los humedales costeros contribuyen a la productividad biológica de las aguas llanas del mar alrededor de las islas . Los humedales también estabilizan las costas atrapando y reteniendo sedimentos no consolidados y amortiguan la acción de las olas y de las tormentas que tienen el potencial de causar daños en la zona.El valor de los humedales de Puerto Rico para la vida silvestre está muy bien documentado . Por ejemplo, las salinas de Cabo Rojo, en la costa suroeste, proveen áreas para el descanso y la alimentación de cientos de aves migratorias en ruta entre Norte y Suramérica. Antes del drenaje de los humedales costeros para propósitos agrícolas, pantanos de agua dulce como los de la Laguna Cartagena, Laguna Guánica y Ciénaga El Anegado proveían hábitat a más de 1 00 especies de aves residentes y migratorias . Los humedales de las tierras altas del área central son el último refugio de la cotorra puertorriqueña, una especie en peligro de extinción. Aún los humedales del área metropolitana de San Juan (Laguna La Torrecilla, Torrecilla Baja, Laguna de Piñones hasta Punta Vacía Talega) proveen un hábitat excelente para la vida silvestre, mantienen criaderos de peces de alto valor económico y proveen recreación y oportunidades educativas a la población urbana.Treintiocho especies de vertebrados, moluscos y crustáceos, y 46 especies de aves, algunos raros o en peligro de extinción como la mariquita, el alcatraz, el pato dominicano, el pato silbón y la paloma cabeciblanca han sido observados en el área . También las playas asociadas con estos humedales urbanos proveen sitios de anidaje para las tortugas carey de concha y tinglar, ambas en peligro de extinción (Del Llano y otros, 1986).

Barium Sulfate

MedlinePlus

... and intestine using x-rays or computed tomography (CAT scan, CT scan; a type of body scan that uses a ... be clearly seen by x-ray examination or CT scan. ... more times before an x-ray examination or CT scan.If you are using a barium sulfate enema, ...

Estructura espacial de las órbitas caóticas en un modelo autoconsistente de galaxia elíptica

NASA Astrophysics Data System (ADS)

Muzzio, J. C.

Hemos logrado construir modelos autoconsistentes de sistemas estelares utilizando una aproximación cuadrupolar para el potencial. Esto nos permite determinar órbitas y exponentes de Lyapunov de objetos que tienen posiciones y velocidades equivalentes a las que se obtienen de la funcón de distribución del sistema. La distribución espacial de las órbitas caóticas exhibe considerable estructura y, lo que es más importante aún, los valores de los exponentes de Lyapunov calculados sobre intervalos finitos de tiempo, muestran una fuerte correlación con el comportamiento de la órbita en esos mismos intervalos, por lo que permiten reconocer distintos subsistemas con diferentes distribuciones espaciales.

Healing Acceleration of Acetic Acid-induced Colitis by Marigold (Calendula officinalis) in Male Rats

PubMed Central

Tanideh, Nader; Jamshidzadeh, Akram; Sepehrimanesh, Masood; Hosseinzadeh, Masood; Koohi-Hosseinabadi, Omid; Najibi, Asma; Raam, Mozhdeh; Daneshi, Sajad; Asadi-Yousefabad, Seyedeh-Leili

2016-01-01

Background/Aim: Ulcerative colitis (UC) is a type of chronic inflammatory bowel disease with unknown etiology. Several therapeutic strategies such as consumption of medicinal plants have been used for its treatment. The aim of this study was to evaluate healing effects of Calendula officinalis hydroalcoholic extract in experimentally induced UC in rat. Materials and Methods: Ninety-six rats, weighing 200 ± 20 g, were randomly divided into eight equal groups. UC induced by 3% acetic acid and oral doses of C. officinalis extract, 1500 and 3000 mg/kg, and enema (gel 10% and 20%) were given. Two groups as positive controls were given asacol (enema) and oral mesalamine. Negative control groups were given normal saline and base gel. On days 3 and 7, intestinal histopathology and weight changes, plus oxidative stress indices including malondialdehyde (MDA) level and myeloperoxidase (MPO) activity were assayed. Results: A significant increase in the body weight of rats was seen in the group given C. officinalis extract 3000 mg/kg orally, oral mesalamine, and 20% intracolonic gel form of marigold extract compared with negative control and base gel groups during the experimental period. Acute inflammation and granular atrophy after UC induction were resolved completely completely by both 20% intracolonic gel and 3000 mg/kg orally. An increase in MPO activity and a decrease in MDA level in response to oral and intracolonic gel form of C. officinalis were observed 3 and and 7 days after treatment (P < 0.05). Conclusion: Our results indicate that oral and enema forms of hydroalcoholic extract of C. officinalis can be offered as are potential therapeutic agents for UC induced in rats. PMID:26831607

Contrast enema as a guide for senna-based laxatives in managing overflow retentive stool incontinence in pediatrics.

PubMed

Radwan, Ahmed Bassiuony; El-Debeiky, Mohammed Soliman; Abdel-Hay, Sameh

2015-08-01

Overflow retentive stool incontinence (ORSI) is secondary to constipation and fecal loading. In our study, the dose and duration of senna-based laxatives (SBL) treatment to achieve full defecatory control will be examined for possible correlation with new parameters measured from the initial contrast enema. Initially, an observational study was conducted prospectively on a group of patient with ORSI to define the optimum dose of SBL to achieve full defecatory control with measurement of six parameters in the initial contrast enema (level of colonic dilatation, recto-anal angle, ratio of maximal diameter of dilated colon to last lumbar spine, ratio of maximum diameter of dilated colon to normal descending colon, immediate and after 24-h post-evacuation residual contrast). The result was analyzed statistically to reach a correlation between the radiological data and prescribed dose. Over 2 and half years, 72 patients were included in the study; their mean age was 6.3 ± 3.33 years. The mean effective starting dose of SBL was 57 ± 18.13 mg/day and the mean effective ending dose was 75 ± 31.68 mg/day. Time lapsed till full defecatory control ranged from 1 to 16 weeks. Statistical correlation revealed that mean effective ending dose of SBL treatment significantly increased with higher levels of colonic dilatation. A weak positive correlation was found for both the mean effective starting and ending doses with the ratio of maximum colonic diameter to last lumbar spine and descending colonic diameters ratio. Senna-based laxatives are effective treatment for overflow retentive stool incontinence and their doses can be adjusted initially depending on the analysis of the radiological data.

National audit of the sensitivity of double-contrast barium enema for colorectal carcinoma, using control charts For the Royal College of Radiologists Clinical Radiology Audit Sub-Committee.

PubMed

Tawn, D J; Squire, C J; Mohammed, M A; Adam, E J

2005-05-01

To audit the sensitivity of double-contrast barium enema (DCBE) for colorectal carcinoma, as currently practised in UK departments of radiology. As part of its programme of national audits, the Royal College of Radiologists Clinical Radiology Audit Sub-Committee undertook a retrospective audit of the sensitivity of DCBE for colorectal carcinoma during 2002. The following targets were set: demonstration of a lesion > or =95%; correct identification as a carcinoma > or =90%. Across the UK, 131 departments took part in the audit, involving 5454 examinations. The mean demonstration rate was 92.9% and the diagnosis rate was 85.9%, slightly below the targets set. The equivocal rate (lesion demonstrated, but not defined as malignant) was 6.9%, the perception failure rate was 2.8% and the technical failure rate was 4.4%. Control-chart methodology was used to analyze the data and to identify any departments whose performance was consistent with special-cause variation. When compared with the diagnosis rate (84.6%) and demonstration rate (92.7%) reported in the Wessex Audit 1995, [Thomas RD, Fairhurst JJ, Frost RA. Wessex regional audit: barium enema in colo-rectal carcinoma. Clin Radiol 1995;50:647-50.] a similar level of performance was observed in the NHS today, implying that the basic process for undertaking and reporting DCBE has remained relatively unchanged over the last few years. Improvement in the future will require fundamental changes to the process of reporting DCBE, in order to minimize the perception failure rate and accurately to describe lesions, so reducing the equivocal rate. Control-chart methodology has a useful role in identifying strategies to deliver continual improvement.

Is the routine use of a water-soluble contrast enema prior to closure of a loop ileostomy necessary? A review of a single institution experience.

PubMed

Dimitriou, Nikoletta; Panteleimonitis, Sofoklis; Dhillon, Ajit; Boyle, Kirsten; Norwood, Mike; Hemingway, David; Yeung, Justin; Miller, Andrew

2015-12-04

The aims of the study were to determine the radiological leak rate in those patients who had undergone a resection for left-sided colorectal cancer and to see if the presence of a leak can be related with the postoperative clinical period. We also aimed to identify any common factors between patients with leak. A retrospective analysis of prospectively collected data of all patients who underwent a left-sided colorectal cancer resection with formation of a defunctioning ileostomy was undertaken. Between 2005 and 2010, 418 such patients were identified. A water-soluble contrast enema was performed in 339 patients (81.1 %). Of these, 24 (7.1 %) were reported to show an anastomotic leak. Data for these 24 patients is presented in this study. Twenty-three (95.8 %) of the leaks occurred in patients who had undergone an anterior resection; 95.8 % of the patients with a leak were male. Fifteen (62.5 %) patients underwent neo-adjuvant radiation. The mean length of stay in those patients shown to have a subsequent radiological leak was 18.8 days (median), compared with the overall unit figures of 12 days. Only 29.2 % of the patients who had a leak identified had an uncomplicated postoperative period. Overall 87.5 % of the patients had a reversal of the ileostomy. Radiological leakage is not uncommon. The majority of patients, who were shown to have a radiological leak in this study, were male, had undergone an anterior resection, had received neo-adjuvant radiation, had a longer initial length of stay and had postoperative complications. Water-soluble contrast enemas could be selectively used in patients with these characteristics.

Rectosigmoid endometriosis: comparison between CT water enema and video laparoscopy.

PubMed

Stabile Ianora, A A; Moschetta, M; Lorusso, F; Lattarulo, S; Telegrafo, M; Rella, L; Scardapane, A

2013-09-01

To evaluate the accuracy of water enema computed tomography (CT) for predicting the location of endometriosis in patients with contraindications to magnetic resonance imaging (MRI), focusing on rectosigmoid lesions and having laparoscopic and histological data as the reference standard. Thirty-three women (mean age 33.4 ± 3.1 years) suspected of having deep pelvic endometriosis underwent 64-row CT and video laparoscopy within 4 weeks. Two radiologists blinded to the clinical data evaluated the CT images obtained after colonic retrograde distension using water as the contrast medium, and a comparison with laparoscopic and histological findings was performed. CT sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated. The radiation dose to patients was estimated. Cohen's weighted kappa (κ) test was used to evaluate the interobserver agreement. In 23 out of 33 patients (69%) intestinal implants were found at surgery and pathological examinations. CT confirmed the diagnosis of rectosigmoid endometriosis in 20 out of 23 implants. Three nodules located on the proximal sigmoid colon (two serosal lesions and one infiltrating the muscularis layer) with a diameter of less than 1 cm were not diagnosed. CT sensitivity, specificity, PPV, NPV, and accuracy values were 87, 100, 100, 77, and 91%, respectively. The mean effective dose estimate was 6.30 ± 1.7 mSv. Almost perfect agreement between the two readers was found (k = 0.84). Water enema CT can play a role in the diagnosis of bowel endometriosis and represents another accurate potential tool for video laparoscopic approaches, especially in patients for whom MRI is contraindicated. Copyright © 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Ultrasound guided reduction of an ileocolic intussusception by a hydrostatic method by using normal saline enema in paediatric patients: a study of 30 cases.

PubMed

Digant, Shastri Mona; Rucha, Seth; Eke, Dessai

2012-12-01

The conventional hydrostatic reduction of an intussusception with barium enema or the pneumatic reduction of an intussusception is associated with considerable ionizing radiations and a risk of perforation; while the hydrostatic reduction of an intussusception under ultrasound guidance is a very safe method because the whole procedure is visualized with real time ultrasound. Also, being a non-invasive method with a high success rate, this procedure has emerged as a useful alternative to a surgical intervention. The aim of this study was to evaluate the role of ultrasound and colour Doppler studies for the guidance of the hydrostatic reduction of a childhood intussusception by using normal saline. Among 41 children who were evaluated with ultrasonography for the confirmation of the presence of intussusceptions, hydrostatic reduction of intussusception were performed under a sonographic guidance in 30 patients, whereas 11 patients were excluded due to clinical contraindications. This disease was observed mostly at the ages of 6 months to 24 months. In 80% of the patients, there was a recent history of gastroenteritis and 40 % had a history of common cold. The most common site of the intussusception was the transverse colon near the hepatic flexor of the colon (90%), with a mean duration of 22.1±17.3 hours. The overall rate of a successful reduction was 87% and the mean reduction time was 14 minutes. None of the cases showed recurrence within 24 hrs. No complications were observed. We conclude that ultrasound with colour Doppler study is very useful for the diagnosis of intussusceptions, as well as for guided hydrostatic reductions by using normal saline enema. This is an optimal, simple, and a safe procedure for the treatment of intussusceptions in paediatric patients.

Gerson Therapy (PDQ®)—Patient Version

Cancer.gov

Gerson therapy is a complex regimen that has been used to treat people with cancer and other diseases. It includes a strict diet, dietary supplements, and enemas. No results of laboratory or animal studies have been published in scientific journals. Learn more in this expert-reviewed summary.

The antegrade continence enema procedure and total anorectal reconstruction

PubMed Central

Zbar, Andrew P.

2014-01-01

Patients may present with anal incontinence (AI) following repair of a congenital anorectal anomaly years previously, or require total anorectal reconstruction (TAR) following radical rectal extirpation, most commonly for rectal cancer. Others may require removal of their colostomy following sphincter excision for Fournier's gangrene, or in cases of severe perineal trauma. Most of the data pertaining to antegrade continence enema (the ACE or Malone procedure) comes from the pediatric literature in the management of children with AI, but also with supervening chronic constipation, where the quality of life and compliance with this technique appears superior to retrograde colonic washouts. Total anorectal reconstruction requires an anatomical or physical supplement to the performance of a perineal colostomy, which may include an extrinsic muscle interposition (which may or may not be ‘dynamized'), construction of a neorectal reservoir, implantation of an incremental artificial bowel sphincter or creation of a terminal, smooth-muscle neosphincter. The advantages and disadvantages of these techniques and their outcome are presented here. PMID:24759342

Radiology of colorectal cancer.

PubMed

Pijl, M E J; Chaoui, A S; Wahl, R L; van Oostayen, J A

2002-05-01

In the past 20 years, the radiology of colorectal cancer has evolved from the barium enema to advanced imaging modalities like phased array magnetic resonance imaging (MRI), virtual colonoscopy and positron emission tomography (PET). Nowadays, primary rectal cancers are preferably imaged with transrectal ultrasound or MRI, while barium enema is still the most often used technique for imaging of colonic cancers. Virtual colonoscopy is rapidly evolving and might considerably change the imaging of colorectal cancer in the near future. The use of virtual colonoscopy for screening purposes and imaging of the colon in occlusive cancer or incomplete colonoscopies is currently under evaluation. The main role of PET is in detecting tumour recurrences, both locally and distantly. Techniques to fuse cross-sectional anatomical (computer tomography (CT) and MRI) and functional (PET) images are being developed. Apart from diagnostic imaging, the radiologists has added image-guided minimally invasive treatments of colorectal liver metastases to their arsenal. The radio-frequency ablation technique is now widely available, and can be used during laparotomy or percutaneously in selected cases.

PubMed

López, Ana Cristina; Cecchetto, Eugenio; Aguirre, Ana Noemí; Ontiveros, Marina Celeste; Roitter, Claudia Valentina; Garcia, Adelaida Judith; Bernet, Jorgelina; Aguirre, Jorge Alberto

2018-03-23

El objetivo del estudio fue describir características clínicas, sociodemográficas y hábitos en adultos con diabetes mellitus y estudiar su asociación con la calidad de vida relacionada con la salud. Se seleccionó una muestra de 311 pacientes del Programa de Diabetes de una obra social universitaria, de la provincia de Córdoba. Se analizaron los datos a como proporciones y los componentes físico y mental del cuestionario SF-36® . El 57,4% alcanzó un nivel de instrucción terciario o universitario. La hipertensión arterial fue el factor de riesgo cardiovascular más prevalente (86,8%), seguida por dislipemia (50,6%) y obesidad (46,5%). El 24,8% tenía complicación macrovascular y el 29% microvascular. En el componente físico (CF) de calidad de vida las mujeres tuvieron una chance 4,2 veces mayor de reportar un valor inferior en relación a los varones. Entre los 50 y los 70 años se triplicó y los mayores de  70 años tuvieron 4 veces peor una puntuación en el CF respecto a los más jóvenes. Las complicaciones macro y microvasculares y los que reportaron menos de 2 hábitos de vida saludables tuvieron el doble de chances de puntuar por debajo del promedio general en el CF. La asociación entre complicaciones y peor calidad de vida es un motivo más para alcanzar un buen control metabólico, optimizar el manejo de factores de riesgo, evitando o retrasando la aparición de complicaciones.

[Not Available].

PubMed

López-Fuenzalida, Antonio; Valdés-Badilla, Pablo; Herrera-Valenzuela, Tomás; Rodríguez Canales, Carolina; Reyes Ponc, Álvaro; Arriaza Ardiles, Enrique; Durán Agüero, Samuel

2016-06-30

Introducción: la categorización del estado nutricional a través del índice de masa corporal (IMC) es uno de los recursos de valoración clínica más utilizados en el síndrome metabólico (SM). Sin embargo, es desconocida su capacidad para identificar las diferencias en la composición corporal.Objetivo: determinar si las variaciones en el estado nutricional se reflejan en la composición corporal en mujeres con SM e identificar la concordancia de clasificación del riesgo cardiometabólico entre el estado nutricional e índices antropométricos.Material y métodos: la muestra incluyó 136 mujeres (edad 42 ± 3,5 años) con SM. Se evaluó el estado nutricional, masa muscular, masa adiposa, perímetro de cintura (PC), índice cintura-cadera (ICC) e índice cintura-estatura (ICE). Se compararon los valores de composición corporale índices antropométricos; adicionalmente se determinó la concordancia clasificatoria del riesgo cardiometabólico entre los índices y el IMC.Resultados: solo la edad (p = 0,358), estatura (p = 0,209) y porcentaje de adiposidad (p = 0,234) no mostraron diferencias significativas entre los grupos. La mejor concordancia clasificatoria del riesgo cardiometabólico se observó en el PC > 88 cm (94,9%) e ICE ≥ 0,5 (94,1%) al categorizar el IMC en normopeso vs. exceso de peso; mientras que el PC > 88 cm obtuvo mejor concordancia separando al grupo en normopeso-sobrepesovs. obesidad (85,3%), aunque la sensibilidad y especificidad fueron más homogéneas con el ICC ≥ 0,85.Conclusión: el IMC no logra identificar las variaciones de la adiposidad corporal en mujeres con SM agrupadas según su estado nutricional. El IMC presenta mejor sensibilidad que especificidad respecto a los índices considerados para determinar riesgo cardiometabólico en mujeres con SM.

Estudio fotométrico de estrellas tardías de alta luminosidad en 23 cúmulos abiertos

NASA Astrophysics Data System (ADS)

Clariá, J. J.; Piatti, A. E.; Osborn, W.

Se presentan resultados obtenidos en los Observatorios de Cerro Tololo, Kitt Peak, Lowell y Las Campanas, a partir de fotometría UBV y DDO de 54 estrellas tardías de alta luminosidad en 23 cúmulos abiertos. La aplicación de dos criterios fotométricos independientes permite asignar a cada estrella probabilidades de pertenencia a cada agregado. Se encuentra que 32 estrellas son muy probablemente miembros de los cúmulos, mientras que las restantes son objetos del campo. En todos los casos se determinan excesos de color E(B-V) a través de procedimientos fotométricos y espectroscópicos tradicionales. Recientes calibraciones del sistema DDO permiten, además, derivar tipos espectrales MK, temperaturas efectivas, y abundancias superficiales de la muestra examinada. Las metalicidades DDO derivadas se distribuyen entre valores típicos de cúmulos moderadamente pobres en metales ([Fe/H]~=-0.3) y moderadamente ricos ([Fe/H]~=0.2), en tanto que las masas calculadas para las gigantes rojas oscilan entre 1 y 4 masas solares, con una dispersión dentro de cada cúmulo menor que 1 Msolar.

"banca del Fare" Summer School in Alta Langa: «THE Ruins to BE Rebuilt Will BE Our CLASSROOMS». Knowledge from Artisans to New Generations, from Ancient Skills to New Building Techniques

NASA Astrophysics Data System (ADS)

Villata, M.

2017-05-01

"Banca del fare" is an ambitious project proposed by "Cultural Park Alta Langa". It is born to hand ancient knowledges down to young people, as meeting place useful to exchange the development of new construction techniques and at the same time the traditional ones. A program of educational workshops, which constitute the summer school, was organized for increasing communication among different generations. Indeed, the last local craftsmen or artisans are coming out from their employment and there is no training process to ensure the migration of knowledge to young architects. The activities of the school took place for the first time during summer of 2016 in Alta Langa, the southern part of Langhe in Piedmont. The landscape of this area is marked by small rural architectures called "ciabòts" shed all over the countryside. Artisans and students work together to recover these buildings every year. The aim of this landscape heritage's valorization is to relate the restored ciabòt into a network, in order to create a widespread hotels system. Therefore, the essay wants to present the results of "Banca del fare" and to suggest a GIS project that can gather information about numerous "ciabòt" widespread in this territory. The interaction between land development and networking process can ensure the optimal reuse of these rural architectures.

Lower Gastrointestinal (GI) Tract X-Ray (Radiography)

MedlinePlus

... or so as your body clears the barium liquid from your system. Some people experience constipation after a barium enema. If you do not have a bowel movement for more than two days after your exam or are unable to pass gas rectally, call your physician promptly. You may need ...

Physical Properties of the SKYLAB North Polar Coronal Hole with an Extended Base and its MHD Self-Consistent Modelling

NASA Astrophysics Data System (ADS)

Bravo, S.; Ocania, G.

1991-04-01

RESUMEN Con base en las observaciones del Skylab del Sol en rayos X que permitieron r la forma de la frontera del hoyo coronal del polo norte y en las observaciones de l 'z que permitieron derivar un perfil de densidad para el flujo de viento solar (IC ese hoyo, Murno yjackson (1977) concluyeron que se requiere una adici6n t l clc energfa al flujo hasta al menos 5 R8. En este trabajo, recalculamos los perfiles de y de temperatura para el mismo hoyo pero considerando una frontera Cs mas ancha en la base, de acuerdo con las observaciones del coron6metro-K del IIAO, los espectroheliogramas en EUV del OSO-7 y las fotografias de la corona solar cerca de los 4 E)()O A. Se tomaron tambien las incertidumbres en el perfil de densidad electr6nica inl & a las observaciones de luz blanca y se consideraron diversos valores posibles dCl fl 'jo (lC masa 1 UA. Encontramos que las diferencias introducidas no son suficientes par clcsc' la necesidad de una energetizaci6n extensa del viento solar, pero una dC las s posibles muestra una concordancia muy buena con el modelado MHD (l( l flujo con el unico t6rmino adicional de la fuerza de Lorentz en la ecuaci6n de # (). ABSTRACT Based on the near to the Sun boundary of the Skylab north polar coroi ' l estimated from the AS & E X-ray photographs and on the density profile fi-C)I white light data, Munro and Jackson (1977) concluded that substantial energy the solar wind flux is required up to at least 5 Rs. In this paper we recalculate `eloci y and temperature profiles for the same hole but considering a different bo ' ry for flux tube which is larger at its base, according to the HAO K- obser"' (i()I0 , the OSO-7 EUV spectroheliograms and pictures of the solar 4500 A. è take into account the uncertainties inherent in the white light observations () electron density profile and consider different possible values of the solar I .' fltix at 1 AU. We that the differences introduced are not sufficient to discard ii y of an extended energetization of the wind, one of the possibilities allowed for fltix the observational uncertailities shows a very good agreement wi4 an NI Ill) seli'consistent modelling with the only additional term of the Lorentz force in the iiii equation. Key words: SUN-CORONA

Ayurvedic approach in the management of spinocerebellar ataxia-2.

PubMed

Singh, Sarvesh Kumar; Rajoria, Kshipra

2016-01-01

Spinocerebellar ataxia -2 is a progressive, degenerative genetic disease caused by an expanded (CAG) trinucleotide repetition on the chromosome 12 resulting in production of an abnormal protein called ataxin-2. There is no known effective management or cure in biomedicine for this genetic disease. In the present study a case of SCA2 that was treated with Ayurvedic intervention is reported. Ayurvedic treatments in this case were directed towards alleviating symptoms and to reduce severe disability due to progressive nature of disease. A 42 year old male patient was diagnosed for Vāta vyādhi (group of various neurological disorders) and was- treated with Śālisastika pinda svedana (sudation with bolus of medicated cooked rice) for 30 days-, Śirobasti (sudation of head with the help of a cap on head) with Aśvagandhā taila for 45 days and Balādi ksīra basti (enema with medicated milk) with Aśvagandhā taila anuvāsana (enema with oil) for 30 days in Karma basti krama (30 days regime of purification and oleation enema) along with a combination of Ayurvedic oral drugs which consisted of Brahadvātacintāmanirasa - 125 mg, Vasantāmaltī rasa- 125 mg, Daśamūla kvātha- 40 ml, Aśvagandhā cūrṇa (powder of Withania somnifera DUNAL)- 3g, Amrtā cūrṇa (powder of Tinospora cordifolia Willd.)- 500 mg, Muktāśukti pisti - 500 mg, Yogarāja Guggulu - 500 mg twice a day for 2 months. Patient's condition was assessed on the Scale for Assessment and Rating of Ataxia (SARA). Before treatment, mean SARA score was 35. This reduced to 15 after treatment. Good relief in dysarthria, fasciculation, heaviness in eye, blurred vision, axial tremor; constipation and quality of life were observed in this case.

Ayurvedic approach in the management of spinocerebellar ataxia-2

PubMed Central

Singh, Sarvesh Kumar; Rajoria, Kshipra

2016-01-01

Spinocerebellar ataxia -2 is a progressive, degenerative genetic disease caused by an expanded (CAG) trinucleotide repetition on the chromosome 12 resulting in production of an abnormal protein called ataxin-2. There is no known effective management or cure in biomedicine for this genetic disease. In the present study a case of SCA2 that was treated with Ayurvedic intervention is reported. Ayurvedic treatments in this case were directed towards alleviating symptoms and to reduce severe disability due to progressive nature of disease. A 42 year old male patient was diagnosed for Vāta vyādhi (group of various neurological disorders) and was- treated with Śālisastika pinda svedana (sudation with bolus of medicated cooked rice) for 30 days-, Śirobasti (sudation of head with the help of a cap on head) with Aśvagandhā taila for 45 days and Balādi ksīra basti (enema with medicated milk) with Aśvagandhā taila anuvāsana (enema with oil) for 30 days in Karma basti krama (30 days regime of purification and oleation enema) along with a combination of Ayurvedic oral drugs which consisted of Brahadvātacintāmanirasa – 125 mg, Vasantāmaltī rasa- 125 mg, Daśamūla kvātha- 40 ml, Aśvagandhā cūrṇa (powder of Withania somnifera DUNAL)- 3g, Amrtā cūrṇa (powder of Tinospora cordifolia Willd.)- 500 mg, Muktāśukti pisti – 500 mg, Yogarāja Guggulu – 500 mg twice a day for 2 months. Patient's condition was assessed on the Scale for Assessment and Rating of Ataxia (SARA). Before treatment, mean SARA score was 35. This reduced to 15 after treatment. Good relief in dysarthria, fasciculation, heaviness in eye, blurred vision, axial tremor; constipation and quality of life were observed in this case. PMID:27143801

Initial evaluation of rectal bleeding in young persons: a cost-effectiveness analysis.

PubMed

Lewis, James D; Brown, Alphonso; Localio, A Russell; Schwartz, J Sanford

2002-01-15

Evaluation of rectal bleeding in young patients is a frequent diagnostic challenge. To determine the relative cost-effectiveness of alternative diagnostic strategies for young patients with rectal bleeding. Cost-effectiveness analysis using a Markov model. Probability estimates were based on published medical literature. Cost estimates were based on Medicare reimbursement rates and published medical literature. Persons 25 to 45 years of age with otherwise asymptomatic rectal bleeding. The patient's lifetime. Modified societal perspective. Diagnostic strategies included no evaluation, colonoscopy, flexible sigmoidoscopy, barium enema, anoscopy, or any feasible combination of these procedures. Life expectancy and costs. For 35-year-old patients, the no-evaluation strategy yielded the least life expectancy. The incremental cost-effectiveness of flexible sigmoidoscopy compared with no evaluation or with any strategy incorporating anoscopy (followed by further evaluation if no anal disease was found on anoscopy) was less than $5300 per year of life gained. A strategy of flexible sigmoidoscopy plus barium enema yielded the greatest life expectancy, with an incremental cost of $23 918 per additional life-year gained compared with flexible sigmoidoscopy alone. As patient age at presentation of rectal bleeding increased, evaluation of the entire colon became more cost-effective. The incremental cost-effectiveness of flexible sigmoidoscopy plus barium enema compared with colonoscopy was sensitive to estimates of the sensitivity of the tests. In a probabilistic sensitivity analysis comparing flexible sigmoidoscopy with anoscopy followed by flexible sigmoidoscopy if needed, the middle 95th percentile of the distribution of the incremental cost-effectiveness ratios ranged from flexible sigmoidoscopy yielding an increased life expectancy at reduced cost to $52 158 per year of life gained (mean, $11 461 per year of life saved). Evaluation of the colon of persons 25 to 45 years of age with otherwise asymptomatic rectal bleeding increases the life expectancy at a cost comparable to that of colon cancer screening.

Modelling the costs and consequences of treating paediatric faecal impaction in Australia.

PubMed

Guest, Julian F; Clegg, John P

2006-01-01

To compare the costs and consequences of using oral macrogol 3350 plus electrolytes (macrogol 3350; Movicol) compared to enemas/suppositories, manual evacuation and naso-gastric administration of macrogol (NGA-PEG) lavage solution in treating paediatric faecal impaction in Australia. A decision model was constructed using published clinical outcomes, utilities and clinician-derived resource utilisation estimates. The model was used to determine the expected Commonwealth and parent costs associated with each treatment over the period of disimpaction and 12 weeks post-disimpaction, in Australian dollars at 2003/2004 prices. 92% of oral macrogol 3350-treated patients are expected to be disimpacted within 6 days following initial treatment, compared with 79% of patients treated with enemas and suppositories who are expected to be disimpacted within 8 days. All patients are expected to be disimpacted within 5 days following a manual evacuation and within 2 days following NGA-PEG. The level of health gain at 12 weeks post-disimpaction irrespective of treatment for disimpaction and subsequent maintenance is expected to be the same; the expected quality-adjusted life years (QALYs) being 0.20 (95% CI: 0.17; 0.23). Starting treatment with oral macrogol 3350 in an outpatient setting is expected to lead to a Commonwealth cost of $758, compared to $1838 with NGA-PEG, $2125 with enemas and suppositories, $3931 with oral macrogol 3350 in an inpatient setting and $4478 with manual evacuation. Resource use associated with maintenance following initial disimpaction is expected to be broadly similar, irrespective of initial laxative. Hence, the expected Commonwealth cost is primarily affected by the treatment used to initially disimpact a patient. Expected parents' costs are expected to be comparable irrespective of treatment ranging from $89 to $112 per patient. Within the limitations of our model, using oral macrogol 3350 in an outpatient setting for treating faecally impacted children affords a cost effective alternative compared to the other treatments investigated.

Confidence Intervals for Omega Coefficient: Proposal for Calculus.

PubMed

Ventura-León, José Luis

2018-01-01

La confiabilidad es entendida como una propiedad métrica de las puntuaciones de un instrumento de medida. Recientemente se viene utilizando el coeficiente omega (ω) para la estimación de la confiabilidad. No obstante, la medición nunca es exacta por la influencia del error aleatorio, por esa razón es necesario calcular y reportar el intervalo de confianza (IC) que permite encontrar en valor verdadero en un rango de medida. En ese contexto, el artículo plantea una forma de estimar el IC mediante el método de bootstrap para facilitar este procedimiento se brindan códigos de R (un software de acceso libre) para que puedan realizarse los cálculos de una forma amigable. Se espera que el artículo sirva de ayuda a los investigadores de ámbito de salud.

[Iatrogen perforation of the rectum after colon radiography].

PubMed

Eggum, R; Kressner, U; Haffner, J

1998-05-10

Perforation of the rectum following barium enema is relatively rare, occurring in 1 of 3,000 procedures. Colorectal perforation is a serious condition and early diagnosis is of paramount importance in order to avoid any delay in treating the patient. Direct suture of the perforation, lavage, presacral drainage and stomia are the preferred methods of primary surgical treatment.

X-Rays - Multiple Languages

MedlinePlus

... Cantonese dialect) (繁體中文) French (français) Hindi (हिन्दी) Japanese (日本語) Korean (한국어) Russian (Русский) Somali (Af-Soomaali ) ... हिन्दी (Hindi) Bilingual PDF Health Information Translations Japanese (日本語) Expand Section Barium Enema - 日本語 (Japanese) Bilingual ...

Evolución de estrellas enanas blancas en el contexto de una constante de gravitación G variable en el tiempo

NASA Astrophysics Data System (ADS)

Benvenuto, O. G.; Althaus, L. G.; Torres, D. F.

En este trabajo se estudia por primera vez de manera autoconsistente la evolución de las estrellas enanas blancas en el caso de una constante de gravitación G variable en el tiempo. Teniendo en cuenta que: 1) las enanas blancas son en general estrellas muy viejas y 2) su fuente de energía es básicamente de origen térmico y gravitacional, estos objetos son en principio muy adecuados para analizar distintas teorías de gravitación. Los cálculos que aquí presentamos fueron realizados utilizando nuestro código de evolución estelar, el cual calcula la evolución de estrellas enanas blancas por medio del esquema iterativo de Henyey. Dicho código, basado en una descripción física muy detallada, ha sido modificado para tener en cuenta la variación del valor de G. Encontramos que un G variable (decreciente en el tiempo) modifica fuertemente la evolución de las enanas blancas, conduciendo a un rápido enfriamiento de la estrella. Nuestros resultados son comparados con recientes datos observacionales sobre la función de luminosidad de las enanas blancas.

[Not Available].

PubMed

Clavijo-Redondo, Arturo R; Vaquero-Cristóbal, Raquel; López-Miñarro, Pedro A; Esparza-Ros, Francisco

2016-06-30

Introducción: a pesar de que las características antropométricas es uno de los métodos utilizados dentro de la selección de talentos deportivos, son pocos los estudios que han analizado el perfil morfológico del jugador de béisbol de élite.Objetivo: analizar el perfil antropométrico de los jugadores de béisbol de élite nacional de forma global y según el puesto ocupado.Material y métodos: Doscientos diecisiete jugadores de béisbol masculino (edad: 23,87 ± 5,32 años) de la División de Honor española participaron en el presente estudio. A todos ellos se les clasificó según su posición de juego y se les realizó una valoración antropométrica. Posteriormente se calculó su somatotipo, composición corporal, índice de masa corporal (IMC) y sumatorio de seis pliegues.Resultados: los jugadores no mostraron diferencias significativas en función de su posición en el campo en la talla, el peso, los pliegues tríceps, subescapular, bíceps, supraespinal, abdominal y pierna, ni en el sumatorio de seis pliegues o el diámetro biestiloideo. Sí que se encontrarondiferencias significativas en el pliegue del muslo, perímetros del brazo contraído y pierna y diámetros biepicondíleo del húmero y fémur. Tampoco se hallaron diferencias significativas en el IMC, la composición corporal o el somatotipo. Los valores de endomorfia fueron altos, los de mesomorfia altos o medio-altos y los de ectomorfia bajos, siendo la clasificación del somatotipo mesoendomorfo o endomorfo-mesomorfo según la posición de juego.Conclusión: existe una gran homogeneidad en el perfil antropométrico de los jugadores de béisbol según su posición de juego, diferenciándose únicamente en algunas variables antropométricas como perímetros y diámetros.

Combinación de Valores de Longitud del Día (LOD) según ventanas de frecuencia

NASA Astrophysics Data System (ADS)

Fernández, L. I.; Arias, E. F.; Gambis, D.

El concepto de solución combinada se sustenta en el hecho de que las diferentes series temporales de datos derivadas a partir de distintas técnicas de la Geodesia Espacial son muy disimiles entre si. Las principales diferencias, fácilmente detectables, entre las distintas series son: diferente intervalo de muestreo, extensión temporal y calidad. Los datos cubren un período reciente de 27 meses (julio 96-oct. 98). Se utilizaron estimaciones de la longitud del día (LOD) originadas en 10 centros operativos del IERS (International Earth Rotation Service) a partir de las técnicas GPS (Global Positioning System) y SLR (Satellite Laser Ranging). La serie temporal combinada así obtenida se comparó con la solución EOP (Parámetros de la Orientación Terrestre) combinada multi-técnica derivada por el IERS (C04). El comportamiento del ruido en LOD para todas las técnicas mostró ser dependiente de la frecuencia (Vondrak, 1998). Por esto, las series dato se dividieron en ventanas de frecuencia, luego de haberles removido bies y tendencias. Luego, se asignaron diferentes factores de peso a cada ventana discriminando por técnicas. Finalmente estas soluciones parcialmente combinadas se mezclaron para obtener la solución combinada final. Sabemos que la mejor solución combinada tendrá una precisión menor que la precisión de las series temporales de datos que la originaron. Aun así, la importancia de una serie combinada confiable de EOP, esto es, de una precisión aceptable y libre de sistematismos evidentes, radica en la necesidad de una base de datos EOP de referencia para el estudio de fenómenos geofísicos que motivan variaciones en la rotación terrestre.

Presentación del estudio "Links" de hombres que tienes sexo con hombres en Buenos Aires, Argentina.

PubMed

Carballo-Diéguez, Alex; Avila, María M; Balán, Iván C; Marone, Rubén; Pando, María A; Barreda, Victoria

2011-03-01

Estudios previos en Buenos Aires reportaron altas prevalencias de HIV entre HSH, con valores que oscilan entre 9 y 14% durante casi 10 años de continuo testeo. El objetivo principal de este estudio fue la evaluación de factores relacionados al comportamiento de alto riesgo para transmisión del HIV entre HSH entre los que se incluyen el conocimiento y factores emocionales, socioculturales y ambientales. Por otro lado se realizó la estimación de prevalencia e incidencia de HIV utilizando RDS (Respondent Driven Sampling), así como la presencia de otras infecciones de transmisión sexual. Por último se evaluaron los hábitos de testeo para HIV indagando que factores facilitan o impiden su realización. El estudio constó de dos fases, en primer lugar una fase cualitativa y posteriormente una fase cuantitativa con una duración total de 4 años y medio. Durante la fase cualitativa se realizaron 44 entrevistas individuales en profundidad, 8 grupos focales y 10 observaciones etnográficas (hoteles, baños públicos ("teteras"), cines pornográficos, fiestas privadas, dark rooms y discotecas). Durante la fase cuantitativa del estudio se realizó el reclutamiento de 500 participantes que provinieron de la Ciudad Autónoma de Buenos Aires, así como del Gran Buenos Aires. El reclutamiento se comenzó con 16 participantes llamados semillas. Se realizó el diagnóstico de infección por HIV, hepatitis B y C (HBV y HCV), Treponema pallidum, Virus Papiloma Humano (HPV) y Chlamidias. La colaboración establecida entre los grupos de trabajo enfocados en áreas diversas posibilitó el abordaje conjunto de nuevas estrategias de investigación antes no exploradas en nuestro país. Los resultados más relevantes de esta investigación serán progresivamente publicados en sucesivos números de Actualizaciones en SIDA.

[Not Available].

PubMed

Burgos Peláez, Rosa; Cuerda Compes, María Cristina; García-Luna, Pedro P; Martínez Faedo, Ceferino; Mauri Roca, Sílvia; Moreno Villares, José Manuel; Virgili Casas, M Nuria; Wanden-Berghe, Carmina

2016-07-19

Introducción:la nutrición parenteral (NP) a largo plazo puede asociarse a complicaciones graves, con un deterioro importante de la calidad de vida de los pacientes con síndrome de intestino corto (SIC). Teduglutida, un análogo del péptido-2 similar al glucagón, pertenece a una nueva familia terapéutica y representa el primer abordaje no sintomático del SIC. Objetivos: revisar los datos preclínicos y clínicos en cuanto a eficacia y seguridad de teduglutida. Resultados: la aprobación de teduglutida se basó en los resultados de un estudio en fase III de 24 semanas, doble ciego, controlado con placebo (STEPS). Pacientes con fallo intestinal por SIC dependientes de NP ≥ 3 veces/semana durante ≥ 12 meses recibieron 0,05 mg/kg de teduglutida (n = 43) o placebo (n = 43) 1 vez/día. En la semana 24 hubo significativamente más respondedores en el grupo de teduglutida que en el de placebo (63 vs.30%; p = 0,002). La reducción absoluta media del volumen de NP frente al valor basal en la semana 24 fue significativamente mayor con teduglutida (4,4 vs.2,3 l/semana; p < 0,001). La necesidad de NP se redujo ≥ 1 día en la semana 24 en el 54% de pacientes tratados con teduglutida vs.23% con placebo. Del total de pacientes que recibieron teduglutida en los ensayos en fase III (n = 134), el 12% consiguió una autonomía completa de la NP. Por lo general, la administración subcutánea de teduglutida se toleró bien. Conclusiones: se ha demostrado que teduglutida recupera la absorción intestinal y reduce significativamente la dependencia de la NP, consiguiendo incluso la independencia en algunos pacientes.

PubMed

Ferrer Gómez, Mercedes; García Zafra, María Victoria; Cuenca Sánchez, Juan Ramón; Sánchez Romera, Juan Francisco; Aranda García, Ana; Rausell Rausell, Víctor José; Hernández Martínez, Antonio Miguel

2016-09-20

Introducción: en Murcia, y hasta 2010, la administración de la nutrición enteral domiciliaria (NED) dictaba cumplir la regulación marcada en cuanto a los facultativos con competencias para su prescripción.Objetivos: examinar aspectos esenciales de este recurso en el periodo 2007-2010, características de la muestra y evolución del coste, así como perspectivas de futuro.Métodos: estudio del perfil de la población NED en un área de salud específica. Selección de recetas facturadas de productos NED en el conjunto de la Región, clasificación por tipos y análisis de la evolución en importe y en envases para el periodo 2007-2010.Resultados: respecto al perfil de la muestra del Área I de Salud de la Región, la patología, vía de administración y tipo de nutrición más frecuentes resultaron, respectivamente, la enfermedad neurológica, la vía oral y la nutrición no específica. Por otro lado, el gasto sanitario en productos dietoterápicos, en el Servicio Murciano de Salud, aumentó alrededor del 50% entre los años 2007 y 2010. Tanto en envases como en importe, Murcia se sitúa por encima de la media nacional.Conclusiones: el perfil de la muestra no coincide con trabajos publicados en otras regiones. Este dato, junto a la posición de Murcia en gasto dietoterápico, y su evidente tendencia al alza en los años analizados, hace evidente la necesidad de medidas que mejoren la calidad de la NED en la Región de Murcia y, en caso de ser posible, conseguir alcanzar valores nacionales en relación con el consumo medio y el gasto.

Prevalence of occult inflammatory bowel disease in ankylosing spondylitis.

PubMed

Costello, P B; Alea, J A; Kennedy, A C; McCluskey, R T; Green, F A

1980-10-01

Fifty-five patients with ankylosing spondylitis and 16 control patients matched for sex and age were examined for evidence of occult inflammatory bowel disease. In all patients evaluation included history and physical examination, barium enema, sigmoidoscopy, and rectal biopsy. The results of this study suggest that there is no increased prevalence of occult inflammatory bowel disease in patients with ankylosing spondylitis.

Appendicostomy irrigation for facilitating colonic evacuation in colostomy patients. Preliminary report.

PubMed

Kotanagi, H; Koyama, K; Sato, Y; Takahashi, K

1998-08-01

A method for bowel irrigation through an appendicostomy (antegrade colonic enema) for patients with a left colostomy is described. The appendicostomy is easily constructed without morbidity. Irrigation through the appendicostomy is performed with minimum equipment, uses a small volume of irrigation water, and takes a relatively short time. This may improve colonic evacuation in patients with left colostomy.

Tissue sulfomucin and sialomucin content in colon mucosa without intestinal transit subjected to intervention with Curcuma longa (curcumin).

PubMed

Alves, Antonio José Tiburcio; Pereira, José Aires; Pansani, Adrieli Heloísa Campardo; Magro, Daniela Oliveira; Coy, Cláudio Saddy Rodrigues; Martinez, Carlos Augusto Real

2017-03-01

To measure the tissue sulfomucin and sialomucin content of the colon mucosa without fecal flow, subjected to intervention with curcumin, and the influence of the concentration used and the intervention time. Thirty-six rats were subjected to proximal right colostomy and distal mucous fistula. They were divided into two groups according to whether sacrifice was performed two or four weeks after the intervention. Each group was divided into three subgroups according to the enema applied daily: saline alone; curcumin at 50 mg/kg/day or curcumin at 200 mg/kg/day. Acid mucins were diagnosed using the Alcian blue technique. The mucin content was quantified by means of computer-assisted image analysis. The significance level of 5% was used throughout (p < 0.05). There were dose-related increases in the quantities of sulfomucins in the animals subjected to interventions with curcumin, both after two weeks (p < 0.00001) and after four weeks (p < 0.00001). There were increases in sialomucin quantity that were concentration-related (p < 0.00001) and time-related (p < 0.00001). Curcumin enemas increase the quantity of acid mucins in the intestinal flow in the excluded colon, with dose and time dependency.

Management of extremely low birth weight neonates with bowel obstruction within 2 weeks after birth.

PubMed

Hatanaka, Akira; Nakahara, Saori; Takeyama, Eriko; Iwanaka, Tadashi; Ishida, Kazuo

2014-12-01

The majority of bowel obstructions in extremely low birth weight (ELBW) neonates are meconium-related ileus (MRI). ELBW neonates with bowel obstruction may recover by conservative treatment, but some do not. Considering the high surgical morbidity rates, unnecessary surgery should be avoided. We sought to identify a reasonable treatment strategy under these conditions. ELBW neonates who started to have bowel obstruction with an unclear cause within 14 days of age were enrolled. The study period was from January 2009 to August 2011. The enrolled patients had daily Gastrografin(®) enemas until 14 days of age or until the obstruction resolved. If the obstruction lasted beyond around 14 days of age, the patient underwent surgical intervention. The clinical data of the patients were collected and analyzed. Fourteen patients were enrolled. Twelve patients had MRI, which resolved within 14 days without surgery. Two patients with persistent obstruction underwent surgery, and they were found to have Hirschsprung's disease and ileal volvulus, respectively. For ELBW neonates with bowel obstruction of unclear etiology, the early and frequent administration of a Gastrografin(®) enema is reasonable. Surgery should be considered if the obstruction lasts beyond approximately 14 days after birth.

Sviluppi di Ricevitori E di Componentistica Per Banda 3 mm Ad INAF-OA Cagliari

NASA Astrophysics Data System (ADS)

Navarrini, Alessandro

2017-11-01

L'INAF-OA Cagliari (OACa) sta sviluppando un ricevitore criogenico a basso rumore basato su un mixer SSB (Single Side Band) a superconduttore SIS (Superconductor-Insulator-Superconductor) per la banda 3 mm. Il ricevitore, acquistato da IRAM, è stato fortemente modificato per essere adattato al fuoco Gregoriano di SRT (Sardinia Radio Telescope). Lo strumento è caratterizzato da una nuova criogenia a ciclo chiuso 4 K (per evitare l'uso di elio liquido in antenna), da un nuovo oscillatore locale (di tipo ALMA Banda 3) e da un nuovo sistema di controllo e di monitoraggio basato su schede Raspberry ed Arduino sviluppato ad OACa. Verranno presentati i recenti sviluppi sul ricevitore, inclusi i risultati preliminari della misura della temperatura di rumore, che raggiunge un valore pari a Trec=66 K alla frequenza di 86 GHz, nonostante la criogenia non sia ancora ottimizzata. L'INAF-OACa è coinvolto nel progetto AETHRA (Advanced European Technologies for Heterodyne Receivers for Astronomy) nel quadro del programma Radionet/Horizon2020 per il quale sta contribuendo al WP1 (Work Package 1). Lo scopo del WP1 è di sviluppare e costruire un dimostratore di un array di ricevitori a doppia polarizzazione per la banda 3 mm basato su amplificatori criogenici a basso rumore (LNA) in tecnologia a semiconduttore MMIC. Nell'ambito del WP1 l'OACa ha in carico il progetto di un OrthomodeTransducer (OMT) in guida d'onda o in tecnologia planare per la banda 72-116 GHz che sia integrabile con amplificatori MMICs ed adatto all'integrazione in un array da installare nel piano focale di un radiotelescopio. Verranno presentati i design preliminari degli OMT per AETHRA, che sono basati su prototipi sviluppati in passato da OACa.

PubMed

Ramírez-Vélez, Robinson; Triana-Reina, Héctor Reynaldo; Carrillo, Hugo Alejandro; Ramos-Sepúlveda, Jeison Alexander

2016-11-29

Objetivo: evaluar la relación entre la percepción de las barreras para la práctica de la actividad física (AF) con la presencia de obesidad abdominal (OA) en universitarios de Colombia.Métodos :estudio descriptivo y transversal en 5.663 sujetos entre 18 y 30 años de edad (3.348 hombres), pertenecientes a tres ciudades de Colombia. Se midió la circunferencia de cintura (CC) como indicador de OA y el riesgo se clasificó según valores de referencia internacionales. La autopercepción de barreras se determinó con el cuestionario Barriers to Being Active Quiz (BBAQ-21) validado en Colombia. Se calcularon razones de prevalencia (RP) entre cada dominio del cuestionario y clasificación de OA.Resultados: la prevalencia de obesidad abdominal fue del 10,4% con diferencias por sexo (7,3% hombres vs.12,6% mujeres p < 0,01). La "falta de tiempo", la "influencia social" y la "falta de habilidades" fueron las barreras más prevalentes para cesar la práctica de AF en el grupo de entrevistados con OA en ambos sexos. Al comparar los estudiantes con CC saludable, la RP de presentar OA fue mayor en el grupo de mujeres que en hombres en los dominios del cuestionario BBAQ-21 "falta de tiempo" (RP = 1,33 [IC 95% 1,11-1,60]) vs.(RP = 1,14 [IC 95% 1,03-1,26]) y "falta de recursos" (RP = 1, 93 [IC 95% 11,67-2,24])vs. (RP = 1,83 [IC 95% 1,68-1,99]), respectivamente.Conclusión: una mayor autopercepción de las barreras para realizar AF se relacionó con mayor frecuencia en el grupo con OA en universitarios de Colombia.

[Not Available].

PubMed

Vizuet Vega, Norma Isela; Shamah Levy, Teresa; Gaona Pineda, Elsa Berenice; Cuevas Nasu, Lucía; Méndez Gómez-Humarán, Ignacio

2016-07-19

Introducción: la anemia es un factor de riesgo en la población infantil con consecuencias graves para su crecimiento y desarrollo. Los programas de ayuda alimentaria pueden contribuir a su prevención y control. Objetivo: estudiar la adherencia al consumo de suplementos y su relación con la prevalencia de anemia en niños menores de tres años de edad en San Luis Potosí, México beneficiarios del programa PROSPERA.Métodos: se realizó un análisis comparativo en niños de 12 a 36 meses que consumen diferentes suplementos alimenticios: 414 pertenecientes al grupo de intervención y 334 al de comparación. Se midió la hemoglobina (Hb) por Hemocue clasificando como anémicos a quienes tuvieron valores <110 g/l. Se aplicaron pruebas de t de Student y X2. Se estimaron efectos de intervención mediante el método de diferencias en diferencias y un puntaje de adherencia al consumo de suplementos.Resultados: al final del estudio la prevalencia de anemia disminuyó 11.2 pp en el grupo de intervención y 8.7 pp en el de comparación; la interacción del puntaje de adherencia por suplemento y etapa de observación mostró que la adherencia al consumo de Bebida láctea + Vitaniño reduce el riesgo de presentar anemia (p = 0,14). El consumo de Nutrisano + Vitaniño se asoció con menor riesgo (0,2), ambos con respecto al consumo de Nutrisano.Conclusiones: el programa PROSPERA tuvo efectos importantes en la disminución de las prevalencias de anemia. Se recomienda llevar a cabo acciones para mejorar la adherencia al consumo de suplementos alimenticios, a fIn de mejorar la efectividad de los programas.

An "If This, Then that" Formulation of Decisions Related to Social Role Valorization as a Better Way of Interpreting It to People

ERIC Educational Resources Information Center

Wolfensberger, Wolf

2011-01-01

Social Role Valorization is interpreted as a high-order empirical social science theory that informs people about the relation between the social roles that people hold and what happens to them as a result, and how to valorize (improve or defend) the social roles of people at risk of social devaluation. Because Social Role Valorization is not a…

Patient Workload Profile: National Naval Medical Center (NNMC), Bethesda, MD.

DTIC Science & Technology

1980-06-01

Diets Sucrose-Fructose Elimination Diet Medium-Chain Triglyceride (MCT) Barium Enema Preparation Diet Ketogenic Diet 125 mg Calcium Test Diet ...Traditional Ketogenic Diet 150 gm and 300 gm Carbohydrate Sodium Restricted Diets Test Diets Sodium Restricted, Calorie Restricted Fat Free Test Diet Diets 100...Rations Served - NNMC, Bethesda 89 7-2 Regular and Therapeutic Diets - NNMC, Bethesda 91 7-3 Regular and Therapeutic Rations Served

Prevalence of occult inflammatory bowel disease in ankylosing spondylitis.

PubMed Central

Costello, P B; Alea, J A; Kennedy, A C; McCluskey, R T; Green, F A

1980-01-01

Fifty-five patients with ankylosing spondylitis and 16 control patients matched for sex and age were examined for evidence of occult inflammatory bowel disease. In all patients evaluation included history and physical examination, barium enema, sigmoidoscopy, and rectal biopsy. The results of this study suggest that there is no increased prevalence of occult inflammatory bowel disease in patients with ankylosing spondylitis. PMID:7436576

Step 6: Does Not Routinely Employ Practices, Procedures Unsupported by Scientific Evidence

PubMed Central

Goer, Henci; Sagady Leslie, Mayri; Romano, Amy

2007-01-01

Step 6 of the Ten Steps of Mother-Friendly Care addresses two issues: 1) the routine use of interventions (shaving, enemas, intravenous drips, withholding food and fluids, early rupture of membranes, and continuous electronic fetal monitoring; and 2) the optimal rates of induction, episiotomy, cesareans, and vaginal births after cesarean. Rationales for compliance and systematic reviews are presented. PMID:18523680

Advances in ulcerative colitis.

PubMed

Ament, M E; Berquist, W; Vargas, J

1988-01-01

Ulcerative colitis is one of the two common chronic inflammatory bowel diseases which affect the colon of children. The disease can occur at any time during infancy and childhood and is far commoner than Crohn's disease of the colon in children less than 6 years old. The Jewish population outside of Israel is at far greater risk of developing the condition than any other ethnic group. The reason for this is unknown. The chances of a family member developing the condition is 2-3 times as great as in the general population. The etiology of the condition remains unknown; however, recent advances in the understanding of the immune mechanisms in the bowel and circulation indicate there are major immunological differences between ulcerative colitis and Crohn's disease. Intestinal B cells secrete enormously increased amounts of IgG1 and a lesser increase in IgG3 in ulcerative colitis whereas in Crohn's disease, all IgG subclasses are increased, but especially IgG2. Failure of the gut immune system to control antigen crossing the colonic mucosa may be the basis for the condition. The disease is classified as moderate to severe two thirds of children as opposed to less than one third of adults. Diagnostic testing must include 3 stool cultures negative for bacterial and viral pathogens, 3 stools negative for amebiasis, trichuriasis and other intestinal parasites and absence of clostridium difficile and its toxin in the stool. Flexible proctosigmoidoscopy and/or colonoscopy should be done in every case with biopsies. Barium enema is contraindicated in the severely ill patient. Major improvements in medical treatment being tested involve the development of nonabsorbable corticosteroid enemas and sulfapyridene-free forms of salicylazosulfapyridene for use in enema and oral form. Surgery for ulcerative colitis has made major advances with the development of the Koch pouch (internal ileostomy) and ileoproctostomy. Both procedures although associated with relatively high complication rates, are esthetically and psychologically better than standard ileostomy because in neither procedure must the patient wear an ileostomy appliance. However these advanced surgical procedures are typically not done until adolescence is reached.

[Effects of Chinese herbal enema therapy combined basic treatment on BUN, SCr, UA, and IS in chronic renal failure patients].

PubMed

Zou, Chuan; Wu, Yu-Chi; Lin, Qi-Zhan

2012-09-01

To assess the clearance role and safety of Chinese herbal enema therapy (CHET) in clearing enterogenic uremic toxins in chronic renal failure (CRF) patients, thus providing evidence for further optimizing the comprehensive treatment. Using nonrandomized concurrent control trial, 96 CRF inpatients of Department of Nephropathy, Guangdong Provincial Hospital of Traditional Chinese Medicine, from March 2010 to December 2010 were assigned to the treatment group and the control group according to their willingness. All patients were treated with basic treatment referring to clinical plans in the non-dialysis phase, while those in the treatment group were additionally treated with CHET, once daily, 2 weeks as one therapeutic course. The symptoms, serum enterogenic uremic toxin levels [including indoxyl sulfate (IS), blood urea nitrogen (BUN), and uric acid (UA)], and serum creatinine (SCr) were observed in the two groups between and after treatment. The adverse reactions were also monitored during the treatment period. The clinical efficacy and safety were also assessed. Totally 84 patients completed this clinical observation, 48 in the treatment group and 36 in the control group. The levels of SCr, BUN, and IS were obviously lower in the treatment group after treatment, showing statistical difference when compared with before treatment (P<0.01). There was no statistical difference in each index in the control group between before and after treatment (P>0.05). The post-treatment the IS level was lower in the treatment group than in the control group with statistical difference (P<0.05). Symptoms like fatigue, soreness of waist and knees, constipation and edema were partially relieved in both groups (P<0.05, P<0.01). The ratios of anorexia and nausea in patients of the treatment group was lowered after treatment (P<0.05). Besides, patients in the treatment group could defecate for more than once daily during the enema treatment period, dominated as rotten and soft feces. No severe adverse event occurred during the treatment period. CHET combined basic treatment could lower the serum levels of enterogenic uremic toxins (IS and BUN) of CRF patients in a short period.

Effect and key factors of byproducts valorization: the case of dairy industry.

PubMed

Banaszewska, A; Cruijssen, F; Claassen, G D H; van der Vorst, J G A J

2014-01-01

Production of many consumer products results in byproducts that contain a considerably large part of nutrients originating from input materials. High production volumes, environmental impact, and nutritional content of byproducts make them an important subject for careful valorization. Valorization allows us to explore the possibility of reusing nutrients in the production of main products, and thus highlights the potential gains that can be achieved. The main aim of this study was to evaluate the added value of cheese whey valorization, and to determine the effect of integral valorization of main products and byproducts on the profit of a dairy producer. Several scenarios and cases were implemented and analyzed using a decision support tool, the integral dairy valorization model. Data originated from the international dairy processor FrieslandCampina (Amersfoort, the Netherlands). The outcomes of scenarios were analyzed with regard to profit and shifts in the production of nonwhey end products, and were validated by company experts. Modeling results showed that the valorization of byproducts is very profitable (24.3% more profit). Furthermore, additional profit can be achieved when 2 valorization processes (main products and byproducts) are integrated. This effect is, however, considerably affected by current capacity and market demand limitations. Significant benefits can be created if demand of whey-based products is increased by 25%. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Gabapentina a dosis de 300 vs. 450 mg como premedicación anestésica para hipertensión reactiva, ansiedad y analgesia.

PubMed

Rascón-Martínez, Dulce María; Guzmán-Sánchez, Joaquín Antonio; Corral-Urdapilleta, Nora Paulina; Arguelles-Uribe, Gema Damaris; Velázquez-Loeza, Jazmín; Soto-Palma, Gustavo; Carrillo-Torres, Orlando

Observar el comportamiento de la gabapentina para aminorar la hipertensión reactiva secundaria a ansiedad y dolor en pacientes sometidos a cirugía oftálmica, así como el consumo de opiáceos entre los grupos. Ensayo clínico controlado aleatorizado y doble ciego que analizó a 125 pacientes divididos en tres grupos: grupo A, gabapentina 300 mg; grupo B, gabapentina 450 mg; grupo C, amaranto en grageas como control 2 horas antes del procedimiento quirúrgico. Se utilizó la prueba de ji al cuadrado para variables sociodemográficas y ANOVA de un factor para variables numéricas continuas. Se consideró como significativo un valor de p < 0.05 para un estudio de dos colas con un poder beta del 80%. La ansiedad y la analgesia transoperatoria y posoperatoria tuvieron diferencias significativas entre los grupos. Se encontró menor consumo de opiáceos en los grupos que usaron gabapentina. La gabapentina por vía oral, 300 o 450 mg, 2 horas antes de la cirugía, reduce el dolor, la ansiedad y el consumo de opiáceos durante el posoperatorio en pacientes sometidos a cirugía oftalmológica. Copyright: © 2018 SecretarÍa de Salud

Simulation of regional-scale groundwater flow in the Azul River basin, Buenos Aires Province, Argentina

NASA Astrophysics Data System (ADS)

Varni, Marcelo R.; Usunoff, Eduardo J.

A three-dimensional modular model (MODFLOW) was used to simulate groundwater flow in the Azul River basin, Buenos Aires Province, Argentina, in order to assess the correctness of the conceptual model of the hydrogeological system. Simulated heads satisfactorily match observed heads in the regional water-table aquifer. Model results indicate that: (1) groundwater recharge is not uniform throughout the region but is best represented by three recharge rates, decreasing downgradient, similar to the distribution of soils and geomorphological characteristics; and (2) evapotranspiration rates are larger than previous estimates, which were made by using the Thornthwaite-Mather method. Evapotranspiration rates estimated by MODFLOW agree with results of independent studies of the region. Model results closely match historical surface-flow records, thereby suggesting that the model description of the aquifer-river relationship is correct. Résumé Un modèle modulaire tridimensionnel (MODFLOW) a été utilisé pour simuler les écoulements souterrains dans le bassin de la rivière Azul (Province de Buenos Aires, Argentine), dans le but d'évaluer la justesse du modèle conceptuel du système hydrogéologique. La piézométrie simulée s'ajuste de façon satisfaisante à celle observée pour l'ensemble de la nappe. Les résultats du modèle indiquent que: (1) la recharge de la nappe n'est pas uniforme sur toute la région, mais qu'elle est mieux approchée par trois valeurs différentes, décroissant vers l'aval-gradient, en suivant la même distribution que les sols et les caractéristiques géomorphologiques et (2) l'évapotranspiration est nettement plus importante que prévu initialement à partir de la méthode de Thornthwaite-Mather. Les valeurs d'évapotranspiration fournies par MODFLOW concordent bien avec les résultats d'autres études portant sur la région. Les résultats du modèle reproduisent convenablement les chroniques de débit des écoulements de surface, suggérant ainsi que la description par le modèle des relations rivière-nappe est correcte. Resumen Se ha utilizado el modelo MODFLOW, del Servicio Geológico de los Estados Unidos, para simular el flujo de agua subterránea en la cuenca del arroyo del Azul, Provincia de Buenos Aires, Argentina, con el objeto de evaluar el modelo hidrogeológico conceptual. Los niveles hidráulicos simulados ajustan satisfactoriamente con los niveles observados. Los resultados de la simulación indican que: (1) la recarga no es uniforme, sino que puede caracterizarse con tres zonas en las que sus valores decrecen en la medida en que decrece la pendiente, que guarda similitud con la distribución de suelos y características geomorfológicas y (2) la evapotranspiración sería mayor que la estimada en estudios previos, en los que se utilizó el método de Thornthwaite-Mather. La evapotranspiración estimada mediante la presente simulación concuerda con resultados de varios estudios independientes en la región. Respecto de la relación acuífero-río, existe un muy buen ajuste entre los aportes del acuífero al río simulados y los valores históricos de caudal base.

Validity of Retrospective Reports of Eating Behavior from the Eating Disorder Examination

DTIC Science & Technology

1999-01-01

counts of self- induced vomiting. misuse of laxatives or diuretics, fasting, and excessive exercise . To date, only three semi-structured assessment...of weight control (self- induced vomiting, laxative misuse. diuretic misuse. and intense exercising ) are assessed. Some of the individual items are...gain, such as self- induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise . C. The binge eating

Intermittent fasting prompted recovery from dextran sulfate sodium-induced colitis in mice.

PubMed

Okada, Toshihiko; Otsubo, Takeshi; Hagiwara, Teruki; Inazuka, Fumika; Kobayashi, Eiko; Fukuda, Shinji; Inoue, Takuya; Higuchi, Kazuhide; Kawamura, Yuki I; Dohi, Taeko

2017-09-01

Fasting-refeeding in mice induces transient hyperproliferation of colonic epithelial cells, which is dependent on the lactate produced as a metabolite of commensal bacteria. We attempted to manipulate colonic epithelial cell turnover with intermittent fasting to prompt recovery from acute colitis. Acute colitis was induced in C57BL/6 mice by administration of dextran sulfate sodium in the drinking water for 5 days. From day 6, mice were fasted for 36 h and refed normal bait, glucose powder, or lactylated high-amylose starch. On day 9, colon tissues were subjected to analysis of histology and cytokine expression. The effect of lactate on the proliferation of colonocytes was assessed by enema in vivo and primary culture in vitro . Intermittent fasting resulted in restored colonic crypts and less expression of interleukin-1β and interleukin-17 in the colon than in mice fed ad libitum . Administration of lactate in the colon at refeeding time by enema or by feeding lactylated high-amylose starch increased the number of regenerating crypts. Addition of lactate but not butyrate or acetate supported colony formation of colonocytes in vitro . In conclusion, intermittent fasting in the resolution phase of acute colitis resulted in better recovery of epithelial cells and reduced inflammation.

Intermittent fasting prompted recovery from dextran sulfate sodium-induced colitis in mice

PubMed Central

Okada, Toshihiko; Otsubo, Takeshi; Hagiwara, Teruki; Inazuka, Fumika; Kobayashi, Eiko; Fukuda, Shinji; Inoue, Takuya; Higuchi, Kazuhide; Kawamura, Yuki I.; Dohi, Taeko

2017-01-01

Fasting-refeeding in mice induces transient hyperproliferation of colonic epithelial cells, which is dependent on the lactate produced as a metabolite of commensal bacteria. We attempted to manipulate colonic epithelial cell turnover with intermittent fasting to prompt recovery from acute colitis. Acute colitis was induced in C57BL/6 mice by administration of dextran sulfate sodium in the drinking water for 5 days. From day 6, mice were fasted for 36 h and refed normal bait, glucose powder, or lactylated high-amylose starch. On day 9, colon tissues were subjected to analysis of histology and cytokine expression. The effect of lactate on the proliferation of colonocytes was assessed by enema in vivo and primary culture in vitro. Intermittent fasting resulted in restored colonic crypts and less expression of interleukin-1β and interleukin-17 in the colon than in mice fed ad libitum. Administration of lactate in the colon at refeeding time by enema or by feeding lactylated high-amylose starch increased the number of regenerating crypts. Addition of lactate but not butyrate or acetate supported colony formation of colonocytes in vitro. In conclusion, intermittent fasting in the resolution phase of acute colitis resulted in better recovery of epithelial cells and reduced inflammation. PMID:28955126

Exploratory study on the ayurvedic therapeutic management of cerebral palsy in children at a tertiary care hospital of karnataka, India.

PubMed

Shailaja, U; Rao, Prasanna N; Debnath, Parikshit; Adhikari, Anjan

2014-01-01

Cerebral palsy (CP) is the leading cause of childhood disability affecting cognitive function and developments in approximately 1.5 to 3 cases per 1000 live births. Based on Ayurvedic therapeutic principles, CP patients were subjected to Abhyanga (massage) with Moorchita Tila Taila (processed sesame oil) and Svedana (fomentation) with Shastikashali Pinda Sveda (fomentation with bolus of drugs prepared with boiled rice). Study group received Mustadi Rajayapana Basti (enema with herbal decoction) and Baladi Yoga (a poly-herbo-mineral formulation), while the placebo group received Godhuma Vati (tablet prepared with wheat powder) and saline water as enema. Treatment with Mustadi Rajayapana Basti and Baladi Yoga improved the activities of daily life by 8.79%, gross motor functions by 19.76%, and fine motor functions 15.05%, and mental functions like memory retention got improved by 15.43%. The placebo group showed an improvement of 0.21% in daily life activities, 2.8% in gross motor, and 2.4% in fine motor functions. Mustadi Rajayapana Basti and Baladi Yoga proved to be more supportive in improving the motor activities and gross behavioral pattern. Further clinical trials are required to evaluate and validate the maximum effect of the combination therapy in a large sample with repetition of the courses for longer duration.

Exploratory Study on the Ayurvedic Therapeutic Management of Cerebral Palsy in Children at a Tertiary Care Hospital of Karnataka, India

PubMed Central

Shailaja, U; Rao, Prasanna N.; Debnath, Parikshit; Adhikari, Anjan

2014-01-01

Cerebral palsy (CP) is the leading cause of childhood disability affecting cognitive function and developments in approximately 1.5 to 3 cases per 1000 live births. Based on Ayurvedic therapeutic principles, CP patients were subjected to Abhyanga (massage) with Moorchita Tila Taila (processed sesame oil) and Svedana (fomentation) with Shastikashali Pinda Sveda (fomentation with bolus of drugs prepared with boiled rice). Study group received Mustadi Rajayapana Basti (enema with herbal decoction) and Baladi Yoga (a poly-herbo-mineral formulation), while the placebo group received Godhuma Vati (tablet prepared with wheat powder) and saline water as enema. Treatment with Mustadi Rajayapana Basti and Baladi Yoga improved the activities of daily life by 8.79%, gross motor functions by 19.76%, and fine motor functions 15.05%, and mental functions like memory retention got improved by 15.43%. The placebo group showed an improvement of 0.21% in daily life activities, 2.8% in gross motor, and 2.4% in fine motor functions. Mustadi Rajayapana Basti and Baladi Yoga proved to be more supportive in improving the motor activities and gross behavioral pattern. Further clinical trials are required to evaluate and validate the maximum effect of the combination therapy in a large sample with repetition of the courses for longer duration. PMID:24872933

The changing trend of diverticular disease in a developing nation.

PubMed

Fong, S S; Tan, E Y; Foo, A; Sim, R; Cheong, D M O

2011-03-01

Left-sided diverticular disease (LDD) is associated with reduced dietary intake, whereas right-sided diverticular disease (RDD) is more common amongst Oriental populations. We aimed to determine whether the prevalence, site and distribution of diverticular disease in our Oriental population has changed over the past two decades. A total of 1663 barium enema studies performed between January 2001 and August 2002 were reviewed retrospectively. The site of disease was correlated with age, gender and ethnicity of the patient. Forty-five per cent of patients in the study population had diverticular disease. Older patients were more likely to have LDD, whereas the Chinese ethnic group was more likely to have RDD. Right-sided diverticular disease peaks at in the sixth decade, while for LDD this occurred in the seventh and eighth decades. Right-sided diverticular disease was more common in all age groups overall. When compared with two barium enema studies carried out in Singapore two decades earlier, there was a statistically significant increase in the incidence of RDD and LDD. There is a positive association of RDD and LDD with Chinese race and increasing age. There is an increasing incidence of both LDD and RDD compared with two decades previously. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

Constipation in adults.

PubMed

Frizelle, Frank; Barclay, Murray

2007-08-01

Although there are defined criteria for the diagnosis of constipation, in practice, diagnostic criteria are less rigid, and in part depend on the perception of normal bowel habit. Constipation is highly prevalent, with approximately 12 million general practitioner prescriptions for laxatives in England in 2001. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of non-drug interventions, and of other interventions, in adults with idiopathic chronic constipation? We searched: Medline, Embase, The Cochrane Library and other important databases up to October 2006 (BMJ Clinical evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 42 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: arachis oil, biofeedback, bisacodyl, cascara, docusate, exercise, glycerine suppositories, glycerol, high-fibre diet, increasing fluids, ispaghula husk, lactitol, lactulose, macrogols (polyethylene glycols), magnesium salts, methylcellulose, paraffin, phosphate enemas, seed oils, senna, sodium citrate enemas, sterculia.

Therapeutic strategies of meconium obstruction of the small bowel in very-low-birthweight neonates.

PubMed

Koshinaga, Tsugumichi; Inoue, Mikiya; Ohashi, Kensuke; Sugito, Kiminobu; Ikeda, Taro; Tomita, Ryouichi

2011-06-01

Meconium obstruction without cystic fibrosis in low-birthweight neonates is a distinct clinical entity. We aimed to determine what therapeutic strategies work best in very-low-birthweight neonates with meconium obstruction of the small bowel under varied clinical conditions caused by the associated diseases of prematurity. Medical records of very-low-birthweight neonates with meconium obstruction of the small bowel treated from 1998 to 2008 were retrospectively reviewed. Pre- and postnatal data, treatments, and clinical outcomes were assessed. Nine patients with perinatal complications were identified. Mean gestational age and birthweight were 26.9 weeks and 863 g, respectively. Abdominal distension developed from 1 to 7 days of life. Five patients were initially treated with Gastrografin enema, three of whom had successful outcomes. Two hemodynamically unstable patients failed to respond to Gastrografin treatment; they ultimately died of sepsis. The remaining four without Gastrografin treatment underwent enterostomy to resolve the obstructions with good results. Gastrografin and surgical treatments should be appropriately selected based on the underlying pathologies of meconium obstruction of the small bowel. Therapeutic Gastrografin enema is effective, safe and repeatable; however, it is not recommended for hemodynamically unstable patients. Surgical intervention is reserved for those who develop rapid abdominal distension that risks perforation. © 2011 The Authors.Pediatrics International © 2011 Japan Pediatric Society.

Moving towards South-South International Health: debts and challenges in the regional health agenda.

PubMed

Herrero, María Belén

2017-07-01

The aim of this paper is twofold. First, it aims to investigate the increased interest in health as an important dimension of the foreign policy and diplomatic concerns together with the emergence of a new framework for regional health integration and regional health diplomacy. Second, it seeks to understand the role and practices of new regional blocs in the field of health and whether they are conducting to the emergence of new strategies for addressing health regional policies in South America. The regional policy process relates to health as a right. Thus, some practices and processes in social policy are setting new standards for political and social cohesion in the construction of new regionalism. Health crosses national, regional, and global agendas in a multi-directional fashion, rather than via one-way, top-down policy transfer. A special feature of Unasur is upholding regional health sovereignty despite the unique fact that member countries retain national autonomy. Unasur has projected foreign policy that promotes social values in ways that seem innovative. Experience as Unasur shows that regional organisms can become a game changer in global diplomacy and an influential actor in the international agenda. Resumen El objetivo de este artículo es doble. En primer lugar,investigar el creciente interés en la salud como una dimensión importante de la política exterior, en sintonía con el surgimiento de un nuevo marcopara la integración regional y la diplomacia en salud. En segundo lugar, comprender el papel y las prácticas de los nuevos bloques regionales en el campo de la salud y si estasconducena la emergencia de nuevas estrategias para abordar las políticas sanitarias regionales en América del Sur. Los nuevos procesos de integración regional se refieren a la salud como un derecho. Así, algunas prácticas y procesos de la política regional están estableciendo nuevos patrones de cohesión política y social en el avancede un nuevo regionalismo. La salud en este proceso de formulación e implementación de la política regional,atraviesa las agendas nacionales, regionales y globales de forma multidireccional. Un valor agregado de Unasur es su propuesta de avanzar es pos de una mayor soberanía regional en salud, a pesar del hecho de que los países miembros mantienen su autonomía nacional. En este sentido, Unasur ha proyectado una política exterior que promueve principios y valores a partir de un enfoque innovador. El caso de Unasur muestra que los organismos regionales tienen el potencial para cambiar las reglas (y el resultado) del juego en la diplomacia global y convertirse en actores influyentes en la agenda internacional.

A "safe space" for learning and reflection: one school's design for continuity with a peer group across clinical clerkships.

PubMed

Chou, Calvin L; Johnston, C Bree; Singh, Bobby; Garber, Jonathan D; Kaplan, Elizabeth; Lee, Kewchang; Teherani, Arianne

2011-12-01

The value of continuity in medical education, particularly during clerkships, is increasingly recognized. Previous clerkship-based models have described changes that emphasize continuity in patient care, learner supervision, and curriculum. The creation of continuous student peer groups can foster interactions that enhance mutual support through uncomfortable professional transitions during the clerkship years. Here, the authors describe a third-year clerkship model based at the San Francisco Veterans Affairs (VA) Medical Center called VA Longitudinal Rotations (VALOR), designed explicitly to establish a supportive learning environment for small peer groups.Seven groups of medical students (42 total) completed VALOR across three academic years between 2007 and 2009. On clerkships during VALOR, one hour per week was designated for faculty-facilitated sessions amongst peer groups. Students' perceptions of peer group support and overall program satisfaction were determined with immediate post surveys and focus groups at the end of VALOR, and with follow-up surveys 5 to 27 months after completing VALOR. Students strongly valued several elements of VALOR peer groups, including support through clerkship challenges, meeting for facilitated reflection, and appreciating patient experiences across the continuum of care. Students' appreciation for their peer group experiences persisted well after the conclusion of VALOR. VALOR students performed the same as or better than traditional clerkship students on knowledge and skill-based outcomes. The authors demonstrate that their third-year clerkship program using peer groups has built supportive learning networks and facilitated reflection, allowing students to develop critical professional skills. Student communication around patient care was also feasible and highly valued.

Presentación del estudio “Links” de hombres que tienes sexo con hombres en Buenos Aires, Argentina

PubMed Central

Carballo-Diéguez, Alex; Ávila, María M; Balán, Iván C.; Marone, Rubén; Pando, María A.; Barreda, Victoria

2011-01-01

Resumen Estudios previos en Buenos Aires reportaron altas prevalencias de HIV entre HSH, con valores que oscilan entre 9 y 14% durante casi 10 años de continuo testeo. El objetivo principal de este estudio fue la evaluación de factores relacionados al comportamiento de alto riesgo para transmisión del HIV entre HSH entre los que se incluyen el conocimiento y factores emocionales, socioculturales y ambientales. Por otro lado se realizó la estimación de prevalencia e incidencia de HIV utilizando RDS (Respondent Driven Sampling), así como la presencia de otras infecciones de transmisión sexual. Por último se evaluaron los hábitos de testeo para HIV indagando que factores facilitan o impiden su realización. El estudio constó de dos fases, en primer lugar una fase cualitativa y posteriormente una fase cuantitativa con una duración total de 4 años y medio. Durante la fase cualitativa se realizaron 44 entrevistas individuales en profundidad, 8 grupos focales y 10 observaciones etnográficas (hoteles, baños públicos (“teteras”), cines pornográficos, fiestas privadas, dark rooms y discotecas). Durante la fase cuantitativa del estudio se realizó el reclutamiento de 500 participantes que provinieron de la Ciudad Autónoma de Buenos Aires, así como del Gran Buenos Aires. El reclutamiento se comenzó con 16 participantes llamados semillas. Se realizó el diagnóstico de infección por HIV, hepatitis B y C (HBV y HCV), Treponema pallidum, Virus Papiloma Humano (HPV) y Chlamidias. La colaboración establecida entre los grupos de trabajo enfocados en áreas diversas posibilitó el abordaje conjunto de nuevas estrategias de investigación antes no exploradas en nuestro país. Los resultados más relevantes de esta investigación serán progresivamente publicados en sucesivos números de Actualizaciones en SIDA. PMID:25264397

Diagnosis of pediatric gastric, small-bowel and colonic volvulus.

PubMed

Garel, Charles; Blouet, Marie; Belloy, Frederique; Petit, Thierry; Pelage, Jean-Pierre

2016-01-01

Digestive volvulus affects the stomach, small bowel and mobile segments of the colon and often has a developmental cause. Reference radiologic examinations include upper gastrointestinal contrast series for gastric volvulus, possibly with ultrasonography for small-bowel volvulus, and contrast enema for colonic volvulus. Treatment is usually surgical. This pictorial essay describes the embryological development and discusses the clinical and radiologic presentation of volvulus, depending on location, and details the appropriate radiologic examinations.

Determinación astronómica de la Desviación de la Vertical

NASA Astrophysics Data System (ADS)

Pacheco, A. M.; Podestá, R. C.

A partir de las coordenadas astronómicas de Latitud y Longitud determinadas en la falla geológica de Nikizanga ubicada en las serranías de Pie de Palo, y, en base a un Punto Datum de referencia, se desarrolla la metodología para la determinación de la Desviación de la Vertical, que comprende la reducción de las observaciones astronómicas, transformaciones de coordenadas, aplicación de correcciones y el cálculo definitivo de los valores angulares de la Vertical. Estos estudios se iniciaron a sugerencia del Servicio Internacional de Latitud, International Polar Motion Service (IPMS), con el objeto de obtener en determinados puntos de la Tierra la Desviación de la Vertical y su variación, dentro de la nueva disciplina denominada Astrogeodinámica, con la idea de correlacionar estas variaciones con la predicción de grandes sismos.

Composición química de cúmulos globulares galácticos: metalicidades derivadas a partir de fotometría de Washington

NASA Astrophysics Data System (ADS)

Torres, M. C.; Clariá, J. J.

Se presentan temperaturas efectivas y abundancias de 183 gigantes rojas en 7 cúmulos globulares galácticos, derivadas a partir de fotometría de Washington realizada en Cerro Tololo. Las metalicidades provienen de una calibración que tiene en cuenta la disminución de sensibilidad de algunos índices con la temperatura. Los valores medios de [Fe/H] obtenidos oscilan entre -1.2 y -2.15, con errores típicos del orden de 0.2 salvo un par de excepciones. Teniendo en cuenta que el índice (C-T1) es significativamente más sensible a la metalicidad que (V-I), se presenta una calibración de abundancia basada en el color (C-T1)o de la rama gigante roja para una determinada magnitud absoluta M(T1). Las abundancias derivadas confirman en general la escala de Zinn (1985, ApJ, 293, 424).

Nuevas observaciones de 3C10 con el VLA*: estudio de la expansión

NASA Astrophysics Data System (ADS)

Reynoso, E. M.; Moffett, D. A.:; Dubner, G. M.; Giacani, E. B.; Reynolds, S. P.; Goss, W. M.; Dickel, J.

Se presentan nuevos resultados sobre la expansión del remanente de la supernova de Tycho a lo largo de un intervalo de 10.9 años, comparando nuevas observaciones tomadas con el VLA a 1375 y 1635 MHz durante 1994 y 1995, con observaciones previas realizadas entre 1983 y 1984 (Dickel y col. ~1991 AJ 101, 2151), usando las mismas configuraciones, anchos de banda, calibradores y tiempos de integración. El coeficiente de expansión se calcula para sectores radiales de 4o de ancho cada uno, ajustando la correlación cruzada de las derivadas de los perfiles promedio para cada época. A partir de la expansión medida, se estima el índice (parámetro de expansión) de la ley potencial R∝ tm como m≡ d ln R/d ln t . Este valor se compara con coeficientes teóricos para diferentes fases evolutivas de remanentes de supernova.

Fotometría UBVI en NGC 6231

NASA Astrophysics Data System (ADS)

Baume, G. L.; Vázquez, R. A.; Feinstein, A.

Se ha realizado fotometría CCD UBVI en la zona del cúmulo abierto NGC 6231, habiéndose observado 1062 estrellas hasta una magnitud V≈ 19. Esto posibilita tener una imagen clara de la parte inferior de la secuencia principal del cúmulo. Combinando nuestros datos con tipos espectrales tomados de la literatura pudimos re-derivar la ley de absorción en dirección a este cúmulo y encontrar que los valores de R muestran variaciones de estrella a estrella. La secuencia principal inferior muestra también algunos rasgos intrigantes: hay un codo notorio en V≈ 13.5 seguido por un gran ``spread'' de magnitudes a color constante entre las estrellas débiles y una inusualmente alta densidad de estrellas a lo largo de una banda que se extiende 1.5 mag encima de la ZAMS. Los cálculos indican que el número esperado de estrellas de campo en dirección al cúmulo debería ser menor que el observado. Una re-evaluación de las funciones de luminosidad y masa dentro de los límites -7.5 < MV < 1.5 mag y 2 Msolar < M arroja pendientes planas para ambas funciones, lo que parece ser típico de cúmulos muy jóvenes. Todos estos rasgos son congruentes con un escenario joven donde las estrellas en fase de contracción están arribando a la secuencia principal.

[Virtual colonoscopy is now reality].

PubMed

Pedersen, Bodil Ginnerup; Achiam, Michael P; Arnesen, Regnar Bøge

2005-10-31

Virtual colonoscopy involves a helical CT or MR scan of the abdomen and pelvis to detect colorectal polyps and cancer. Both modalities have shown promising sensitivity in revealing larger polyps, in comparison with colonoscopy. Caution should be exercised in its clinical implementation due to significant interobserver variation and individual learning curves. A Danish study indicates that CT colonography (CTC) can be performed cost-effectively compared to colonoscopy. CTC is recommended in preference to double-contrast barium enema after incomplete colonoscopy.

Dexpanthenol enemas in ulcerative colitis: a pilot study.

PubMed

Loftus, E V; Tremaine, W J; Nelson, R A; Shoemaker, J D; Sandborn, W J; Phillips, S F; Hasan, Y

1997-07-01

To test the hypothesis that topical administration of pantothenic acid, a precursor of coenzyme A, might result in increased tissue levels of coenzyme A, improvement of fatty acid oxidation, and amelioration of ulcerative colitis. In an open-label pilot study, three patients with active left-sided ulcerative colitis received nightly enemas that contained 1,000 mg of dexpanthenol for 4 weeks. Before and after the study, patients submitted stool specimens for short-chain fatty acid analysis and urine collections for measurement of pantothenic acid and dicarboxylic acids; they also underwent flexible sigmoidoscopy for procurement of biopsy specimens for histologic examination and measurement of colonic coenzyme A activity. A clinical disease activity index and histologic disease activity index were used to assess response. Despite increases in urinary pantothenic acid, no significant changes were found in colonic tissue coenzyme A concentrations, fecal short-chain fatty acid concentrations, or urinary dicarboxylic acid concentrations. Moreover, no significant changes in clinical or histologic disease activity were noted. Although stool frequency and rectal bleeding remained unchanged, all patients noted increased abdominal cramping, and one patient had an increased extent of disease. Topically administered dexpanthenol seems to be absorbed, but at the dose used in this study, it did not influence concentrations of colonic coenzyme A activity, fecal short-chain fatty acids, or clinical response in patients with active left-sided ulcerative colitis.

Trends in referral to a single encopresis clinic over 20 years.

PubMed

Fishman, Laurie; Rappaport, Leonard; Schonwald, Alison; Nurko, Samuel

2003-05-01

To compare the characteristics of children with encopresis referred to a single encopresis clinic over the course of 20 years, including symptoms, previous diagnostic and therapeutic interventions, and parental attitudes. A retrospective study was conducted of an encopresis clinic at a tertiary care pediatric hospital. Questionnaires at initial evaluation elicited information about bowel habits, soiling, previous evaluations, previous treatments, and parental attitudes. In 503 children with encopresis, the average age of referral dropped from 115 months during the earliest 5 years to 77 months during the most recent 5 years. Children who had soiling for >3 years before referral decreased from 63% to 12%. The use of barium enema before referral decreased from 14% to 5%, as did psychological evaluation, from 25% to 14%. Previous therapy with enemas decreased from 45% to 27%. Mineral oil use remained at approximately 50%, and 20% of children had no previous treatment. Symptoms at referral and parental attitudes did not change across the years. Children are now referred at an earlier age to our tertiary encopresis clinic. The number of invasive and psychological evaluations has decreased before referral. However, treatment by many primary care providers before the referral has not changed. These data may suggest that pediatricians have increased awareness of encopresis and greater appreciation of its primarily physical rather than psychological nature. Additional studies will be needed to determine how these factors affect outcome.

After the honeymoon comes divorce: long-term use of the antegrade continence enema procedure.

PubMed

Yardley, Iain E; Pauniaho, Satu-Liisa; Baillie, Colin T; Turnock, Rick R; Coldicutt, Pat; Lamont, Graham L; Kenny, Simon E

2009-06-01

Having reported that 18% of children discontinue use of the antegrade continence enema (ACE) after 5 years, we aimed to determine long-term use after an ACE procedure. A postal/telephone questionnaire was conducted. Subjects were consecutive children undergoing an ACE between 1993 and 1999. Outcome measures were use of ACE, reasons for nonuse, complications, and overall satisfaction. Of 84 eligible subjects, data were available on 61 (73%) aged 22.4 years (15.5-35.1 years). Underlying diagnoses included spina bifida (n = 27), anorectal malformations (n = 18), constipation (n = 11), Hirschsprung's disease (n = 1), sacral agenesis (n = 2), and trauma/tumor (n = 2). Follow-up was 11.02 years (8.34-14.39 years). Thirty-six (59%) of 61 patients were still using their ACE. Reasons for nonuse were lack of effectiveness (n = 14), complications (n = 5), psychologic issues (n = 2), and poor compliance (n = 2). There was no association between diagnosis and nonuse (chi(2), P = .63). In those still using ACE, the overall satisfaction score was 4.1 (1-5). Several individuals reported feeling abandoned on becoming adults and losing the support they had in childhood. There is a late "failure" rate for the ACE procedure. However, satisfaction was high among those still using the ACE. This study further emphasizes the need for robust transitional care arrangements.

Combination of pseudocontinent perineal colostomy and appendicostomy: a new approach in the treatment of low rectal cancer.

PubMed

Azizi, Rasoul; Alvandipour, Mina; Shoar, Saeed; Mahjoubi, Bahar

2013-10-01

Abdominal perineal resection (APR) with applied colostomy remains the standard treatment for low rectal cancer; however, to date, a very high morbidity rate has been reported. The aims of this study were to assess fecal continence, persistence of disease-related symptoms, and quality of life in patients with low rectal cancer after APR and pseudocontinent perineal colostomy and concomitant appendicostomy. We included 17 patients with low rectal cancer who underwent APR at our hospital in this cross-sectional study. Following APR, pseudocontinent perineal colostomy and concomitant appendicostomy were performed. Patients then underwent antegrade colonic enema with tap water. Patients' symptoms, fecal continence, and quality of life were evaluated at regular time intervals. After a median follow-up of 12 months, 15 of 17 patients completed the study period. All patients were able to perform an antegrade enema by themselves. Mean continence score was 7 (out of 20) based on the Wexner Scale scoring system. Mean global health status score was 78, physical function was 93, and emotional function was 88. Minor morbidity was observed in 6 patients (40%). Pseudocontinent perineal colostomy with appendicostomy provides an acceptable level of continence and functional and emotional improvement in patients with low rectal cancer undergoing APR. Hence, this combinative method could be considered as an alternative for abdominal colostomy in selected patients.

[Perineal colostomy with antegrade continence enemas as an alternative after abdominoperineal resection for low rectal cancer].

PubMed

Penninckx, F; D'Hoore, A; Vanden Bosch, A

2005-06-01

Some young and active patients requiring abdominoperineal resection for rectum cancer ask for an alternative of an abdominal colostomy. We analysed the results after a combination of a perineal colostomy and antegrade continence enemas (ACE). Fifteen patients have been operated between 1999 and 2004. Follow-up was >six months in 12 patients with a mean of two years and with a maximum of 55 months. The QLQ-C30 (version 3) and CR 38 questionnaires of the EORTC have been used to evaluate quality of life aspects. Five out of 15 patients presented complications: infection of the caecal conduit (2), small bowel obstruction (1), prolapse of the perineal colostomy (1), eventration (1), urologic complications (2). ACE are still used by all patients. The volume needed was 400 ml and duration of irrigation was 30 minutes (15-45 minutes). The median score for faecal incontinence was 0 ; faecal pseudocontinence was obtained by 7/12 patients. The scores for all aspects of functioning were excellent, as well as the score for body image. The general health status and quality of life were estimated at 75% from normal value. The procedure is simple and can be performed in one operative session. A perineal colostomy with ACE seems to be a valuable and less expensive alternative for an abdominal colostomy, and certainly for total anorectal reconstruction.

Diverticular Disease of the Colon in Korea

PubMed Central

Kim, Byoung Ho; Lee, Sung Hoon; Lee, Seung Sei; Oh, Dong Joo; Chung, Eul Soon; Lee, Sang Jong

1987-01-01

This study is designed to determine the relative prevalence and characteristics of diverticular disease of the colon in Korea. We did a retrospective evaluation of 16,964 consecutive barium enemas performed at Koryo General Hospital between January 1971 and October 1986, and found 100 patients with diverticular disease of the colon. The results are as follows: 1) Colonic diverticula were found in 100 patients, and incidence of 0.59% in 16,964 consecutive barium enemas. The male to female ratio was 2.1:1.2) Incidence rose with advancing age from 0.45% in the second decade to 2.5% in the seventh decade.3) Patient age ranged from 19 to 77 years with more than 70% of the patients in the 5th, 6th and 7th decades.4) The greater majority (81%) of the diverticular disease the right colon.5) Fifty percent of the cases were classified as multiple diverticula.6) The mean age of patients with right sided diverticula was 47.5 years and that of patients with left sided diverticula was 57.7 years. The mean age of single diverticular patients was 50.4 years and that of multiple diverticular patients was 48.4 year.7) Associated diseases were hemorrhoids (18%), gall stones (12%) and previous appendectomy (11%). Among the 29 patients who had hemorrhoids and or a previous appendectomy, 28 of those had right sided diverticula. PMID:3154819

Constipation in adults.

PubMed

Mueller-Lissner, Stefan A; Wald, Arnold

2010-07-05

Although there are defined criteria for the diagnosis of constipation, in practice, diagnostic criteria are less rigid, and depend in part on the perception of normal bowel habit. Constipation is highly prevalent, with approximately 12 million general practitioner prescriptions for laxatives in England in 2001. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of non-drug interventions, bulk-forming laxatives, faecal softeners, stimulant laxatives, osmotic laxatives, prostaglandin derivatives, and 5-HT4 agonists in adults with idiopathic chronic constipation? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 51systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: arachis oil, biofeedback, bisacodyl, cascara, docusate, exercise, glycerol/glycerine suppositories, high-fibre diet, increasing fluids, ispaghula husk, lactitol, lactulose, lubiprostone, macrogols (polyethylene glycols), magnesium salts, methylcellulose, paraffin, phosphate enemas, seed oils, senna, sodium citrate enemas, prucalopride, and sterculia.

Soap Suds Enema are Efficacious and Safe for Treating Fecal Impaction in Children with Abdominal Pain

PubMed Central

Chumpitazi, Corrie E.; Henkel, Erin B.; Valdez, Karina L.; Chumpitazi, Bruno P.

2016-01-01

Importance Constipation is a common cause of pediatric abdominal pain and emergency department (ED) presentation. Despite the high prevalence, there is a dearth of clinical information and wide practice variation in childhood constipation management in the ED. Objective To assess the efficacy and safety of soap suds enema (SSE) in the treatment of fecal impaction in children with abdominal pain within the pediatric emergency department (ED) setting. The primary outcome was stool output following SSE. Secondary outcomes were adverse events, admissions, and return visits within 72 hours. Methods This is a retrospective cross-sectional study performed in the ED at a quaternary care children’s hospital of patients seen over a 12-month period who received a SSE for fecal impaction. Results Five hundred twelve patients (53% female, median age 7.8 years, range: 8 months-23 years) received SSE therapy over a 1-year period. Successful therapy (bowel movement) following SSE occurred in 419 (82%). Adverse events included abdominal pain in 24 (5%) and nausea/vomiting in 18 (4%). No SSE-related serious adverse events were identified. Following SSE, 405 (79%) were subsequently discharged, of which 15 (3.7%) returned to the ED for re-evaluation within 72 hours. Conclusions and Relevance SSE is an efficacious and safe therapeutic option for the acute treatment of childhood fecal impaction in the ED setting. PMID:26655947

Racial and gender variation in use of diagnostic colonic procedures in the Michigan Medicare population.

PubMed

McMahon, L F; Wolfe, R A; Huang, S; Tedeschi, P; Manning, W; Edlund, M J

1999-07-01

There is accumulating evidence that screening programs can alter the natural history of colorectal cancer, a significant cause of mortality and morbidity in the US. Understanding how the technology to diagnose colonic diseases is utilized in the population provides insight into both the access and processes of care. Using Medicare Part B billing files from the state of Michigan from 1986 to 1989 we identified all procedures used to diagnose colorectal disease. We utilized the Medicare Beneficiary File and the Area Resource File to identify beneficiary-specific and community-sociodemographic characteristics. The beneficiary and sociodemographic characteristics were, then, used in multiple regression analyses to identify their association with procedure utilization. Sigmoidoscopic use declined dramatically with the increasing age cohorts of Medicare beneficiaries. Urban areas and communities with higher education levels had more sigmoidoscopic use. Among procedures used to examine the entire colon, isolated barium enema was used more frequently in African Americans, the elderly, and females. The combination of barium enema and sigmoidoscopy was used more frequently among females and the newest technology, colonoscopy, was used most frequently among White males. The existence of race, gender, and socioeconomic disparities in the use of colorectal technologies in a group of patients with near-universal insurance coverage demonstrates the necessity of understanding the reason(s) for these observed differences to improve access to appropriate technologies to all segments in our society.

Factors Influencing Choices for Colorectal Cancer Screening Among Previously Unscreened African and Caucasian Americans: Findings from a Triangulation Mixed Methods Investigation

PubMed Central

Ruffin, Mack T.; Creswell, John W.; Jimbo, Masahito

2014-01-01

We investigated factors that influence choice of colorectal cancer (CRC) screening test and assessed the most- and least-preferred options among fecal occult blood testing (FOBT), flexible sigmoidoscopy, colonoscopy, and double contrast barium enema among adults with varied race, gender, and geographic region demographics. Mixed methods data collection consisted of 10 focus group interviews and a survey of the 93 focus group participants. Participants were ≥50 years of age and reported not having been screened for colorectal cancer in the last ten years. Analyses examined differences by race, gender, and geographic location. Participants had modest knowledge about CRC and there were fewer correct answers to knowledge questions by African Americans. Participants recognized value of early detection, and identified health symptoms and their doctor's recommendation as influential for obtaining CRC screening. They chose colonoscopy and FOBT as the most preferred tests, while barium enema was least preferred. The analysis revealed intra-group variations in preference, though there were no significant differences by race, gender, or location. Openness of discussing this sensitive topic, lack of knowledge about colorectal cancer and screening costs, and diversity of preferences expressed within study groups suggest the importance of patient-physician dialogue about colorectal cancer screening options. New approaches to promoting colorectal cancer screening need to explore methods to facilitate patients establishing and expressing preferences among the screening options. PMID:19082695

Soap Suds Enemas Are Efficacious and Safe for Treating Fecal Impaction in Children With Abdominal Pain.

PubMed

Chumpitazi, Corrie E; Henkel, Erin B; Valdez, Karina L; Chumpitazi, Bruno P

2016-07-01

Constipation is a common cause of pediatric abdominal pain and emergency department (ED) presentation. Despite the high prevalence, there is a dearth of clinical information and wide practice variation in childhood constipation management in the ED. The objective of the study was to assess the efficacy and safety of soap suds enema (SSE) in the therapy for fecal impaction in children with abdominal pain within the pediatric ED setting. The primary outcome was stool output following SSE. Secondary outcomes were adverse events, admissions, and return visits within 72 hours. The present study is a retrospective cross-sectional study performed in the ED at a quaternary care children's hospital of patients seen during a 12-month period who received an SSE for fecal impaction. Five hundred twelve patients (53% girls, median age 7.8 years, range: 8 months-23 years) received SSE therapy during a 1-year period. Successful therapy (bowel movement) following SSE occurred in 419 (82%). Adverse events included abdominal pain in 24 (5%) and nausea/vomiting in 18 (4%). No SSE-related serious adverse events were identified. Following SSE, 405 (79%) were subsequently discharged, of which 15 (3.7%) returned to the ED for re-evaluation within 72 hours. SSE is an efficacious and safe therapeutic option for the acute treatment of childhood fecal impaction in the ED setting.

Primary Swenson's pull-through in children with chronic constipation: a preliminary report.

PubMed

Bakare Tajudeen, I B; Badmus, T A; Lawal, A O; Katung, A I

2010-01-01

The discrepancy in diameters of the resected ends coupled with the heavy faecal loads in the colon of chronically constipated children with Hirschsprung's disease makes definitive primary pull-through procedure quite difficulty in this group. Four consecutive patients (aged 5 months to 11 years) who presented with chronic constipation were given warm saline enema along with Castor oil per oram twice daily for 1 week before and 2 weeks after full-thickness biopsies that confirmed Hirschsprung's disease. All patients had intravenous Cefuroxime or Ceftriaxone plus Metronidazole at induction of anaesthesia. Intra-operatively, the levels of resections were 6-8 cm proximal to the most contractile part of the colon adjacent to the transition zone observed after complete division of mesenteric vessels. There were three males and one female, aged 5 months to 11 years. The levels of aganglionosis were in the rectosigmoid region, except one in the descending colon. There was one case each of anastomotic stenoses, mild enterocolitis and deep peri-anal excoriation. The bowel motions were two to four times daily within 1 month post-operatively. It can be concluded from this preliminary study that with pre-operative saline enema and oral Castor oil for about 3 weeks in chronically constipated children with Hirschsprung's disease primary pull-through procedures can be performed successfully. However, further prospective work is required with this method.

Fuentes de variabilidad en el diagnóstico de gastritis atrófica multifocal asociada con la infección por Helicobacter pylori1

PubMed Central

Bravo, Luis Eduardo; Bravo, Juan Carlos; Realpe, José Luis; Zarama, Guillermo; Piazuelo, MarÍa Blanca; Correa, Pelayo

2014-01-01

RESUMEN Introducción El mapeo de las diferentes regiones del estómago y el número de fragmentos de mucosa gástrica disponibles para evaluación histopatológica son fuentes importantes de variación en el momento de clasificar y hacer la gradación de la gastritis crónica. Objetivos Estimar la sensibilidad del número de fragmentos de mucosa gástrica necesarios para establecer los diagnósticos de gastritis atrófica con metaplasia intestinal (MI), displasia y estado de infección por Helicobacter pylori. Además evaluar la variabilidad intra-observador en la clasificación de estas lesiones precursoras del cáncer gástrico. Materiales y métodos En una cohorte de 6 años de seguimiento se evaluaron 1,958 procedimientos de endoscopia realizados por dos gastroenterólogos. En cada procedimiento y de cada participante se obtuvieron 5 biopsias de mucosa gástrica que representaban antro, incisura angularis y cuerpo. Un único patólogo hizo la interpretación histológica de las 5 biopsias y proporcionó un diagnóstico definitivo global que se utilizó como patrón de referencia. Cada fragmento de mucosa gástrica examinado condujo a un diagnóstico individual para cada biopsia que se comparó con el patrón de referencia. La variabilidad intra-observador se evaluó en 127 personas que corresponden a una muestra aleatoria de 20% del total de endoscopias hechas a los 72 meses de seguimiento. Resultados La sensibilidad del diagnóstico de MI y displasia gástrica aumentó de manera significativa con el número de fragmentos de mucosa gástrica evaluados El sitio anatómico de mayor sensibilidad para el diagnóstico de MI y displasia fue la incisura angularis. Para descubrir H. pylori se logró alta sensibilidad con el estudio de un solo fragmento de mucosa gástrica (95.9%) y fue independiente del sitio de obtención de la biopsia. El acuerdo intra-observador para el diagnóstico de gastritis crónica fue 86.1% con valor kappa de 0.79 IC 95% (0.76-0.85). Las biopsias fijadas en alcohol fueron inadecuadas para demostrar H. pylori e interpretar los cambios de displasia. Conclusión El número de fragmentos de mucosa gástrica evaluados, el método de fijación y la región del estómago donde se obtienen las biopsias son factores muy importantes para lograr una correcta clasificación de la gastritis crónica atrófica multifocal. PMID:25267864

[Not Available].

PubMed

San Mauro Martín, Ismael; Cevallos, Vanesa; Pina Ordúñez, Diana; Garicano Vilar, Elena

2016-07-19

Introducción: existen alteraciones frecuentes en la alimentación de la población infantil femenina, y especialmente en atletas de deportes estéticos por la presión ejercida para mantener un cuerpo.Objetivos: evaluar los aspectos nutricionales, antropométricos y la percepción del peso de niñas que realizan gimnasia rítmica frente a un grupo control.Métodos: estudio descriptivo comparativo. Se compararon 25 niñas gimnastas con 25 niñas no gimnastas (control). Se realizó una valoración antropométrica, mediante protocolo ISAK, y nutricional, mediante un registro dietético de siete días; así como una valoración cuantitativa y cualitativa de la ingesta alimentaria, mediante el software DIAL. Se rellenó un cuestionario de hábitos y sobre la percepción de su peso corporal.Resultados: los datos antropométricos no presentaron diferencias significativas entre ambos grupos, excepto en los pliegues cutáneos y el porcentaje de grasa, el cual era estadísticamente inferior en gimnastas. La ingesta energética (1.413 ± 283 Kcal/día) de las gimnastas era inferior a la recomendada por la Food and Nutrition Board de acuerdo a su edad. La distribución de los macronutrientes cumplía con los valores normales establecidos (10-30% proteínas, 45-65% hidratos, 20-35% grasas). El 32% de las gimnastas y el 36,4% de las niñas control consideraron que les gustaría pesar menos.Conclusión: teniendo en cuenta la intensa actividad de las gimnastas, sus requerimientos energéticos deberían ajustarse a ello, ya que esto contribuirá a su desarrollo y crecimiento y a una mejor ejecución del ejercicio. En la muestra estudiada, el consumo de alimentos de las gimnastas se aleja de una alimentación equilibrada. No se observaron comportamientos diferentes en la percepción del peso entre ambos grupos.

Surgical Management of Functional Constipation: Preliminary Report of a New Approach Using a Laparoscopic Sigmoid Resection Combined with a Malone Appendicostomy.

PubMed

Gasior, Alessandra; Brisighelli, Giulia; Diefenbach, Karen; Lane, Victoria Alison; Reck, Carlos; Wood, Richard J; Levitt, Marc

2017-08-01

Introduction  Functional constipation is a common problem in children. It usually can be managed with laxatives but a small subset of patients develop intolerable cramps and need to be temporarily treated with enemas. The senior author has previously reported: 1) open sigmoid resection as a surgical option, but this did not sufficiently reduce the laxative need, then 2) a transanal approach (with resection of rectosigmoid), but this led to a high rate of soiling due to extensive stretching of the anal canal and loss of the rectal reservoir. The understanding of these procedures' results has led us to use a laparoscopic sigmoid ± left colonic resection with a Malone appendicostomy for these patients, to decrease the laxative requirements, temporarily treat with antegrade flushes, and to reduce postoperative soiling. Methods  A single-institution retrospective review (3/2014-9/2015) included patients who failed our laxative protocol, and therefore were considered surgical candidates. Patients with anorectal malformation (ARM), Hirschsprung disease, spina bifida, tethered cord, trisomy 21, cerebral palsy, mitochondrial disease, prior colon resection at other facilities, or those that did not participate in our laxative program were excluded. Demographics, duration of symptoms, prior treatments, postoperative complications, and postoperative bowel regimens were evaluated. Results  A total of 6 patients (3 males; median age of 12.5 years) presented with soiling related to constipation and intolerance to laxatives. Four patients failed preoperative cecostomy (done prior to referral to us). An average of 4.7 medication treatments were previously tried. In all, 4 patients had required in-patient disimpactions. Duration of symptoms was 7.5 years (median). The median senna dose was 30 mg (range, 15-150 mg), and all patients had intolerable symptoms or failed to empty their colon, which we considered a failed laxative trial. All had contrast enemas that demonstrated a dilated and/or redundant sigmoid colon, and colonic manometry was abnormal in 4. All patients underwent laparoscopic sigmoid and left colon resection, or only sigmoid resection (a low anterior resection). Two patients had postoperative colitis treated with oral antibiotics. The median follow-up was 52 days (range, 8-304 days). Five patients are on antegrade enemas with plans to convert to laxatives at 6 months, 1 is taking laxatives alone at a 33% lower dosage. Five of six are completely clean, 1 soils occasionally and their daily flush is being adjusted. Conclusion  Only a minority of patients with functional constipation are medically unmanageable. This preliminary report shows that laparoscopic colon resection combined with antegrade flushes is an effective surgical technique to treat that group. A laparoscopic approach, guided by contrast enema and colonic manometry, allows for a defined resection of the abnormal segment of colon with the advantages of minimally invasive surgery including allowing for an extensive rectal resection (an improvement over open sigmoid resection) and avoidance of overstretching of the anal canal and removal of the rectal reservoir (an improvement over the transanal approach). Having antegrade access is useful to manage soiling and avoiding cramping from laxatives in the early postoperative period. Although our series is small, we believe that long-term most patients can avoid antegrade flushes and be on no, or a dramatically reduced, laxative dose. Georg Thieme Verlag KG Stuttgart · New York.

Experience of Soviet Medicine in a Great Patriotic War 1941-1945,

DTIC Science & Technology

1980-08-27

catheterization of the bladder and daily enemas ( Lemberg (Lemberg)]. If in wounded were detected the signs of the compression of spinal cord, surgeons tried in the...Cainesa liberation movement of known into the history by the name "Boxer rebellion", the majority of surgeons in essence adhered to the conservative tactics... history of the surgery of spine (V. Vladykin, 1896). In the following, 1897, to year V. 1. Bekhterav expressed thought about the need for production in

Spontaneous uretero-sigmoid fistula secondary to calculus

PubMed Central

Marzouk, Ines; Moussa, Makram; Saadallah, Lotfi; Bouchoucha, Sami; Hendaoui, Lotfi

2016-01-01

A 25-year-old man was referred to the urology department after a subacute history of left back pain, burning micturition associated with pneumaturia and fecaluria. Ultrasonography was performed showing hydronephrosis, and plain film radiography demonstrated a long vertical left pelvic calculi. Uro-computed tomography (CT) combined with a water enema CT showed a 10 cm long calculus with the cranial extremity fistulating the sigmoidal wall. Surgical treatment included left nephroureterectomy and sigmoidectomy with a colorectal anastomosis. Postoperative course was uneventful. PMID:28096928

Systematic Review: Rectal Therapies for the Treatment of Distal Forms of Ulcerative Colitis.

PubMed

Cohen, Russell D; Dalal, Sushila R

2015-07-01

Many therapeutic options are available for patients with distal forms of ulcerative colitis (UC). Rectal therapies (e.g., suppositories, foams, gels, and enemas) may be recommended either alone or in combination with oral treatment. Compared with oral therapies, rectal therapies are underused in patients with distal forms of UC, although rectal therapies have favorable efficacy and safety profiles. This systematic review identified 48 articles for inclusion after a comprehensive PubMed search and the identification of additional relevant articles through other sources. Inclusion criteria were clinical studies examining efficacy and safety of 5-aminosalicylic acid, corticosteroid, and non-5-aminosalicylic acid rectal therapies (suppositories, foams, gels, and enemas) that induce or maintain remission in patients with ulcerative proctitis, ulcerative proctosigmoiditis, or left-sided colitis (i.e., distal forms of UC). The quality of the evidence presented was evaluated using the GRADE system. Overall, a greater percentage of patients with distal forms of UC receiving 5-aminosalicylic acids or corticosteroid rectal formulations derived greater therapeutic benefit after treatment compared with patients receiving placebo. Furthermore, most uncontrolled studies of rectal therapies reported that patients with distal forms of UC had marked improvement from baseline after treatment. The overall safety profile of rectal therapies was favorable. Treatment with second-generation corticosteroids, such as budesonide and beclomethasone dipropionate, did not increase the incidence of steroid-related adverse effects. The current literature supports the use of rectal therapies for both induction and maintenance of remission in patients with distal forms of UC.

Barium enema in frail elderly patients.

PubMed

Segal, R; Khahil, A; Leibovitz, A; Gil, I; Annuar, M; Habot, B

2000-01-01

Barium enema (BE) examinations for the investigation of suspected colonic disease are often unsuccessful in elderly patients. The purpose of this study was to evaluate the success rate of BE in hospitalized frail elderly patients. Four hundred and seventy-two elderly patients hospitalized for different reasons underwent BE examinations. The medical charts and radiological reports were retrospectively reviewed. One hundred and ninety-two (41%) BE examinations were considered inadequate; mostly (32%) because of inappropriate preparation. Sixty-seven patients (14%) were not cooperative and could not retain the contrast material, and in 25 patients (5%), the examination failed due to both these reasons. The characteristics associated with unsuccessful BE examination were the mean number of medical problems (p < 0.001), the mean number of scheduled medications (p < 0.05) and in particular the long-term use of laxatives (p < 0.01) or antiparkinsonian drugs (p < 0.01). Of great significance in predicting an inadequate BE were the patient's functional status (p < 0.001) and the presence of dementia (p < 0.001). The high percentage of unsuccessful BEs in the frail elderly suggests that clinicians should carefully consider the need for that examination in these patients. We suggest that only in patients where there is a clear suspicion of a bleeding or obstructing tumor should a BE examination be performed, and even in these cases, colonoscopy or CT may be preferable as the initial examination in the frail elderly. Copyright 2000 S. Karger AG, Basel

Rectal water contrast transvaginal ultrasound versus double-contrast barium enema in the diagnosis of bowel endometriosis.

PubMed

Jiang, Jipeng; Liu, Ying; Wang, Kun; Wu, Xixiang; Tang, Ying

2017-09-07

The aim of study was to compare the accuracy between rectal water contrast transvaginal ultrasound (RWC-TVS) and double-contrast barium enema (DCBE) in evaluating the bowel endometriosis presence as well as its extent. 198 patients at reproductive age with suspicious bowel endometriosis were included. Physicians in two groups specialised at endometriosis performed RWC-TVS as well as DCBE before laparoscopy and both groups were blinded to other groups' results. Findings from RWC-TVS or DCBE were compared with histological results. The severity of experienced pain severity through RWC-TVS or DCBE was assessed by an analogue scale of 10 cm. In total, 110 in 198 women were confirmed to have endometriosis nodules in the bowel by laparoscopy as well as histopathology. For bowel endometriosis diagnosis, DCBE and RWC-TVS demonstrated sensitivities of 96.4% and 88.2%, specificities of 100% and 97.3%, positive prediction values of 100% and 98.0%, negative prediction values of 98.0% and 88.0%, accuracies of 98.0% and 92.4%, respectively. DCBE was related to more tolerance than RWC-TVS. RWC-TVS and DCBE demonstrated similar accuracies in the bowel endometriosis diagnosis; however, patients showed more tolerance for RWC-TVS than those with DCBE. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Valorization of Cereal Based Biorefinery Byproducts: Reality and Expectations

PubMed Central

2013-01-01

The growth of the biobased economy will lead to an increase in new biorefinery activities. All biorefineries face the regular challenges of efficiently and economically treating their effluent to be compatible with local discharge requirements and to minimize net water consumption. The amount of wastes resulting from biorefineries industry is exponentially growing. The valorization of such wastes has drawn considerable attention with respect to resources with an observable economic and environmental concern. This has been a promising field which shows great prospective toward byproduct usage and increasing value obtained from the biorefinery. However, full-scale realization of biorefinery wastes valorization is not straightforward because several microbiological, technological and economic challenges need to be resolved. In this review we considered valorization options for cereals based biorefineries wastes while identifying their challenges and exploring the opportunities for future process. PMID:23931701

Valorization of cereal based biorefinery byproducts: reality and expectations.

PubMed

Elmekawy, Ahmed; Diels, Ludo; De Wever, Heleen; Pant, Deepak

2013-08-20

The growth of the biobased economy will lead to an increase in new biorefinery activities. All biorefineries face the regular challenges of efficiently and economically treating their effluent to be compatible with local discharge requirements and to minimize net water consumption. The amount of wastes resulting from biorefineries industry is exponentially growing. The valorization of such wastes has drawn considerable attention with respect to resources with an observable economic and environmental concern. This has been a promising field which shows great prospective toward byproduct usage and increasing value obtained from the biorefinery. However, full-scale realization of biorefinery wastes valorization is not straightforward because several microbiological, technological and economic challenges need to be resolved. In this review we considered valorization options for cereals based biorefineries wastes while identifying their challenges and exploring the opportunities for future process.

Il ruolo svolto dall’attività lavorativa sull’ipertensione arteriosa

PubMed Central

Barbini, N.; Gorini, G.; Ferrucci, L.; Biggeri, A.

2009-01-01

RIASSUNTO Introduzione I parametri di pressione arteriosa, sistolica (PAS) o diastolica (PAD) hanno costituito I’oggetto di numerosi studi, alcuni dei quali stabiliscono un’associazione tra I’aumnto di tali parametri e la mortalità, in particolare alle età medie. I fattori di rischio di ipertensione più frequentemente studiati sono il consumo di alcol, il fumo e I’origine etnica in riferimento sia alle differenze genetiche che nella condotta alimentare, mentre i fattori di origine professionale sono stati presi in considerazione più raramente e in maniera poco approfondita, inoltre sono state riferite notevoli differenze nelle pressioni arteriose medie di individui che svolgono professioni diverse. Sembra infatti che i “colletti blu” siano più a rischio dei “colletti bianchi”. Obiettivi Il nostro scopo è valutare se determinati rischi o vincoli connessi con l’attività professionale o determinati stili di vita rappresentano un fattore di rischio per l’ipertensione arteriosa in considerazioni dell’aumentare dell’età. Elementi specifici che rendano conto di questa relazione non sono stati ancora completamente chiariti e soprattutto i dati sulla popolazione italiana sono molto limitati. Metodi La metodologia di ricerca utilizzata è stata quella dell’indagine francese ESTEV (Derriennic, Touranchet, Volkoff) - VISAT (Marquie, Janson), studio epidemiologico longitudinale su oltre 23000 lavoratori attivata in Francia nel 1990 al fine di indagare gli effetti a lungo termine delle condizioni di lavoro, riferite all’intera vita professionale, sia sull’invecchiamento sia sulla salute dei lavoratori. Analoga indagine è stata avviata in Italia, nel 2000, in 6 Regioni, prendendo in esame i lavoratori dipendenti di diversi settori produttivi appartenenti a 5 coorti di età: da 32 a 52 anni con intervallo di 5 anni. Le rilevazioni sono state effettuate dai medici del lavoro di azienda attraverso 3 questionari: 1. sulle condizioni professionali (esposizione a determinati rischi o vincoli); 2. sugli stili di vita e la salute percepita secondo il Nottingham Health Profile; 3. sulle condizioni oggettive di salute. Per il presente lavoro saranno considerati solo alcuni parametri utili all’approfondimento epidemiologico nel settore cardiocircolatorio. Essi riguarderanno: 1) le condizioni di lavoro, 2) la valutazione soggettiva del lavoro, 3) costrizioni specifiche del lavoro vissute come più gravose con l’avanzare dell’età. Relativamente all’ipertensione, sono stati considerati ipertesi i soggetti che presentavano una PAS ≥160 mm/Hg e/o una PAD ≥90 mm/Hg nonché coloro in cura antipertensiva. Risultati I risultati si riferiscono a 1104 lavoratori, di cui 76% uomini e 24% donne. La prevalenza di ipertensione si è dimostrata più elevata nei maschi (33% Vs 22%). Le stime del rischio hanno evidenziato una associazione statisticamente significativa con alcuni fattori lavorativi come mantenere posture difficili (O.R. 1.71), lavorare in presenza di calore (O.R. 1.43), a contatto con agenti chimici (O.R, 1.31). stare a lungo seduti (O.R. 1.48), fare più cose contemporaneamente (O.R. 1.41), essere interrotti nel proprio lavoro (O.R. 1,35). non poter distogilere gli occhi dal lavoro (O.R.1.61). Conclusioni Noi abbiamo osservato che alcune caratteristiche fisiche del lavoro, ma soprattutto quelle di tipo organizzativo sono fortemente associate all’ipertensione arteriosa. Un elemento importante è sembrata la valutazione soggettiva del valore che i lavoratori danno del proprio lavoro: tale elemento è fortemente connesso con I’organizzazione del lavoro, pertanto è un possibile target di prevenzione (fattore di rischio modificabile). PMID:17886759

Critical design of heterogeneous catalysts for biomass valorization: current thrust and emerging prospects

DOE PAGES

De, Sudipta; Dutta, Saikat; Saha, Basudeb

2016-01-01

Catalysis in the heterogeneous phase plays a crucial role in the valorization of biorenewable substrates with controlled reactivity, efficient mechanical process separation, greater recyclability and minimization of environmental effects.

Diagnosis of compliance of health care product processing in Primary Health Care.

PubMed

Roseira, Camila Eugenia; Silva, Darlyani Mariano da; Passos, Isis Pienta Batista Dias; Orlandi, Fabiana Souza; Padoveze, Maria Clara; Figueiredo, Rosely Moralez de

2016-11-21

identify the compliance of health care product processing in Primary Health Care and assess possible differences in the compliance among the services characterized as Primary Health Care Service and Family Health Service. quantitative, observational, descriptive and inferential study with the application of structure, process and outcome indicators of the health care product processing at ten services in an interior city of the State of São Paulo - Brazil. for all indicators, the compliance indices were inferior to the ideal levels. No statistically significant difference was found in the indicators between the two types of services investigated. The health care product cleaning indicators obtained the lowest compliance index, while the indicator technical-operational resources for the preparation, conditioning, disinfection/sterilization, storage and distribution of health care products obtained the best index. the diagnosis of compliance of health care product processing at the services assessed indicates that the quality of the process is jeopardized, as no results close to ideal levels were obtained at any service. In addition, no statistically significant difference in these indicators was found between the two types of services studied. identificar a conformidade do processamento de produtos para saúde na Atenção Primária à Saúde e avaliar possível diferença na conformidade entre as unidades caracterizadas como Unidade Básica de Saúde e Unidade Saúde da Família. estudo quantitativo, observacional, descritivo e inferencial, com a aplicação de indicadores de estrutura, processo e resultado referentes ao processamento de produtos para a saúde em dez unidades, de um município do interior de São Paulo - Brasil. todos os indicadores obtiveram índice de conformidade inferior ao ideal. Não houve diferença estatisticamente significante nos indicadores entre os dois tipos de unidades investigadas, sendo o indicador de limpeza de produtos para saúde o de menor índice de conformidade, enquanto indicador de recursos técnico-operacionais para preparo, acondicionamento, desinfecção/esterilização, guarda e distribuição de produtos para saúde, o de melhor índice. o diagnóstico de conformidade do processamento de produtos para saúde nas unidades avaliadas indica comprometimento da qualidade do processo, uma vez que não foram obtidos resultados próximos ao valor ideal em nenhuma unidade. Além disso, não houve diferença estatisticamente significante desses indicadores entre os dois tipos de unidades estudadas. identificar la conformidad del procesamiento de productos para la salud en la Atención Primaria a la Salud y evaluar una posible diferencia en la conformidad entre las unidades caracterizadas: Unidad Básica de Salud y Unidad Salud de la Familia. estudio cuantitativo, observacional, descriptivo e inferencial; se aplicaron indicadores de estructura, proceso y resultado, referentes al procesamiento de productos para la salud en diez unidades de un municipio del interior de Sao Paulo, Brasil. todos los indicadores obtuvieron índice de conformidad inferior a lo ideal. No hubo diferencia estadísticamente significativa de los indicadores entre los dos tipos de unidades investigadas, siendo el indicador de limpieza de productos para la salud el de menor índice de conformidad; por otro lado, como indicador de recursos técnico-operacionales para preparación, acondicionamiento, desinfección/esterilización, almacenamiento y distribución de productos para la salud, fue el de mejor índice. el diagnóstico de conformidad del procesamiento de productos para la salud en las unidades evaluadas indica que está comprometida la calidad del proceso, ya que no fueron obtenidos resultados próximos al valor ideal en ninguna unidad. Además de eso, no hubo diferencia estadísticamente significativa de esos indicadores entre los dos tipos de unidades estudiadas.

La historia orbital de Deimos y la oblicuidad de Marte

NASA Astrophysics Data System (ADS)

Brunini, A.; Yokoyama, T.

Recientemente, se ha demostrado mediante extensas integraciones numéricas, que la rotación de Marte pasó repetidamente por estados caóticos de movimiento, debido al pasaje por zonas de resonancia spin - órbita. En dichas circunstancias, la oblicuidad marciana pudo haber sufrido grandes excursiones de varias decenas de grados. Las consecuencias de dichas variaciones son de extrema importancia en el contexto de la búsqueda de manifestaciones de vida fósil en dicho planeta. El estudio de la dinámica orbital del satélite más exterior de Marte, Deimos, nos ha permitido comprobar, en el marco de las distintas teorías sobre su orígen, que la oblicuidad de Marte dificilmente pudo haber sufrido variaciones que la aparten más de 10o respecto de actual valor. Este resultado parece ser mucho más robusto que las simulaciones numéricas de Touma y Wisdom asi como las de Laskar y Robutel, lo que permite poner cotas más severas a la evolución paleoclimática de Marte.

Granulocytic sarcoma of the rectum: a rare complication of myelodysplasia.

PubMed Central

Dabbagh, V; Browne, G; Parapia, L A; Price, J J; Batman, P A

1999-01-01

A 67 year old man with myelodysplasia was admitted as an emergency with a six week history of rectal bleeding and diarrhoea. Barium enema showed an irregular polypoid filling defect in the lateral wall of the proximal rectum near the rectosigmoid junction. Histology showed this to be a granulocytic sarcoma (extramedullary granulocytic leukaemia; chloroma) infiltrating the bowel. A low index of suspicion of this lesion results in an incorrect diagnosis in many such cases. A chloroacetate esterase immunoperoxidase stain will confirm the granulocytic nature of the tumour cells. Images PMID:10690184

The first case of type B infant botulism in Japan.

PubMed

Kakinuma, H; Maruyama, H; Takahashi, H; Yamakawa, K; Nakamura, S

1996-10-01

A six-month-old girl with a 5 consecutive day history of constipation and poor feeding developed generalized weakness, poor head control, difficulties in sucking and swallowing, and cranial nerve dysfunction within a few days. These characteristic manifestations and clinical course prompted examination of the possibility of infant botulism, although no history of eating honey was obtained. Mouse bioassay performed with enema effluent demonstrated type B botulinum toxin. Culture of the effluent was positive for Clostridium botulinum type B. This is the first case of type B infant botulism in Japan.

A cost accounting of routine sigmoidoscopic examinations

PubMed Central

Ward, K. M.; Bourdages, R.; Beck, I. T.

1974-01-01

Proctosigmoidoscopic examinations were performed on 363 patients who had gastrointestinal but no colonic symptoms. Thirty-four, all over the age of 40, were found to have polypoid lesions, 24 of which were adenomatous. Air-contrast barium enemas were utilized to rule out higher lesions in the patients with one or more adenomatous polyps. One early carcinoma of the ascending colon was so discovered. The cost of finding an adenomatous polyp in a patient without colonic symptoms was calculated to be $523.75 and of a carcinoma $12,570. PMID:4411616

AIDS: The Role of Imaging Modalities and Infection Control Policies

PubMed Central

Moore-Stovall, Joyce

1988-01-01

The availability of imaging modalities, such as the chest radiograph, gallium scan, double-contrast barium enema, computed tomography, and nuclear magnetic resonance, are very helpful in the diagnosis, treatment, and follow-up evaluation of patients with acquired immunodeficiency syndrome (AIDS). Because this syndrome causes irreversible destruction of the immune system, patients are susceptible to a multitude of opportunistic infections and malignancies. Health care professionals and the general public would be less fearful and apprehensive of AIDS victims if properly informed about the communicability of this syndrome. PMID:3047412

Can a tailored knowledge translation strategy improve short term outcomes? A pilot study to increase compliance with bowel preparation recommendations in general surgery.

PubMed

Eskicioglu, Cagla; Gagliardi, Anna; Fenech, Darlene S; Victor, Charles J; McLeod, Robin S

2011-07-01

Previous studies have shown that practices supported by level I evidence may take up to 20 years before they are adopted. Although mechanical bowel preparation (MBP) has been a routine practice in colorectal surgery, there is strong evidence dating back to the early 1990s suggesting that in most patients MBP before elective colorectal surgery is not required. The objective of this study was to determine if surgical practices pertaining to bowel preparation could be altered using a tailored knowledge translation strategy. A multi-faceted strategy including guideline development, consensus, education by opinion leaders, audit and feedback, and reminder cards was used in this before-after study. The primary outcome was compliance with the recommendations presented in the guideline regarding MBP, normal diet on the day prior to surgery, and enemas. Two-hundred eighty-two patients were enrolled in the study with 111 enrolled before the intervention and 171 enrolled after the intervention. Demographic and clinical characteristics between the 2 groups were similar. Overall, there was a 7.8% increase in compliance with MBP recommendations (81.1% vs 88.4%, P = .038), a 10.2% increase in compliance with diet recommendations (45.6% vs 55.8%, P = .080), and a 5.6% increase in compliance with enema recommendations (88.5% vs 94.2%, P < .001). The results of this study reveal that a tailored, multi-faceted knowledge translation strategy is effective in changing surgeon behavior. Copyright © 2011 Mosby, Inc. All rights reserved.

Enteral diets enriched with medium-chain triglycerides and N-3 fatty acids prevent chemically induced experimental colitis in rats.

PubMed

Kono, Hiroshi; Fujii, Hideki; Ogiku, Masahito; Tsuchiya, Masato; Ishii, Kenichi; Hara, Michio

2010-11-01

The specific purpose of this study was to evaluate the significant effects of medium-chain triglycerides (MCTs) and N-3 fatty acids on chemically induced experimental colitis induced by 2,4,6-trinitrobenzene sulphonic acid (TNBS) in rats. Male Wistar rats were fed liquid diets enriched with N-6 fatty acid (control diets), N-3 fatty acid (MCT- diets), and N-3 fatty acid and MCT (MCT+ diets) for 2 weeks and then were given an intracolonic injection of TNBS. Serum and tissue samples were collected 5 days after ethanol or TNBS enema. The severity of colitis was evaluated pathologically, and tissue myeloperoxidase activity was measured in colonic tissues. Furthermore, protein levels for inflammatory cytokines and a chemokine were assessed by an enzyme-linked immunosorbent assay in colonic tissues. Induction of proinflammatory cytokines tumor necrosis factor-α and interleukin-1β in the colon by TNBS enema was markedly attenuated by the MCT+ diet among the 3 diets studied. Furthermore, the induction of chemokines macrophage inflammatory protein-2 and monocyte chemotactic protein-1 also was blunted significantly in animals fed the MCT+ diets. As a result, MPO activities in the colonic tissue also were blunted significantly in animals fed the MCT+ diets compared with those fed the control diets or the MCT- diets. Furthermore, the MCT+ diet improved chemically induced colitis significantly among the 3 diets studied. Diets enriched with both MCTs and N-3 fatty acids may be effective for the therapy of inflammatory bowel disease as antiinflammatory immunomodulating nutrients. Copyright © 2010 Mosby, Inc. All rights reserved.

Outcomes of asymptomatic anastomotic leaks found on routine postoperative water-soluble enema following anterior resection for cancer.

PubMed

Killeen, S; Souroullas, P; Ho Tin, H; Hunter, I A; O'Grady, H; Gunn, J; Hartley, J E

2013-11-01

The incidence and consequence of an anastomotic leak associated with low anterior resection for cancer mandates covering stoma in most cases. A water-soluble enema is often performed to assess anastomotic integrity prior to stoma reversal. The functional outcome following reversal in patients with occult radiologically detected leaks is poorly defined. The goal of the present study was to determine the functional outcome in patients with a radiologically detected anastomotic leak who subsequently underwent stoma reversal. This case control study used patients with and without radiologically detected occult anastomotic leak having undergone reversal of covering stomata. The study group was matched with controls for age, gender, procedure, tumor stage, and adjuvant/neoadjuvant therapy. Validated fecal incontinence quality of life (FIQL), Cleveland Clinic Fecal Incontinence Score (CCFIS), and the Memorial Sloan-Kettering Cancer Center (MSKCC) Bowel Function Index (BFI) were used. Patient satisfaction, medication use, and ancillary procedures prior to closure were also recorded. Thirteen patients with radiologically detected occult anastomotic leaks and 13 matched controls were identified from a prospectively maintained database. The FIQL, CCFIS, and MSKCC BFI scores were significantly reduced in those with occult leaks. The mean number of radiological and surgical interventions was significantly greater in the patients with occult leaks. Antidiarrheal and bulking agent use, as well as patient satisfaction, were the same for both groups. Only one patient in the occult leak group would not undergo stoma reversal again. Reversal of a defunctioning ileostomy in the presence of an occult radiological leak can be associated with poorer functional outcomes, but patient satisfaction is undiminished.

A novel local anti-colorectal cancer drug delivery system: negative lipidoid nanoparticles with a passive target via a size-dependent pattern

NASA Astrophysics Data System (ADS)

Ding, Weifeng; Wang, Feng; Zhang, Jianfeng; Guo, Yibing; Ju, Shaoqing; Wang, Huimin

2013-09-01

The nontoxic, targeted and effective delivery of nucleic acid drugs remains an important challenge for clinical development. Here, we describe a novel negative lipidoid nanoparticle delivery system, providing entrapment-based transfection agents for local delivery of siRNA to the colorectal cancer focus. The delivery system was synthesized with lipidoid material 98N12-5(1), mPEG2000-C12/C14 glyceride and cholesterol at a desired molar ratio to realize the anionic surface charge of particles, which could alleviate to a larger degree the inflammatory response and immune stimulation of the organism, embodying dramatic biocompatibility. In particular, mPEG2000-C12/C14 glyceride was selected to ameliorate the stability of the delivery system and protection of nucleic acids by extending the tail length of the carbons, crucial also to neutralize the positive charge of 98N12-5(1) to form a resultant anionic particle. In vivo experiments revealed that a particle size of 90 nm perfectly realized a passive target in a size-dependent manner and did not affect the function of the liver and kidneys by a local delivery method, enema. We clarified that the uptake of negative lipidoid nanoparticles internalized through a lipid raft endocytotic pathway with low cytotoxicity, strong biocompatibility and high efficacy. This study suggests that negative lipidoid nanoparticles with enema delivery costitute, uniquely and appropriately, a local anti-colorectal cancer nucleic acid drug delivery platform, and the application of similar modes may be feasible in other therapeutic settings.

Impact of intestinal mannitol on hyperammonemia, oxidative stress and severity of hepatic encephalopathy in the ED.

PubMed

Montes-Cortés, Daniel H; Novelo-Del Valle, José L; Olivares-Corichi, Ivonne M; Rosas-Barrientos, José V; Jara, Luis J; Cruz-Domínguez, María Pilar

2018-01-10

Hyperammonemia results from hepatic inability to remove nitrogenous products generated by protein metabolism of intestinal microbiota, which leads to hepatic encephalopathy (HE) in chronic liver disease (CLD). In ammonium neurotoxicity, oxidative stress (OxS) plays a pathogenic role. Our objective was to evaluate if intestinal mannitol is as effective and safe as conventional treatment for diminishing hyperammonemia, OxS, and HE in patients with CLD. We included 30 patients with HE classified by "Haven Criteria for Hepatic Encephalopathy". They were randomized into two groups: 1) Mannitol Group (MG) with mannitol 20% administered into the intestine by an enema, 2) conventional group (CG) with lactulose 40 g enema both substances were diluted in 800 mL of double distilled solution every 6 h; all patients received neomycin. We evaluated ammonia concentration, plasma oxidative stress, HE severity, intestinal discomfort and adverse effects. Hyperammonemia (171 ± 104 vs 79 ± 49 μmol ammonia/L, p < 0.01), and oxidative stress (MDA 29 vs 27%, formazan 15 vs 11%, carbonyls 16 vs 9% and dityrosines 10 vs 5%) were reduced in MG and CG respectively. The HE severity decreased by two degrees compared to baseline values in both groups. Intestinal discomfort and electrolyte plasma alterations were less frequent (p < 0.05) in MG than CG. Intestinal mannitol is as effective and safe as conventional treatment for reducing hyperammonemia, oxidative stress, and hepatic encephalopathy of CLD patients in the emergency room. Likewise, mannitol is better tolerated than conventional treatment. Copyright © 2018. Published by Elsevier Inc.

Per rectal endoscopic myotomy for the treatment of adult Hirschsprung's disease: First human case (with video).

PubMed

Bapaye, Amol; Wagholikar, Gajanan; Jog, Sameer; Kothurkar, Aditi; Purandare, Shefali; Dubale, Nachiket; Pujari, Rajendra; Mahadik, Mahesh; Vyas, Viral; Bapaye, Jay

2016-09-01

Hirschsprung's disease (HD) is a congenital disorder characterized by the absence of intrinsic ganglion cells in submucosal and myenteric plexuses of the hindgut; and presents with constipation, intestinal obstruction and/or megacolon. HD commonly involves the rectosigmoid region (short segment HD), although shorter and longer variants of the disease are described. Standard treatment involves pull-through surgery for short segment HD or posterior anorectal myotomy in selected ultrashort segment candidates. Third space endoscopy has evolved during the past few years. Per oral endoscopic myotomy and per oral pyloromyotomy are described for treatment of achalasia cardia and refractory gastroparesis, respectively. Using the same philosophy of muscle/sphincter disruption for spastic bowel segments, per rectal endoscopic myotomy could be considered as a treatment option for short segment HD. A 24-year-old male patient presented with refractory constipation since childhood, and habituated to high-dose laxative combinations. Diagnosis was confirmed as adult short segment HD by barium enema, colonoscopic deep suction mucosal biopsies and anorectal manometry. Histopathology confirmed aganglionosis in the distal 15 cm. By implementing principles of third space endoscopy, per rectal endoscopic myotomy 20 cm in length was successfully carried out. At 24-week follow up, the patient reported significant relief of constipation and associated symptoms. Sigmoidoscopy, anorectal manometry and barium enema confirm improved rectal distensibility and reduced rectal pressures. The present case report describes the first human experience of per rectal endoscopic myotomy for successful treatment of adult short segment HD. © 2016 Japan Gastroenterological Endoscopy Society.

Enema reduction of intussusception: the success rate of hydrostatic and pneumatic reduction.

PubMed

Khorana, Jiraporn; Singhavejsakul, Jesda; Ukarapol, Nuthapong; Laohapensang, Mongkol; Wakhanrittee, Junsujee; Patumanond, Jayanton

2015-01-01

Intussusception is a common surgical emergency in infants and children. The incidence of intussusception is from one to four per 2,000 infants and children. If there is no peritonitis, perforation sign on abdominal radiographic studies, and nonresponsive shock, nonoperative reduction by pneumatic or hydrostatic enema can be performed. The purpose of this study was to compare the success rates of both the methods. Two institutional retrospective cohort studies were performed. All intussusception patients (ICD-10 code K56.1) who had visited Chiang Mai University Hospital and Siriraj Hospital from January 2006 to December 2012 were included in the study. The data were obtained by chart reviews and electronic databases, which included demographic data, symptoms, signs, and investigations. The patients were grouped according to the method of reduction followed into pneumatic reduction and hydrostatic reduction groups with the outcome being the success of the reduction technique. One hundred and seventy episodes of intussusception occurring in the patients of Chiang Mai University Hospital and Siriraj Hospital were included in this study. The success rate of pneumatic reduction was 61% and that of hydrostatic reduction was 44% (P=0.036). Multivariable analysis and adjusting of the factors by propensity scores were performed; the success rate of pneumatic reduction was 1.48 times more than that of hydrostatic reduction (P=0.036, 95% confidence interval [CI] =1.03-2.13). Both pneumatic and hydrostatic reduction can be performed safely according to the experience of the radiologist or pediatric surgeon and hospital setting. This study showed that pneumatic reduction had a higher success rate than hydrostatic reduction.

High mucosal healing rates in 5-ASA-treated ulcerative colitis patients: results of a meta-analysis of clinical trials.

PubMed

Römkens, Tessa E H; Kampschreur, Milou T; Drenth, Joost P H; van Oijen, Martijn G H; de Jong, Dirk J

2012-11-01

Recently, mucosal healing (MH) is regarded as an important treatment goal in ulcerative colitis (UC). 5-Aminosalicylates (5-ASA) are the standard treatment in mild-to-moderate UC, but the effect on MH is less known. The aim of this study was to systematically review the medical literature in order to compare different preparations of 5-ASA for the effect on MH. We conducted a structured search of PubMed and the Cochrane Central Register of Controlled Trials to identify randomized controlled clinical trials with 5-ASA in UC providing data about MH. We calculated the sample size-weighted pooled proportion of patients with MH, and performed meta-analysis of head-to-head comparisons. Out of 645 hits, we included 90 treatment arms, involving 3977 patients using oral 5-ASA (granulate and tablets) and 2513 patients using rectal 5-ASA (suppositories, enema, and foam). Overall, 43,7% of 5-ASA treated patients achieved MH (oral 36,9%; rectal 50,3%). In oral studies, 49% of patients using granulate (7 treatment-arms) achieved MH compared to 34,9% using tablets (43 treatment-arms). In rectal studies the proportion of MH was 62% for suppositories (eight treatment arms), 51% for foam (nine treatment arms), and 46% for enema (23 treatment arms), respectively. 5-ASA preparations achieved MH in nearly 50% of UC patients. There were no significant differences in MH between the various 5-ASA agents, either in the oral or the rectal treatment groups. Copyright © 2012 Crohn's & Colitis Foundation of America, Inc.

The value of auditing negative lower GI investigations preceding a final diagnosis of colorectal cancer.

PubMed

Somasekar, A; James, L; Stephenson, B M; Thompson, I W; Vellacott, K D; Allison, M C

2009-09-01

To review all preceding 'negative' large bowel investigations in patients with a final diagnosis of colorectal cancer, and to examine whether delayed diagnosis was associated with worse outcome. Details were gathered on all patients with a new diagnosis of colorectal adenocarcinoma presenting over 4.5 years. For each patient the hospital's clinical workstation and radiology and endoscopy databases were interrogated for all flexible sigmoidoscopies, colonoscopies and barium enemas during the 5 years prior to diagnosis. Among the 570 patients, 28 (5%) had undergone colonoscopy and/or flexible sigmoidoscopy that had not shown colorectal cancer during the 5 years preceding final diagnosis, and a further 28 (5%) had undergone 'negative' barium enemas. Polyp surveillance might have missed four lesions destined to become malignant. Correspondingly there were three patients undergoing IBD surveillance found to have CRC, having had a negative complete colonoscopy within the preceding 5 years. Among patients undergoing de novo colonoscopy for diagnosis the true miss rate was only one patient per year. At August 2007, 29 (58%) of those with delayed diagnosis were still alive, compared with 216 (42%) of those diagnosed during initial investigation (chi2 = 5.04, P < 0.05). Colonoscopic miss rates are in line with previous studies. The application of simple clinical ground rules will avoid most pitfalls. The methodology described herein may assist in auditing the quality assurance of lower gastrointestinal diagnostic services. Despite the delay, late diagnosis was found to be associated with improved survival and a lower likelihood of metastatic disease.

Medición de los parámetros cosmológicos q0, ΩM, y ΩΛ, usando supernovas de Tipo Ia distantes

NASA Astrophysics Data System (ADS)

Clocchiatti, A.; High-Z Sne Search Team

Las supernovas de tipo Ia son una herramienta de gran precisión para la medición de distancias de interés cosmológico. Los métodos recientes de calibración de su luminosidad intrínseca, que hacen uso de la forma de las curvas de luz en varios colores y permiten diferenciar entre supernovas distantes, intrínsecamente débiles, u oscurecidas por extinción, reducen la dispersión del método que las asume de magnitud absoluta constante de 0.50 mag a 0.15 mag, e incrementa el valor de la constante de Hubble de ~55 km s-1 Mpc-1, a 65 km s-1 Mpc-1. A partir de la calibración de las supernovas cercanas, con redshifts menores que 0.1, se pueden obtener distancias precisas a supernovas que explotan a alto redshift. Hemos aplicado estos métodos a 16 supernovas con 0.16 < Z < 0.97, encontrando que sus distancias son, en promedio, entre 10% y 13% (dependiendo del método empleado) mayores que las que uno esperaría en un universo con poca masa (Ω = 0.2), sin una constante cosmológica. Todos los métodos de ajuste de curvas de luz, y selección de subgrupos de la muestra de supernovas observadas, favorecen consistentemente modelos del universo que se expanden eternamente y que tienen una constante cosmológica positiva (ΩΛ > 0), y una aceleración de la expansión al presente (q0 < 0). Hay distintas fuentes de posibles errores sistemáticos que merecen ser analizadas, entre ellas: evolución de la metalicidad y estrellas progenitoras, extinción, bias en la elección de la muestra, amplificación por gravitational lensing, y contaminación de la muestra. Ninguno de estos efectos alcanza para reconciliar los datos con ΩΛ = 0, o q0 > 0.

Eficacia de la detección sistemática de la gripe en las fronteras en los viajeros que llegan por vía aérea*

PubMed Central

Priest, Patricia C.; Jennings, Lance C.; Duncan, Alasdair R.; Brunton, Cheryl R.; Baker, Michael G.

2015-01-01

Objetivos. Se midieron los síntomas y la prevalencia de la gripe (también llamada influenza), así como la eficacia del mecanismo de detección sistemática basado en los síntomas y la temperatura para diagnosticar la gripe en viajeros internacionales que llegaban por vía aérea. Métodos. El presente estudio transversal recopiló datos de viajeros que llegaron al aeropuerto internacional de Christchurch (Nueva Zelandia) en el invierno del 2008 mediante un cuestionario de salud, medición de la temperatura y toma de muestras de las vías respiratorias. Resultados. De los viajeros, 15 976 (68%) entregaron los formularios completos. De ellos, 17% notificaron al menos un síntoma de gripe; los síntomas más comunes fueron rinorrea o congestión nasal (10%) y tos (8%). Se tomaron muestras de las vías respiratorias de 3 769 viajeros. La prevalencia estimada de la gripe fue de 1,1% (4% en las personas sintomáticas, 0,2% en las asintomáticas). La sensibilidad de los criterios de detección varió de 84% para “cualquier síntoma” a 3% para la fiebre de 37,8 °C o mayor. El valor predictivo positivo fue bajo para todos los criterios. Conclusiones. El método de detección sistemática en las fronteras mediante la autonotificación de síntomas y la toma de la temperatura presenta limitaciones para impedir que una gripe pandémica entre en un país. Basarse en criterios como “cualquier síntoma” o la tos haría que se investigara a varias personas no infectadas, mientras que algunas personas infectadas pasarían inadvertidas. Si se usaran criterios más específicos como la fiebre, la mayoría de las personas infectadas entrarían en el país a pesar del mecanismo de detección.

Trends in food waste valorization for the production of chemicals, materials and fuels: Case study South and Southeast Asia.

PubMed

Ong, Khai Lun; Kaur, Guneet; Pensupa, Nattha; Uisan, Kristiadi; Lin, Carol Sze Ki

2018-01-01

Staggering amounts of food waste are being generated in Asia by means of agricultural processing, food transportation and storage, and human food consumption activities. This along with the recent sustainable development goals of food security, environmental protection, and energy efficiency are the key drivers for food waste valorization. The aim of this review is to provide an insight on the latest trends in food waste valorization in Asian countries such as India, Thailand, Singapore, Malaysia and Indonesia. Landfilling, incineration, and composting are the first-generation food waste processing technologies. The advancement of valorisation alternatives to tackle the food waste issue is the focus of this review. Furthermore, a series of examples of key food waste valorization schemes in this Asian region as case studies to demonstrate the advancement in bioconversions in these countries are described. Finally, important legislation aspects for food waste disposal in these Asian countries are also reported. Copyright © 2017 Elsevier Ltd. All rights reserved.

The valorization of the plastic waste to the rheological characteristics of bituminous mixtures

NASA Astrophysics Data System (ADS)

Boucherba, Mohammed; Kriker, Abdelouahed; Kebaili, Nabil

2017-02-01

The valorization of materials used at the end of the cycle currently constitutes one of the major challenges for the state for the safeguarding of the environment. Indeed, plastic waste from their obstruction and weak biodegradability often constitutes a threat for health, nature and the environment. The present study treats a mining method and valorization of these wastes in the road, where this waste is incorporated in the pure bitumen of asphalt concretes using the Dry process. The vital objective of this work is to see their impact on the mechanical behavior of these concretes using the Marshall Test and NAT.

A comprehensive dairy valorization model.

PubMed

Banaszewska, A; Cruijssen, F; van der Vorst, J G A J; Claassen, G D H; Kampman, J L

2013-02-01

Dairy processors face numerous challenges resulting from both unsteady dairy markets and some specific characteristics of dairy supply chains. To maintain a competitive position on the market, companies must look beyond standard solutions currently used in practice. This paper presents a comprehensive dairy valorization model that serves as a decision support tool for mid-term allocation of raw milk to end products and production planning. The developed model was used to identify the optimal product portfolio composition. The model allocates raw milk to the most profitable dairy products while accounting for important constraints (i.e., recipes, composition variations, dairy production interdependencies, seasonality, demand, supply, capacities, and transportation flows). The inclusion of all relevant constraints and the ease of understanding dairy production dynamics make the model comprehensive. The developed model was tested at the international dairy processor FrieslandCampina (Amersfoort, the Netherlands). The structure of the model and its output were discussed in multiple sessions with and approved by relevant FrieslandCampina employees. The elements included in the model were considered necessary to optimally valorize raw milk. To illustrate the comprehensiveness and functionality of the model, we analyzed the effect of seasonality on milk valorization. A large difference in profit and a shift in the allocation of milk showed that seasonality has a considerable impact on the valorization of raw milk. Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Application of life-cycle assessment (LCA) methodology for valorization of building demolition materials and products

NASA Astrophysics Data System (ADS)

Sara, Balazs; Antonini, Ernesto; Tarantini, Mario

2001-02-01

The VAMP project (VAlorization of building demolition Materials and Products, LIFE 98/ENV/IT/33) aims to build an effective and innovative information system to support decision making in selective demolition activity and to manage the valorization (recovery-reuse-recycling) of waste flows produced by the construction and demolition (C&D) sector. The VAMP information system will be tested it in Italy in some case studies of selective demolition. In this paper the proposed demolition-valorization system will be compared to the traditional one in a life cycle perspective, applying LCA methodology to highlight the advantages of VAMP system from an eco-sustainability point of view. Within the system boundaries demolition processes, transport of demolition wastes and its recovery/treatment or disposal in landfill were included. Processes avoided due to reuse-recycling activities, such as extraction of natural resources and manufacture of building materials and components, were considered too. In this paper data collection procedure applied in inventory and impact assessment phases and a general overview about data availability for LCA studies in this sector are presented. Results of application of VAMP methodology to a case study are discussed and compared with a simulated traditional demolition of the same building. Environmental advantages of VAMP demolition-valorization system are demonstrated quantitatively emphasizing the special importance of reuse of building components with high demand of energy for manufacture.

Ileocolic perforation secondary to sodium polystyrene sulfonate in sorbitol use: A case report

PubMed Central

Trottier, Vincent; Drolet, Sébastien; Morcos, Mohib W

2009-01-01

Hyperkalemia is a common condition encountered in medical and surgical patients. It can lead to various complications including cardiac arrhythmias. Sodium polystyrene sulfonate (SPS) in sorbitol is an ion-exchange resin that can be used to treat hyperkalemia. It can be used in enema or in oral form. The present article describes the case of an intensive care unit patient who experienced severe, diffuse, intestinal perforation induced by the use of SPS-sorbitol, requiring multiple laparotomies, followed by a brief review of the relevant literature and recommendations regarding the use of SPS-sorbitol. PMID:19826644

Nursing Care Hour Standards Study. Part 1. Section B. Patient Classification System Model Development

DTIC Science & Technology

1981-09-01

Measurement/Adult El FI~ [El 1:11] II PIES Form 326e (OT) 1 Novembeti 1978 A-3 sfti= 237 Saline IrrigatioD (Gastric)W uli il 111 Enema: Cleansing Mi...U lIED Dilatation and -Curettage/Assisting Physician ii) El Do~ EI M.1 L or Evacuation Vaginal /Pelvic Examinrations/Assisting Physician ElU L. IE l2...ADMINISTRATION: Oral -QB E ED EE ElE Suppositories Rectal/ Vaginal 1E El El El I ElD Topical MI~II iE Sublingual III ol El El El DIAGNOSTIC TESTS: Bone

[Successful Removal of Hard Sigmoid Fecaloma Using Endoscopic Cola Injection].

PubMed

Lee, Jong Jin; Kim, Jeong Wook

2015-07-01

Colorectal fecaloma is hardening of feces into lumps of varying size that is much harder in consistency than a fecal impaction. Complications of colorectal fecaloma include ulceration, bleeding, perforation and obstruction of the colon. Most fecalomas are successfully removed by conservative treatment with laxatives, enemas and rectal evacuation to relieve fecal impaction. When conservative treatments have failed, a surgical intervention may be needed. Herein, we report a case of 4.7 cm sized sigmoid fecaloma showing no response to conservative treatments that was successfully removed by endoscopic fragmentation with Coca-Cola injection instead of surgery.

Assessment of pediatric Malone antegrade continence enema (MACE) complications: Effects of variations in technique.

PubMed

Saikaly, Sami K; Rich, Mark A; Swana, Hubert S

2016-08-01

The Malone antegrade continence enema (MACE) procedure is performed for patients with fecal incontinence and constipation who do not respond to medical therapy. The MACE procedure provides antegrade catheter access to the right colon and allows administration of enemas to help evacuate the bowel regularly. The objective of this study was to identify risk factors for surgical complications in children who undergo the MACE procedure. Records from 97 pediatric patients who underwent MACE procedure were reviewed retrospectively. Data collected included age, sex, weight (obese/not obese), stomal location, presence of a permanent button/catheter in the stoma, open vs. laparoscopic surgery, and etiology of fecal incontinence/constipation. The complications reviewed included stomal stenosis, leakage, and stomal site infection. The relationships between the independent variables and complications were assessed using chi-square tests and Fisher's exact test. Statistical significance was set at p < 0.05. Overall, 66 (68%) patients had at least one complication. Twenty-three (23.7%) patients developed stomal stenosis, and 27 (27.8%) patients had significant stomal leakage. Insertion of a stomal button/catheter device was associated with an increased risk of developing stomal leakage and stomal infection. The presence of a stomal button/catheter was also associated with a decreased risk of stomal stenosis (Figure). The non-intubated, imbricated sub-population, preteen patients (<12 years old) experienced more stomal leakage than teenage patients. In this subgroup, patients with umbilical stomas also experienced more leakage than patients with right lower quadrant (RLQ) stomas. The prevalence rates of stomal complications in our study were consistent with previously reported series. In our study, however, stomal leakage had a higher prevalence in comparison with stomal stenosis. This seems to be related to the heterogeneity of the study group, which contained two variants of the MACE procedure; non-imbricated, intubated MACE and imbricated, non-intubated MACE. The use of stomal buttons in conjunction with MACE has previously been reported without changes in complication rates. We found the use of stomal buttons/catheters to be associated with changes in the prevalence of stomal complications. Stomal complications are common in the MACE procedure. The use of a permanent stomal button/catheter is associated with changes in the rates of stomal complications. While many find an umbilical stomal site is more cosmetically appealing, there is an increased risk of leakage with imbricated, non-intubated stomas. In the non-intubated, imbricated sub-population, the MACE procedure results in a higher risk of stomal leakage in preteen patients in comparison with teenage patients. Copyright © 2016 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Valor Collegiate Academies

ERIC Educational Resources Information Center

EDUCAUSE, 2015

2015-01-01

The four guiding principles behind the blended, competency-based, personalized learning model of Valor Collegiate Academies, a charter organization serving grades 5-12 in Nashville, TN: (1) Reflect the diversity of both our country and local community; (2) Personalize a student's experience to meet his/her unique academic and non-academic needs;…

Sentido de coherencia y mapa de activos para la salud en jóvenes presos de la Comunidad Valenciana en España.

PubMed

Vera-Remartínez, Enrique J; Paredes-Carbonell, Joan J; Aviñó Juan-Ulpiano, Dory; Jiménez-Pérez, Mercedes; Araujo Pérez, Rosa; Agulló-Cantos, José M; Mora Notario, Almudena

2017-09-01

Estudio realizado desde el enfoque de la salutogénesis que pretende determinar el sentido de coherencia (SOC) en jóvenes presos de la Comunidad Valenciana en España y elaborar un mapa de activos para la salud dirigido a promover la salud en esta población. Se utilizó el test "SOC-13" y un cuestionario de preguntas abiertas elaborado ad hoc, el cual autocompletaron los internos de 18 a 22 años de edad, de los tres centros penitenciarios de la región. Participaron 124 jóvenes varones (ya que no había ninguna mujer) y se recogieron variables sociodemográficas y penitenciarias. En el análisis cuantitativo, las variables categóricas se expresaron como frecuencias absolutas y relativas; y las cuantitativas, mediante medias con intervalos de confianza (IC) al 95%. Se realizó un estudio comparativo bivariante, utilizando las siguientes pruebas: Student t-test, análisis de variación (ANOVA), Wilcoxon y Ji-cuadrado. Del cuestionario de preguntas abiertas, se realizó un análisis cualitativo descriptivo temático de los activos identificados, clasificándolos en: internos (recursos personales, en relación con los demás y capacidad para realizar comportamientos saludables) y externos (personas, grupos, instituciones y espacios físicos, situados tanto dentro como fuera de prisión). La edad media fue de 21,1 años (IC 95%: 20,8-21,3); y el SOC de 52,4 (IC 95%: 50,5-54,3), de entre un valor mínimo de 13 y máximo de 91 para la prueba. Los internos del centro penitenciario que ofrecía más actividades escolares y deportivas obtuvieron una puntuación mayor en la dimensión de significatividad del SOC ( p = 0,024), y los internos inmigrantes presentaron un SOC superior ( p = 0,037) a los españoles, en los tres centros. Los jóvenes identificaron los activos internos que cualitativamente se vinculan con las dimensiones de comprensibilidad, manejabilidad y significatividad del SOC; y los activos externos, sobre todo los amigos, familiares y espacios relacionados con la actividad físico-deportiva, tanto dentro como fuera de prisión. Estos activos y sus interrelaciones podrían incorporarse al diseño de futuras intervenciones de promoción de la salud.

76 FR 37375 - Meeting of the Public Safety Officer Medal of Valor Review Board

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-27

... INFORMATION: The Public Safety Officer Medal of Valor Review Board carries out those advisory functions... who wish to participate must register at least seven (7) days in advance of the meeting/conference... registration. Anyone requiring special accommodations should contact Mr. Joy at least seven (7) days in advance...

VALORATE: fast and accurate log-rank test in balanced and unbalanced comparisons of survival curves and cancer genomics.

PubMed

Treviño, Victor; Tamez-Pena, Jose

2017-06-15

The association of genomic alterations to outcomes in cancer is affected by a problem of unbalanced groups generated by the low frequency of alterations. For this, an R package (VALORATE) that estimates the null distribution and the P -value of the log-rank based on a recent reformulation is presented. For a given number of alterations that define the size of survival groups, the log-rank density is estimated by a weighted sum of conditional distributions depending on a co-occurrence term of mutations and events. The estimations are accurately accelerated by sampling across co-occurrences allowing the analysis of large genomic datasets in few minutes. In conclusion, the proposed VALORATE R package is a valuable tool for survival analysis. The R package is available in CRAN at https://cran.r-project.org and in http://bioinformatica.mty.itesm.mx/valorateR . vtrevino@itesm.mx. Supplementary data are available at Bioinformatics online. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Confirmatory factor analysis of the Appraisal of Self-Care Agency Scale - Revised.

PubMed

Stacciarini, Thaís Santos Guerra; Pace, Ana Emilia

2017-01-30

to analyze the factor structure of the Appraisal of Self-Care Agency Scale-Revised (ASAS-R), adapted for Brazil. methodological study conducted with 150 individuals with diabetes mellitus cared for by the Family Health Strategy, most of whom are elderly with low educational levels. The test of the hypothesis concerning the confirmatory factor composition of the ASAS-R was performed using latent variables structural equations. the model's goodness-of-fit indexes were satisfactory (χ2 = 259.19; χ2/g.l = 2.97, p < 0.001; GFI = 0.85; RMR = 0.07; RMSEA = 0.09); the factor loads were greater than 0.40; and most item-to-factor-correlations presented moderate to strong magnitude (0.34 to 0.58); total alpha value was 0.74, while the alpha of the three factors were 0.69, 0.38 and 0.69, respectively. the scale's factor structure presented satisfactory validity and reliability results, with the exception of one factor. Application of this scale to samples of the general population is desirable in order to strengthen analyses of internal consistency and the dimensionality of the factor structure. This study is expected to contribute to further studies addressing the self-care agency construct and the development of the ASAS-R. analisar a estrutura fatorial da escala de avaliação da capacidade de autocuidado, Appraisal of Self Care Agency Scale-Revised (ASAS-R), adaptada no Brasil. estudo metodológico conduzido em 150 usuários com diabetes mellitus, maioria idosos e com baixa escolaridade, em seguimento na Estratégia Saúde da Família. O teste de hipótese da composição fatorial confirmatória da escala ASAS-R foi realizado via modelo de equações estruturais para variáveis latentes. os valores dos índices de ajuste do modelo foram satisfatórios (χ2 de 259,19; χ2/g.l de 2,97, p < 0,001; GFI = 0,85; RMR = 0,07; RMSEA = 0,09), as cargas fatoriais foram superiores a 0,40, maioria das correlações item e fator foi de moderada a forte magnitude (0,34 a 0,58) e os valores de alfa total de 0,74 e dos três fatores de 0,69, 0,38 e 0,69, respectivamente. estrutura fatorial da escala com resultados satisfatórios de validade e de confiabilidade, exceto um de seus fatores. É desejável que essa Escala seja aplicada em amostras da população geral, para fortalecer as análises de consistência interna e de dimensionalidade da estrutura fatorial, e espera-se que este estudo possa contribuir no avanço de outras pesquisas que trabalham com o construto de capacidade de autocuidado e no desenvolvimento da Escala ASAS-R. analizar la estructura factorial de la escala de evaluación de la capacidad de autocuidado, Appraisal of Self Care Agency Scale-Revised (ASAS-R), adaptada en Brasil. estudio metodológico conducido en 150 usuarios con diabetes mellitus, mayoría de ancianos y con baja escolaridad, acompañados por la Estrategia Salud de la Familia. El test de hipótesis de la composición factorial confirmatoria de la escala ASAS-R fue realizado por medio del modelo de ecuaciones estructurales para variables latentes. los valores de los índices de ajuste del modelo fueron satisfactorios (χ2 de 259,19; χ2/g.l de 2,97, p < 0,001; GFI = 0,85; RMR = 0,07; RMSEA = 0,09), las cargas factoriales fueron superiores a 0,40, la mayoría de las correlaciones ítem y factor varió de moderada a fuerte magnitud (0,34 la 0,58); valores de alfa total de 0,74 y de los tres factores de 0,69, 0,38 y 0,69, respectivamente. la estructura factorial de la escala obtuvo resultados satisfactorios de validez y de confiabilidad, excepto uno de sus factores. Es deseable que esa escala sea aplicada en muestras de la población general, para fortalecer los análisis de consistencia interna y de dimensionalidad de la estructura factorial; y se espera que este estudio pueda contribuir para avanzar en nuevas investigaciones que vengan a trabajar con el constructo de capacidad de autocuidado y con el desarrollo de la escala ASAS-R.

Study on the valorization routes of ashes from thermoelectric power plants working under mono-and co-combustion regimes

NASA Astrophysics Data System (ADS)

Barbosa, Rui Pedro Fernandes

The main objective of this thesis was to study new valorization routes of ashes produced in combustion and co-combustion processes. Three main valorization pathways were analyzed: (i)production of cement mortars, (ii) production of concretes, and (iii) use as chemical agents to remove contaminants from wastewaters. Firstly, the ashes produced during the mono-combustion of coal, co-combustion of coal and meat and bone meal (MBM), and mono-combustion of MBM were characterized. The aim of this study was to understand the ashes properties in extreme levels of substitution of coal by a residue with a high contamination of specific metals. The substitution of coal by MBM produced ashes with higher content of heavy metals. Secondly, the ashes coming from an industrial power plant working under mono-combustion(coal) and co-combustion conditions (coal+sewage sludge+MBM) were studied. The use of cofuels did not promote significant changes in the chemical and ecotoxicological properties of ashes. Fly ashes were successfully stabilized/solidified in cement mortar, and bottom and circulating ashes were successfully used as raw materials in concrete. The third step involved the characterization and valorization of biomass ashes resulting from the combustion of forestry residues. The highest concentrations of metals/metalloids were found in the lowest particle size fractions of ashes. Biomass ashes successfully substituted cement and natural aggregates in concretes, without compromising their mechanical, chemical, and ecotoxicological properties. Finally, the biomass ashes were tested as chemical agents to remove contaminants from wastewaters. The removal of P, mainly phosphates, and Pb from wastewaters was assayed. Biomass ashes presented a high capacity to remove phosphates. As fly ashes were more efficient in removing phosphates, they were further used to remove Pb from wastewaters. Again, they presented a high efficiency in Pb removal. New potential valorization routes for these ashes are now opened, contributing to improve their valorization rates.

Pediatric colonic volvulus: A single-institution experience and review.

PubMed

Tannouri, Sami; Hendi, Aditi; Gilje, Elizabeth; Grissom, Leslie; Katz, Douglas

2017-06-01

Pediatric colonic volvulus is both rare and underreported. Existing literature consists only of case reports and small series. We present an analysis of cases (n=11) over 15 years at a single institution, focusing on workup and diagnosis. This was an institutional review board approved single-institution retrospective chart review of 11 cases of large bowel volvulus occurring over 15 years (2000-2015). In our series, the most common presenting symptoms were abdominal pain and distention. Afflicted patients often had prior abdominal surgery, a neurodevelopmental disorder or chronic constipation. Of the imaging modalities utilized in the 11 patients studied, colonic volvulus was correctly diagnosed by barium enema in 100% of both cases, CT in 55.6% of cases and by plain radiography of the abdomen in only 22.2%of cases. Colonic volvulus was confirmed by laparotomy in all cases. The cecum (n=5) was the most often affected colonic segment, followed by the sigmoid (n=3). Operative treatment mainly consisted of resection (63.6%) and ostomy creation (36.4%). Colopexy was performed in 18.2% of cases. Plain abdominal radiography may be performed as an initial diagnostic study, however, it should be followed CT or air or contrast enema in children where there is high clinical suspicion and who do not have indications for immediate laparotomy. CT may be the most specific and useful test in diagnosis of colonic volvulus and has the added advantage of detection of complications including bowel ischemia. We demonstrate a range of diagnostic and therapeutic modalities for pediatric colonic volvulus. This underscores the need for further study to draft standard best practices for this life-threatening condition. Prognosis Study: Level IV. Study of a Diagnostic Test: Level III. Copyright © 2017 Elsevier Inc. All rights reserved.

Improvement in the Diagnostic Evaluation of a Positive Fecal Occult Blood Test in an Integrated Health Care Organization

PubMed Central

Miglioretti, Diana L.; Rutter, Carolyn M.; Bradford, Susan Carol; Zauber, Ann G.; Kessler, Larry G.; Feuer, Eric J.; Grossman, David C.

2014-01-01

Background Screening for fecal occult blood can be effective in reducing colorectal cancer mortality only if positive tests are appropriately followed up with complete diagnostic evaluation (i.e., colonoscopy or flexible sigmoidoscopy with double contrast barium enema) and treatment. Objectives To examine whether rates of complete diagnostic evaluation following a positive fecal occult blood test (FOBT) have improved over time after the implementation of tracking systems and physician guidelines within a large integrated health care organization. Research Design From 1993 to 2005, 8513 positive FOBTs were identified on 8291 enrollees aged 50–79 of a large health care system. Automated records were used to identify repeat FOBTs, colonoscopy, flexible sigmoidoscopy, and double-contrast barium enema within one year after the positive FOBT. National rates of complete diagnostic evaluation were estimated from the 2005 National Health Interview Survey. Results In this integrated health care organization, the percentage of positive FOBTs followed by complete diagnostic evaluation within one year increased from 57%–64% in 1993–1996 to 82%–86% from 2000–2005. Use of repeat FOBT following a positive FOBT decreased from 28–31% in 1993–1996 to 6–11% in 2000–2005. Based on the National Health Interview Survey, only 52% of positive FOBTs from 2000–2005 were followed by complete diagnostic evaluation nationally. Conclusions Adherence to recommendations for complete diagnostic evaluation following a positive FOBT has greatly improved over time in an integrated group medical practice. Through the use of tracking systems and screening guidelines, it may be possible to reach levels of follow-up that are comparable to those observed in randomized trials. PMID:18725839

Impact of mechanical bowel preparation in elective colorectal surgery: A meta-analysis.

PubMed

Rollins, Katie E; Javanmard-Emamghissi, Hannah; Lobo, Dileep N

2018-01-28

To analyse the effect of mechanical bowel preparation vs no mechanical bowel preparation on outcome in patients undergoing elective colorectal surgery. Meta-analysis of randomised controlled trials and observational studies comparing adult patients receiving mechanical bowel preparation with those receiving no mechanical bowel preparation, subdivided into those receiving a single rectal enema and those who received no preparation at all prior to elective colorectal surgery. A total of 36 studies (23 randomised controlled trials and 13 observational studies) including 21568 patients undergoing elective colorectal surgery were included. When all studies were considered, mechanical bowel preparation was not associated with any significant difference in anastomotic leak rates (OR = 0.90, 95%CI: 0.74 to 1.10, P = 0.32), surgical site infection (OR = 0.99, 95%CI: 0.80 to 1.24, P = 0.96), intra-abdominal collection (OR = 0.86, 95%CI: 0.63 to 1.17, P = 0.34), mortality (OR = 0.85, 95%CI: 0.57 to 1.27, P = 0.43), reoperation (OR = 0.91, 95%CI: 0.75 to 1.12, P = 0.38) or hospital length of stay (overall mean difference 0.11 d, 95%CI: -0.51 to 0.73, P = 0.72), when compared with no mechanical bowel preparation, nor when evidence from just randomized controlled trials was analysed. A sub-analysis of mechanical bowel preparation vs absolutely no preparation or a single rectal enema similarly revealed no differences in clinical outcome measures. In the most comprehensive meta-analysis of mechanical bowel preparation in elective colorectal surgery to date, this study has suggested that the use of mechanical bowel preparation does not affect the incidence of postoperative complications when compared with no preparation. Hence, mechanical bowel preparation should not be administered routinely prior to elective colorectal surgery.

Evaluation of two minimal-preparation regimes for CT colonography: optimising image quality and patient acceptability.

PubMed

Pollentine, A; Mortimer, A; McCoubrie, P; Archer, L

2012-08-01

To compare a 2 day bowel preparation regime of barium, iodine and a mild stimulant laxative with a 1 day iodine-only regime for CT colonography (CTC). 100 consecutive patients underwent CTC. The first 50 patients (Regime 1) ingested 1 bisacodyl tablet twice a day 3 days before CTC and 1 dose each of 50 ml of barium and 20 ml of iodinated contrast per day starting 2 days before CTC. The second 50 patients (Regime 2) ingested 3 doses of iodinated contrast over 24 h prior to CTC. Volumes of residual stool and fluid, and the effectiveness of stool and fluid tagging, were graded according to methods established by Taylor et al (Taylor S, Slaker A, Burling D, Tam E, Greenhalgh R, Gartner L, et al. CT colonography: optimisation, diagnostic performance and patient acceptability of reduced-laxative regimens using barium-based faecal tagging. Eur Radiol 2008; 18: 32-42). A 3 day low-residue diet was taken by both cohorts. Questionnaires rating the side-effects and burden of the bowel preparation were compared to a control cohort of patients undergoing barium enema. The proportion of colons producing none/scattered stool (score 1) was 90.3% with Regime 1 and 65.0% with Regime 2 (p<0.005). Any residual stool was significantly better tagged with Regime 1 (score 5), with 91.7% of Regime 1 exhibiting optimum tagging vs 71.3% of Regime 2 (p<0.05). No significant differences in side-effects between the bowel preparation regimes for CTC were elicited. Bowel preparation for barium enema was tolerated significantly worse than both of the CTC bowel preparation regimes. Regime 1, containing a 3 day preparation of a mild laxative, barium and iodine, produced a significantly better prepared colon, with no difference in patient acceptability.

[Performance and optimisation of a trigger tool for the detection of adverse events in hospitalised adult patients].

PubMed

Guzmán Ruiz, Óscar; Pérez Lázaro, Juan José; Ruiz López, Pedro

To characterise the performance of the triggers used in the detection of adverse events (AE) of hospitalised adult patients and to define a simplified panel of triggers to facilitate the detection of AE. Cross-sectional study of charts of patients from a service of internal medicine to detect EA through systematic review of the charts and identification of triggers (clinical event often related to AE), determining if there was AE as the context in which it appeared the trigger. Once the EA was detected, we proceeded to the characterization of the triggers that detected it. Logistic regression was applied to select the triggers with greater AE detection capability. A total of 291 charts were reviewed, with a total of 562 triggers in 103 patients, of which 163 were involved in detecting an AE. The triggers that detected the most AE were "A.1. Pressure ulcer" (9.82%), "B.5. Laxative or enema" (8.59%), "A.8. Agitation" (8.59%), "A.9. Over-sedation" (7.98%), "A.7. Haemorrhage" (6.75%) and "B.4. Antipsychotic" (6.75%). A simplified model was obtained using logistic regression, and included the variable "Number of drugs" and the triggers "Over-sedation", "Urinary catheterisation", "Readmission in 30 days", "Laxative or enema" and "Abrupt medication stop". This model showed a probability of 81% to correctly classify charts with EA or without EA (p <0.001; 95% confidence interval: 0.763-0.871). A high number of triggers were associated with AE. The summary model is capable of detecting a large amount of AE, with a minimum of elements. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Effects of Changtai granules, a traditional compound Chinese medicine, on chronic trinitrobenzene sulfonic acid-induced colitis in rats

PubMed Central

Cao, Yong-Bing; Zhang, Jun-Dong; Diao, Ya-Ying; Yan, Lan; Wang, De-Jun; Jia, Xin-Ming; Gao, Ping-Hui; Cheng, Ming-He; Xu, Zheng; Wang, Yan; Jiang, Yuan-Ying

2005-01-01

AIM: To study the effects of Changtai granules (CTG), a traditional compound Chinese medicine, on chronic trinitrobenzene sulfonic acid-induced colitis in rats. METHODS: Healthy adult Sprague-Dawley (SD) rats of both sexes, weighing 250-300 g, were employed in the present study. The rat colitis models were induced by 2,4,6-trinitrobenzene sulfonic acid (TNBS) enemas at a concentration of 100 mg/kg in 50% ethanol. The experimental animals were randomly divided into dexamethasone (DX) treatment, CTG treatment, and model control groups, which were intracolicly treated daily with DX (0.2 mg/kg), CTG at doses of 2.9, 5.7 and 11.4 g crude drug/kg, and the equal amount of saline respectively from 6 h following induction of the colitis in rats inflicted with TNBS to the end of study. A normal control group of rats treated without TNBS but saline enema was also included in the study. After 3 wk of treatment, the animals were assessed for colonal inflammatory and ulcerative responses with respect to mortality, frequency of diarrhea, histology and myeloperoxidase activity (MPO). RESULTS: The therapeutic effect of CTG on ulcerative colitis (UC) was better than DX. CTG effectively inhibited the activity of granulocytes, macrophages and monocytes in a dose-dependent manner. Also it reduced MPO and formation of inflammation in colonic mucosal tissue. Furthermore, administration of CTG significantly prevented body mass loss and death, and decreased frequency of diarrhea in UC rats, when compared with the model control group rats. CONCLUSION: CTG would prove to be an ideal drug for chronic UC, and is warranted to be studied further. PMID:15962370

Effectiveness of an organized bowel management program in the management of severe chronic constipation in children.

PubMed

Russell, Katie W; Barnhart, Douglas C; Zobell, Sarah; Scaife, Eric R; Rollins, Michael D

2015-03-01

Chronic constipation is a common problem in children. The cause of constipation is often idiopathic, when no anatomic or physiologic etiology can be identified. In severe cases, low dose laxatives, stool softeners and small volume enemas are ineffective. The purpose of this study was to assess the effectiveness of a structured bowel management program in these children. We retrospectively reviewed children with chronic constipation without a history of anorectal malformation, Hirschsprung's disease or other anatomical lesions seen in our pediatric colorectal center. Our bowel management program consists of an intensive week where treatment is assessed and tailored based on clinical response and daily radiographs. Once a successful treatment plan is established, children are followed longitudinally. The number of patients requiring hospital admission during the year prior to and year after initiation of bowel management was compared using Fisher's exact test. Forty-four children with refractory constipation have been followed in our colorectal center for greater than a year. Fifty percent had at least one hospitalization the year prior to treatment for obstructive symptoms. Children were treated with either high-dose laxatives starting at 2mg/kg of senna or enemas starting at 20ml/kg of normal saline. Treatment regimens were adjusted based on response to therapy. The admission rate one-year after enrollment was 9% including both adherent and nonadherent patients. This represents an 82% reduction in hospital admissions (p<0.001). Implementation of a structured bowel management program similar to that used for children with anorectal malformations, is effective and reduces hospital admissions in children with severe chronic constipation. Copyright © 2015 Elsevier Inc. All rights reserved.

Difficulty in diagnosis and different prognoses between colorectal cancer with ovarian metastasis and advanced ovarian cancer: An empirical study of different surgical adoptions.

PubMed

Lee, Ko-Chao; Lin, Hao; ChangChien, Chan-Chao; Fu, Hung-Chun; Tsai, Ching-Chou; Wu, Chen-Hsuan; Ou, Yu-Che

2017-02-01

To determine the clinical manifestations and optimal management of female patients with advanced colorectal cancer (CRC) metastasis in ovaries mimicking advanced ovarian malignancy. A retrospective medical records review of female patients with primary CRC metastasis to ovaries, which were initially diagnosed as ovarian malignancy, and treated between 2001 and 2013. Clinical presentations, pathologic findings, and treatment outcomes were analyzed. In total, 19 cases were collected in the study through a hospital tumor registry. The mean age of the patients at the time of diagnosis was 45 years (range, 28-63 years). The most common symptoms were abdominal pain or increased abdominal girth (63%). None of them had rectal bleeding. The ratio of cancer antigen-125 to carcinoembryonic antigen was available in 13 out 19 patients (less than 25 in 76.9%). Barium enema or colonoscopic exam was only performed in 10 outpatients. None of them had a positive finding. All 19 patients went for surgery, all of them had ovarian metastasis but only eight of them had bilateral involvement, and 14 of them had carcinomatosis. All patients went for either optimal cytoreduction surgery or suboptimal cytoreduction surgery. The patients who received optimal cytoreduction surgery had a significant better progression-free and overall survival than those who did not. Clinical manifestations of primary CRC with ovarian metastasis may be confused with advanced ovarian cancer. Negative barium enema or colonoscopic exam cannot rule out the possibility of CRC. For patients with a cancer antigen-125 to carcinoembryonic antigen ratio less than 25, 76% are good reference of CRC metastasis to ovaries. Optimal cytoreduction surgery like that used for treating advanced ovarian cancer had a better prognosis than suboptimal cytoreduction colorectal cancer treatment. Copyright © 2017. Published by Elsevier B.V.

Long-term follow-up of patients after antegrade continence enema procedure.

PubMed

Siddiqui, Anees A; Fishman, Steven J; Bauer, Stuart B; Nurko, Samuel

2011-05-01

Antegrade continence enema (ACE) has become an important therapeutic modality in the treatment of intractable constipation and fecal incontinence. There are little data available on the long-term performance of the ACE procedure in children. A retrospective review of patients who underwent the ACE procedure was conducted. Irrigation characteristics and complications were noted. Outcome was assessed for individual encounters based on frequency of bowel movements, incontinence, pain, and predictability. One hundred seventeen patients underwent an ACE. One hundred five patients had at least 6 months of follow-up, and were included in the analysis. Diagnoses included myelodysplasia (39%), functional intractable constipation (26%), anorectal malformations (21%), nonrelaxing internal anal sphincter (7%), cerebral palsy (3%), and other diagnoses (4%). The average follow-up was 68 months (range 7-178 months). At the last follow-up, 69% of patients had successful bowel management. Of the 31% of patients who did not have successful bowel management, 20% were using the ACE despite suboptimal results, 10% required surgical removal, and 2% were not using the ACE because of behavioral opposition to it. Patients were started on normal saline, but were switched to GoLYTELY (PEG-3350 and electrolyte solution) if there was an inadequate response (61% at final encounter). Additives were needed in 34% of patients. The average irrigation dose was 23 ± 0.7 mL/kg. The average toilet sitting time was 51.7 ± 3.5 minutes, with infusions running for 12.1 ± 1.2 minutes. Stomal complications occurred in 63% (infection, leakage, and stenosis) of patients, 33% required surgical revision and 6% eventually required diverting ostomies. Long-term use of the ACE gives successful results in 69% of patients, whereas 63% had a stoma-related complication and 33% required surgical revision of the stoma.

Determination of aquifer roof extending under the sea from variable-density flow modelling of groundwater response to tidal loading: case study of the Jahe River Basin, Shandong Province, China

NASA Astrophysics Data System (ADS)

Cheng, Jianmei; Chen, Chongxi; Ji, Menrui

The main task of studies on salt-water intrusion into coastal confined aquifers is to predict the position of the fresh- salt-water interface, which can be determined from the length of the aquifer roof extending under the sea. Records of groundwater level affected by tides can be used to infer hydrological conditions and determine hydraulic parameters of an aquifer extending under the sea. In this paper, a three-dimensional, variable-density groundwater flow model has been developed to determine the equivalent roof length of an aquifer extending under the sea from the tidal-effected data of groundwater level in the Jahe River Basin, Shandong Province, China. The seaward boundary is obtained by converging hydraulic head fluctuations observed in drill holes with calculated values, and the aquifer parameters in the extending zone are estimated. The impacts of aquifer roof length and aquifer parameters on the fluctuation of tidal groundwater are studied. It is concluded that the length of the aquifer roof extending under the sea should correspond with certain aquifer parameters in the extrapolation zone. Therefore, the seaward boundary determined from tidal-effect information is the equivalent boundary in hydrodynamic characteristics rather than the true boundary of the confined aquifer Les sujets principaux des études d'instrusion saline dans les aquifères confinés en zone côtière sont la prédiction de la position de l'interface entre l'eau salée et l'eau fraîche, qui peut être déterminée à partir de l'extention du toit de l'aquifère sous la mer. Les enregistrements des niveaux des eaux souterraines influencés par les marées peuvent être utilisés pour préciser les conditions hydrologiques et déterminer les paramètres hydrauliques d'un aquifère possédant une extension sous la mer. Dans cet article, un modèle tridimensionnel comprenant des eaux souterraines de densité variable a été développé pour déterminer la longueur équivalente du toit d'un aquifère qui s'étend sous la mer à partir des données concernant les effets de marée sur les eaux souterraines dans le bassin de la rivière Jahe, dans la province de Shandong, Chine. La limite de salinité est déterminée en faisant converger les fluctuations des hauteurs piézométriques avec les valeurs calculées, et les paramètres de l'aquifère sont estimés dans la zone s'étendant sous la mer. L'incidence de la longueur de l'aquifère sous la mer sur les fluctuations des niveaux est étudiée. On en conclut que la longueur du toit de l'aquifère sous la mer peut correspondre à certains aquifères paramètres dans la zone d'extrapolation. Par conséquent, la limite de salinité déterminée à partir des effets de marée est l'équivalent d'une limite hydrodynamique plutôt que la véritable limite de l'aquifère. El principal objetivo de los estudios sobre intrusiones de agua salada en acuíferos costeros confinados es predecir la posición de la interfase agua dulce-agua salada, la cual puede determinarse a partir de la longitud del techo del acuífero que se extiende por debajo del mar. Los registros de niveles de agua subterránea afectados por las mareas puede utilizarse para inferir las condiciones hidrológicas y determinar los parámetros hidráulicos de un acuífero que se extiende por debajo del mar. En este artículo se ha desarrollado un modelo de flujo tri-dimensional de agua subterránea de densidad variable para determinar la longitud del techo equivalente de un acuífero que se extiende por debajo del mar a partir de datos, afectados por la marea, de niveles de agua subterránea en la Cuenca del Río Jahe, Provincia Shandong, China. El límite hacia el océano se obtiene por convergencia de fluctuaciones de presiones hidráulicas observadas en pozos con valores calculados, y se estiman los parámetros del acuífero en la zona extendida. Se estudian los impactos de la longitud del techo del acuífero y los parámetros del acuífero en la fluctuación del agua subterránea afectada por las mareas. Se concluye que la longitud del techo del acuífero que se extiende por debajo del mar debería corresponder con ciertos parámetros del acuífero en la zona de extrapolación. Por lo tanto, el límite hacia el océano determinado a partir de información de efectos de marea es el límite equivalente en características hidrodinámicas más que el límite real del acuífero confinado.

Social Role Valorization: A Proposed New Term for the Principle of Normalization

ERIC Educational Resources Information Center

Wolfensberger, Wolf

2011-01-01

The highest goal of the principle of normalization has recently been clarified to be the establishment, enhancement, or defense of the social role(s) of a person or group, via the enhancement of people's social images and personal competencies. In consequence, it is proposed that normalization be henceforth called "social role valorization."

75 FR 30859 - Meeting of the Public Safety Officer Medal of Valor Review Board

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-02

... INFORMATION: The Public Safety Officer Medal of Valor Review Board carries out those advisory functions... participate must register at least seven (7) days in advance of the meeting/conference call by contacting Mr.... Anyone requiring special accommodations should contact Mr. Joy at least seven (7) days in advance of the...

Operational tools and applications of EO satellite data to retrieve surface fluxes in semi-arid countries

NASA Astrophysics Data System (ADS)

Tanguy, Maliko

The objective of the thesis is to develop and evaluate useful tools and applications of Earth Observation (EO) satellite data to estimate surface fluxes in semi-arid countries. In a first part (Chapter 4), we assess the performance of a new parameterisation scheme of ground heat flux (G) to be used in remote sensing (RS) evapotranspiration (ET) estimation methods. The G-parameterisation optimized with AMMA flux data performs well and improves the sensible heat flux (H) and ET retrieved by means of the triangle method (Jiang & Islam, 2001). In a second part (Chapter 5), the triangle method is compared with ET estimated by means of a land surface model (JULES). An attempt is made to calibrate JULES using the triangle method through Monte Carlo simulations, but the two methods supply rather different results, indicating that further intercomparison tasks should be carried out to assess the performance of RS-based algorithms and land surface models in estimating the components of the land surface energy balance. Chapter 6 presents a set of operational examples for retrieving surface fluxes using RS data. The first example is the study of temporal evolution of ET-maps in Western Africa under monsoonal influence. In a second example, we apply the new scheme proposed in Chapter 4 to retrieve and analyse the long term evolution (2000-2009) of the surface energy balance components, G, H and ET at several sites of the Segura Basin (S-E Spain) using MODIS-Terra data (land surface temperature and NDVI). Temporal and spatial distribution of evapotranspiration reveals different controls on ET. (Chapter 6). In the last example, MODIS-Aqua Sea Surface Temperature (SST) is used to validate a mathematical model to retrieve surface fluxes in a Mediterranean coastal lagoon (Mar Menor, S-E Spain). El objetivo de esta tesis es de desarrollar y evaluar herramientas y aplicaciones de la teledetección para estimar flujos de superficie en zonas semiáridas. En una primera parte (Capítulo 4), se evalúa la fiabilidad de una nueva parametrización para estimar el flujo de calor en el suelo (G) con el fin de ser utilizado en métodos de estimación de la evapotranspiración (ET) usando datos de teledetección. La parametrización de G se optimiza usando datos de flujo de energía obtenido durante las campañas del proyecto AMMA, y muestra buenos resultados y una mejora de las estimaciones del flujo de calor sensible (H) y de ET cuando se utiliza conjuntamente con el método del triángulo (Jiang & Islam, 2001). En una segunda parte (Capítulo 5), el método del triángulo se compara con valores de ET estimado por un modelo de superficie terrestre (JULES). Se intenta calibrar JULES usando el método del triángulo mediante simulaciones de Monte Carlo, pero los dos métodos muestran resultados muy diferentes, indicando que se necesita tareas de comparación profundizadas para poder evaluar la eficacia de estos modelos (de superficie terrestre y basados en la teledetección) para estimar los flujos de energía a la superficie. El capítulo 6 presenta un conjunto de ejemplos de aplicaciones operacionales para estimar los flujos de superficie usando datos de teledetección. El primer ejemplo consiste en el estudio de la evolución temporal de mapas de ET en África occidental bajo la influencia del monzón africano. En el segundo ejemplo, se aplica la nueva parametrización de G descrita en el capítulo 4 para calcular y analizar la evolución a largo plazo (2000-2009) de los componentes del balance de energía a la superficie, G, H y ET, en diferentes puntos de la cuenca del río Segura (Sureste español) utilizando datos del sensor MODIS-Terra (temperatura superficial y NDVI). La distribución temporal y espacial de ET revela diferentes controles sobre ET. En el último ejemplo, datos de temperatura superficial del mar del sensor MODIS-Aqua se utilizaron para validar un modelo matemático para calcular los flujos superficiales de una laguna costera del Mediterráneo (Mar Menor en el Sureste español).

Population size and selection intensity effects on short-term response for a selection index in Tribolium.

PubMed

Campo, J L; Turrado, H

1997-01-12

The effects of population size and selection intensity on the short-term response to selection were investigated in an experiment with Tribolium, using a two-trait empirical selection index for pupal and adult weights. Twenty lines were selected following a factorial design of five population sizes (1, 2, 4, 8, and 16 pairs of parents) and four selection intensities (20, 25, 33, and 50%), with three replicates. For each replicate, an unselected control with 16 pairs of parents was produced. There were four generations of selection per line. Selection response was significant in all lines with the 20% selection intensity and/or the 16-pair population size. Selection intensity and population size were significant effects and there was significant interaction between them. Higher selection intensities produced more overall significant response to selection (20% > (25% = 33%) > 50%); this significance was also found for the 16-pair population size. There was an overall significant difference among population sizes, with the larger population sizes giving more response than the smaller sizes (16-pair = 8-pair = 4-pair) > (2-pair = 1-pair); this significance was also found for the 20% selection intensity. There was a good agreement between observed and expected responses, except for the 50% selection intensity and/or 1-pair population size; expected values in generation 1 overestimated observed values. The realized heritability was similar in all lines. With equal and high numbers of individuals scored, it was better to choose a high selection intensity than a large population size. The results show that the effect of population size cannot be ignored, even in short-term selection response; the main influence of population size is through selection differential. RESUMEN: Los efectos del tamaño de población y la intensidad de selección sobre la respuesta a corto plazo para un índice de selección en Tribolium Los efectos del tamaño de población y la intensidad de selección sobre la respuesta a la selección a corto plazo fueron estudiados en un experimento con Tribolium usando un índice empírico de selección para dos caracteres (peso de pupa y peso adulto). Se seleccionaron 20 líneas siguiendo un modelo factorial de cinco tamaños de población (1, 2, 4, 8 y 16 pares de padres) y cuatro intensidades de selección (20, 25, 33 y 50%), con tres repeticiones. En cada repetición, había una línea control sin seleccionar con 16 pares de padres. Se hicieron cuatro generaciones de selección, por línea. La respuesta a la selección fue significativa en todas las líneas con el 20% de intensidad de selección y/o 16 pares de padres. Tanto la intensidad de selección como el tamaño de población fueron efectos significativos y hubo interacción significativa entre ellos. Las intensidades de selección más altas produjeron significativamente más respuesta en general (20% > (25% = 33%) > 50%), y esta significación se mantenía cuando el tamaño de población era de 16 pares de padres. Hubo diferencias significativas entre tamaños de población, dando los mayores tamaños más respuesta en general que los menores tamaños (16 pares = 8 pares = 4 pares) > (2 pares = 1 par), manteniendose esta significación para la intensidad de selección del 20%. La concordancia entre las respuestas observadas y las esperadas era buena, excepto cuando la intensidad de selección era 50% y/o el tamaño de población era 1 par de padres; los valores esperados en la generación 1 sobreestimaban los valores observados. La heredabilidad realizada fue similar en todas las líneas. Cuando el número total de animales era igual y alto, era mejor elegir una intensidad de selección alta que un tamaño de población grande. Los resultados indican que el efecto del tamaño de población no se puede ignorar incluso en experimentos de selección a corto plazo, y que la influencia principal de este efecto es a través del diferencial de selección. 1997 Blackwell Verlag GmbH.

Factors associated with problematic drug use among psychiatric outpatients.

PubMed

Corradi-Webster, Clarissa Mendonça; Gherardi-Donato, Edilaine Cristina da Silva

2016-11-28

to examine the factors associated with problematic drug use among psychiatric outpatients. a cross-sectional study was carried out in two mental health services. Eligible individuals were patients of these mental health services, who used them within the data collection period. Instruments: standardized questionnaire with sociodemographic, social network, social harm, and clinical information; Alcohol, Smoking and Substance Involvement Screening Test; Barratt Impulsiveness Scale; Holmes and Rahe Stress Scale. Statistical analysis was performed using parametric statistics considering a significance level of p ≤ 0.05. Study participants were 243 patients, with 53.9% of these presenting problematic drug use. the most important independent predictors of problematic drug use were marital status (OR = 0.491), religious practice (OR = 0.449), satisfaction with financial situation (OR = 0.469), having suffered discrimination (OR = 3.821) and practicing sports activities in previous 12 months (OR = 2.25). the variables found to be predictors were those related to the social context of the patient, there, it is recommended that mental health services valorize psychosocial actions, seeking to know the social support network of patients, their modes of socialization, their financial needs, and their experiences of life and suffering. analisar os fatores associados ao consumo problemático de droga entre pacientes psiquiátricos ambulatoriais. estudo transversal em dois serviços de saúde mental. Foram considerados indivíduos elegíveis os usuários desses serviços de saúde mental, que os utilizaram dentro do período de coleta de dados. Instrumentos: Questionário padronizado sobre dados sociodemográficos, redes sociais, prejuízos sociais e informações clínicas; Teste de Triagem do Envolvimento com Álcool, Cigarro e outras Substâncias (ASSIST); Escala de Impulsividade de Barratt; e Escala de Avaliação de Reajustamento Social de Holmes e Rahe. A análise estatística foi realizada utilizando-se estatísticas paramétricas considerando um nível de significância de p ≤ 0,05. Participaram do estudo 243 pacientes, com 53,9% destes apresentando consumo problemático de drogas. os preditores independentes mais importantes do consumo problemático de drogas foram o estado civil (OR = 0,491), a prática religiosa (OR = 0,449), a satisfação com a situação financeira (OR = 0,469), ter sofrido discriminação (OR = 3,821) e a prática de atividades esportivas nos últimos 12 meses (OR = 2,25). as variáveis consideradas preditoras foram aquelas relacionadas ao contexto social do paciente, e por isso, recomenda-se que os serviços de saúde mental valorize ações psicossociais, buscando conhecer a rede de suporte social dos pacientes, seus modos de socialização, suas necessidades financeiras e suas experiências de vida e sofrimento. analizar los factores asociados al consumo problemático de droga entre pacientes siquiátricos en ambulatorios. estudio transversal en dos servicios de salud mental. Fueron considerados individuos elegibles los usuarios de esos servicios de salud mental, que utilizaron drogas dentro del período de recolección de datos. Instrumentos: cuestionario estandarizado sobre datos sociodemográficos, redes sociales, perjuicios sociales e informaciones clínicas; Test de Detección del Involucramiento con Alcohol, Cigarro y otras Sustancias (ASSIST); Escala de Impulsividad de Barratt; y Escala de Evaluación de Readecuación Social de Holmes y Rahe. El análisis estadístico fue realizada utilizando estadísticas paramétricas considerando un nivel de significación de p ≤ 0,05. Participaron del estudio 243 pacientes, con 53,9% de estos presentando consumo problemático de drogas. los predictores independientes más importantes del consumo problemático de drogas fueron: el estado civil (OR = 0,491), la práctica religiosa (OR = 0,449), la satisfacción con la situación financiera (OR = 0,469), el haber sufrido discriminación (OR = 3,821) y la práctica de actividades deportivas en los últimos 12 meses (OR = 2,25). las variables consideradas predictoras fueron aquellas relacionadas al contexto social del paciente, y por eso, se recomienda que los servicios de salud mental valoricen acciones psicosociales, buscando conocer la red de soporte social de los pacientes, sus modos de socialización, sus necesidades financieras y sus experiencias de vida y sufrimiento.

Seguridad del paciente en Radioterapia Intraoperatoria: Impacto de los elementos controlados por el Radiofisico

NASA Astrophysics Data System (ADS)

Tarjuelo, Juan Lopez

Introduccion: En la administracion de la radioterapia intervienen profesionales y equipos de tratamiento, por lo que existe el riesgo de error y se precisa que dicho equipamiento funcione conforme a lo esperado. A los radiofisicos les corresponde participar en las actividades de garantia o aseguramiento de la calidad, incluyendo el control de calidad de los equipos, y en la evaluacion de los riesgos asociados. La radioterapia intraoperatoria (RIO) es una tecnica radioterapica de intensificacion de dosis, altamente selectiva, dirigida a volumenes anatomicos restringidos durante el tratamiento quirurgico oncologico, basada en la administracion de una dosis absorbida alta por medio de un haz de electrones tras el examen visual directo del lecho tumoral. Como incorporar los ultimos avances en el refuerzo de la seguridad en radioterapia es una tarea ambiciosa y compleja, resulta mas concreta y de inmediata aplicacion su introduccion en la RIO. El objetivo es analizar los elementos que reducen los riesgos y aumentan la seguridad en la RIO y su dosimetria, y valorar la funcion del radiofisico en esta labor. Material y metodos: Se emplearon el planificador Radiance de GMV y el acelerador lineal de los tratamientos de RIO Elekta Precise, controlado con el verificador diario de haces Daily QA Check 1090 y medido con las camaras de ionizacion PPC 40, FC65-G y FC65-P de PTW-Freiburg, a su vez verificadas con fuentes radiactivas adecuadas de estroncio-90 modelos CDP y CDC de IBA Dosimetry. Se realizo un analisis de modos de fallo y efectos (failure mode and effect analysis, FMEA) con el fin de identificar los elementos que forman la RIO y aplicar las herramientas necesarias para la minimizacion de los riesgos y la mejora de la seguridad en la tecnica. Se estudiaron las verificaciones diarias de dicho acelerador Precise con el control estadistico de procesos (statistical process control, SPC) y se simularon intervenciones para devolverlo al estado llamado en control. El SPC tambien se uso para estudiar la estabilidad de las camaras de ionizacion mencionadas. Se realizo la dosimetria in vivo en 45 pacientes con MOSFET reforzados mobile TN-502RDM-H, pelicula radiocromica Gafchromic MD-55-2, y se elaboro un modelo teorico para explicar los datos. Por ultimo, al precisarse el uso en RIO de la simulacion virtual y del calculo de la dosis absorbida en el paciente virtual, se ha ilustrado este apartado con la aceptacion y el estado de referencia inicial del planificador de tratamientos modulados con calculo de Monte Carlo Elekta Monaco. Para ello se utilizaron la camara de ionizacion TW31016-0104 y la matriz seven29 de PTW-Freiburg, pelicula radiocromica Gafchromic EBT-2, y diferentes maniquies. Resultados: El FMEA identifico 57 modos de fallo y efectos potenciales. No se experimentaron sucesos relativos a una administracion inadecuada de la dosis absorbida. Se identificaron las revisiones dobles y por un par como claves para reducir los riesgos asociados al equipo de profesionales involucrado en la RIO. Se identificaron tambien oportunidades de mejora con el uso de la automatizacion y el enclavamiento. En cuanto al SPC, los indices de capacidad del proceso abarcaron de 1,6 a 9,3 para un nivel de especificaciones del +/-2%. Las intervenciones simuladas alcanzaron del 2% al 34% de las sesiones de medida. Las camaras de ionizacion Farmer derivaron en direcciones opuestas en un periodo de 6 anos; aunque ello no se aprecio en los informes de calibracion del laboratorio acreditado. No derivo la camara PPC-40. En la dosimetria in vivo, las medidas de los MOSFET no se desviaron significativamente de las medidas con pelicula. Los valores centrales de las dosis absorbidas quedaron entre la dosis absorbida prescrita y la maxima, con lo que indicaron un tratamiento correcto del lecho tumoral. Las anchuras de los intervalos de confianza de las dosis absorbidas esperadas segun el modelo teorico al nivel del 95% abarcaron del 8,6% al 14,7%. Las verificaciones de Monaco resultaron satisfactorias excepto en el caso de la transferencia de datos, que obligo a cambiar el flujo de trabajo. Conclusiones: El FMEA es crucial para priorizar las intervenciones reductoras del riesgo. Tipos diferentes de procesos fallidos se pueden eliminar o paliar con tipos diferentes de tales intervenciones. El SPC puede evaluar la variabilidad inherente del procedimiento monitorizador de haces de electrones, indica cuando intervenir para devolver un proceso al estado de control y si un proceso es capaz con respecto a unas especificaciones o requisitos establecidos. Es viable realizar dosimetria in vivo con un acelerador convencional fijo y obtener resultados satisfactorios en cada localizacion estudiada a pesar de su variabilidad. El modelo teorico desarrollado puede describir con exito resultados globales, aunque no puede explicar todos los datos experimentales. Se ha mostrado que un planificador puede funcionar correctamente en condiciones de laboratorio o trabajando solo; pero puede fallar cuando se conecta con otros equipos de radioterapia. Todos estos aspectos presentados y evaluados aqui constituyen competencias actuales o futuras, y deseables, de los radiofisicos, tanto en el campo de la RIO como en la extension a la radioterapia en su conjunto.

Evidence-based management of neonatal vomiting in the emergency department.

PubMed

Ratnayake, Kristin; Kim, Tommy Y

2014-11-01

Vomiting accounts for up to 36% of neonatal visits to the emergency department. The causes of vomiting can range from benign to life-threatening. Evidence to guide the diagnosis and management of neonatal vomiting in the emergency department is limited. History and physical examination are extremely important in these cases, especially in identifying red flags such as bilious or projectile emesis. A thorough review is presented, discussing various imaging modalities, including plain abdominal radiography, upper gastrointestinal studies, ultrasonography, and contrast enema. A systematic approach in the emergency department, as outlined in this review, is required to identify the serious causes of vomiting in the neonate.

Osteopathic Manipulative Treatment Limits Chronic Constipation in a Child with Pitt-Hopkins Syndrome.

PubMed

Aquino, Alessandro; Perini, Mattia; Cosmai, Silvia; Zanon, Silvia; Pisa, Viviana; Castagna, Carmine; Uberti, Stefano

2017-01-01

Pitt-Hopkins Syndrome (PTHS) is a rare genetic disorder caused by insufficient expression of the TCF4 gene. Children with PTHS typically present with gastrointestinal disorders and early severe chronic constipation is frequently found (75%). Here we describe the case of a PTHS male 10-year-old patient with chronic constipation in whom Osteopathic Manipulative Treatment (OMT) resulted in improved bowel functions, as assessed by the diary, the QPGS-Form A Section C questionnaire, and the Paediatric Bristol Stool Form Scale. The authors suggested that OMT may be a valid tool to improve the defecation frequency and reduce enema administration in PTHS patients.

Osteopathic Manipulative Treatment Limits Chronic Constipation in a Child with Pitt-Hopkins Syndrome

PubMed Central

Perini, Mattia; Pisa, Viviana

2017-01-01

Pitt-Hopkins Syndrome (PTHS) is a rare genetic disorder caused by insufficient expression of the TCF4 gene. Children with PTHS typically present with gastrointestinal disorders and early severe chronic constipation is frequently found (75%). Here we describe the case of a PTHS male 10-year-old patient with chronic constipation in whom Osteopathic Manipulative Treatment (OMT) resulted in improved bowel functions, as assessed by the diary, the QPGS-Form A Section C questionnaire, and the Paediatric Bristol Stool Form Scale. The authors suggested that OMT may be a valid tool to improve the defecation frequency and reduce enema administration in PTHS patients. PMID:28251008

Unreported sauna use in anorexia nervosa: evidence from the world-wide-web.

PubMed

Vähäsoini, A; Vazquez, R; Birmingham, C L; Gutierrez, E

2004-03-01

Weight loss methods employed in anorexia nervosa (AN) are vomiting, laxatives, diuretics, enemas, suppositories, ipecac, weight loss medications and inadequate insulin in diabetics. Some methods result in weight loss from fluid depletion and not a reduction in body fat. Sauna use causes rapid fluid loss, but has not been reported in the medical literature as a weight loss strategy used in AN. We found reports of sauna use in AN on the world-wide-web are rare. We hypothesize that the warming caused by the use of sauna, may result in physical improvement in AN and thereby reduce its acceptability as a weight loss strategy.

Discretion vs. Valor: The Development and Evaluation of a Simulation Game about Being a Believer in the Soviet Union.

ERIC Educational Resources Information Center

Blackstone, Barbara

A study was conducted to determine the effectiveness of "Discretion vs. Valor," a simulation game designed to give North American players a chance to: (1) identify with "believers" (Christians) in the Soviet Union in order to form new images of these persons; (2) gain empathy for Christians by understanding the dilemmas they…

Experience of valorization projects ISTC for laser technologies

NASA Astrophysics Data System (ADS)

Sartory, A. V.; Stepennov, D. B.; Vlasova, E. Y.; Pokrovsky, K. K.

2002-04-01

Application of the achievements of the ISTC projects is one of the main problems being solved to achieve one of the basic goals of the ISTC, namely, to adapt Russian scientists to conditions of developing market economy in Russia. The present report is aimed at rendering of promotional services for ISTC project teams in the context of the program of projects outcomes valorization.

Knowledge and Valorization of Historical Sites Through 3d Documentation and Modeling

NASA Astrophysics Data System (ADS)

Farella, E.; Menna, F.; Nocerino, E.; Morabito, D.; Remondino, F.; Campi, M.

2016-06-01

The paper presents the first results of an interdisciplinary project related to the 3D documentation, dissemination, valorization and digital access of archeological sites. Beside the mere 3D documentation aim, the project has two goals: (i) to easily explore and share via web references and results of the interdisciplinary work, including the interpretative process and the final reconstruction of the remains; (ii) to promote and valorize archaeological areas using reality-based 3D data and Virtual Reality devices. This method has been verified on the ruins of the archeological site of Pausilypon, a maritime villa of Roman period (Naples, Italy). Using Unity3D, the virtual tour of the heritage site was integrated and enriched with the surveyed 3D data, text documents, CAAD reconstruction hypotheses, drawings, photos, etc. In this way, starting from the actual appearance of the ruins (panoramic images), passing through the 3D digital surveying models and several other historical information, the user is able to access virtual contents and reconstructed scenarios, all in a single virtual, interactive and immersive environment. These contents and scenarios allow to derive documentation and geometrical information, understand the site, perform analyses, see interpretative processes, communicate historical information and valorize the heritage location.

Valorization of winery waste vs. the costs of not recycling

DOE Office of Scientific and Technical Information (OSTI.GOV)

Devesa-Rey, R., E-mail: rosa.devesa.rey@uvigo.es; Vecino, X.; Varela-Alende, J.L.

Graphical abstract: Highlights: > Lactic acid, biosurfactants, xylitol or ethanol may be obtained from wine residues. > By-products valorization turns wine wastes into products with industrial applications. > The costs of waste disposal enhances the search of economically viable solutions for valorizing residues. - Abstract: Wine production generates huge amounts of waste. Before the 1990s, the most economical option for waste removal was the payment of a disposal fee usually being of around 3000 Euros. However, in recent years the disposal fee and fines for unauthorized discharges have increased considerably, often reaching 30,000-40,000 Euros, and a prison sentence is sometimesmore » also imposed. Some environmental friendly technologies have been proposed for the valorization of winery waste products. Fermentation of grape marc, trimming vine shoot or vinification lees has been reported to produce lactic acid, biosurfactants, xylitol, ethanol and other compounds. Furthermore, grape marc and seeds are rich in phenolic compounds, which have antioxidants properties, and vinasse contains tartaric acid that can be extracted and commercialized. Companies must therefore invest in new technologies to decrease the impact of agro-industrial residues on the environment and to establish new processes that will provide additional sources of income.« less

Performance of the dipstick screening test as a predictor of negative urine culture.

PubMed

Marques, Alexandre Gimenes; Doi, André Mario; Pasternak, Jacyr; Damascena, Márcio Dos Santos; França, Carolina Nunes; Martino, Marinês Dalla Valle

2017-01-01

To investigate whether the urine dipstick screening test can be used to predict urine culture results. A retrospective study conducted between January and December 2014 based on data from 8,587 patients with a medical order for urine dipstick test, urine sediment analysis and urine culture. Sensitivity, specificity, positive and negative predictive values were determined and ROC curve analysis was performed. The percentage of positive cultures was 17.5%. Nitrite had 28% sensitivity and 99% specificity, with positive and negative predictive values of 89% and 87%, respectively. Leukocyte esterase had 79% sensitivity and 84% specificity, with positive and negative predictive values of 51% and 95%, respectively. The combination of positive nitrite or positive leukocyte esterase tests had 85% sensitivity and 84% specificity, with positive and negative predictive values of 53% and 96%, respectively. Positive urinary sediment (more than ten leukocytes per microliter) had 92% sensitivity and 71% specificity, with positive and negative predictive values of 40% and 98%, respectively. The combination of nitrite positive test and positive urinary sediment had 82% sensitivity and 99% specificity, with positive and negative predictive values of 91% and 98%, respectively. The combination of nitrite or leukocyte esterase positive tests and positive urinary sediment had the highest sensitivity (94%) and specificity (84%), with positive and negative predictive values of 58% and 99%, respectively. Based on ROC curve analysis, the best indicator of positive urine culture was the combination of positives leukocyte esterase or nitrite tests and positive urinary sediment, followed by positives leukocyte and nitrite tests, positive urinary sediment alone, positive leukocyte esterase test alone, positive nitrite test alone and finally association of positives nitrite and urinary sediment (AUC: 0.845, 0.844, 0.817, 0.814, 0.635 and 0.626, respectively). A negative urine culture can be predicted by negative dipstick test results. Therefore, this test may be a reliable predictor of negative urine culture. Verificar se a triagem de urina por fitas reativas é capaz de predizer a cultura de urina. Métodos Estudo retrospectivo realizado entre janeiro e dezembro de 2014 com 8.587 pacientes, com solicitação médica de triagem de urina (fita), sedimento urinário e cultura de urina. sensibilidade, especificidade, valor preditivo positivo, valor preditivo negativo e curva ROC. Foram positivas 17,5% das culturas. O nitrito apresentou sensibilidade de 28% e especificidade de 99%. O valor preditivo positivo foi de 89% e o valor preditivo negativo de 87%. Esterase apresentou sensibilidade de 79% e especificidade de 84%. Valor preditivo positivo e valor preditivo negativo foram de 51% e 95%, respectivamente. A combinação de nitrito ou esterase positivos apresentou sensibilidade de 85% e especificidade de 84%. Valor preditivo positivo e valor preditivo negativo foram, respectivamente, 53% e 96%. O sedimento positivo (mais de dez leucócitos por microlitro) apresentou sensibilidade de 92% e especificidade de 71%. O valor preditivo positivo foi 40% e o negativo, 98%. A combinação de nitrito e sedimento urinário positivos apresentou sensibilidade de 82% e especificidade de 99%. Os valores preditivos positivo e negativo foram 91% e 98%, respectivamente. Para o nitrito ou esterase positivos mais os leucócitos positivos, a sensibilidade foi de 94% e a especificidade de 84%. O valor preditivo positivo foi de 58% e o negativo foi de 99%. Com base na curva ROC, o melhor indicador de urocultura positiva foi a associação entre a esterase ou nitrito positivos na fita mais os leucócitos positivos no sedimento, seguido por nitrito e esterase positivos, sedimento urinário positivo isolado, esterase positiva isolada, nitrito positivo isolado e, finalmente, pela associação entre nitrito e sedimento urinário positivos (AUC: 0,845, 0,844, 0,817, 0,814, 0,635 e 0,626, respectivamente). Uma urocultura negativa pode ser prevista com resultados negativos na fita. Portanto, este teste pode ser um preditor confiável de urocultura negativa.

Domestic violence on children: development and validation of an instrument to evaluate knowledge of health professionals.

PubMed

Oliveira, Lanuza Borges; Soares, Fernanda Amaral; Silveira, Marise Fagundes; Pinho, Lucinéia de; Caldeira, Antônio Prates; Leite, Maísa Tavares de Souza

2016-08-18

to develop and validate an instrument to evaluate the knowledge of health professionals about domestic violence on children. this was a study conducted with 194 physicians, nurses and dentists. A literature review was performed for preparation of the items and identification of the dimensions. Apparent and content validation was performed using analysis of three experts and 27 professors of the pediatric health discipline. For construct validation, Cronbach's alpha was used, and the Kappa test was applied to verify reproducibility. The criterion validation was conducted using the Student's t-test. the final instrument included 56 items; the Cronbach alpha was 0.734, the Kappa test showed a correlation greater than 0.6 for most items, and the Student t-test showed a statistically significant value to the level of 5% for the two selected variables: years of education and using the Family Health Strategy. the instrument is valid and can be used as a promising tool to develop or direct actions in public health and evaluate knowledge about domestic violence on children. elaborar e validar um instrumento para avaliação do conhecimento dos profissionais de saúde sobre a violência doméstica contra a criança. estudo realizado com 194 profissionais médicos, enfermeiros e cirurgiões dentistas. Para elaboração dos itens e identificação das dimensões, realizou-se a revisão da literatura. A validação aparente e de conteúdo foram realizadas por meio da análise de três especialistas e de 27 professores universitários da área de saúde da criança. Para a validação de construto, avaliou-se o coeficiente alfa de Cronbach, e o teste Kappa foi usado para verificar a reprodutibilidade. A validação de critério foi conduzida com uso do teste t-student. o instrumento final apresentou 56 itens, o alfa Cronbach foi de 0,734, o teste Kappa revelou concordância superior a 0,6 para a maioria dos itens, e o teste t-student apresentou valor estatisticamente significante até o nível de 5% para as duas variáveis selecionadas, tempo de formação e tempo na Estratégia Saúde da Família. o instrumento apresentou-se válido e, deste modo , pode ser usado como ferramenta promissora para desenvolver ou direcionar as ações em saúde pública e avaliação do conhecimento sobre a violência doméstica contra a criança. elaborar y validar un instrumento para evaluación del conocimiento de los profesionales de la salud sobre la violencia doméstica ejercida contra el niño. estudio realizado con 194 profesionales: médicos, enfermeros y cirujanos dentistas. Para elaboración de los ítems e identificación de las dimensiones, se realizó una revisión de la literatura. La validación aparente y de contenido fueron realizadas por medio del análisis de tres especialistas y de 27 profesores universitarios del área de la salud del niño. Para la validación de constructo, se evaluó el coeficiente alfa de Cronbach, y la prueba Kappa fue usada para verificar la reproductibilidad. La validación de criterio fue realizada con uso de la prueba t de Student. el instrumento final presentó 56 ítems, el alfa Cronbach fue de 0,734, la prueba Kappa reveló concordancia superior a 0,6 para la mayoría de los ítems, y la prueba t de Student presentó valor estadísticamente significativo hasta el nivel de 5% para las dos variables seleccionadas: tiempo de graduación y tiempo en el programa Estrategia Salud de la Familia. el instrumento se presentó válido y, de ese modo, puede ser usado como herramienta promisora para desarrollar o dirigir acciones de salud pública y evaluar el conocimiento sobre la violencia doméstica contra el niño.

Physiological adaptation of maternal plasma volume during pregnancy: a systematic review and meta-analysis.

PubMed

de Haas, S; Ghossein-Doha, C; van Kuijk, S M J; van Drongelen, J; Spaanderman, M E A

2017-02-01

To describe the physiological pattern of gestational plasma volume adjustments in normal singleton pregnancy and compare this with the pattern in pregnancies complicated by pregnancy-induced hypertension, pre-eclampsia or fetal growth restriction. We performed a meta-analysis of the current literature on plasma volume adjustments during physiological and complicated pregnancies. Literature was retrieved from PubMed (NCBI) and EMBASE (Ovid) databases. Included studies reported both reference plasma volume measurements (non-pregnant, prepregnancy or postpartum) and measurements obtained during predetermined gestational ages. Mean differences bet ween the reference and pregnancy plasma volume measurements were calculated for predefined intervals of gestational age using a random-effects model described by DerSimonian and Laird. Thirty studies were included in the meta-analysis with publication dates ranging from 1934 to 2007. Plasma volume increased in the first weeks of pregnancy, with the steepest increase occurring during the second trimester. Plasma volume continued to increase in the third trimester with a pooled maximum increase of 1.13 L (95% CI, 1.07-1.19 L), an increase of 45.6% (95% CI, 43.0-48.1%) in physiological pregnancies compared with the reference value. The plasma volume expansion in gestational hypertensive and growth-restricted pregnancies was 0.80 L (95% CI, 0.59-1.02 L), an increase of 32.3% (95% CI, 23.6-41.1%) in the third trimester, a smaller increase than in physiological pregnancies (P < 0.0001). During physiological pregnancy, plasma volume increases by, on average, more than 1 L as compared with non-pregnant conditions. In pregnancies complicated by pregnancy-induced hypertension, pre-eclampsia or fetal growth restriction, plasma volume increase in the third trimester is 13.3% lower than in normal pregnancy. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Adaptación fisiológica del volumen del plasma materno durante el embarazo: una revisi\\xF3n sistemática y metaanálisis RESUMEN OBJETIVO: Describir el patrón fisiológico de los cambios en el volumen del plasma gestacional en embarazos normales con feto único y compararlo con el patrón en los embarazos complicados por hipertensión gestacional, preeclampsia o restricción del crecimiento fetal. MÉTODOS: Se realizó un metaanálisis de la literatura actual sobre los cambios en el volumen de plasma durante embarazos complicados y fisiológicos. La literatura se obtuvo de las bases de datos PubMed (NCBI) y EMBASE (Ovid). Los estudios incluidos mencionaban tanto mediciones de referencia del volumen plasmático (no embarazada, antes del embarazo o después del parto) como mediciones tomadas a edades gestacionales predeterminadas. Se calcularon las medias de las diferencias entre las mediciones de referencia y las del embarazo para el volumen plasmático a intervalos predefinidos de la edad gestacional, utilizando un modelo de efectos aleatorios descrito por DerSimonian y Laird. En el metaanálisis se incluyeron treinta estudios con fechas de publicación entre 1934 y 2007. El volumen plasmático aumentó en las primeras semanas de embarazo y el mayor incremento se produjo durante el segundo trimestre. El volumen de plasma continuó aumentando en el tercer trimestre con un aumento combinado máximo de 1,13L (IC 95%, 1,7-1,19 L), lo que supone un aumento del 45,6% (IC 95%, 43,0-48,1%) en embarazos fisiológicas en comparación con el valor de referencia. El aumento del volumen plasmático en los embarazos con hipertensión y con crecimiento intrauterino restringido fue de 0,80L (IC 95%, 0,59-1,02 L), lo que supone un aumento del 32,3% (IC 95%, 23,6-41,1%) en el tercer trimestre, y un incremento menor que en los embarazos fisiológicos (P <0,0001). Durante el embarazo fisiológico el volumen de plasma aumenta, en promedio, más de 1L, en comparación con el de las no embarazadas. En los embarazos complicados por hipertensión gestacional, preeclampsia o restricción del crecimiento fetal, el aumento del volumen plasmático en el tercer trimestre es un 13,3% menor que en el embarazo normal. :meta : ,、。 : meta。PubMed(NCBI)EMBASE(Ovid)。(、)。DerSimonianLaird,。 : Meta30,19342007。,。,1.13 L(95% CI,1.07~1.19 L),,45.6%(95% CI,43.0%~48.1%)。0.80 L(95%CI,0.59~1.02 L),32.3%(95% CI,23.6%~41.1%),(P<0.0001)。 : ,,1 L。、,13.3%。. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

Recent advances in oxidative valorization of lignin

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ma, Ruoshui; Guo, Mond; Zhang, Xiao

Lignin, an aromatic macromolecule synthesized by all higher plants, is one of the most intriguing natural materials for utilization across a wide range of applications. Depolymerization and fragmentation of lignin into small chemicals constituents which can either replace current market products or be used building blocks for new material synthesis is a focus of current lignin valorization strategies. And among the variety of lignin degradation chemistries, catalytic oxidation of lignin presents an energy efficient means of lignin depolymerization and generating selective reaction products. Our review provides a summary of the recent advancements in oxidative lignin valorization couched in a discussionmore » on how these chemistries may contribute to the degradation of the lignin macromolecule through three major approaches: 1) inter-unit linkages cleavage; 2) propanyl side-chain oxidative modification; and 3) oxidation of the aromatic ring and ring cleavage reactions.« less

Recent advances in oxidative valorization of lignin

DOE PAGES

Ma, Ruoshui; Guo, Mond; Zhang, Xiao

2017-07-21

Lignin, an aromatic macromolecule synthesized by all higher plants, is one of the most intriguing natural materials for utilization across a wide range of applications. Depolymerization and fragmentation of lignin into small chemicals constituents which can either replace current market products or be used building blocks for new material synthesis is a focus of current lignin valorization strategies. And among the variety of lignin degradation chemistries, catalytic oxidation of lignin presents an energy efficient means of lignin depolymerization and generating selective reaction products. Our review provides a summary of the recent advancements in oxidative lignin valorization couched in a discussionmore » on how these chemistries may contribute to the degradation of the lignin macromolecule through three major approaches: 1) inter-unit linkages cleavage; 2) propanyl side-chain oxidative modification; and 3) oxidation of the aromatic ring and ring cleavage reactions.« less

Social Role Theory and Social Role Valorization for Care Management Practice.

PubMed

Blakely, Thomas J; Dziadosz, Gregory M

2015-01-01

This article proposes that social role theory (SRT) and social role valorization (SRV) be established as organizing theories for care managers. SRT is a recognized sociological theory that has a distinctive place in care management practice. SRV is an adjunct for SRT that focuses on people who are devalued by being in a negative social position and supports behavior change and movement to a valued social position.

[Ulcerative colitis and Crohn's disease].

PubMed

Pavlović-Calić, Nada

2003-01-01

There is an enigma of inflammatory bowel diseases, despite significant advantages during last 10 years in medicamentous and surgical treatment. Ulcerative colitis and Crohns disease are chronic with remissions and recidives. Crohns disease involves any part of digestive tube. Histological changes in ulcerative colitis are: inflammation of mucosa and submucosal tissue, crypt abscesses and ulcerations, pseudopolpys, bowel shortening and toxic megacolon in severe inflammation. In Crohns disease, transmural inflammation, "jumping lesions", deeper ulcerations, coble-stone mucosa, progressive fibrosis, granuloma with gigantic epithelial cells. ulcerative colitis: mesalazine, rectal 5-ASA and hydrocortisone enemas, surgery. Crohns disease: mesalazine and prednisolone. For terminal ilcitis, corticosteroid budesonid could be applied. Severe symptomatic disease: hospitalization, parenteral nutrition, antibiotics, prednisone, surgery in partial bowel obstruction, fistulas, abscessus, perforation.

UNSEDATED COMPUTED TOMOGRAPHY FOR DIAGNOSIS OF PELVIC CANAL OBSTRUCTION IN A LEOPARD GECKO (EUBLEPHARIS MACULARIUS).

PubMed

DeCourcy, Kelly; Hostnik, Eric T; Lorbach, Josh; Knoblaugh, Sue

2016-12-01

An adult leopard gecko ( Eublepharis macularius ) presented for lethargy, hyporexia, weight loss, decreased passage of waste, and a palpable caudal coelomic mass. Computed tomography showed a heterogeneous hyperattenuating (∼143 Hounsfield units) structure within the right caudal coelom. The distal colon-coprodeum lumen or urinary bladder was hypothesized as the most likely location for the heterogeneous structure. Medical support consisted of warm water and lubricant enema, as well as a heated environment. Medical intervention aided the passage of a plug comprised centrally of cholesterol and urates with peripheral stratified layers of fibrin, macrophages, heterophils, and bacteria. Within 24 hr, a follow-up computed tomography scan showed resolution of the pelvic canal plug.

Costs of Public Pharmaceutical Services in Rio de Janeiro Compared to Farmácia Popular Program.

PubMed

Silva, Rondineli Mendes da; Caetano, Rosângela

2016-12-22

To analyze the costs of public pharmaceutical services compared to Farmácia Popular Program (Popular Pharmacy Program). Comparison between prices paid by Aqui Tem Farmácia Popular Program (Farmácia Popular is available here) with the full costs of medicine provision by the Municipal Health Department of Rio de Janeiro. The comparison comprised 25 medicines supplied by both the municipal pharmaceutical service and Aqui Tem Farmácia Popular Program. Calculating the cost per pharmaceutical unit of each medicine included expenditure by Municipal Health Department of Rio de Janeiro with procurement (price), logistics, and local dispensation. The reference price of medicines paid by Aqui Tem Farmácia Popular was taken from the Brazilian Ministry of Health standard in force in 2012. Comparisons included full reference price; reference price minus 10.0% copayment by users; and maximum reference paid by the Ministry of Health (minus copayment and taxes). Simulations were carried out of the differences between the costs of Municipal Health Department of Rio de Janeiro with the common medicines and those potentially incurred based on the reference price of Aqui Tem Farmácia Popular. The Municipal Health Department of Rio de Janeiro spent R$28,526,526.57 with 25 medicines of the common list in 2012; 58.7% accounted for direct procurement costs. The estimated costs of the Health Department were generally lower than the reference prices of the Aqui Tem Farmácia Popular Program for 20 medicines, regardless of reference prices. The potential costs incurred by Health Department if expenditure of its consumption pattern were based on the reference prices of Aqui Tem Farmácia Popular would be R$124,170,777.76, considering the best scenario of payment by the Brazilian Ministry of Health (90.0% of the reference price, minus taxes). The difference in costs between public provision by Municipal Health Department of Rio de Janeiro and Farmácia Popular Program indicates that some reference prices could be reviewed aiming at their reduction. Analisar custos da assistência farmacêutica pública frente ao Programa Farmácia Popular. Comparação entre os valores pagos pelo Programa Aqui Tem Farmácia Popular com os custos integrais relativos à provisão de medicamentos pela Secretaria Municipal de Saúde do Rio de Janeiro. A comparação compreendeu 25 medicamentos, comuns tanto à provisão pela assistência farmacêutica pública municipal quanto pelo Programa Aqui Tem Farmácia Popular. O cálculo do custo unitário por unidade farmacotécnica de cada medicamento envolveu os gastos da Secretaria Municipal de Saúde com custos de aquisição (preço), logísticos e com a dispensação em nível local. O valor de referência dos medicamentos pago pelo Aqui Tem Farmácia Popular foi extraído da norma ministerial em vigor em 2012. As comparações envolveram o valor de referência pleno; valor de referência com desconto dos 10,0% pagos de contrapartida pelos usuários; e valor de referência máximo pago pelo Ministério da Saúde (descontados contrapartida e sem impostos).Foram realizadas simulações das diferenças entre os gastos da Secretaria Municipal de Saúde do Rio de Janeiro com os medicamentos do elenco comum e os que seriam incorridos se esses tivessem sido executados com base no valor de referência do Aqui Tem Farmácia Popular. A Secretaria Municipal de Saúde do Rio de Janeiro gastou R$28.526.526,57 com 25 medicamentos do rol comum em 2012; 58,7% corresponderam a custos diretos com a aquisição dos produtos. Os custos estimados da Secretaria Municipal de Saúde do Rio de Janeiro foram, em geral, menores que os valores de referência do Programa Aqui Tem Farmácia Popular em 20 medicamentos, independentemente dos valores de referência. Os custos que seriam incorridos pela Secretaria Municipal de Saúde do Rio de Janeiro, caso seu padrão de consumo tivesse como valor de pagamento os valores de referência do Aqui Tem Farmácia Popular seriam de R$124.170.777,76 considerando a melhor situação de pagamento pelo Ministério da Saúde (90,0% do valor de referência, com impostos descontados). A diferença de custos entre a provisão pública pela Secretaria Municipal de Saúde do Rio de Janeiro e o Programa Aqui Tem Farmácia Popular sinaliza que alguns valores de referência poderiam ser objetos de exame para sua redução.

Calibración del retardo ionosférico en observaciones astrométricas y geodésicas a partir de observaciones GPS

NASA Astrophysics Data System (ADS)

Brunini, C.; Kleusberg, A.; Arias, E. F.; de Biasi, M. S.

Los parámetros astrométricos y geodésicos de precisión se determinan hoy mediante la observación con técnicas espaciales (VLBI, GPS y LSR). Las técnicas VLBI y GPS operan en la banda de microondas y en ella la ionósfera terrestre es dispersiva. Las señales que provienen de las radiofuentes y de los satélites atraviesan la ionósfera, donde el índice de refracción difiere de la unidad en una cantidad que es proporcional a la densidad de electrones libres e inversamente proporcional al cuadrado de la frecuencia de la onda portadora. Actualmente el International GPS Service for Geodynamics (IGS) mantiene operacional una red global integrada por más de 50 estaciones equipadas con receptores GPS de alta performance; las observaciones diarias son accesibles a los usuarios mediante ftp. La posibilidad de utilizar estas observaciones en un monitoreo continuo de la ionósfera fue señalada por diversos autores, razón por la cual en los últimos años se ha invertido un significativo esfuerzo en la producción de mapas ionosféricos regionales y globales. En el presente trabajo se utilizan 28 estaciones cuyas observaciones mapean la mayor parte de la ionósfera global. Los resultados obtenidos demuestran la posibilidad de obtener mapas ionosféricos globales con una resolución de medio día y con una precisión de (1.5 nseg (rms)). Dichos mapas proveen valores medios globales para el intervalo ajustado. Los residuos del ajuste por mínimos cuadrados constituyen una señal a partir de la cual pueden estudiarse mejor las variaciones geográficas de la ionósfera y las componentes estadísticas de su variación temporal.

Alvarado score in the diagnostic of pain in the right lower quadrant.

PubMed

Lada, Paul Eduardo

2017-09-08

Acute appendicitis neither suspected nor diagnosed could develop a perforation or otherwise it would take to removing of a normal appendix. Utilization of a clinical score system for aided diagnosis of this pathology and can reduce a negative appendicitis. National Clinicas Hospital. Córdoba. Argentina. Prospective and protocolized study. 594 patients were studied between October 2002 and December 2013. 312 males and 282 females their age average was 26.2 years. Alvarado score was realized in all patients when they entered. According clinic and second valoration with the score surgical exploration was decided in 574 patients. The remaining 20 were excluded due to other pathology. The diagnosis in acute appendicitis was confirmed by surgical finding and histopathologic studies. In surgical finding we showed 594 patients (91,28 %) had acute appendicitis. There was no operative mortality. Respects morbidity there was 1,74 % of medical and 13,93 % of surgical complications. The anatomo-pathologic report showed a normal cecal appendix in 50. The incidence of negative appendicectomy was about 8.71 %. The utilization of score related to the surgical and anatomo-pathologic finding confirmed it was appreciable from 6 points to acute appendicitis diagnosis.   RESUMENAntecedentes: La apendicitis aguda no sospechada y diagnosticada puede evolucionar hacia la perforación, ó por el contrario conduce a la remoción de un apéndice normal. Objetivo: La utilización de un  sistema  de Score, desde un  punto de vista clínico, para el diagnóstico de esta patología y lograr disminuir las apendicetomías negativas.Lugar de Aplicación: Hospital Nacional de Clínicas. Córdoba. (Argentina)Diseño: Estudio prospectivo y protocolizado.Material y Métodos: Comprende a 594 pacientes estudiados entre octubre de 2002 y diciembre del 2013. De ellos, 312 eran del sexo masculino y 282 del femenino, con una edad promedio de 26,2 años de edad. A todos los pacientes se les realizo al ingreso el Score de Alvarado. En base a la clínica y a una segunda valoración con el Score se decidió la exploración quirúrgica en 574 pacientes. De los 20 restantes, fueron excluidos por otra patología. El diagnóstico de apendicitis aguda fue confirmado por los hallazgos quirúrgicos y la  anatomía patológica.Resultados: En los hallazgos operatorios se encontró en 524 pacientes (91,28%) que tenían una apendicitis aguda. No hubo mortalidad postoperatoria. En relación a la morbilidad hubo un 1,74 % de complicaciones médicas y un 13,93 % de las quirúrgicas. El informe anatomopatológico mostró en 50 pacientes un apéndice cecal normal. Por lo tanto la incidencia de las apendicetomías negativas fue del 8,71%. Conclusiones: La utilización del Score en relación a los hallazgos quirúrgicos y anatomopatológicos confirma que fue sensible a partir de 6 puntos para el diagnóstico de apendicitis aguda.

Electric field-based technologies for valorization of bioresources.

PubMed

Rocha, Cristina M R; Genisheva, Zlatina; Ferreira-Santos, Pedro; Rodrigues, Rui; Vicente, António A; Teixeira, José A; Pereira, Ricardo N

2018-04-01

This review provides an overview of recent research on electrotechnologies applied to the valorization of bioresources. Following a comprehensive summary of the current status of the application of well-known electric-based processing technologies, such as pulsed electric fields (PEF) and high voltage electrical discharges (HVED), the application of moderate electric fields (MEF) as an extraction or valorization technology will be considered in detail. MEF, known by its improved energy efficiency and claimed electroporation effects (allowing enhanced extraction yields), may also originate high heating rates - ohmic heating (OH) effect - allowing thermal stabilization of waste stream for other added-value applications. MEF is a simple technology that mostly makes use of green solvents (mainly water) and that can be used on functionalization of compounds of biological origin broadening their application range. The substantial increase of MEF-based plants installed in industries worldwide suggests its straightforward application for waste recovery. Copyright © 2018 Elsevier Ltd. All rights reserved.

Newborns' temperature submitted to radiant heat and to the Top Maternal device at birth.

PubMed

Albuquerque, Rosemeire Sartori de; Mariani, Corintio; Bersusa, Ana Aparecida Sanches; Dias, Vanessa Macedo; Silva, Maria Izabel Mota da

2016-08-08

to compare the axillar temperatures of newborns that are put immediately after birth in skin-to-skin contact under the Top Maternal device, as compared to those in a radiant heat crib. comparatives observational study of the case-control type about temperature of 60 babies born at the Obstetric Center and Normal Delivery Center of a public hospital of the municipality of Sao Paulo, being them: 29 receiving assistance in heated crib and 31 in skin-to skin contact, shielded by a cotton tissue placed on mother's thorax, called Top Maternal. the temperature of the babies of the skin-to-skin contact group presented higher values in a larger share of the time measures verified, as compared to those that were placed in radiant heat crib, independently from the place of birth. Differences between the two groups were not statistically significant. the study contributes to generate new knowledge, supporting the idea of keeping babies with their mothers immediately after birth protected with the Maternal Top, without harming their wellbeing, as it keeps the axillar temperature in recommendable levels. comparar a temperatura axilar dos recém-nascidos acomodados - imediatamente após o nascimento - em contato pele a pele, sob o Top Maternal, em berço de calor radiante. estudo comparativo observacional do tipo Caso-Controle sobre a temperatura de 60 bebês nascidos no Centro Obstétrico e Centro de Parto Normal de um hospital público do município de São Paulo, sendo: 29 assistidos em berço aquecido e 31 em contato pele a pele, protegidos por uma malha de algodão colocada sobre o tórax da mãe, denominada Top Maternal. a temperatura dos bebês do grupo de contato pele a pele teve maior valor na maioria dos tempos verificados comparada à dos que foram colocados em berço de calor radiante, independentemente do local de nascimento. A diferença entre os grupos não foi estatisticamente significante. o estudo contribui com a geração de um novo conhecimento que sustenta a manutenção dos bebês com suas mães imediatamente após o nascimento por meio do contato pele a pele protegidos pelo Top Maternal, sem prejuízos ao seu bem-estar, uma vez que a temperatura axilar se manteve em níveis recomendáveis. comparar la temperatura axilar de los recién nacidos (Rn) acomodados, inmediatamente después del nacimiento, en contacto piel con piel, bajo el Top Maternal, en cuna de calor radiante. estudio comparativo observacional del tipo Caso Control sobre la temperatura de 60 bebés nacidos en el Centro Obstétrico y Centro de Parto Normal de un hospital público del municipio de Sao Paulo, siendo: 29 asistidos en cuna calentada y 31 en contacto piel con piel, protegidos por un tejido de algodón colocado sobre el tórax de la madre, denominado Top Maternal. la temperatura de los bebés del grupo de contacto piel con piel fue más alta en la mayoría de los tiempos verificados, ello comparado con los que fueron colocados en cuna de calor radiante, independientemente del local de nacimiento. La diferencia entre los grupos no fue estadísticamente significativa. el estudio contribuye con la generación de un nuevo conocimiento que sustenta que se debe mantener a los bebés con sus madres inmediatamente después del nacimiento por medio del contacto piel con piel protegidos por el Top Maternal, sin perjuicios a su bienestar, una vez que la temperatura axilar se mantuvo en niveles recomendables.

The effects of taxing sugar-sweetened beverages across different income groups.

PubMed

Sharma, Anurag; Hauck, Katharina; Hollingsworth, Bruce; Siciliani, Luigi

2014-09-01

This paper investigates the impact of sugar-sweetened beverages (SSB) taxes on consumption, bodyweight and tax burden for low-income, middle-income and high-income groups using an Almost Ideal Demand System and 2011 Household level scanner data. A significant contribution of our paper is that we compare two types of SSB taxes recently advocated by policy makers: A 20% flat rate sales (valoric) tax and a 20 cent/L volumetric tax. Censored demand is accounted for using a two-step procedure. We find that the volumetric tax would result in a greater per capita weight loss than the valoric tax (0.41 kg vs. 0.29 kg). The difference between the change in weight is substantial for the target group of heavy purchasers of SSBs in low-income households, with a weight reduction of up to 3.20 kg for the volumetric and 2.06 kg for the valoric tax. The average yearly per capita tax burden on low-income households is $17.87 (0.21% of income) compared with $15.17 for high-income households (0.07% of income) for the valoric tax, and $13.80 (0.15%) and $10.10 (0.04%) for the volumetric tax. Thus, the tax burden is lower, and weight reduction is higher under a volumetric tax. Copyright © 2014 John Wiley & Sons, Ltd.

Can Contrast-Enhanced Sonography Detect Bowel Wall Fibrosis in Mixed Inflammatory and Fibrotic Crohn Disease Lesions in an Animal Model?

PubMed

Dillman, Jonathan R; Rubin, Jonathan M; Johnson, Laura A; Moons, David S; Higgins, Peter D R

2017-03-01

To determine whether contrast-enhanced sonographic quantitative perfusion parameters can detect bowel wall fibrosis in the setting of mixed inflammatory and fibrotic lesions in a Crohn disease animal model. This study was approved by the institutional Committee on the Use and Care of Animals. Multiple (range, 1-5) 2,4,6-trinitrobenzenesulfonic acid-ethanol enemas were used to create intestinal inflammatory lesions with variable fibrosis in female Lewis rats. Low-mechanical index contrast-enhanced sonography was performed 3 days after the final enema using a 0.2-mL bolus of sulfur hexafluoride microbubbles injected through a tail vein. Contrast-enhanced sonographic data were analyzed with software that converts video data into echo-power (linearized) data. Colorectal lesions were scored for histopathologic inflammation and fibrosis; bowel wall collagen was quantified by Western blotting. The Spearman correlation was used to assess associations between contrast-enhanced sonographic quantitative parameters and bowel wall collagen; the Kruskal-Wallis test was used to compare continuous results between histopathologic groups. Thirty-one animals were included in our analysis. Animals were placed into 3 histopathologic cohorts: (1) severe bowel wall inflammation/minimal or no fibrosis (n = 11); (2) severe bowel wall inflammation/moderate fibrosis (n = 9); and (3) severe bowel wall inflammation/severe fibrosis (n = 11). Western blotting showed a significant difference in bowel wall collagen between histopathologic cohorts (P = .0001). There was no correlation between any contrast-enhanced sonographic quantitative parameter and bowel wall collagen (P > .05). There was no difference between histopathologic cohorts for any contrast-enhanced sonographic quantitative parameter (P > .05). Contrast-enhanced sonographic quantitative perfusion parameters failed to effectively detect bowel wall fibrosis in the setting of superimposed inflammation in a Crohn disease animal model. © 2017 by the American Institute of Ultrasound in Medicine.

European Paediatric Surgeons' Association Survey on the Management of Hirschsprung Disease.

PubMed

Zani, Augusto; Eaton, Simon; Morini, Francesco; Puri, Prem; Rintala, Risto; Heurn, Ernest van; Lukac, Marija; Bagolan, Pietro; Kuebler, Joachim F; Friedmacher, Florian; Wijnen, Rene; Tovar, Juan A; Hoellwarth, Michael E; Pierro, Agostino

2017-02-01

Aim  This study aims to define patterns of Hirschsprung disease (HD) management. Methods  An online questionnaire was sent to all European Paediatric Surgeons' Association (EUPSA) members. Results  A total of 294 members (61 countries) answered (response rate: 61%). All respondents perform rectal biopsies (61% rectal suction [RSBs], 39% open full-thickness), 96% contrast enema, and 31% anorectal manometry. At RSB, 17% take the most distal biopsy 1 cm above the dentate line, 34% take 2 cm, 30% take 3 cm, and 19% take > 3 cm. Rectal biopsy staining's are hematoxylin/eosin (77%), acetylcholinesterase (74%), calretinin (31%), S100 (2%), nicotinamide adenine dinucleotide-tetrazolium reductase (2%), succinate dehydrogenase (1%), and neuron-specific enolase (1%). A total of 85% respondents recognize entities including hypoganglionosis (69%), intestinal neuronal dysplasia (55%), and ultrashort segment HD (50%). Pull-through (PT) is performed at diagnosis by 33% or delayed by 67% (4 months or > 5 kg). Awaiting definitive surgery, 77% perform rectal irrigations, 22% rectal dilatation/stimulations, and 33% perform a stoma. The preferred type of PT is the Soave approach (65%), performed with transanal technique by 70% respondents. If symptoms persist after PT, most opt for conservative approach (enemas/laxatives = 76%; botulinum toxin = 27%), 30% would redo the PT. Total colonic aganglionosis: PT is performed in neonates (4%), at 1 to 6 months (29%), 6 to 12 months (37%) or older (30%). If required, a stoma is sited in the ileum (31%), according to intraoperative biopsies (54%), macroscopic impression (13%), and radiology (2%). Duhamel PT is performed by 52%, Soave by 31%, and Swenson by 17%. Overall, 31% would perform a J-pouch. Conclusions  Most aspects of HD management lack consensus with wide variations in obtaining a diagnosis. Transanal Soave PT is the most common technique in standard segment HD. Guidelines should be developed to avoid such variability in management and to facilitate research studies. Georg Thieme Verlag KG Stuttgart · New York.

Evaluation of two minimal-preparation regimes for CT colonography: optimising image quality and patient acceptability

PubMed Central

Pollentine, A; Mortimer, A; Mccoubrie, P; Archer, L

2012-01-01

Objective To compare a 2 day bowel preparation regime of barium, iodine and a mild stimulant laxative with a 1 day iodine-only regime for CT colonography (CTC). Methods 100 consecutive patients underwent CTC. The first 50 patients (Regime 1) ingested 1 bisacodyl tablet twice a day 3 days before CTC and 1 dose each of 50 ml of barium and 20 ml of iodinated contrast per day starting 2 days before CTC. The second 50 patients (Regime 2) ingested 3 doses of iodinated contrast over 24 h prior to CTC. Volumes of residual stool and fluid, and the effectiveness of stool and fluid tagging, were graded according to methods established by Taylor et al (Taylor S, Slaker A, Burling D, Tam E, Greenhalgh R, Gartner L, et al. CT colonography: optimisation, diagnostic performance and patient acceptability of reduced-laxative regimens using barium-based faecal tagging. Eur Radiol 2008; 18: 32–42). A 3 day low-residue diet was taken by both cohorts. Questionnaires rating the side-effects and burden of the bowel preparation were compared to a control cohort of patients undergoing barium enema. Results The proportion of colons producing none/scattered stool (score 1) was 90.3% with Regime 1 and 65.0% with Regime 2 (p<0.005). Any residual stool was significantly better tagged with Regime 1 (score 5), with 91.7% of Regime 1 exhibiting optimum tagging vs 71.3% of Regime 2 (p<0.05). No significant differences in side-effects between the bowel preparation regimes for CTC were elicited. Bowel preparation for barium enema was tolerated significantly worse than both of the CTC bowel preparation regimes. Conclusion Regime 1, containing a 3 day preparation of a mild laxative, barium and iodine, produced a significantly better prepared colon, with no difference in patient acceptability. PMID:22422379

High prevalence of sexually transmitted infections in HIV-infected men during routine outpatient visits in the Netherlands.

PubMed

Heiligenberg, Marlies; Rijnders, Bart; Schim van der Loeff, Maarten F; de Vries, Henry J C; van der Meijden, Willem I; Geerlings, Suzanne E; Fennema, Han S A; Prins, Maria; Prins, Jan M

2012-01-01

In the Netherlands, no guidelines exist for routine sexually transmitted infection (STI) screening of human immunodeficiency virus (HIV)-infected men having sex with men (MSM). We assessed prevalence and factors associated with asymptomatic STI. MSM visiting HIV outpatient clinics of academic hospitals were tested for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), syphilis, and hepatitis B and C infection. Prevalence and risk factors were studied using logistic regression. In total, 659 MSM were included between 2007 and 2008. STI were found in 16.0% of patients, mostly anal CT and syphilis. One new hepatitis B and 3 new hepatitis C infections were identified. In multivariate analyses, any STI (syphilis, CT, or NG) was associated with patient's age below 40 years (odds ratio [OR]: 2.5, 95% confidence interval [CI]: 1.3-5.0), having had sex with 2 or more sexual partners (OR 2.1, 95% CI: 1.2-3.5), the use of the same sexual toys with a sexual partner (OR 2.2, 95% CI: 1.0-4.9), and enema use before sex (OR: 2.3, 95% 1.2-4.2). Syphilis was independently associated with fisting with gloves versus no fisting (OR: 4.9, 95% CI: 1.7-13.7) and with rimming (OR: 5.0, 95% CI: 1.7-15.0). CT or NG were associated with age below 45 years (age 40-44 years: OR: 2.4, 95% CI: 1.1-5.3; age <40 years: OR: 2.4, 95% CI: 1.1-5.4), enema use before sex (OR: 2.4, 95% CI: 1.3-4.4) and drug use during sex (OR: 2.4, 95% CI: 1.4-4.0). High-risk sexual behavior was very common, and 16% of HIV-infected MSM in HIV care had an asymptomatic STI, mostly anal CT and syphilis. Development of STI screening guidelines is recommended.

Pattern and distribution of colonic diverticulosis: analysis of 2877 barium enemas in Thailand.

PubMed

Lohsiriwat, Varut; Suthikeeree, Wanwarang

2013-12-14

To determine the pattern and distribution of colonic diverticulosis in Thai adults. A review of the computerized radiology database for double contrast barium enema (DCBE) in Thai adults was performed at the Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. Incomplete studies and DCBE examinations performed in non-Thai individuals were excluded. The pattern and distribution of colonic diverticulosis detected during DCBE studies from June 2009 to October 2011 were determined. The occurrence of solitary cecal diverticulum, rectal diverticulum and giant diverticulum were reported. Factors influencing the presence of colonic diverticulosis were evaluated. A total of 2877 suitable DCBE examinations were retrospectively reviewed. The mean age of patients was 59.8 ± 14.7 years. Of these patients, 1778 (61.8%) were female and 700 (24.3%) were asymptomatic. Colonic diverticulosis was identified in 820 patients (28.5%). Right-sided diverticulosis (641 cases; 22.3%) was more frequently reported than left-sided diverticulosis (383 cases; 13.3%). Pancolonic diverticulosis was found in 98 cases (3.4%). The occurrence of solitary cecal diverticulum, rectal diverticulum and giant diverticulum were 1.5% (42 cases), 0.4% (12 cases), and 0.03% (1 case), respectively. There was no significant difference in the overall occurrence of colonic diverticulosis between male and female patients (28.3% vs 28.6%, P = 0.85). DCBE examinations performed in patients with some gastrointestinal symptoms revealed the frequent occurrence of colonic diverticulosis compared with those performed in asymptomatic individuals (29.5% vs 25.3%, P = 0.03). Change in bowel habit was strongly associated with the presence of diverticulosis (a relative risk of 1.39; P = 0.005). The presence of diverticulosis was not correlated with age in symptomatic patients or asymptomatic individuals (P > 0.05). Colonic diverticulosis was identified in 28.5% of DCBE examinations in Thai adults. There was no association between the presence of diverticulosis and gender or age.

Hospital-Level Variation in Practice Patterns and Patient Outcomes for Pediatric Patients Hospitalized With Functional Constipation.

PubMed

Librizzi, Jamie; Flores, Samuel; Morse, Keith; Kelleher, Kelly; Carter, Jodi; Bode, Ryan

2017-06-01

Constipation is a common pediatric condition with a prevalence of 3% to 5% in children aged 4 to 17 years. Currently, there are no evidence-based guidelines for the management of pediatric patients hospitalized with constipation. The primary objective was to evaluate practice patterns and patient outcomes for the hospital management of functional constipation in US children's hospitals. We conducted a multicenter, retrospective cohort study of children aged 0 to 18 years hospitalized for functional constipation from 2012 to 2014 by using the Pediatric Health Information System. Patients were included by using constipation and other related diagnoses as classified by International Classification of Diseases, Ninth Revision . Patients with complex chronic conditions were excluded. Outcome measures included percentage of hospitalizations due to functional constipation, therapies used, length of stay, and 90-day readmission rates. Statistical analysis included means with 95% confidence intervals for individual hospital outcomes. A total of 14 243 hospitalizations were included, representing 12 804 unique patients. The overall percentage of hospitalizations due to functional constipation was 0.65% (range: 0.19%-1.41%, P < .0001). The percentage of patients receiving the following treatment during their hospitalization included: electrolyte laxatives: 40% to 96%; sodium phosphate enema: 0% to 64%; mineral oil enema: 0% to 61%; glycerin suppository: 0% to 37%; bisacodyl 0% to 47%; senna: 0% to 23%; and docusate 0% to 11%. Mean length of stay was 1.97 days (range: 1.31-2.73 days, P < .0001). Mean 90-day readmission rate was 3.78% (range: 0.95%-7.53%, P < .0001). There is significant variation in practice patterns and clinical outcomes for pediatric patients hospitalized with functional constipation across US children's hospitals. Collaborative initiatives to adopt evidence-based best practices guidelines could help standardize the hospital management of pediatric functional constipation. Copyright © 2017 by the American Academy of Pediatrics.

Analysis of Geometric Shifts and Proper Setup-Margin in Prostate Cancer Patients Treated With Pelvic Intensity-Modulated Radiotherapy Using Endorectal Ballooning and Daily Enema for Prostate Immobilization.

PubMed

Jeong, Songmi; Lee, Jong Hoon; Chung, Mi Joo; Lee, Sea Won; Lee, Jeong Won; Kang, Dae Gyu; Kim, Sung Hwan

2016-01-01

We evaluate geometric shifts of daily setup for evaluating the appropriateness of treatment and determining proper margins for the planning target volume (PTV) in prostate cancer patients.We analyzed 1200 sets of pretreatment megavoltage-CT scans that were acquired from 40 patients with intermediate to high-risk prostate cancer. They received whole pelvic intensity-modulated radiotherapy (IMRT). They underwent daily endorectal ballooning and enema to limit intrapelvic organ movement. The mean and standard deviation (SD) of daily translational shifts in right-to-left (X), anterior-to-posterior (Y), and superior-to-inferior (Z) were evaluated for systemic and random error.The mean ± SD of systemic error (Σ) in X, Y, Z, and roll was 2.21 ± 3.42 mm, -0.67 ± 2.27 mm, 1.05 ± 2.87 mm, and -0.43 ± 0.89°, respectively. The mean ± SD of random error (δ) was 1.95 ± 1.60 mm in X, 1.02 ± 0.50 mm in Y, 1.01 ± 0.48 mm in Z, and 0.37 ± 0.15° in roll. The calculated proper PTV margins that cover >95% of the target on average were 8.20 (X), 5.25 (Y), and 6.45 (Z) mm. Mean systemic geometrical shifts of IMRT were not statistically different in all transitional and three-dimensional shifts from early to late weeks. There was no grade 3 or higher gastrointestinal or genitourianry toxicity.The whole pelvic IMRT technique is a feasible and effective modality that limits intrapelvic organ motion and reduces setup uncertainties. Proper margins for the PTV can be determined by using geometric shifts data.

Analysis of Geometric Shifts and Proper Setup-Margin in Prostate Cancer Patients Treated With Pelvic Intensity-Modulated Radiotherapy Using Endorectal Ballooning and Daily Enema for Prostate Immobilization

PubMed Central

Jeong, Songmi; Lee, Jong Hoon; Chung, Mi Joo; Lee, Sea Won; Lee, Jeong Won; Kang, Dae Gyu; Kim, Sung Hwan

2016-01-01

Abstract We evaluate geometric shifts of daily setup for evaluating the appropriateness of treatment and determining proper margins for the planning target volume (PTV) in prostate cancer patients. We analyzed 1200 sets of pretreatment megavoltage-CT scans that were acquired from 40 patients with intermediate to high-risk prostate cancer. They received whole pelvic intensity-modulated radiotherapy (IMRT). They underwent daily endorectal ballooning and enema to limit intrapelvic organ movement. The mean and standard deviation (SD) of daily translational shifts in right-to-left (X), anterior-to-posterior (Y), and superior-to-inferior (Z) were evaluated for systemic and random error. The mean ± SD of systemic error (Σ) in X, Y, Z, and roll was 2.21 ± 3.42 mm, −0.67 ± 2.27 mm, 1.05 ± 2.87 mm, and −0.43 ± 0.89°, respectively. The mean ± SD of random error (δ) was 1.95 ± 1.60 mm in X, 1.02 ± 0.50 mm in Y, 1.01 ± 0.48 mm in Z, and 0.37 ± 0.15° in roll. The calculated proper PTV margins that cover >95% of the target on average were 8.20 (X), 5.25 (Y), and 6.45 (Z) mm. Mean systemic geometrical shifts of IMRT were not statistically different in all transitional and three-dimensional shifts from early to late weeks. There was no grade 3 or higher gastrointestinal or genitourianry toxicity. The whole pelvic IMRT technique is a feasible and effective modality that limits intrapelvic organ motion and reduces setup uncertainties. Proper margins for the PTV can be determined by using geometric shifts data. PMID:26765418

Outcome of excision of megarectum in children with anorectal malformation.

PubMed

Keshtgar, Alireza S; Ward, Harry C; Richards, Catherine; Clayden, Graham S

2007-01-01

Megarectum in association with anorectal malformation contributes to chronic constipation and fecal incontinence. Resection of megarectum in anorectal malformation improves bowel function, but neuropathy and poor sphincter quality may affect the outcome of fecal continence adversely. The aim of this study was to evaluate the benefits of resection of megarectum in anorectal malformation and to ascertain the impact of anal sphincter quality and neuropathy on the outcome. We studied 62 children with intractable fecal incontinence after repair of anorectal malformation between January 1991 and January 2005. All patients were investigated with anorectal manometry and anal endosonography under ketamine anesthesia. On endosonography, an intact or scarred internal anal sphincter (IAS) was classified as good and a fragmented or absent IAS as poor. On manometry, a resting anal sphincter pressure equal to or more than 30 mm Hg was classified as good and a lower pressure as poor. Functional assessment of fecal continence was done before and after excision of megarectum using a modified Wingfield scores. Sixteen children had excision of megarectum with median age of 9 years (range, 2-15 years) and postoperative follow-up of 5 years (range, 1-10 years). Seven had formation of antegrade continent enema stoma before excision of megarectum. Children were classified into three groups of anomalies: low (n = 6), intermediate (n = 4), and high (n = 6). All children were incontinent of feces. After excision of megarectum, of the 9 children with good IAS and no neuropathy, 7 became continent of feces. Of the remaining 7 children, 4 had poor IAS and 3 had neuropathy, 5 of whom required an antegrade continent enema stoma to be clean. Excision of megarectum in children who had previous repair of anorectal malformation results in fecal continence in the presence of a good IAS and absence of neuropathy. Patients with a poor IAS or neuropathy will often require artificial means of fecal continence.

Long-term Follow-up of Patients After Antegrade Continence Enema Procedure

PubMed Central

Siddiqui, Anees A.; Fishman, Steven J.; Bauer, Stuart B.; Nurko, Samuel

2013-01-01

Background Antegrade continence enema (ACE) has become an important therapeutic modality in the treatment of intractable constipation and fecal incontinence. There are little data available on the long-term performance of the ACE procedure in children. Methods A retrospective review of patients who underwent the ACE procedure was conducted. Irrigation characteristics and complications were noted. Outcome was assessed for individual encounters based on frequency of bowel movements, incontinence, pain, and predictability. Results One hundred seventeen patients underwent an ACE. One hundred five patients had at least 6 months of follow-up, and were included in the analysis. Diagnoses included myelodysplasia (39%), functional intractable constipation (26%), anorectal malformations (21%), nonrelaxing internal anal sphincter (7%), cerebral palsy (3%), and other diagnoses (4%). The average follow-up was 68 months (range 7–178 months). At the last follow-up, 69% of patients had successful bowel management. Of the 31% of patients who did not have successful bowel management, 20% were using the ACE despite suboptimal results, 10% required surgical removal, and 2% were not using the ACE because of behavioral opposition to it. Patients were started on normal saline, but were switched to GoLYTELY (PEG-3350 and electrolyte solution) if there was an inadequate response (61% at final encounter). Additives were needed in 34% of patients. The average irrigation dose was 23 ± 0.7mL/kg. The average toilet sitting time was 51.7 ± 3.5minutes, with infusions running for 12.1 ± 1.2minutes. Stomal complications occurred in 63% (infection, leakage, and stenosis) of patients, 33% required surgical revision and 6% eventually required diverting ostomies. Conclusions Long-term use of the ACE gives successful results in 69% of patients, whereas 63% had a stoma-related complication and 33% required surgical revision of the stoma. PMID:21502828

Condiciones Físicas en Nebulosas Gaseosas

NASA Astrophysics Data System (ADS)

Luridiana, V.

1999-03-01

El presente trabajo se ha enfocado a determinar y entender las condiciones físicas en una variedad de objetos nebulares, prestando particular atención al problema de la determinación de las abundancias químicas. Para este fin, hemos utilizado métodos analíticos en algunos casos, y modelos numéricos de fotoionización en otros. El objetivo general del trabajo es proveer de una visión amplia de las herramientas teórico-observacionales que se utilizan para la determinación de la estructura de temperatura y densidad de las regiones fotoionizadas, poniendo en evidencia posibles fuentes de errores sistemáticos y sus consecuencias para la determinación de las abundancias químicas, y proponiendo métodos para corregirlos. Los resultados principales de este trabajo est´n listados a continuación: a) Se discute el problema de la discrepancia entre T(C III) y T(O III) en las nebulosas planetarias, y se muestra como tal discrepancia implica probablemente la presencia de fluctuaciones de temperatura. Debido a que la temperatura de O++ es muy afectada por fluctuaciones de temperatura, se recomienda usar la temperatura de C++ para determinar la abundancia de carbono. b) Presentamos dos nuevos métodos para determinar la temperatura electrónica en nebulosas planetarias, basados en la medición de las intensidades de las líneas de He I. Las temperaturas que se obtienen a partir de estos métodos son menores que aquellas que se obtienen a partir de las líneas de [O III], implicando la presencia de fluctuaciones espaciales de temperatura. Despreciando las fluctuaciones de temperatura, se obtienen valores sesgados de las abundancias químicas. Determinamos las abundancias en las nebulosas planetarias de tipo I de algunos de los elementos más importantes, tomando en cuenta las fluctuaciones de temperatura. c) Presentamos modelos numéricos de las dos regiones H II extragalácticas gigantes NGC 2363 y NGC 5461. Con el modelaje numérico, pretendemos acotar las carácteristicas principales de las nubes ionizadas (distribución espacial del gas, estructura de ionización y de temperatura) y de los cúmulos ionizantes (función inicial de masa, historia de formación estelar, edad). En ambos casos, mostramos que con modelos numéricos calculados para el valor de metalicidad que se determina a partir de la temperatura de [O III], no es posible reproducir el espectro de emisión observado, y que para reproducir las restricciones más robustas es necesario subir la metalicidad de los modelos por un factor de 2. Esto constituye una fuerte indicación en favor de la presencia de fluctuaciones de temperatura. d) Para poder comparar los modelos numéricos con los datos observacionales. mostramos la importancia de corregir las predicciones de los modelos por el sesgo introducido por el tamaío finito de la rendija.

Field technique of permeability tests in highly fissured limestone strata

NASA Astrophysics Data System (ADS)

Al-Salihi, Adnan; Asaad, Abdulah

2002-05-01

Résumé.L'étude de dispositifs de dénoyage est nécessaire pour l'amélioration de sites avant la construction de certaines structures. L'étude de dispositifs de dénoyage efficaces exige d'estimer la valeur du coefficient de perméabilité in situ. Les relations disponibles pour estimer le coefficient de perméabilité ont été développées sur la base de mesures et de conditions de terrain limitées, et les prédictions varient de plusieurs ordres de grandeur. C'est pourquoi il est nécessaire de réaliser des mesures de perméabilité sur le terrain et de déterminer la relation qui permet le meilleur ajustement de ces mesures avant l'étude du dispositif de dénoyage pour des conditions locales et géologiques spécifiques. Ce papier présente des mesures de perméabilité sur le terrain dans des niveaux calcaires complexes chaotiques et diagénétisés. Il propose également une analyse comparative de plusieurs relations disponibles dans la littérature destinées à prédire le coefficient de perméabilité in situ. L'analyse est faite en conditions permanentes et non permanentes. Les résultats montrent que la valeur du coefficient de perméabilité dépend du niveau de la nappe, qui est affecté par le régime de marées. On montre que l'équation de l'US Navy donne la meilleure corrélation avec les mesures de terrain. Resumen.El diseño de sistemas de desecado es necesario para mejorar las condiciones de un emplazamiento antes de la construcción de determinadas estructuras. El diseño de un sistema eficiente de desecado requiere de la estimación del valor de la permeabilidad in-situ. Las relaciones disponibles para tal fin han sido desarrolladas bajo condiciones y medidas de campo limitadas; sus predicciones varían en algunos órdenes de magnitud. Por tanto, es necesario tomar medidas de permeabilidad en campo y determinar la relación que reproduce mejor dichas medidas como paso previo al diseño de un sistema de desecado en condiciones geológicas y de emplazamiento específicas. Este artículo presenta medidas de permeabilidad en campo para estratos de calcita caóticos y diagenéticos. También ofrece un análisis comparativo de diversas relaciones disponibles en la bibliografía con el fin de predecir el valor de la permeabilidad in-situ. El análisis se ha hecho tanto en régimen permanente como en estacionario. Los resultados demuestran que la permeabilidad depende del nivel freático, el cual está afectado por las mareas. La ecuación de la Marina estadounidense es la que proporciona una mejor correlación con las medidas de campo.

Financial impact of nursing professionals staff required in an Intensive Care Unit.

PubMed

Araújo, Thamiris Ricci de; Menegueti, Mayra Gonçalves; Auxiliadora-Martins, Maria; Castilho, Valéria; Chaves, Lucieli Dias Pedreschi; Laus, Ana Maria

2016-11-21

to calculate the cost of the average time of nursing care spent and required by patients in the Intensive Care Unit (ICU) and the financial expense for the right dimension of staff of nursing professionals. a descriptive, quantitative research, using the case study method, developed in adult ICU patients. We used the workload index - Nursing Activities Score; the average care time spent and required and the amount of professionals required were calculated using equations and from these data, and from the salary composition of professionals and contractual monthly time values, calculated the cost of direct labor of nursing. the monthly cost of the average quantity of available professionals was US$ 35,763.12, corresponding to 29.6 professionals, and the required staff for 24 hours of care is 42.2 nurses, with a monthly cost of US$ 50,995.44. the numerical gap of nursing professionals was 30% and the monthly financial expense for adaptation of the structure is US$ 15,232.32, which corresponds to an increase of 42.59% in the amounts currently paid by the institution. calcular o custo do tempo médio de assistência de enfermagem despendido e requerido pelos pacientes internados em Unidade de Terapia Intensiva (UTI) e o dispêndio financeiro para adequação do quadro de profissionais de enfermagem. pesquisa descritiva, quantitativa, na modalidade de estudo de caso, desenvolvida na UTI de pacientes adultos. Utilizou-se o índice de carga de trabalho - Nursing Activities Score; o tempo médio de assistência despendido, requerido e o quantitativo de profissionais requerido foram calculados por meio de equações e, a partir desses dados, e de valores da composição salarial dos profissionais e tempo mensal contratual, calculou-se o custo da mão de obra direta de enfermagem. o custo mensal do quantitativo médio de profissionais disponível foi de US$ 35.763,12, correspondendo a 29,6 profissionais, e o requerido para 24 horas de cuidado é de 42,2 profissionais de enfermagem, com custo mensal de US$ 50.995,44. a defasagem numérica de profissionais da enfermagem foi de 30% e o dispêndio financeiro mensal para adequação do quadro é de US$ 15.232,32, o que corresponde a um acréscimo de 42,59% nos valores atualmente desembolsados pela instituição. calcular el costo del tiempo promedio de asistencia de enfermería invertido y requerido por los pacientes internados en la unidad de cuidados intensivos (UCI) y el gasto para la adecuación de la dotación de profesionales de enfermería. investigación descriptiva y cuantitativa en la modalidad de estudio de caso desarrollada en la UCI de pacientes adultos. Se utilizó el índice de carga de trabajo Nursing Activities Score; el tiempo promedio de asistencia invertido y requerido y la cantidad de profesionales necesaria se calculó con ecuaciones y, a partir de estos datos y de los valores de la composición de salario de los profesionales y el tiempo de contrato mensual, se calculó el costo de la mano de obra directa de enfermería. el costo mensual de la cantidad promedio de profesionales disponible fue de US$ 35,763.12, que corresponde a 29.6 profesionales, mientras que el requerido para 24 horas de atención es de 42.2 profesionales de enfermería, con un costo mensual de US$ 50,995.44. el desfase numérico de profesionales de enfermería fue de 30% y el gasto mensual para la adecuación de la dotación es de US$ 15,232.32, que corresponde a un incremento de 42.59% en los valores que actualmente desembolsa la institución.

Implications of cost-effectiveness analysis of medical technology. background paper number 5. four common x-ray procedures: problems and prospects for economic evaluation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wagner, J.L.; Krieger, M.J.

This paper is about the economic evaluation of diagnostic procedures. The issue of economic evaluation is explored in the context of four common diagnostic X-ray procedures: the chest X-ray, the skull X-ray, the barium enema study, and the excretory urogram. The paper is divided into two parts. The first part summarizes the different evaluative models underlying studies of the four diagnostic X-ray procedures and to lay out the strengths and weaknesses of each method. The second part contains four separate chapters summarizing what is known about the utilization, costs, risks, and benefits of each procedure, with particular emphasis on themore » evaluative methods employed.« less

Transabdominal electrical stimulation (TES) for the treatment of slow-transit constipation (STC).

PubMed

Hutson, John M; Dughetti, Lauren; Stathopoulos, Lefteris; Southwell, Bridget R

2015-05-01

Slow-transit constipation (STC) is a newly described subtype of intractable constipation in children which we originally identified with deficiency of substance P in axons supplying the proximal colonic muscle. When nuclear transit studies became available, the patients were found to have slow proximal colonic transit, and responded to antegrade enemas. Using the appendicostomy, we found that there was reduced frequency in propagating sequences throughout the colon. We began testing whether transcutaneous electrical stimulation (TES) could improve motility and symptoms, and over several trials have now shown that TES is remarkably effective in treating children with STC, with long-lasting effects. TES holds promise for treating STC, as well as a range of gastrointestinal motility disorders.

Massive hyperphosphatemia in a patient with neuronal intestinal dysplasia after bowel preparation with oral sodium phosphate.

PubMed

Arikan, Hakki; Guler, Derya; Birdal, Gurdal; Nalcaci, Serdar; Aykut, Emre; Ozcan, Ceren; Irmak, Rahmi; Banzragch, Munkhtsetseg; Arzu, Velioglu

2013-07-01

Oral sodium phosphate-based laxatives are frequently used for bowel preparation or relief of constipation in some countries. However, these agents are not without risk. Small and clinical insignificant increments on serum phosphorus levels are observed in almost all individuals after use of oral sodium phosphate. Some patients are prone to severe hyperphosphatemia such as elders, those with chronic or acute renal disease and those with poor bowel motility. Severe hyperphosphatemia accompanied with hypocalcemia may be life-threatening in these patients. We present an 18-year-old woman with neuronal intestinal dysplasia who developed symptomatic and severe hyperphosphatemia after bowel preparation with oral sodium phosphate enema. Urgent hemodialysis was performed two times for severe hyperphosphatemia.

Variability of transrectal ultrasound-guided prostate biopsy prophylactic measures.

PubMed

Hillelsohn, Joel H; Duty, Brian; Blute, Michael L; Okhunov, Zhamshid; Kashan, Mahyar; Moldwin, Robert; Ashley, Richard N

2012-12-01

To assess the variability of pre-prostate biopsy prophylaxis among American urologists. A survey was electronically mailed to 3355 urologists around the country. Urologists were surveyed on their antibiotic prophylaxis choice, the route and duration of antimicrobial prophylaxis. Additionally they were questioned about their knowledge of local antimicrobial resistance and if rectal enemas were routinely used. There were 679 (21%) responses to the survey. The survey revealed differences in pre-prostate biopsy prophylaxis among urologists. Ten different classes of antibiotics were used orally, 4 classes intramuscular, 5 classes intravenous, and there was also 14 different duration regimens. Despite the initiation of the 2008 American Urological Association Guidelines on this topic, there still is a lack of uniformity in prostate biopsy prophylaxis.

Initial treatment of sigmoid volvulous by colonoscopy.

PubMed Central

Starling, J R

1979-01-01

The initial management of acute, nonstrangulated sigmoid volvulous is to attempt proctosigmoidoscopic, rectal tube, or barium enema reduction and evacuation. If unsuccessful emergency surgery is necessary. The flexible colonoscope offers an additional therapeutic modality to effectuate preoperative reduction of the twisted sigmoid colon if attempts with conventional methods fail. Three cases of acute sigmoid volvulous are presented which illustrate for the first time successful reduction of acute sigmoid volvulous by colonoscopy after failure of the usual methods of treatment. Instead of emergency surgery all of these patients had elective resection with primary colocolostomy. Patients with acute sigmoid volvulous refractile to reduction by conventional modalities should have an attempt at flexible colonoscopic reduction. Images Fig. 1. Fig. 2. Fig. 3. Fig. 4. PMID:464675

Benign Duodenocolic Fistula: a Case Report.

PubMed

Soheili, Marzieh; Honarmand, Shirin; Soleimani, Heshmatollah; Elyasi, Anvar

2015-08-01

Benign duodenocolic fistula (DCF), known as a fistula between the duodenum and colon with or without cecum of nonmalignant origin, is an unusual complication of different gastrointestinal diseases. The present paper records a case in which the patient presented with chronic diarrhea, abdominal pain, weight loss as well as having a history of gastric ulcer. Most frequently the condition presents with signs of malabsorption such as weight loss and diarrhea, but other symptoms include nausea, vomiting (sometimes with fecal), and abdominal pain. Gastrointestinal inflammatory conditions are the usual causes. The most common ones are perforated duodenal ulcer and Crohn's disease. Barium enemas are usually diagnostic. Treatment consists of excising the fistula and repairing the duodenal and colonic defects. Closure of the fistula provides quick relief.

Toward an Understanding of Changes in Diversity Associated with Fecal Microbiome Transplantation Based on 16S rRNA Gene Deep Sequencing

PubMed Central

Shahinas, Dea; Silverman, Michael; Sittler, Taylor; Chiu, Charles; Kim, Peter; Allen-Vercoe, Emma; Weese, Scott; Wong, Andrew; Low, Donald E.; Pillai, Dylan R.

2012-01-01

ABSTRACT Fecal microbiome transplantation by low-volume enema is an effective, safe, and inexpensive alternative to antibiotic therapy for patients with chronic relapsing Clostridium difficile infection (CDI). We explored the microbial diversity of pre- and posttransplant stool specimens from CDI patients (n = 6) using deep sequencing of the 16S rRNA gene. While interindividual variability in microbiota change occurs with fecal transplantation and vancomycin exposure, in this pilot study we note that clinical cure of CDI is associated with an increase in diversity and richness. Genus- and species-level analysis may reveal a cocktail of microorganisms or products thereof that will ultimately be used as a probiotic to treat CDI. PMID:23093385

Lignin Valorization: Emerging Approaches

DOE Office of Scientific and Technical Information (OSTI.GOV)

Beckham, Gregg T

Lignin, an aromatic biopolymer found in plant cell walls, is a key component of lignocellulosic biomass and generally utilized for heat and power. However, lignin's chemical composition makes it an attractive source for biological and catalytic conversion to fuels and chemicals. Bringing together experts from biology, catalysis, engineering, analytical chemistry, and techno-economic/life-cycle analysis, Lignin Valorization presents a comprehensive, interdisciplinary picture of how lignocellulosic biorefineries could potentially employ lignin valorization technologies. Chapters will specifically focus on the production of fuels and chemicals from lignin and topics covered include (i) methods for isolating lignin in the context of the lignocellulosic biorefinery, (ii)more » thermal, chemo-catalytic, and biological methods for lignin depolymerization, (iii) chemo-catalytic and biological methods for upgrading lignin, (iv) characterization of lignin, and (v) techno-economic and life-cycle analysis of integrated processes to utilize lignin in an integrated biorefinery. The book provides the latest breakthroughs and challenges in upgrading lignin to fuels and chemicals for graduate students and researchers in academia, governmental laboratories, and industry interested in biomass conversion.« less

Citrus waste as feedstock for bio-based products recovery: Review on limonene case study and energy valorization.

PubMed

Negro, Viviana; Mancini, Giuseppe; Ruggeri, Bernardo; Fino, Debora

2016-08-01

The citrus peels and residue of fruit juices production are rich in d-limonene, a cyclic terpene characterized by antimicrobial activity, which could hamper energy valorization bioprocess. Considering that limonene is used in nutritional, pharmaceutical and cosmetic fields, citrus by-products processing appear to be a suitable feedstock either for high value product recovery or energy bio-processes. This waste stream, more than 10MTon at 2013 in European Union (AIJN, 2014), can be considered appealing, from the view point of conducting a key study on limonene recovery, as its content of about 1%w/w of high value-added molecule. Different processes are currently being studied to recover or remove limonene from citrus peel to both prevent pollution and energy resources recovery. The present review is aimed to highlight pros and contras of different approaches suggesting an energy sustainability criterion to select the most effective one for materials and energy valorization. Copyright © 2016 Elsevier Ltd. All rights reserved.

Bio-refinery approach for spent coffee grounds valorization.

PubMed

Mata, Teresa M; Martins, António A; Caetano, Nídia S

2018-01-01

Although normally seen as a problem, current policies and strategic plans concur that if adequately managed, waste can be a source of the most interesting and valuable products, among which metals, oils and fats, lignin, cellulose and hemicelluloses, tannins, antioxidants, caffeine, polyphenols, pigments, flavonoids, through recycling, compound recovery or energy valorization, following the waste hierarchy. Besides contributing to more sustainable and circular economies, those products also have high commercial value when compared to the ones obtained by currently used waste treatment methods. In this paper, it is shown how the bio-refinery framework can be used to obtain high value products from organic waste. With spent coffee grounds as a case study, a sequential process is used to obtain first the most valuable, and then other products, allowing proper valorization of residues and increased sustainability of the whole process. Challenges facing full development and implementation of waste based bio-refineries are highlighted. Copyright © 2017 Elsevier Ltd. All rights reserved.

The protein fraction from wheat-based dried distiller's grain with solubles (DDGS): extraction and valorization

PubMed Central

Villegas-Torres, M.F.; Ward, J.M.; Lye, G.J.

2015-01-01

Nowadays there is worldwide interest in developing a sustainable economy where biobased chemicals are the lead actors. Various potential feedstocks are available including glycerol, rapeseed meal and municipal solid waste (MSW). For biorefinery applications the byproduct streams from distilleries and bioethanol plants, such as wheat-based dried distiller's grain with solubles (DDGS), are particularly attractive, as they do not compete for land use. Wheat DDGS is rich in polymeric sugars, proteins and oils, making it ideal as a current animal feed, but also a future substrate for the synthesis of fine and commodity chemicals. This review focuses on the extraction and valorization of the protein fraction of wheat DDGS as this has received comparatively little attention to date. Since wheat DDGS production is expected to increase greatly in the near future, as a consequence of expansion of the bioethanol industry in the UK, strategies to valorize the component fractions of DDGS are urgently needed. PMID:25644639

Recharge areas and hydrochemistry of carbonate springs issuing from Semmering Massif, Austria, based on long-term oxygen-18 and hydrochemical data evidence

NASA Astrophysics Data System (ADS)

Yehdegho, Beyene; Reichl, Peter

2002-10-01

Résumé. Les teneurs en oxygène-18 et l'hydrochimie des sources émergeant du massif de Semmering ont été suivies de manière intensive dans le but de caractériser les zones de recharge et l'évolution hydrochimique. L'effet d'altitude sur le δ18O a été déterminé grâce aux données isotopiques et hydrogéologiques de petites sources de référence, principalement en terrains cristallins; cet effet est d'environ -0,27 et -0,21‰ par 100 m pour les versants respectivement nord et sud du massif. En appliquant ces valeurs, l'altitude moyenne de recharge des sources a été calculée. Pour les sources à fort débit issues des carbonates, elle est comprise entre 1,100 et 1,400 m, compatible avec le cadre topographique et hydrogéologique des calcaires et des dolomies de l'Austro-alpin inférieur alimentant ces sources. La composition chimique des sources des carbonates est dominée par les ions Ca2+, Mg2+, HCO3- et SO42-. Les sources sont presque toutes proches de la saturation par rapport à la calcite, mais sont sous-saturées en dolomite (sauf quelques sources proches de la saturation). Comme cela est habituel en ce qui concerne le dioxyde de carbone fourni par les sols en régions montagneuses, la pCO2 équilibrante moyenne est faible, comprise entre 10-3.0 et 10-2.5 atm (0,1 à 0,3% en volume). En ce qui concerne les variations à long terme, le pH, SIc, Sid et la pCO2 équilibrante sont soumis à des variations saisonnières, alors que les concentrations en Ca2+, Mg2+ et HCO3- ne varient pratiquement pas. En intégrant les résultats de δ18O et les données hydrochimiques, la variabilité altitudinale du chimisme des eaux souterraines des carbonates est démontrée. Reflétant les variations d'activité biologique et des conditions de recharge dans les zones d'alimentation, une covariation négative résulte de l'altitude de recharge et de la pCO2 et la concentration en HCO3- n'est pas modifiée par aucun des termes source ou puits, ce qui fait varier la chimie des carbonates. La pCO2 et la concentration en HCO3- diminuent respectivement d'environ 0,22 unité log (atm) et 38,6 mg/l pour un accroissement de 100 m de l'altitude de recharge. Resumen. Se ha muestreado exhaustivamente el contenido en oxígeno-18 y la hidroquímica de los manantiales existentes en el macizo de Semmering (Austria) con el fin de caracterizar las áreas de recarga y su evolución hidroquímica. Se ha determinado el efecto altitudinal del δ18O con datos isotópicos e hidrogeológicos obtenidos en pequeños manantiales originados en rocas cristalinas que sirven como nivel de referencia; los resultados han sido de -0,27‰ por cada 100 m en la zona Morte del macizo, y de -0,21‰/100 m hacia el Sur. Aplicando estos valores, se ha calculado la altitud promedio a la que se produce su recarga. Para los manantiales de caudal elevado en materiales carbonatados, la altitud de recarga varía entre 1.100 y 1.410 m, cosa que es compatible con el marco topográfico e hidrogeológico de las rocas calizas y dolomíticas Mesozoicas propias del Austroalpino Bajo que los alimenta. La composición hidroquímica de los manantiales carbonatados está dominada por los iones calcio, magnesio, bicarbonato y sulfato. Los manantiales están casi saturados en calcita, pero subsaturados en dolomita, excepto en algunos que parecen hallarse cerca de la saturación. Como caracteriza a los suelos en regiones montañosas, la presión parcial de equilibrio del dióxido de carbono (PCO2) es baja, con valores comprendidos entre 10-3,0 y 10-2,5 atm. A largo plazo, el pH y los valores calculados de los índices de saturación en calcita (SIc) y en dolomita (SId), junto con la PCO2 en equilibrio, evidencian una fuerte estacionalidad; en cambio, las concentraciones de calcio, magnesio y bicarbonato prácticamente no varían. Integrando los resultados de δ18O y de la hidroquímica, se demuestra la variabilidad de la química de aguas subterráneas carbonatadas con respecto a la altitud. Reflejando el cambio sistemático de la actividad biótica y de las condiciones de recarga en la cuenca, se obtiene una correlación negativa entre la altitud de la recarga y la PCO2, mientras que la concentración de bicarbonato no es modificada por términos fuente/sumidero, lo cual atribuye el cambio a la química de los carbonatos. La PCO2 y el bicarbonato disminuyen aproximadamente 0,22 unidades logarítimicas (en atmósferas) y 38,6 mg/l, respectivamente, por cada 100 m de incremento en la altitud de recarga.

Dual-porosity modeling of groundwater recharge: testing a quick calibration using in situ moisture measurements, Areuse River Delta, Switzerland

NASA Astrophysics Data System (ADS)

Alaoui, Abdallah; Eugster, Werner

A simple method for calibrating the dual-porosity MACRO model via in situ TDR measurements during a brief infiltration run (2.8 h) is proposed with the aim of estimating local groundwater recharge (GR). The recharge was modeled firstly by considering the entire 3 m of unsaturated soil, and secondly by considering only the topsoil to the zero-flux plane (0-0.70 m). The modeled recharge was compared against the GR obtained from field measurements. Measured GR was 313 mm during a 1-year period (15 October 1990-15 October 1991). The best simulation results were obtained when considering the entire unsaturated soil under equilibrium conditions excluding the macropore flow effect (330 mm), whereas under non-equilibrium conditions GR was overestimated (378 mm). Sensitivity analyses showed that the investigation of the topsoil is sufficient in estimating local GR in this case, since the water stored below this depth appears to be below the typical rooting depth of the vegetation and is not available for evapotranspiration. The modeled recharge under equilibrium conditions for the 0.7-m-topsoil layer was found to be 364 mm, which is in acceptable agreement with measurements. Une méthode simple pour la calibration du modèle à double porosité MACRO par des mesures TDR in situ durant un bref essai d'infiltration (2.8 h) a été proposée pour l'estimation locale de la recharge de la nappe (RN). La RN a été d'abord simulée en tenant compte de toute la zone non saturée (3 m) et ensuite, en considérant uniquement la couverture du sol entre zéro et le plan du flux nul (0.70 m). La RN simulée a été comparée à la RN observée. La RN mesurée durant une année (15 octobre 1990-15 octobre 1991) était de 313 mm. Les meilleures simulations ont été obtenues en tenant compte de toute la zone non saturée sous les conditions d'équilibre excluant le flux préférentiel (330 mm). Sous les conditions de non équilibre, la RN a été surestimée (378 mm). Les analyses de sensitivité ont montré que l'investigation de la couverture du sol est suffisante pour l'estimation locale de la RN du fait que l'eau traversant le plan du flux nul se trouverait sous la zone des racines et échapperait à l'évapotranspiration. La RN simulée sur les 0.70 m du sol sous les conditions d'équilibre était de 364 mm, ce qui est comparable aux mesures. Se propone un método sencillo para calibrar el modelo de doble porosidad "MACRO" mediante medidas in-situ obtenidas por TDR durante un breve ensayo de infiltración (2,8 horas), con el objetivo de estimar la recarga local al acuífero. Ésta ha sido modelada de dos formas: considerando los 3 m de suelo no saturado y empleando sólo desde la capa superior hasta el plano de flujo nulo (de 0 a 0,70 m). Se compara la recarga modelada con la recarga local medida en campo, la cual fue de 313 mm durante un ciclo anual (del 15 de octubre de 1990 al 15 de octubre de 1991). Las mejores simulaciones corresponden a la hipótesis de columna entera no saturada en condiciones de equilibrio, excluyendo el efecto de macroporos (valor de 330 mm), mientras que el resultado obtenido para condiciones de no equilibrio en la recarga local está sobreestimado (378 mm). Los análisis de sensibilidad muestran que la investigación del horizonte superior del suelo es suficiente para estimar la recarga local en este caso, ya que el agua almacenada por debajo de esta profundidad parece estar fuera del alcance típico de las raíces de la vegetación y no puede ser evapotranspirada. La recarga modelada en condiciones de equilibrio para la capa superior de 0,70 m de espesor es de 364 mm, valor aceptable respecto a las medidas.

Rectal 5-aminosalicylic acid for maintenance of remission in ulcerative colitis.

PubMed

Marshall, John K; Thabane, Marroon; Steinhart, A Hillary; Newman, Jamie R; Anand, Anju; Irvine, E Jan

2012-11-14

5-Aminosalicylic acid (5-ASA) is a first-line therapy for inducing and maintaining remission of mild and moderately active ulcerative colitis (UC). When the proximal margin of inflammation is distal to the splenic flexure, 5-ASA therapy can be delivered as a rectal suppository, foam or liquid enema. The primary objective was to assess the efficacy and safety of rectal 5-ASA for maintaining remission of distal UC. We searched MEDLINE (1966 to August 2012), the Cochrane Library (August 2012), abstracts from major gastroenterology meetings (1997-2011) and bibliographies of relevant publications to identify relevant studies. Eligible studies were randomized controlled trials comparing rectal 5-ASA to placebo or another active treatment for a minimum duration of six months. Symptom scores needed to be assessed in at least one study outcome. Patients had to be at least 12 years of age with disease extent less than 60 cm from the anal verge or distal to the splenic flexure, as determined by barium enema, colonoscopy or sigmoidoscopy. Patients were expected to be in remission prior to the treatment trial. Study eligibility was independently assessed by three authors. Data were extracted using standardized forms by two independent reviewers, with inter-rater agreement assessed using Cohen's Kappa and disagreements resolved by consensus. In cases where clarification of study results or methodology was needed, corresponding authors were contacted. The methodological quality of each trial was assessed by the Cochrane risk of bias tool and by a 30-point scale developed and used previously by the authors. Pooled risk ratios (RR) and corresponding 95% confidence intervals (CI) for continued clinical, endoscopic and histologic remission were estimated for comparisons between rectal 5-ASA and placebo or oral 5-ASA, and for comparisons among 5-ASA doses. Heterogeneity was assessed using the Chi(2) test and visual inspection of forest plots. If no significant heterogeneity was identified (P > 0.10 for Chi(2)) a fixed-effect model (Mantel-Haenstzel) was used. If heterogeneity was significant, a random-effects model was used. Nine studies (484 patients) met the pre-specified inclusion criteria (Kappa 1.00). Six studies were rated as low risk of bias. Three studies were rated as high risk of bias due to blinding (two open label and one single-blind). The total daily dose of rectal 5-ASA ranged from 0.5 g to 4 g, and dose frequency ranged from once to three times daily. 5-ASA was delivered as liquid enema in five studies or as a suppository in four studies. Follow-up ranged from 6 to 24 months. Rectal 5-ASA was significantly superior to placebo for maintenance of symptomatic remission over a period of 12 months.Sixty-two per cent of patients in the rectal 5-ASA group maintained symptomatic remission compared to 30% of patients in the placebo group (4 studies; 301 patients; RR 2.22, 95% CI 1.26 to 3.90; I(2) = 67%; P < 0.01). A GRADE analysis indicated that the overall quality of the evidence for the primary outcome was low due to imprecision (i.e. sparse data 144 events) and inconsistency (i.e. unexplained heterogeneity). Rectal 5-ASA was significantly superior to placebo for maintenance of endoscopic remission over a 12 month period. Seventy-five per cent of patients in the rectal 5-ASA group maintained endoscopic remission compared to 15% of patients in the placebo group (1 study; 25 patients; RR 4.88, 95% CI 1.31 to 18.18; P < 0.05). There was no statistically significant difference in the proportion of patients who experienced at least one adverse event. Sixteen per cent of patients in the rectal 5-ASA group experienced at least one adverse compared to 12% of placebo patients (2 studies; 160 patients; RR 1.35, 95% CI 0.63 to 2.89; I(2) = 0%; P = 0.44). The most commonly reported adverse events were anal irritation and abdominal pain. No statistically significant differences between rectal and oral 5-ASA were identified for either symptomatic or endoscopic remission over a period of six months. Eighty per cent of patients in the rectal 5-ASA group maintained symptomatic remission compared to 65% of patients in the oral 5-ASA group (2 studies; 69 patients; RR 1.24, 95% CI 0.92 to 1.66; I(2) = 0%; P = 0.15). A GRADE analysis indicated that the overall quality of the evidence for the primary outcome was low due to imprecision (i.e. sparse data 50 events) and high risk of bias (i.e. both studies in the pooled analysis were open label). Eighty per cent of patients in the rectal 5-ASA group maintained endoscopic remission compared to 70% of patients in the oral 5-ASA group (2 studies; 91 patients; RR 1.14, 95% CI 0.90 to 1.45; I(2) = 0%; P = 0.26). In two small trials, one comparing 2 g/day 5-ASA enemas to 4 g/day 5-ASA enemas and the other comparing 0.5 g/day 5-ASA suppositories to 1 g/day 5-ASA suppositories no dose response relationship was observed. The limited data available suggest that rectal 5-ASA is effective and safe for maintenance of remission of mild to moderately active distal UC. Well designed randomized trials are needed to establish the optimal dosing regimen for rectal 5-ASA, to compare rectal 5-ASA with rectal corticosteroids and to identify subgroups of patients who are more or less responsive to specific rectal 5-ASA regimens. The combination of oral and rectal 5-ASA appears to be more effective than either oral or rectal monotherapy for induction of remission. The efficacy of combination therapy for maintenance of remission has not been assessed and could be evaluated in future trials.

Association between ovine protein polymorphisms and geographical variables in Europe and south-west Asia.

PubMed

Ordas, J G; Carriedo, J A

1997-01-12

The spatial distribution of six blood-protein polymorphisms in European and south-west Asian ovine breeds was analysed. Latitudinal clines were found for haemoglobin and transferrin loci. The respective F(ST) values are not significantly greater than those for protein-X, esterase, carbonic anhydrase, and albumin, where gene frequencies are not associated with latitude. The results suggest that historical processes of gene flow, rather than adaptation to different environments, have played a major role in determining the observed lives of gene frequencies. RESUMEN: Asociación entre polimorfismos proteicos ovinos y variables geográficas en Europa y sudoeste de Asia Se ha analizado la distribución espacial de seis polimorfismos proteicos sanguíneos en razas ovinas de Europa y del sudoeste de Asia. La hemoglobina y la transferrina muestran clinas latitudinales. Los valores de F(ST) para estos dos loci no son significativamente más grandes que los de la proteína-X, esterasa, anhidrasa carbónica y albúmina, cuyas frecuencias génicas no están asociadas con la latitud. Los resultados sugieren que la distribución de las frecuencias génicas de la hemoglobina y la transferrina se debe a procesos históricos de flujo génico y deriva genética. 1997 Blackwell Verlag GmbH.

Opportunities and challenges in biological lignin valorization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Beckham, Gregg T.; Johnson, Christopher W.; Karp, Eric M.

Lignin is a primary component of lignocellulosic biomass that is an underutilized feedstock in the growing biofuels industry. Despite the fact that lignin depolymerization has long been studied, the intrinsic heterogeneity of lignin typically leads to heterogeneous streams of aromatic compounds, which in turn present significant technical challenges when attempting to produce lignin-derived chemicals where purity is often a concern. In Nature, microorganisms often encounter this same problem during biomass turnover wherein powerful oxidative enzymes produce heterogeneous slates of aromatics compounds. Some microbes have evolved metabolic pathways to convert these aromatic species via ‘upper pathways’ into central intermediates, which canmore » then be funneled through ‘lower pathways’ into central carbon metabolism in a process we dubbed ‘biological funneling’. This funneling approach offers a direct, biological solution to overcome heterogeneity problems in lignin valorization for the modern biorefinery. Coupled to targeted separations and downstream chemical catalysis, this concept offers the ability to produce a wide range of molecules from lignin. This perspective describes research opportunities and challenges ahead for this new field of research, which holds significant promise towards a biorefinery concept wherein polysaccharides and lignin are treated as equally valuable feedstocks. In particular, we discuss tailoring the lignin substrate for microbial utilization, host selection for biological funneling, ligninolytic enzyme–microbe synergy, metabolic engineering, expanding substrate specificity for biological funneling, and process integration, each of which presents key challenges. Ultimately, for biological solutions to lignin valorization to be viable, multiple questions in each of these areas will need to be addressed, making biological lignin valorization a multidisciplinary, co-design problem.« less

Toward engineering E. coli with an autoregulatory system for lignin valorization

PubMed Central

Wu, Weihua; Liu, Fang; Singh, Seema

2018-01-01

Efficient lignin valorization could add more than 10-fold the value gained from burning it for energy and is critical for economic viability of future biorefineries. However, lignin-derived aromatics from biomass pretreatment are known to be potent fermentation inhibitors in microbial production of fuels and other value-added chemicals. In addition, isopropyl-β-d-1-thiogalactopyranoside and other inducers are routinely added into fermentation broth to induce the expression of pathway enzymes, which further adds to the overall process cost. An autoregulatory system that can diminish the aromatics’ toxicity as well as be substrate-inducible can be the key for successful integration of lignin valorization into future lignocellulosic biorefineries. Toward that goal, in this study an autoregulatory system is demonstrated that alleviates the toxicity issue and eliminates the cost of an external inducer. Specifically, this system is composed of a catechol biosynthesis pathway coexpressed with an active aromatic transporter CouP under induction by a vanillin self-inducible promoter, ADH7, to effectively convert the lignin-derived aromatics into value-added chemicals using Escherichia coli as a host. The constructed autoregulatory system can efficiently transport vanillin across the cell membrane and convert it to catechol. Compared with the system without CouP expression, the expression of catechol biosynthesis pathway with transporter CouP significantly improved the catechol yields about 30% and 40% under promoter pTrc and ADH7, respectively. This study demonstrated an aromatic-induced autoregulatory system that enabled conversion of lignin-derived aromatics into catechol without the addition of any costly, external inducers, providing a promising and economically viable route for lignin valorization. PMID:29500185

From gene to biorefinery: microbial β-etherases as promising biocatalysts for lignin valorization.

PubMed

Picart, Pere; de María, Pablo Domínguez; Schallmey, Anett

2015-01-01

The set-up of biorefineries for the valorization of lignocellulosic biomass will be core in the future to reach sustainability targets. In this area, biomass-degrading enzymes are attracting significant research interest for their potential in the production of chemicals and biofuels from renewable feedstock. Glutathione-dependent β-etherases are emerging enzymes for the biocatalytic depolymerization of lignin, a heterogeneous aromatic polymer abundant in nature. They selectively catalyze the reductive cleavage of β-O-4 aryl-ether bonds which account for 45-60% of linkages present in lignin. Hence, application of β-etherases in lignin depolymerization would enable a specific lignin breakdown, selectively yielding (valuable) low-molecular-mass aromatics. Albeit β-etherases have been biochemically known for decades, only very recently novel β-etherases have been identified and thoroughly characterized for lignin valorization, expanding the enzyme toolbox for efficient β-O-4 aryl-ether bond cleavage. Given their emerging importance and potential, this mini-review discusses recent developments in the field of β-etherase biocatalysis covering all aspects from enzyme identification to biocatalytic applications with real lignin samples.

From gene to biorefinery: microbial β-etherases as promising biocatalysts for lignin valorization

PubMed Central

Picart, Pere; de María, Pablo Domínguez; Schallmey, Anett

2015-01-01

The set-up of biorefineries for the valorization of lignocellulosic biomass will be core in the future to reach sustainability targets. In this area, biomass-degrading enzymes are attracting significant research interest for their potential in the production of chemicals and biofuels from renewable feedstock. Glutathione-dependent β-etherases are emerging enzymes for the biocatalytic depolymerization of lignin, a heterogeneous aromatic polymer abundant in nature. They selectively catalyze the reductive cleavage of β-O-4 aryl-ether bonds which account for 45–60% of linkages present in lignin. Hence, application of β-etherases in lignin depolymerization would enable a specific lignin breakdown, selectively yielding (valuable) low-molecular-mass aromatics. Albeit β-etherases have been biochemically known for decades, only very recently novel β-etherases have been identified and thoroughly characterized for lignin valorization, expanding the enzyme toolbox for efficient β-O-4 aryl-ether bond cleavage. Given their emerging importance and potential, this mini-review discusses recent developments in the field of β-etherase biocatalysis covering all aspects from enzyme identification to biocatalytic applications with real lignin samples. PMID:26388858

[Determination of cost-effective strategies in colorectal cancer screening].

PubMed

Dervaux, B; Eeckhoudt, L; Lebrun, T; Sailly, J C

1992-01-01

The object of the article is to implement particular methodologies in order to determine which strategies are cost-effective in the mass screening of colorectal cancer after a positive Hemoccult test. The first approach to be presented consists in proposing a method which enables all the admissible diagnostic strategies to be determined. The second approach enables a minimal cost function to be estimated using an adaptation of "Data Envelopment Analysis". This method proves to be particularly successful in cost-efficiency analysis, when the performance indicators are numerous and hard to aggregate. The results show that there are two cost-effective strategies after a positive Hemoccult test: coloscopy and sigmoidoscopy; they put into question the relevance of double contrast barium enema in the diagnosis of colo-rectal lesions.

A primer of complementary and alternative medicine commonly used by cancer patients.

PubMed

Ernst, E

2001-01-15

Complementary and alternative medicine (CAM) is frequently used by cancer patients, and many oncologists have limited knowledge of CAM. This article provides a brief, evidence-based introduction to several CAM treatments relevant in the context of cancer. "Alternative" diets, chiropractic, coffee enemas, ozone therapy, and shark cartilage seem to have little to offer cancer patients. The evidence for or against homoeopathy and spiritual healing is at present inconclusive. Acupuncture, aromatherapy, and meditation may be useful for nausea/vomiting, for mild relaxation, and for pain/anxiety, respectively. Herbal treatments offer no reasonable prospect of a cure (mistletoe), but could be useful as palliative treatments (eg, for depression [St John's wort] or anxiety [kava]). Our knowledge regarding the potential benefit and harm of CAM is insufficient.

[Primary colonic intussusception protruding from the anus in adults. Two cases].

PubMed

Bail, J P; Holderbach, L J; Robaszkiewicz, M; Dartoy, C; Noundou, P M; Charles, J F

1992-01-01

The authors report two cases of colonic intussusception in the adult protruding from the anus--or colon-anal intussusception--, not due to a tumor. The first case was a chronic ileo-caeco-colique intussusception, the second case was an acute colo-rectal intussusception. Colo-anal intussusceptions are very rare: less than twenty cases have been described since 1925 in adults. The absence of a tumor origin in our cases represents a special feature, as only three other similar cases have been described. The surgical treatment in both cases was primary colonic resection without colostomy. The surgical treatment of the first case was subtotal colectomy with ileo-rectal anastomosis. The second case was primarily reduced by barium enema which allowed optimal secondary surgical resection of a prepared colon.

Pressure ulcer dressings in critical patients: a cost analysis.

PubMed

Silva, Dinara Raquel Araújo; Bezerra, Sandra Marina Gonçalves; Costa, Jéssica Pereira; Luz, Maria Helena Barros Araújo; Lopes, Vanessa Caminha Aguiar; Nogueira, Lidya Tolstenko

2017-06-12

To assess the direct cost of dressings in pressure ulcer treatment. This was a descriptive observational study conducted at an intensive care unit in the Northeast region of Brazil, between November and December 2015. Data were gathered using the Pressure Ulcer Scale for Healing and a form to characterize and assess costs. Values in Brazilian reais (BRL) were converted into U.S. dollars at the exchange rate of USD 0.26/BRL. Univariate and bivariate analyses were conducted. The sample consisted of 15 patients with at least stage 2 ulcers. There was a significant reduction in costs with dressing materials between the initial and final assessments (p=0.002), with a mean of USD 11.9 (±7.4). The most common topical treatments used were essential fatty acids and papain. Cost reduction was proportional to the stage of pressure ulcer. The role of nurses in creating evidence-based care plans is crucial to improve care management. Avaliar o custo direto com curativos no tratamento de lesões por pressão. Estudo observacional descritivo, realizado em Unidade de Terapia Intensiva do nordeste do Brasil, de novembro a dezembro de 2015. Foi aplicada a Pressure Ulcer Scale for Healing e formulário para caracterização e avaliação de custos. Os valores da moeda brasileira (R$) foram convertidos para a moeda norte-americana (US$) à taxa de US$0,26/R$. Foram realizadas análises univariadas e bivariadas. Compuseram a amostra 15 pacientes com lesões, no mínimo, estágio 2. Houve redução significativa dos custos com materiais de curativos entre as avaliações inicial e final (p=0,002), com média de US$11,9 (±7,4). As terapias tópicas mais frequentes foram ácidos graxos essenciais e papaína. Verificou-se redução de custos proporcional aos estágios das lesões. Enfatiza-se o papel do enfermeiro na elaboração de planos de cuidados baseados em evidências para melhor gerenciamento do cuidado. Evaluar el costo directo de curativos para el tratamiento de lesiones por presión. Estudio observacional descriptivo en la Unidad de Cuidados Intensivos del noreste de Brasil, de noviembre a diciembre del año 2015. Se aplicó la Pressure Ulcer Scale for Healing y formulario para la caracterización y evaluación de los costos. Los valores de la moneda brasileña (Reales- R$) se convirtieron al dólar estadounidense (US$) a razón de $0.26/R$. Se realizaron análisis univariados y bivariados. La muestra consistió en 15 pacientes con lesiones al menos en Etapa 2. Hubo una reducción significativa en el costo de los materiales de curación entre las evaluaciones inicial y final (p=0,002), con un promedio de US$11.9 (±7.4). Los tratamientos tópicos más comunes son los ácidos grasos esenciales y papaína. Se verificó una reducción de los costos proporcional a las etapas de las lesiones. Se hace hincapié en el papel de los enfermeros en el desarrollo de planes de cuidados basados en la evidencia, para una mejor gestión de la atención.

[In Process Citation].

PubMed

Alarcón Hormazábal, Manuel; Delgado Floody, Pedro; Castillo Mariqueo, Lidia; Thuiller Lepelegy, Nicole; Bórquez Becerra, Pablo; Sepúlveda Mancilla, Carlos; Rebolledo Quezada, Sara

2016-03-25

Introducción: existe una alta prevalencia de sedentarismo, sobrepeso y obesidad en jóvenes universitarios. Objetivo: el propósito del estudio fue determinar los efectos de un programa de entrenamiento intervalado de alta intensidad (HIIT) sobre el perfil antropométrico, glicemia basal y VO 2 máx (consumo máximo de oxígeno) de jóvenes sedentarios con malnutrición por exceso. Material y métodos: 6 mujeres y 2 hombres (2 obesos y 6 con sobrepeso) se sometieron a un programa de entrenamiento de alta intensidad de 8 semanas de duración (3 sesiones/semana). Se evaluó en ayuno y posterior a 72 horas de la última intervención; peso, índice de masa corporal (IMC), contorno de cintura (CC), perímetro de cadera y glicemia de basal. El VO 2 máx fue evaluado en condiciones normales previo a la primera sesión. Resultados: las variables de estudio no presentaron cambios significativos (p > 0,05), pero reportaron disminuciones porcentuales. El peso disminuyó un 0,18%, el IMC un 0,27%, el CC 2,67%, el perímetro de cadera un 1,15%, y el VO 2 máx un 0,48%. La glicemia basal presentó la mayor disminución, pasó de 95,13 ± 23,91 a 89,88 ± 12,45 mg/dl (5,52%), estabilizando y mejorando sus niveles en cada uno de los participantes. Conclusiones: el programa de entrenamiento intervalado de alta intensidad fue factible de realizar sin resultados adversos para la salud de los participantes, la glicemia basal mostró la mayor variación, estabilizando sus valores en los participantes, lo que es un indicador positivo dentro del programa. Es necesario seguir investigando sobre esta metodología HIIT y aumentar los tiempos de estudio para ver los cambios que se pueden producir en distintos parámetros metabólicos, antropométricos y físicos en población con malnutrición por exceso.

[Not Available].

PubMed

MIján de la Torre, Alberto

2016-06-03

El síndrome de caquexia cancerosa es responsable de la muerte de un número significativo de pacientes con cáncer. Se caracteriza por la presencia de una ingesta reducida, con inflamación sistémica y un metabolismo alterado. Los enfermos presentan característicamente una progresiva pérdida de peso y de masa muscular, junto a deterioro funcional. La pérdida muscular se debe a la combinación de reducción de la síntesis proteica con aumento de su degradación. Ello conduce tanto a un acortamiento como a una reducción en el área de la fibra muscular. Asimismo, existen datos que apoyan que selectivamente algunos de los tipos de fibra muscular se ven más afectados. Es necesario definir bien los valores de corte de sarcopenia para diagnosticar la pérdida muscular y existen diferentes métodos. El sistema de la ubiquitina-proteasoma parece desempeñar un papel predominante en la degradación de la proteína miofibrilar. La tendencia a perder masa muscular en los pacientes con caquexia cancerosa parece estar asociada a la activación de señales catabólicas por citoquinas proinflamatorias, así como por productos tumorales del tipo factor inductor de proteólisis. En referencia a los factores pronósticos, el riesgo de muerte está bien documentado en pacientes con sarcopenia y, especialmente, en aquellos con obesidad asociada a la sarcopenia. Asimismo, se ha establecido una relación directa entre la pérdida intensa de masa muscular y la supervivencia en pacientes con diferentes tipos de tumores del tipo de cáncer de páncreas, pulmón, tracto biliar o cáncer colorrectal. Respecto de la terapia en el síndrome de caquexia cancerosa, es factible que requiera tratamiento con varios grupos combinados que incluyan, junto al soporte nutricional, fármacos orexígenos, con efecto anabólico y antinflamatorio, asociados a intervenciones que estimulen el ejercicio físico.

La masa de los grandes impactores

NASA Astrophysics Data System (ADS)

Parisi, M. G.; Brunini, A.

Los planetas han sido formados fundamentalmente acretando masa a través de colisiones con planetesimales sólidos. La masa más grande de la distribución de planetesimales y las masas máxima y mínima de los impactores, han sido calculadas usando los valores actuales del período y de la inclinación de los planetas (Lissauer & Safronov 1991; Parisi & Brunini 1996). Recientes investigaciones han mostrado, que las órbitas de los planetas gigantes no han sufrido variaciones con el tiempo, siendo su movimiento regular durante su evolución a partir de la finalización de la etapa de acreción (Laskar 1990, 1994). Por lo tanto, la eccentricidad actual de los planetas gigantes se puede utilizar para imponer una cota máxima a las masas y velocidades orbitales de los grandes impactores. Mediante un simple modelo dinámico, y considerando lo arriba mencionado, obtenemos la cota superior para la masa del planetesimal más grande que impactó a cada planeta gigante al final de su etapa de acreción. El resultado más importante de este trabajo es la estimación de la masa máxima permitida para impactar a Júpiter, la cúal es ~ 1.136 × 10 -1, siendo en el caso de Neptuno ~ 3.99 × 10 -2 (expresada en unidades de la masa final de cada planeta). Además, fue posible obtener la velocidad orbital máxima permitida para los impactores como una función de su masa, para cada planeta. Las cotas obtenidas para la masa y velocidad de los impactores de Saturno y Urano (en unidades de la masa y velocidad final de cada planeta respectivamente) son casi las mismas que las obtenidas para Júpiter debido a que estos tres planetas poseen similar eccentricidad actual. Nuestros resultados están en buen acuerdo con los obtenidos por Lissauer & Safronov (1991). Estas cotas podrían ser utilizadas para obtener la distribución de planetesimales en el Sistema Solar primitivo.

Life cycle costing of food waste: A review of methodological approaches.

PubMed

De Menna, Fabio; Dietershagen, Jana; Loubiere, Marion; Vittuari, Matteo

2018-03-01

Food waste (FW) is a global problem that is receiving increasing attention due to its environmental and economic impacts. Appropriate FW prevention, valorization, and management routes could mitigate or avoid these effects. Life cycle thinking and approaches, such as life cycle costing (LCC), may represent suitable tools to assess the sustainability of these routes. This study analyzes different LCC methodological aspects and approaches to evaluate FW management and valorization routes. A systematic literature review was carried out with a focus on different LCC approaches, their application to food, FW, and waste systems, as well as on specific methodological aspects. The review consisted of three phases: a collection phase, an iterative phase with experts' consultation, and a final literature classification. Journal papers and reports were retrieved from selected databases and search engines. The standardization of LCC methodologies is still in its infancy due to a lack of consensus over definitions and approaches. Research on the life cycle cost of FW is limited and generally focused on FW management, rather than prevention or valorization of specific flows. FW prevention, valorization, and management require a consistent integration of LCC and Life Cycle Assessment (LCA) to avoid tradeoffs between environmental and economic impacts. This entails a proper investigation of methodological differences between attributional and consequential modelling in LCC, especially with regard to functional unit, system boundaries, multi-functionality, included cost, and assessed impacts. Further efforts could also aim at finding the most effective and transparent categorization of costs, in particular when dealing with multiple stakeholders sustaining costs of FW. Interpretation of results from LCC of FW should take into account the effect on larger economic systems. Additional key performance indicators and analytical tools could be included in consequential approaches. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Toward engineering E. coli with an autoregulatory system for lignin valorization.

PubMed

Wu, Weihua; Liu, Fang; Singh, Seema

2018-03-20

Efficient lignin valorization could add more than 10-fold the value gained from burning it for energy and is critical for economic viability of future biorefineries. However, lignin-derived aromatics from biomass pretreatment are known to be potent fermentation inhibitors in microbial production of fuels and other value-added chemicals. In addition, isopropyl-β-d-1-thiogalactopyranoside and other inducers are routinely added into fermentation broth to induce the expression of pathway enzymes, which further adds to the overall process cost. An autoregulatory system that can diminish the aromatics' toxicity as well as be substrate-inducible can be the key for successful integration of lignin valorization into future lignocellulosic biorefineries. Toward that goal, in this study an autoregulatory system is demonstrated that alleviates the toxicity issue and eliminates the cost of an external inducer. Specifically, this system is composed of a catechol biosynthesis pathway coexpressed with an active aromatic transporter CouP under induction by a vanillin self-inducible promoter, ADH7, to effectively convert the lignin-derived aromatics into value-added chemicals using Escherichia coli as a host. The constructed autoregulatory system can efficiently transport vanillin across the cell membrane and convert it to catechol. Compared with the system without CouP expression, the expression of catechol biosynthesis pathway with transporter CouP significantly improved the catechol yields about 30% and 40% under promoter pTrc and ADH7, respectively. This study demonstrated an aromatic-induced autoregulatory system that enabled conversion of lignin-derived aromatics into catechol without the addition of any costly, external inducers, providing a promising and economically viable route for lignin valorization. Copyright © 2018 the Author(s). Published by PNAS.

Is phytoremediation without biomass valorization sustainable? - comparative LCA of landfilling vs. anaerobic co-digestion.

PubMed

Vigil, Miguel; Marey-Pérez, Manuel F; Martinez Huerta, Gemma; Álvarez Cabal, Valeriano

2015-02-01

This study examines the sustainability of phytoremediation for soils contaminated with heavy metals, especially the influence of management of the produced metal-enriched biomass on the environmental performance of the complete system. We examine a case study in Asturias (north of Spain), where the land was polluted with Pb by diffuse emissions from an adjacent steelmaking factory. A Phytoremediation scenario based on this case was assessed by performing a comparative life cycle assessment and by applying the multi-impact assessment method ReCiPe. Our Baseline scenario used the produced biomass as feedstock for an anaerobic digester that produces biogas, which is later upgraded cryogenically. The Baseline scenario was compared with two alternative scenarios: one considers depositing the produced biomass into landfill, and the other considers excavating the contaminated soil, disposing it in a landfill, and refilling the site with pristine soil. A sensitivity analysis was performed using different yields of biomass and biogas, and using different distances between site and biomass valorization/disposal center. Our results show that the impacts caused during agricultural activities and biomass valorization were compensated by the production of synthetic natural gas and the avoided impact of natural gas production. In addition, it was found that if the produced biomass was not valorized, the sustainability of phytoremediation is questionable. The distance between the site and the biomass processing center is not a major factor for determining the technology's sustainability, providing distances are less than 200-300 km. However, distance to landfill or to the source of pristine soil is a key factor when deciding to use phytoremediation or other ex-situ conventional remediation techniques. Copyright © 2014 Elsevier B.V. All rights reserved.

Adsorptive removal of organics from aqueous phase by acid-activated coal fly ash: preparation, adsorption, and Fenton regenerative valorization of "spent" adsorbent.

PubMed

Wang, Nannan; Hao, Linlin; Chen, Jiaqing; Zhao, Qiang; Xu, Han

2018-05-01

Raw coal fly ash was activated to an adsorbent by sulfuric acid impregnation. The activation condition, the adsorption capacity, and the regenerative valorization of the adsorbent were studied. The results show that the optimal preparation conditions of the adsorbent are [H 2 SO 4 ] = 1 mol L -1 , activation time = 30 min, the ratio of coal fly ash to acid = 1:20 (g:mL), calcination temperature = 100 °C. The adsorption of p-nitrophenol on the adsorbent accords with the pseudo-second-order kinetic equation and the adsorption rate constant is 0.089 g mg -1  min -1 . The adsorption on this adsorbent can be considered enough after 35 min, when the corresponding adsorption capacity is 1.07 mg g -1 (85.6% of p-nitrophenol removal). Compared with raw coal fly ash, the adsorbent has a stable adsorption performance at low pH range (pH = 1-6) and the adsorption of p-nitrophenol is an exothermic process. Ninety minutes is required for the regenerative valorization of saturated adsorbent by Fenton process. The regenerative valorization for this saturated adsorbent can reach 89% under the optimal proposed conditions (30 °C, pH = 3, [H 2 O 2 ] = 5.0 mmol L -1 , [Fe 2+ ] = 5.5 mmol L -1 ). Within 15 experimental runs, the adsorbent has a better and better stability with the increase of experimental runs. Finally, the mechanism of activating coal fly ash is proposed, being verified by the results of the SEM and BET test.

LCA applied to elucidate opportunities for biogas from wastewaters in Colombia.

PubMed

Meneses-Jácome, A; Osorio-Molina, A; Parra-Saldívar, R; Gallego-Suárez, D; Velásquez-Arredondo, H I; Ruiz-Colorado, A A

2015-01-01

Biogas produced in municipal and industrial wastewater treatment facilities (BWWF) is a resource wasted in several socio-economic contexts. BWWF-based projects are compared against energy projects using conventional electricity or natural gas (NG), following strict economic considerations that usually tip the balance in favour of conventional energy supply. This is because the economic gain associated with the environmental benefits of using small biogas sources like BWWF does not overcome the technical and financial effort required in these types of project. This paper shows a broader application of life cycle assessment (LCA) methodology to explore opportunities for positive (or effective) utilization of BWWF in the Colombian context. LCA has been used to evaluate the supply-chain of NG which is the direct competitor of BWWF, in three different Colombian regions, in order to identify those where higher NG environmental impacts offer increased environmental added-value to BWWF use. LCA was also applied to study two BWWF valorization scenarios in the poultry processing industry. It shows how valorization options for BWWF are more realistic and effective when specific-regional loads are applied to the environmental assessment of NG supply-chain and BWWF valorization.

Cheese whey management: a review.

PubMed

Prazeres, Ana R; Carvalho, Fátima; Rivas, Javier

2012-11-15

Cheese whey is simultaneously an effluent with nutritional value and a strong organic and saline content. Cheese whey management has been focused in the development of biological treatments without valorization; biological treatments with valorization; physicochemical treatments and direct land application. In the first case, aerobic digestion is reported. In the second case, six main processes are described in the literature: anaerobic digestion, lactose hydrolysis, fermentation to ethanol, hydrogen or lactic acid and direct production of electricity through microbial fuel cells. Thermal and isoelectric precipitation, thermocalcic precipitation, coagulation/flocculation, acid precipitation, electrochemical and membrane technologies have been considered as possible and attractive physicochemical processes to valorize or treat cheese whey. The direct land application is a common and longstanding practice, although some precautions are required. In this review, these different solutions are analyzed. The paper describes the main reactors used, the influence of the main operating variables, the microorganisms or reagents employed and the characterizations of the final effluent principally in terms of chemical oxygen demand. In addition, the experimental conditions and the main results reported in the literature are compiled. Finally, the comparison between the different treatment alternatives and the presentation of potential treatment lines are postulated. Copyright © 2012 Elsevier Ltd. All rights reserved.

Selective recovery of silver from waste low-temperature co-fired ceramic and valorization through silver nanoparticle synthesis.

PubMed

Swain, Basudev; Shin, Dongyoon; Joo, So Yeong; Ahn, Nak Kyoon; Lee, Chan Gi; Yoon, Jin-Ho

2017-11-01

Considering the value of silver metal and silver nanoparticles, the waste generated during manufacturing of low temperature co-fired ceramic (LTCC) were recycled through the simple yet cost effective process by chemical-metallurgy. Followed by leaching optimization, silver was selectively recovered through precipitation. The precipitated silver chloride was valorized though silver nanoparticle synthesis by a simple one-pot greener synthesis route. Through leaching-precipitation optimization, quantitative selective recovery of silver chloride was achieved, followed by homogeneous pure silver nanoparticle about 100nm size were synthesized. The reported recycling process is a simple process, versatile, easy to implement, requires minimum facilities and no specialty chemicals, through which semiconductor manufacturing industry can treat the waste generated during manufacturing of LTCC and reutilize the valorized silver nanoparticles in manufacturing in a close loop process. Our reported process can address issues like; (i) waste disposal, as well as value-added silver recovery, (ii) brings back the material to production stream and address the circular economy, and (iii) can be part of lower the futuristic carbon economy and cradle-to-cradle technology management, simultaneously. Copyright © 2017 Elsevier Ltd. All rights reserved.

Occult Blood Testing for Early Detection of Colorectal Cancer: Diagnostic Outcomes

PubMed Central

Hislop, T. Gregory; Morrison, Brenda J.; Hoogewerf, Peter E.; Burns, Sheilagh D.; Sizto, Ronald

1987-01-01

Three thousand five hundred and fifty-four asymptomatic persons from 32 family practices returned hemoccult II tests for colorectal cancer; 2.2% of these returned tests were positive. The diagnoses for the 47 persons with positive tests which were done while on meat restriction included six cancers (1.7/1000) and five polyps (1.4/1000); 18 were diagnosed with other known sources, and 18 were undiagnosed. All polyps and four of six cancers were diagnosed by combined barium enema with sigmoidoscopy or by colonoscopy. Five of six cancers were diagnosed at early stages. Meat restriction, the method of returning the test for analysis, the number of holes completed in the test, and the delay time from completing the test to analysis did not influence the likelihood of a positive test. PMID:20469468

Validation of maternal cardiac output assessed by transthoracic echocardiography against pulmonary artery catheterization in severely ill pregnant women: prospective comparative study and systematic review.

PubMed

Cornette, J; Laker, S; Jeffery, B; Lombaard, H; Alberts, A; Rizopoulos, D; Roos-Hesselink, J W; Pattinson, R C

2017-01-01

Most severe pregnancy complications are characterized by profound hemodynamic disturbances, thus there is a need for validated hemodynamic monitoring systems for pregnant women. Pulmonary artery catheterization (PAC) using thermodilution is the clinical gold standard for the measurement of cardiac output (CO), however this reference method is rarely performed owing to its invasive nature. Transthoracic echocardiography (TTE) allows non-invasive determination of CO. We aimed to validate TTE against PAC for the determination of CO in severely ill pregnant women. This study consisted of a meta-analysis combining data from a prospective study and a systematic review. The prospective arm was conducted in Pretoria, South Africa, in 2003. Women with severe pregnancy complications requiring invasive monitoring with PAC according to contemporary guidelines were included. TTE was performed within 15 min of PAC and the investigator was blinded to the PAC measurements. Comparative measurements were extracted from similar studies retrieved from a systematic review of the literature and added to a database. Simultaneous CO measurements by TTE and PAC were compared. Agreement between methods was assessed using Bland-Altman statistics and intraclass correlation coefficients (ICC). Thirty-four comparative measurements were included in the meta-analysis. Mean CO values obtained by PAC and TTE were 7.39 L/min and 7.18 L/min, respectively. The bias was 0.21 L/min with lower and upper limits of agreement of -1.18 L/min and 1.60 L/min, percentage error was 19.1%, and ICC between the two methods was 0.94. CO measurements by TTE show excellent agreement with those obtained by PAC in pregnant women. Given its non-invasive nature and availability, TTE could be considered as a reference for the validation of other CO techniques in pregnant women. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Las complicaciones del embarazo más graves se caracterizan por trastornos hemodinámicos serios, debido a los cuales existe la necesidad de sistemas validados de monitorización hemodinámica para mujeres embarazadas. Aunque la cateterización de la arteria pulmonar (CAP) mediante termodilución es el patrón de referencia clínico para la medición del gasto cardíaco (GC), este método se usa con poca frecuencia debido a su naturaleza invasiva. La ecocardiografía transtorácica (ETT) permite la determinación no invasiva del GC. El objetivo de este estudio fue validar la ETT frente al CAP para determinar el GC en mujeres embarazadas gravemente enfermas. MÉTODOS: Este estudio consistió en un metaanálisis que combinó datos de un estudio prospectivo y una revisión sistemática. El estudio prospectivo se llevó a cabo en Pretoria (Sudáfrica) en 2003. Se incluyeron mujeres con complicaciones graves en el embarazo que requerían una monitorización invasiva mediante CAP según las directrices de ese momento. Se realizó una ETT en un plazo de 15 minutos de haber realizado el CAP y el investigador no tuvo acceso a las mediciones del CAP. Las mediciones comparativas se extrajeron de estudios similares obtenidos a partir de una revisión sistemática de la literatura y se añadieron a una base de datos. Se compararon las mediciones simultáneas del GC mediante ETT y CAP. La concordancia entre métodos se evaluó a través del método estadístico de Bland-Altman y de coeficientes de correlación intraclase (CCI). Se incluyeron treinta y cuatro mediciones comparativas en el metaanálisis. Los valores medios del GC obtenidos mediante CAP y ETT fueron de 7,39 l/min y 7.18 l/min, respectivamente. El sesgo fue de 0,21 l/min, siendo los límites inferior y superior de la concordancia de -1,18 l/min y 1.60 l/min; el error porcentual fue del 19,1%, y el CCI entre ambos métodos fue de 0,94. Las mediciones del GC en mujeres embarazadas mediante ETT muestran una excelente concordancia con las obtenidas mediante CAP. Dada su naturaleza no invasiva y su disponibilidad, la ETT podría considerarse como referencia para la validación de otras técnicas relacionadas con el GC en mujeres embarazadas. : ,。(pulmonary artery catheterization,PAC)(cardiac output,CO),,。(transthoracic echocardiography,TTE)CO。PACTTECO。 : meta。2003。PAC。PAC 15 minTTE,PAC。,。TTEPACCO。Bland-Altman(intraclass correlation coefficients,ICC)。 : meta34。PACTTECO7.39 L/min7.18 L/min。-1.18 L/min、1.60 L/min0.21 L/min,19.1%,ICC0.94。 : TTECOPACCO。,TTECO。. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

Decoding how a soil bacterium extracts building blocks and metabolic energy from ligninolysis provides road map for lignin valorization (Towards Lignin valorization: How a soil bacterium extracts building blocks and metabolic energy from "Lignolysis")

DOE Office of Scientific and Technical Information (OSTI.GOV)

Varman, Arul M.; He, Lian; Follenfant, Rhiannon

Lignin is a major resources for the production of next generation renewable aromatics. Sphingobium sp. SYK-6 is a bacterium that has been well-studied for the breakdown of lignin-derived compounds. There has been a lot of interest in SYK-6 lignolytic activity and many recent works have focused on understanding the unique catabolic pathway it possesses for the degradation of lignin derived monomers and oligomers. Furthermore, there has been no prior effort in understanding the central fluxome based on lignin derived substrates into value-added chemicals.

Ultrasound and photochemical procedures for nanocatalysts preparation: application in photocatalytic biomass valorization.

PubMed

Colmenares, Juan Carlos

2013-07-01

Nano-photocatalysis is becoming increasingly important due to its multiple applications and multidisciplinary aspects. Applications such as water/air purification, solar energy storage, chemicals production and optoelectronics are some of the most promising. In recent years, the development of novel environmental friendly and cost efficient methods for materials preparation that could replace the old ones is on demand. Unconventional and "soft" techniques such as sonication and photochemistry offer huge possibilities for the synthesis of a broad spectrum of nanostructured materials (e.g., nano-photocatalysts). In the present study, I focus on ultrasound and photochemical procedures for the preparation of nanostructured photocatalysts (e.g., supported metals, metal oxides) and their application in food organic wastes valorization.

Decoding how a soil bacterium extracts building blocks and metabolic energy from ligninolysis provides road map for lignin valorization (Towards Lignin valorization: How a soil bacterium extracts building blocks and metabolic energy from "Lignolysis")

DOE PAGES

Varman, Arul M.; He, Lian; Follenfant, Rhiannon; ...

2016-09-15

Lignin is a major resources for the production of next generation renewable aromatics. Sphingobium sp. SYK-6 is a bacterium that has been well-studied for the breakdown of lignin-derived compounds. There has been a lot of interest in SYK-6 lignolytic activity and many recent works have focused on understanding the unique catabolic pathway it possesses for the degradation of lignin derived monomers and oligomers. Furthermore, there has been no prior effort in understanding the central fluxome based on lignin derived substrates into value-added chemicals.

Shell Biorefinery: Dream or Reality?

PubMed

Chen, Xi; Yang, Huiying; Yan, Ning

2016-09-12

Shell biorefinery, referring to the fractionation of crustacean shells into their major components and the transformation of each component into value-added chemicals and materials, has attracted growing attention in recent years. Since the large quantities of waste shells remain underexploited, their valorization can potentially bring both ecological and economic benefits. This Review provides an overview of the current status of shell biorefinery. It first describes the structural features of crustacean shells, including their composition and their interactions. Then, various fractionation methods for the shells are introduced. The last section is dedicated to the valorization of chitin and its derivatives for chemicals, porous carbon materials and functional polymers. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

VALOR joint oscillation analysis using multiple LAr-TPCs in the Booster Neutrino Beam at Fermilab

NASA Astrophysics Data System (ADS)

Andreopoulos, C.; Barry, C.; Bench, F.; Chappell, A.; Dealtry, T.; Dennis, S.; Escudero, L.; Jones, R.; Grant, N.; Roda, M.; Sgalaberna, D.; Shah, R.

2017-09-01

Anomalies observed by different experiments, the most significant ones being the ∼3.8 sigma νe appearance in a ∼50 MeV νµ beam from muon decay at rest observed by the LSND experiment and the ∼3.8 sigma νe and {\\bar{ν }}e appearance in a ∼1 GeV neutrino beam from pion decay in flight observed by MiniBooNE, suggest the existence of sterile neutrinos. The Short Baseline Neutrino (SBN) program at Fermilab aims to perform a sensitive search for sterile neutrinos by performing analyses of νe appearance and νµ disappearance employing three Liquid Argon Time Projection Chambers (LAr-TPCs) at different baselines. The VALOR neutrino fitting group was established within the T2K experiment and has led numerous flagship T2K oscillation analyses, and provided sensitivity and detector optimisation studies for DUNE and Hyper-K. The neutrino oscillation framework developed by this group is able to perform fits of several samples and systematic parameters within different neutrino models and experiments. Thus, VALOR is an ideal environment for the neutrino oscillation fits using multiple LAr-TPC detectors with proper treatment of correlated systematic uncertainties necessary for the SBN analyses.

Intussusception: a rare complication in a patient with acute leukaemia after consolidation chemotherapy.

PubMed

Qasrawi, Ayman; Abu Ghanimeh, Mouhanna; Abughanimeh, Omar; Qasem, Abdulraheem

2017-02-28

Intussusception is telescoping of one segment of the gastrointestinal tract into an adjacent one. It is more common in children than adults. When it occurs in adults, it is usually associated with a lead point. Intussusception is very rare in acute leukaemia and has only been reported in few cases. We present a case of an adult woman who presented with intussusception after a cycle of consolidation chemotherapy with high-dose cytarabine for acute myeloid leukaemia. Other causes of acute abdominal pain were excluded, and the diagnosis was established by CT scan of the abdomen and barium enema. No pathological lead points were found intraoperatively. She underwent a right-sided hemicolectomy with complete recovery. To the best of our knowledge, this is only the fourth case of intussusception that has been reported in an adult patient with acute myeloid leukaemia. 2017 BMJ Publishing Group Ltd.

Cecal volvulus: Report of a case and review of Japanese literature

PubMed Central

Katoh, Toshio; Shigemori, Tsunehiko; Fukaya, Ryo; Suzuki, Hiroshi

2009-01-01

A 78-year-old woman presented with fever, severe abdominal pain, and distension. She had been institutionalized for depression and senile dementia. Laboratory examinations disclosed a leucocytosis (WBC: 12 500/μL) and elevated levels of serum C-reactive protein (2.8 mEq/L). Diagnosis of acute cecal volvulus was made from a “coffee bean sign” on an abdominal computed tomography and a “beak sign” on a gastrographin enema. An emergent laparotomy confirmed the diagnosis and an ileo-colectomy with primary anastomosis was carried out. The patient recovered after intensive respiratory care and fluid therapy, and then returned to her former institution. A review of Japanese literature disclosed that: (1) a marked increase of aged patients with mental disability presenting with cecal volvulus, (2) adoption of ileo-colectomy as the standard surgical procedure, and (3) improved survival of the patients, were observed in the last decade. PMID:19469008

Guidelines for Feeding Very Low Birth Weight Infants

PubMed Central

Dutta, Sourabh; Singh, Balpreet; Chessell, Lorraine; Wilson, Jennifer; Janes, Marianne; McDonald, Kimberley; Shahid, Shaneela; Gardner, Victoria A.; Hjartarson, Aune; Purcha, Margaret; Watson, Jennifer; de Boer, Chris; Gaal, Barbara; Fusch, Christoph

2015-01-01

Despite the fact that feeding a very low birth weight (VLBW) neonate is a fundamental and inevitable part of its management, this is a field which is beset with controversies. Optimal nutrition improves growth and neurological outcomes, and reduces the incidence of sepsis and possibly even retinopathy of prematurity. There is a great deal of heterogeneity of practice among neonatologists and pediatricians regarding feeding VLBW infants. A working group on feeding guidelines for VLBW infants was constituted in McMaster University, Canada. The group listed a number of important questions that had to be answered with respect to feeding VLBW infants, systematically reviewed the literature, critically appraised the level of evidence, and generated a comprehensive set of guidelines. These guidelines form the basis of this state-of-art review. The review touches upon trophic feeding, nutritional feeding, fortification, feeding in special circumstances, assessment of feed tolerance, and management of gastric residuals, gastro-esophageal reflux, and glycerin enemas. PMID:25580815

A multidisciplinary treatment for encopresis in children with developmental disabilities.

PubMed

Call, Nathan A; Mevers, Joanna Lomas; McElhanon, Barbara O; Scheithauer, Mindy C

2017-04-01

Achieving continence of one's bowel movements is a key step in development and failure to do so leads to many negative consequences. Treatments for encopresis appearing in the literature have employed behavioral strategies; medications such as suppositories, laxatives, or enemas; and in some studies a combination of these approaches. To date, attempts to extend successful treatments for encopresis in typically developing children to those with developmental disabilities have been limited. The current study included three participants diagnosed with developmental disabilities who had a history of encopresis. None of the participants had a continent bowel movement under baseline conditions. Continent bowel movements increased during treatment that included the addition of suppositories to elicit continent bowel movements. Two participants began having independent continent bowel movements (i.e., without requiring suppositories) and medication was successfully faded out for the remaining participant. Treatment took between 13 and 21 days. © 2017 Society for the Experimental Analysis of Behavior.

A case of granuloma of the ascending colon due to penetration of Trichuris trichiura.

PubMed

Kojima, Y; Sakuma, H; Izumi, R; Nakagawara, G; Miyazaki, I; Yoshimura, H

1981-01-01

A 33 year-old woman was admitted with chief complaint of abdominal pain and high fever. A barium-enema showed serration and a tumor was seen in the proximal ascending colon. At laparotomy, a localized tumor about 5 cm in diameter was located in the proximal portion of the ascending colon. The operation was made according to the ileoceal resection. On the macroscopic examination of the resected specimen, a small hole penetrating into the subserosa of the ascending colon was noticed and a tumor measuring approximately 3 x 1.2 x 1 cm was located under the hole. A female worm, Trichuris trichiura, was found to be harbored in the adjacent site of the lesion. Histopathologic examination revealed granulomatous tissue reaction due to penetrating of Trichuris trichiura. The patient is in good health now 20 months after operation.

Perianal pain as a presentation of lumbosacral neurofibroma: a case report.

PubMed

Moghaddasi, Mehdi; Aghaii, Mahboubeh; Mamarabadi, Mansoureh

2014-12-01

Rectal and perianal pain is a common problem. Most people have experienced it at least once in their lifetime. It usually manifests as mild discomfort, but sometimes the pain can be so severe that it is incapacitating. A 59-year-old woman admitted with a 2-year history of paroxysmal perianal pain underwent a full work-up including proctoscopy, sigmoidoscopy, full colonoscopy, and barium enema that were unremarkable. Lumbosacral magnetic resonance imaging with and without gadolinium showed an intradural-extramedullary lesion at the level of L5. The pathologic diagnosis was a neurofibroma. She underwent surgery, and after a few weeks she felt well and medication was no longer needed for her paroxysmal pain. Although one should consider the usual causes of colorectal pain such as hemorrhoids, anal fissure, proctalgia fugax, and chronic perianal pain syndrome, we should keep in mind that some referral pain may mimic local pathologies and should be evaluated properly.

Perianal Pain as a Presentation of Lumbosacral Neurofibroma: A Case Report

PubMed Central

Moghaddasi, Mehdi; Aghaii, Mahboubeh; Mamarabadi, Mansoureh

2014-01-01

Rectal and perianal pain is a common problem. Most people have experienced it at least once in their lifetime. It usually manifests as mild discomfort, but sometimes the pain can be so severe that it is incapacitating. A 59-year-old woman admitted with a 2-year history of paroxysmal perianal pain underwent a full work-up including proctoscopy, sigmoidoscopy, full colonoscopy, and barium enema that were unremarkable. Lumbosacral magnetic resonance imaging with and without gadolinium showed an intradural-extramedullary lesion at the level of L5. The pathologic diagnosis was a neurofibroma. She underwent surgery, and after a few weeks she felt well and medication was no longer needed for her paroxysmal pain. Although one should consider the usual causes of colorectal pain such as hemorrhoids, anal fissure, proctalgia fugax, and chronic perianal pain syndrome, we should keep in mind that some referral pain may mimic local pathologies and should be evaluated properly. PMID:25485211

Anismus in chronic constipation.

PubMed

Preston, D M; Lennard-Jones, J E

1985-05-01

Among patients complaining of constipation, a group can be defined in which there is slow whole gut transit shown by retention of radiopaque markers but a rectum and colon of normal width judged by measurements of barium enema radiographs compared with control observations. It is not known whether their symptoms are due to an abnormality of colonic motility or to a failure of the defecatory mechanism. Defecation was simulated experimentally in a group of these patients by asking them to expel a water-filled rectal balloon. The constipated patients were not able to expel the balloon, whereas normal subjects could do so. Electromyography of the striated pelvic floor muscles during attempts at expulsion of the balloon in the constipated patients showed failure of the normal inhibition of resting activity. Failure of external and sphincter relaxation on attempted defecation may contribute to the symptoms of some patients who complain of constipation.

Management of obstructed defecation.

PubMed

Podzemny, Vlasta; Pescatori, Lorenzo Carlo; Pescatori, Mario

2015-01-28

The management of obstructed defecation syndrome (ODS) is mainly conservative and mainly consists of fiber diet, bulking laxatives, rectal irrigation or hydrocolontherapy, biofeedback, transanal electrostimulation, yoga and psychotherapy. According to our experience, nearly 20% of the patients need surgical treatment. If we consider ODS an "iceberg syndrome", with "emerging rocks", rectocele and rectal internal mucosal prolapse, that may benefit from surgery, at least two out of ten patients also has "underwater rocks" or occult disorders, such as anismus, rectal hyposensation and anxiety/depression, which mostly require conservative treatment. Rectal prolapse excision or obliterative suture, rectocele and/or enterocele repair, retrograde Malone's enema and partial myotomy of the puborectalis muscle are effective in selected cases. Laparoscopic ventral sacral colporectopexy may be an effective surgical option. Stapled transanal rectal resection may lead to severe complications. The Transtar procedure seems to be safer, when dealing with recto-rectal intussusception. A multidisciplinary approach to ODS provides the best results.

Management of obstructed defecation

PubMed Central

Podzemny, Vlasta; Pescatori, Lorenzo Carlo; Pescatori, Mario

2015-01-01

The management of obstructed defecation syndrome (ODS) is mainly conservative and mainly consists of fiber diet, bulking laxatives, rectal irrigation or hydrocolontherapy, biofeedback, transanal electrostimulation, yoga and psychotherapy. According to our experience, nearly 20% of the patients need surgical treatment. If we consider ODS an “iceberg syndrome”, with “emerging rocks”, rectocele and rectal internal mucosal prolapse, that may benefit from surgery, at least two out of ten patients also has “underwater rocks” or occult disorders, such as anismus, rectal hyposensation and anxiety/depression, which mostly require conservative treatment. Rectal prolapse excision or obliterative suture, rectocele and/or enterocele repair, retrograde Malone’s enema and partial myotomy of the puborectalis muscle are effective in selected cases. Laparoscopic ventral sacral colporectopexy may be an effective surgical option. Stapled transanal rectal resection may lead to severe complications. The Transtar procedure seems to be safer, when dealing with recto-rectal intussusception. A multidisciplinary approach to ODS provides the best results. PMID:25632177

Ulcerative proctitis: a review of pharmacotherapy and management.

PubMed

Lakatos, Peter Laszlo; Lakatos, Laszlo

2008-04-01

Ulcerative proctitis (UP) is a common presentation of ulcerative colitis (UC). To summarize available literature on up-to-date management and pharmacotherapy of UP patients. Extensive Medline/Embase literature search was performed to identify relevant articles. Topical medication with rectally administered 5-aminosalicylic acid (5-ASA)/corticosteroid suppositories or enemas is effective treatment for most UP patients. Locally administered 5-ASA is more efficacious than oral compounds. The combination of topical 5-ASA and oral 5-ASA or topical steroids should be considered for escalation of treatment. Maintenance treatment is indicated in all UC cases. 5-ASA suppositories are suggested as first-line maintenance therapy if accepted by patients, although oral 5-ASA as maintenance therapy might prevent proximal extension of the disease. After re-assessment, chronically active patients refractory or intolerant to 5-ASAs and corticosteroids may require immunomodulators or biological therapy. Exceptional cases may require a proctocolectomy.

Occult gastrointestinal bleeding. An evaluation of available diagnostic methods.

PubMed

Richardson, J D; McInnis, W D; Ramos, R; Aust, J B

1975-05-01

Occult gastrointestinal bleeding was defined as continued bleeding in spite of a normal series of roentgenorgrams of the upper part of the gastrointestinal tract, barium enema, and sigmoidoscopy. Twenty-six such patients were treated. A thorough systematic evaluation, including gastroscopy, colonoscopy, visceral angiography, and isotopic scanning, was done preoperatively. Using colonoscopy and arteriography, nearly 60% of the bleeding sites were identified. Seventy-six percent of the lesions identified were in the terminal part of the ileum or the ascending colon. Exploratory laparotomy should be performed for life-threatening hemorrhage or as a diagnostic test only after a thorough preoperative evaluation. If results of a complete preoperative evaluation including arteriography were normal, then the likelihood of finding a discrete cause of bleeding at laparotomy was high (80%). A systematic evaluation and diligence of both physcian and patient in localizing the site of bleeding are essential.

Strangulating intestinal obstructions in four captive elephants (Elephas maximus and Loxodonta africana).

PubMed

Wiedner, Ellen B; Peddie, James; Peddie, Linda Reeve; Abou-Madi, Noha; Kollias, George V; Doyle, Charles; Lindsay, William A; Isaza, Ramiro; Terrell, Scott; Lynch, Tim M; Johnson, Kari; Johnson, Gary; Sammut, Charlie; Daft, Barbara; Uzal, Francisco

2012-03-01

Three captive-born (5-day-old, 8-day-old, and 4-yr-old) Asian elephants (Elephas maximus) and one captive-born 22-yr-old African elephant (Loxodonta africana) from three private elephant facilities and one zoo in the United States presented with depression, anorexia, and tachycardia as well as gastrointestinal signs of disease including abdominal distention, decreased borborygmi, tenesmus, hematochezia, or diarrhea. All elephants showed some evidence of discomfort including agitation, vocalization, or postural changes. One animal had abnormal rectal findings. Nonmotile bowel loops were seen on transabdominal ultrasound in another case. Duration of signs ranged from 6 to 36 hr. All elephants received analgesics and were given oral or rectal fluids. Other treatments included warm-water enemas or walking. One elephant underwent exploratory celiotomy. Three animals died, and the elephant taken to surgery was euthanized prior to anesthetic recovery. At necropsy, all animals had severe, strangulating intestinal lesions.

Production and quality assurance in the SIT Africa Mediterranean fruit fly (Diptera: Tephritidae) rearing facility in South Africa

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barnes, B.; Rosenberg, S.; Arnolds, L.

A mass-rearing facility for Mediterranean fruit fly Ceratitis capitata (Wiedemann) was commissioned in Stellenbosch in 1999 to produce sterile male fruit flies for a sterile insect technique (SIT) project in commercial fruit orchards and vineyards in the Western Cape province of South Africa. The mass-rearing procedure was largely based on systems developed by the FAO/IAEA Agriculture and Biotechnology Laboratory, Seibersdorf, Austria. A number of genetic sexing strains were used to produce only males for release. Initial cramped rearing and quality management conditions were alleviated in 2001 with the construction of a new adult rearing room and quality control laboratory. Inmore » 2002 a comprehensive Quality Management System was implemented, and in 2003 an improved genetic sexing strain, VIENNA 8, was supplied by the FAO/IAEA Laboratory in Seibersdorf. For most of the first 3 years the facility was unable to supply the required number of sterile male Mediterranean fruit flies for the SIT program without importing sterile male pupae from another facility. From mid-2002, after the quality management system was implemented, both production and quality improved but remained below optimum. After the introduction of the VIENNA 8 genetic sexing strain, and together with an improvement in the climate control equipment, production stability, and quality assurance parameters improved substantially. The critical factors influencing production and quality were an inadequate rearing infrastructure, problems with the quality of the larval diet, and the initial absence of a quality management system. The results highlight the importance of effective quality management, the value of a stable and productive genetic sexing strain, and the necessity for a sound funding base for the mass-rearing facility. (author) [Spanish] La facilidad para criar en masa la mosca mediterranea de la fruta, Ceratitis capitata (Wiedemann) fue comisionada en Stellenbosch en 1999 para producir machos esteriles de moscas para el proyecto de la tecnica del insecto esteril (TIE) en huertos de frutos y vinas comerciales en la provincia del Cabo Occidental del Sudafrica. El procedimiento de criar en masa fue en su mayor parte basado en los sistemas desarrollados por el Laboratorio de Agricultura y Biotecnologia de la FAO/IAEA, Seibersdorf, Austria. Un numero de razas que separara los sexos geneticamente fueron utilizadas para producir solo machos para la liberacion. La congestionada condicion inicial para criar las moscas y su manejo de calidad fueron aliviadas en 2001 con la construccion de un nuevo cuarto de cria para adultos y un laboratorio de control de calidad. En 2002, un Sistema de Manejo de Calidad comprensivo fue implementado, y en 2003 una raza mejorada que separa los sexos geneticamente, VIENNA 8, fue proveido por el Laboratorio de la FAO/IAEA en Seibersdorf. En la mayor parte de los primeros 3 anos la facilidad no pudo suplir el numero requerido de machos esteriles de la mosca mediterranea de la fruta para el programa de TIE sin la necesidad para importar machos esteriles de otra facilidad. Desde medio del ano de 2002, despues que el sistema de manejo de calidad fue implementado, la produccion y la calidad mejoraron pero aun quedaron por debajo del nivel optimo. Despues de la introduccion de la raza VIENNA 8 que separa los sexos geneticamente, y junto con el equipo mejorado de control de clima, la estabilidad y los parametros de seguridad de calidad mejoraron substancialmente. Los factores criticos que influyeron en la produccion y la calidad fueron la infraestructura inadecuada para criar las moscas, problemas con la calidad de la dieta para las larvas y la ausencia inicial de un sistema de manejo de calidad. Los resultados muestran claramente la importancia de un manejo efectivo de la calidad, el valor de una raza productiva que separa los sexos geneticamente y la necesidad de contar con una base solida de financimiento para la infraestructura de una cria en masa. (author)« less

Synthesis of Pure Ca(OH)2 Nanoparticles and Superhydrophobic Suspensions: Consolidation and Waterproofing of Architectural Heritage Materials

NASA Astrophysics Data System (ADS)

Madrid Mendoza, Juan Antonio

El objetivo de esta tesis es investigar sobre la sintesis, propiedades y aplicaciones de las nanoparticulas de Ca(OH)2 para consolidar materiales patrimoniales arquitectonicos. Las nanoparticulas de Ca(OH)2 se han utilizado recientemente en la conservacion del patrimonio, aunque algunos aspectos de la sintesis no son completamente comprendidos. En el presente estudio, hemos desarrollado metodos optimizados para obtener nanoparticulas de alta pureza mediante sintesis de fase homogenea y heterogenea utilizando diferentes materiales de partida. Se han realizado del orden de cien sintesis en diferentes condiciones para comprobar la validez y fiabilidad del metodo sintetico. Los resultados confirman que la temperatura de reaccion tiene una gran influencia en el tamano y la morfologia de las nanoparticulas de Ca(OH)2. Ademas, se ha investigado la estabilidad de las nanoparticulas a lo largo del tiempo en mezclas de 2-propanol / agua, en las que se encontro que la ausencia de agua era critica para evitar la aglomeracion de Ca(OH)2. Una vez dispersas en 2-propanol, las nanoparticulas se han utilizado para consolidar sustratos reales (piedra, adobe y estuco) confirmando su alto rendimiento en terminos de consolidacion superficial y - cuando se mezcla con ciertos surfactantes - en reduccion de la absorcion de agua. Asimismo, se ha investigado el uso de nanoparticulas modificadas basadas en M(OH)2, donde M=Ca2+, Mg2+, con el objetivo de mejorar tanto la cohesion superficial como la durabilidad de los materiales patrimoniales (p. ej. piedra Tabaire). Finalmente, el tratamiento de consolidacion basado en nanoparticulas puras de Ca(OH)2 se utilizo en emplazamientos con valor patrimonial, como edificios historicos y yacimientos arqueologicos (Teatro Romano de Cartagena) obteniendo resultados satisfactorios. The aim of this thesis is to investigate on the synthesis, properties and applications of Ca(OH)2 nanoparticles to consolidate architectural heritage materials. Ca(OH)2 nanoparticles have recently been used in heritage conservation, although some aspects of the synthesis are not fully-understood. In the present study, we have developed optimised methods for obtaining high-purity nanoparticles based on homogenous and heterogeneous phase synthesis using different starting materials. Around one hundred syntheses have been performed to test the validity and reliability of the synthetic method in different conditions. The results confirm that the reaction temperature has a great influence on the size and morphology of Ca(OH)2 nanoparticles. Besides, the nanoparticles stability has been investigated over time in 2-propanol / water mixtures, in which the absence of water was found to be critical to avoid Ca(OH)2 agglomeration. Once dispersed in 2-propanol, the nanoparticles have been used to consolidate real substrates (stone, adobe and stucco) confirming their high performance in terms of surface consolidation and - when mixed with certain surfactants - water absorption. Likewise, the use of modified nanoparticles based on M(OH)2, where M=Ca2+, Mg2+, has been investigated with the aim of improving both the surface cohesion and durability of heritage materials (e.g. Tabaire stone). Finally, the consolidation treatment consisting in pure Ca(OH)2 nanoparticles has been used in cultural heritage sites, such as historical buildings and archaeological monuments (Roman Theatre of Cartagena) leading to satisfactory results.

[Globalization and environmentalism: polyphonic ethnicities in the Amazon].

PubMed

Garnelo, Luiza; Sampaio, Sully

2005-01-01

The article examines the issue of globalization, along with its contradictions and the ways in which it guides and shapes specific situations within the Amazon's present-day reality, while simultaneously engendering the uniformization of economic production and the valorization of cultural differences. The discussion explores the nuances of implementing a massified, standardized productive base that paradoxically fosters the valorization of cultural differences and favors alliances between, on the one hand, ethno-political leaders from indigenous Amazon groups and, on the other, environmentalists and other transworld actors who wield strong decision-making power. The article analyzes the indigenous movement's network of alliances and highlights the polyphony of the different political agents that come to clash with each other within this post-modern geopolitical setting.

Caracterización espectroscópica de hielos de interés atmosférico y astrofísico

NASA Astrophysics Data System (ADS)

Escribano, R.

En años recientes se ha incrementado el estudio de procesos físicos y químicos que tienen lugar en la superficie o el interior de hielos, tanto en medios astrofísicos como en la atmósfera terrestre y en otros cuerpos del sistema solar. Se ha comprobado que las partículas heladas actúan como catalizadores de reacciones químicas, que no ocurrirían en su ausencia. En la atmósfera terrestre, es bien conocida la importancia de partículas de hidratos de ácido nítrico, formando las llamadas nubes estratosféricas polares, en los procesos de destrucción de ozono estratosférico. En hielos astrofísicos, átomos como H, C, N y O pueden adherirse o introducirse en la estructura cristalina o amorfa del hielo, y dar lugar a reacciones de formación de moléculas evitando su barrera de activación. Existen partículas heladas en el medio interestelar formando parte de las llamadas nubes moleculares densas y frías, con valores del orden de 106 átomos de H por cm3 y temperaturas entre 3 y 90 K. Alrededor de protoestrellas, pueden formarse hielos de distinta composición, polares o apolares, en las zonas de alejamiento y temperatura decreciente a partir del núcleo caliente. Por su parte, los cometas están formados por un núcleo de hielo y rocas, sobre el que se encuentran adheridas moléculas gaseosas, y una cola, formada por los gases liberados por efecto del calentamiento debido a la radiación solar incidente. En nuestro sistema solar, los polos de La Tierra y de Marte están cubiertos de hielo, así como la mayoría de los cuerpos externos. Los satélites de Júpiter han sido estudiados detalladamente, y se han encontrado en ellos, y en Tritón (satélite de Neptuno), hielos de moléculas como SON2, CO2, N2, CH4 y otros. Para la caracterización espectroscópica de estos hielos se precisan medidas en el laboratorio, aún conociendo la imposibilidad intrínseca de reproducir exactamente las condiciones en que se formaron y se encuentran en los medios astrofísicos. El montaje experimental requiere un sistema que permita alcanzar bajas presiones y temperaturas, formado usualmente por una cámara en cuyo interior se forman películas de hielo de la composición deseada, depositadas sobre un sustrato inerte. Las películas pueden ser a continuación tratadas por diversas técnicas, tales como irradiación UV, bombardeo con electrones o iones, calentamiento y enfriamiento, etc. Habitualmente todos los procesos se controlan por espectroscopía de infrarrojo. La radiación proveniente de un espectrómetro se hace incidir sobre la muestra y se extrae de la cámara mediante ventanas, y se enfoca posteriormente sobre el detector. En el laboratorio de Física Molecular del Instituto de Estructura de la Materia disponemos de un montaje experimental diseñado para el estudio de partículas de hielo similares a las formadas en las nubes estratosféricas polares de nuestra atmósfera. El montaje es similar al descrito anteriormente, excepto en lo que se refiere a las condiciones de presión y temperatura, que son menos estrictas en nuestros experimentos. La extensión de estas condiciones de trabajo a las requeridas en medios astrofísicos es una posibilidad a discutir. Por otra parte, disponemos de un método de cálculo de estructuras periódicas, basado en el programa SIESTA (acrónimo de Spanish Initiative for Electronic Simulations of Thousands of Atoms), que ha proporcionado excelentes resultados en lo relativo a la determinación de estructuras cristalinas y predicción de su espectro infrarrojo, en los sistemas estudiados hasta la fecha, es decir, los hidratos de ácido nítrico de interés atmosféricos. Su aplicación para el estudio de hielos de relevancia astrofísica podría ser del máximo interés.

Analysis of the maximum discharge of karst springs

NASA Astrophysics Data System (ADS)

Bonacci, Ognjen

2001-07-01

Analyses are presented of the conditions that limit the discharge of some karst springs. The large number of springs studied show that, under conditions of extremely intense precipitation, a maximum value exists for the discharge of the main springs in a catchment, independent of catchment size and the amount of precipitation. Outflow modelling of karst-spring discharge is not easily generalized and schematized due to numerous specific characteristics of karst-flow systems. A detailed examination of the published data on four karst springs identified the possible reasons for the limitation on the maximum flow rate: (1) limited size of the karst conduit; (2) pressure flow; (3) intercatchment overflow; (4) overflow from the main spring-flow system to intermittent springs within the same catchment; (5) water storage in the zone above the karst aquifer or epikarstic zone of the catchment; and (6) factors such as climate, soil and vegetation cover, and altitude and geology of the catchment area. The phenomenon of limited maximum-discharge capacity of karst springs is not included in rainfall-runoff process modelling, which is probably one of the main reasons for the present poor quality of karst hydrological modelling. Résumé. Les conditions qui limitent le débit de certaines sources karstiques sont présentées. Un grand nombre de sources étudiées montrent que, sous certaines conditions de précipitations extrêmement intenses, il existe une valeur maximale pour le débit des sources principales d'un bassin, indépendante des dimensions de ce bassin et de la hauteur de précipitation. La modélisation des débits d'exhaure d'une source karstique n'est pas facilement généralisable, ni schématisable, à cause des nombreuses caractéristiques spécifiques des écoulements souterrains karstiques. Un examen détaillé des données publiées concernant quatre sources karstiques permet d'identifier les raisons possibles de la limitation de l'écoulement maximal: (1) la dimension limitée du conduit karstique, (2) l'écoulement en charge, (3) le débordement dans un autre bassin, (4) le débordement du réseau s'écoulant vers la source principale par des sources temporaires dans le même bassin, (5) le stockage d'eau dans la zone surmontant l'aquifère karstique ou la zone épikarstique du bassin, et (6) des facteurs tels que le climat, le sol et le couvert végétal, l'altitude et la géologie du bassin d'alimentation. Le phénomène de capacité limitée du débit maximal des sources karstiques n'est pas pris en compte dans la modélisation des processus de précipitation-ruissellement, ce qui est probablement une des principales raisons de l'actuelle médiocre qualité de la modélisation hydrologique du karst. Resumen. Se presenta un análisis de las condiciones que limitan la descarga de algunos manantiales kársticos. Un elevado número de los manantiales estudiados muestra que, bajo condiciones de precipitación extremadamente intensa, hay un valor máximo para la descarga de los manantiales principales de la cuenca, independientemente del tamaño de ésta y del volumen de precipitación. La modelación de la descarga de manantiales kársticos no es fácil de generalizar y esquematizar debido a la existencia de numerosas características que son inherentes a los sistemas kársticos de flujo. A partir del estudio detallado de los datos publicados sobre cuatro manantiales kársticos, se identificó las posibles causas de la existencia de un caudal máximo de descarga: (1) el tamaño limitado del conducto kárstico, (2) el caudal surgente, (3) la descarga a otras cuencas, (4) el desbordamiento del sistema de flujo principal hacia manantiales intermitentes dentro de la misma cuenca, (5) el almacenamiento de agua en la zona superior del acuífero kárstico o zona epikárstica de la cuenca, y (6) factores tales como el clima, suelo y cubierta vegetal, y la altitud y geología de la zona de captación. La limitación de la descarga máxima de los manantiales kársticos no ha sido incluida en la modelación del proceso lluvia-escorrentía, hecho que probablemente es esencial para explicar los resultados poco satisfactorios de la modelación hidrológica de sistemas kársticos.

Comparative effectiveness of senna to prevent problematic constipation in pediatric oncology patients receiving opioids: a multicenter study of clinically detailed administrative data.

PubMed

Feudtner, Chris; Freedman, Jason; Kang, Tammy; Womer, James W; Dai, Dingwei; Faerber, Jennifer

2014-08-01

Pediatric oncology patients often receive prolonged courses of opioids, which can result in constipation. Comparing patients who received senna matched with similar patients who received other oral bowel medications, determine the subsequent risk of "problematic constipation," assessed as the occurrence of the surrogate markers of receiving an enema, escalation of oral bowel medications, and abdominal radiographic imaging. This was a retrospective cohort study of hospitalized pediatric oncology patients less than 21 years of age in 78 children's and adult hospitals between 2006 and 2011 who were started on seven consecutive days or more of opioid therapy and were started on an oral bowel medication within the first two days of opioid therapy. Clinically detailed administrative data were used from the Pediatric Health Information System and the Premier Perspective Database. After performing propensity score matching of similar patients who started senna and who started a different oral bowel medication, Cox regression modeling was used to compare the subsequent hazard of the surrogate markers. The final matched sample of 586 patients averaged 11.5 years of age (range 0-20 years); 41.8% (n = 245) had blood cancer, 50.3% (n = 295) had solid tumor cancer, and 7.9% (n = 46) had brain cancer. Initiating senna therapy within two days of starting the prolonged opioid course, compared with initiating another oral bowel medication, was significantly associated with a lower hazard during the ensuing five days for receipt of an enema (hazard ratio [HR], 0.31; 95% CI, 0.11-0.91) or undergoing abdominal radiographic imaging (HR, 0.74; 95% CI, 0.55-0.98), was marginally associated with a lower hazard of oral bowel medicine escalation (HR, 0.78; 95% CI, 0.59-1.03), and overall was significantly associated with a lower hazard of the composite end point of problematic constipation (HR, 0.70; 95% CI, 0.56-0.88). Initiating senna therapy, compared with other oral bowel medications, diminishes the subsequent risk of surrogate markers of problematic constipation in this population. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Bupivacaine administered intrathecally versus rectally in the management of intractable rectal cancer pain in palliative care

PubMed Central

Zaporowska-Stachowiak, Iwona; Kowalski, Grzegorz; Łuczak, Jacek; Kosicka, Katarzyna; Kotlinska-Lemieszek, Aleksandra; Sopata, Maciej; Główka, Franciszek

2014-01-01

Background Unacceptable adverse effects, contraindications to and/or ineffectiveness of World Health Organization step III “pain ladder” drugs causes needless suffering among a population of cancer patients. Successful management of severe cancer pain may require invasive treatment. However, a patient’s refusal of an invasive procedure necessitates that clinicians consider alternative options. Objective Intrathecal bupivacaine delivery as a viable treatment of intractable pain is well documented. There are no data on rectal bupivacaine use in cancer patients or in the treatment of cancer tenesmoid pain. This study aims to demonstrate that bupivacaine administered rectally could be a step in between the current treatment options for intractable cancer pain (conventional/conservative analgesia or invasive procedures), and to evaluate the effect of the mode of administration (intrathecal versus rectal) on the bupivacaine plasma concentration. Cases We present two Caucasian, elderly inpatients admitted to hospice due to intractable rectal/tenesmoid pain. The first case is a female with vulvar cancer, and malignant infiltration of the rectum/vagina. Bupivacaine was used intrathecally (0.25–0.5%, 1–2 mL every 6 hours). The second case is a female with ovarian cancer and malignant rectal infiltration. Bupivacaine was adminstered rectally (0.05–0.1%, 100 mL every 4.5–11 hours). Methods Total bupivacaine plasma concentrations were determined using the high-performance liquid chromatography-ultraviolet method. Results Effective pain control was achieved with intrathecal bupivacaine (0.077–0.154 mg·kg−1) and bupivacaine in enema (1.820 mg·kg−1). Intrathecal bupivacaine (0.5%, 2 mL) caused a drop in blood pressure; other side effects were absent in both cases. Total plasma bupivacaine concentrations following intrathecal and rectal bupivacaine application did not exceed 317.2 ng·mL−1 and 235.7 ng·mL−1, respectively. Bupivacaine elimination was slower after rectal than after intrathecal administration (t½= 5.50 versus 2.02 hours, respectively). Limitations This study reports two cases only, and there could be inter-patient variation. Conclusion Bupivacaine in boluses administered intrathecally (0.25%, 2 mL) provided effective, safe analgesia in advanced cancer patients. Bupivacaine enema (100 mg·100 mL−1) was shown to be a valuable option for control of end-of-life tenesmoid cancer pain. PMID:25336967

Allogeneic guinea pig mesenchymal stem cells ameliorate neurological changes in experimental colitis.

PubMed

Stavely, Rhian; Robinson, Ainsley M; Miller, Sarah; Boyd, Richard; Sakkal, Samy; Nurgali, Kulmira

2015-12-30

The use of mesenchymal stem cells (MSCs) to treat inflammatory bowel disease (IBD) is of great interest because of their immunomodulatory properties. Damage to the enteric nervous system (ENS) is implicated in IBD pathophysiology and disease progression. The most commonly used model to study inflammation-induced changes to the ENS is 2,4,6-trinitrobenzene-sulfonate acid (TNBS)-induced colitis in guinea pigs; however, no studies using guinea pig MSCs in colitis have been performed. This study aims to isolate and characterise guinea pig MSCs and then test their therapeutic potential for the treatment of enteric neuropathy associated with intestinal inflammation. MSCs from guinea pig bone marrow and adipose tissue were isolated and characterised in vitro. In in vivo experiments, guinea pigs received either TNBS for the induction of colitis or sham treatment by enema. MSCs were administered at a dose of 1 × 10(6) cells via enema 3 h after the induction of colitis. Colon tissues were collected 24 and 72 h after TNBS administration to assess the level of inflammation and damage to the ENS. The secretion of transforming growth factor-β1 (TGF-β1) was analysed in MSC conditioned medium by flow cytometry. Cells isolated from both sources were adherent to plastic, multipotent and expressed some human MSC surface markers. In vitro characterisation revealed distinct differences in growth kinetics, clonogenicity and cell morphology between MSC types. In an in vivo model of TNBS-induced colitis, guinea pig bone marrow MSCs were comparatively more efficacious than adipose tissue MSCs in attenuating weight loss, colonic tissue damage and leukocyte infiltration into the mucosa and myenteric plexus. MSCs from both sources were equally neuroprotective in the amelioration of enteric neuronal loss and changes to the neurochemical coding of neuronal subpopulations. MSCs from both sources secreted TGF-β1 which exerted neuroprotective effects in vitro. This study is the first evaluating the functional capacity of guinea pig bone marrow and adipose tissue-derived MSCs and providing evidence of their neuroprotective value in an animal model of colitis. In vitro characteristics of MSCs cannot be extrapolated to their therapeutic efficacy. TGF-β1 released by both types of MSCs might have contributed to the attenuation of enteric neuropathy associated with colitis.

[Cambios en la salud sexual de los pacientes obesos tras cirugía bariátrica].

PubMed

Pomares-Callejón, María A; Ferrer-Márquez, Manuel; Solvas-Salmerón, María J

2018-01-01

Los objetivos del estudio fueron: 1) evaluar la salud sexual en pacientes con obesidad grave/mórbida candidatos a cirugía bariátrica; y 2) valorar la evolución de la salud sexual tras 12 meses de la cirugía. Estudio descriptivo, prospectivo desde febrero de 2011 hasta junio de 2014. Se valoró la actividad sexual en los hombres a través del cuestionario EVAS-H y la función sexual en la mujer a través de la escala FSM (44 pacientes). Durante el estudio basal en los hombres, un 21% de la muestra presentó disfunción sexual en diferentes dimensiones, mientras que un 43% presentó problemas de eyaculación precoz. Tras 12 meses de la intervención, se observó un incremento de la actividad sexual global (p = 0.026). En torno al 70-89% de las mujeres, previamente a la cirugía, no presentaban trastorno. En la evolución no se observaron cambios medios relevantes (p > 0.05). Los pacientes con obesidad grave/mórbida candidatos a cirugía bariátrica presentan alteraciones considerables en diversas dimensiones de la salud sexual. Después de 12 meses de seguimiento, la salud sexual parece mejorar en los hombres. The aims of the study were: 1) to assess sexual health patients severe/morbid obesity patients candidates for bariatric surgery; and 2) to assess sexual health evolution after 12 months of surgery. Descriptive, prospective study from February 2011 to June 2014. Sexual activity in men was valued through EVAS-H questionnaire and through FSM scale on women (44 patients). During the basal study in men, a 21% of the sample showed sexual disfunction in different dimensions, while a 43% showed problems with premature ejaculation. 12 months after surgery, global sexual activity was improved significantly (p = 0,026). Approximately 70-89% of women presented no disturbance before surgery. No average relevant changes were observed within the evolution (p > 0.05). Morbid/severe obesity patients candidates to bariatric surgery, show considerable alterations on diverse sexual health dimensions. After 12 months following bariatric surgery, men’s sexual health appears to improve. Copyright: © 2018 SecretarÍa de Salud.

Curvas de fusión de regiones genómicas específicas: una herramienta prometedora para el diagnóstico y tipificación de las especies causantes de la leishmaniasis cutánea en Colombia.

PubMed

Marin, Johana; Urrea, Daniel; Muskus, Carlos; Echeverry, María Clara; Mejía, Ana María; Triana, Omar

2017-12-01

Introducción. La leishmaniasis cutánea es una enfermedad causada por parásitos del género Leishmania que tiene gran incidencia en Colombia. El diagnóstico y la identificación de la especie infecciosa son factores críticos en el momento de escoger e iniciar el tratamiento. Actualmente, los métodos de diagnóstico y tipificación requieren procedimientos complejos, por lo que es necesario validar nuevos marcadores moleculares y métodos que simplifiquen el proceso.Objetivo. Desarrollar una herramienta basada en la reacción en cadena de la polimerasa (PCR) con curvas de fusión (High Resolution Melting; PCR-HRM) para el diagnóstico y tipificación de las tres especies de Leishmania de importancia epidemiológica en casos de leishmaniasis cutánea en Colombia.Materiales y métodos. Los genomas de Leishmania panamensis, L. braziliensis y L. guyanensis se compararon mediante métodos bioinformáticos. Las regiones específicas de especie identificadas se validaron mediante PCR. Para los marcadores seleccionados se diseñó una PCR-HRM y se estimaron algunos parámetros de validez y seguridad usando aislamientos de pacientes colombianos caracterizados previamente mediante PCR y análisis de polimorfismos en la longitud de los fragmentos de restricción (Restriction Fragment Length Polymorphism - RFLP; PCR-RFLP) del gen hsp70.Resultados. El análisis genómico comparativo mostró 24 regiones específicas de especie. Sin embargo, la validación mediante PCR solo identificó un marcador específico para cada especie de Leishmania. Los otros marcadores mostraron amplificación cruzada. El límite de detección para los tres marcadores seleccionados fue de un parásito, mientras que la sensibilidad, la especificidad, el valor predictivo positivo y el negativo fueron de 91,4, 100, 100 y 75 %, respectivamente.Conclusiones. Las tres regiones seleccionadas pueden emplearse como marcadores moleculares en el diagnóstico y tipificación de las especies causantes de la leishmaniasis cutánea en Colombia.

Prediction uncertainty of plume characteristics derived from a small number of measuring points

NASA Astrophysics Data System (ADS)

French, H. K.; van der Zee, S. E. A. T. M.; Leijnse, A.

A small number of measuring points may inflict a bias on the characterisation of flow and transport based on field experiments in the unsaturated zone. Simulation of pure advective transport of a Gaussian plume through a setup of 30 regularly placed measuring points revealed regular temporal fluctuations about the real spatial moments. An irregular setup predicted both irregular fluctuations and larger discrepancies from the real value. From these considerations, a regular setup is recommended. Spatial moments were sensitive to the plume size relative to the distance between individual measuring points. To reduce prediction errors of the variance, the distance between the measuring points should be less than twice the standard deviation of the examined plume. The total size of the setup should cover several standard deviations of the plume to avoid mass being lost from the monitored area. Numerical simulations of a dispersing plume (comparing calculations based on 9000 nodes with 30 measuring points) revealed that vertical and horizontal centres of mass were predicted well at all degrees of heterogeneity, and the same was the case for horizontal variances. Vertical variances were more susceptible to prediction errors, but estimates were of the same order of magnitude as the real values. Résumé Lorsque l'on cherche à caractériser l'écoulement et le transport à partir d'expériences de terrain dans la zone saturée, il arrive qu'un petit nombre de points introduisent un biais. La simulation d'un transport purement advectif d'un panache gaussien au travers d'un ensemble de 30 points de mesures espacés régulièrement fait apparaître des variations temporelles régulières autour des moments spatiaux réels. Un ensemble irrégulier conduit à prédire à la fois des variations irrégulières et de plus grandes divergences par rapport à la valeur réelle. A partir de ces constations, un ensemble régulier est recommandé. Les moments spatiaux sont apparus sensibles à la dimension du panache en fonction de la distance entre les différents points de mesure. Afin de réduire les erreurs de prédiction de la variance, la distance entre les points de mesure doit être inférieure au double de l'écart-type du panache examiné. La dimension totale de l'ensemble doit couvrir une étendue de plusieurs écarts-types du panache pour éviter qu'une partie de la matière échappe à la zone surveillée. Des simulations numériques du panache en dispersion (les calculs de comparaison sont basés sur 9000 nœuds avec 30 points de mesure) montrent que le centre vertical et le centre horizontal de la matière dispersée ont été bien prédits à tous les degrés d'hétérogénéité, de même que pour les variances horizontales. Les variances verticales ont été plus sensibles aux erreurs de prédiction, mais les estimations étaient du même ordre de grandeur que les valeurs réelles. Resumen Un número pequeño de puntos de medida puede producir un sesgo en la caracterización en campo del flujo y transporte de solutos en la zona no saturada. La simulación de transporte advectivo (no difusivo) de un penacho Gaussiano a travs de un conjunto de 30 puntos de medida regularmente distribuidos revelan fluctuaciones temporales regulares de los momentos espaciales del penacho. Una distribución irregular de puntos de medida predijo a su vez fluctuaciones irregulares, más alejadas de la realidad, por lo que se recomienda el uso de esquemas de muestreo regulares. Los momentos espaciales fueron sensibles a la relación entre tamaño del penacho y distancia entre puntos de medida. Para reducir los errores en la predicción de la varianza, la distancia entre puntos de observación debe ser menor que dos veces la desviación estándar del penacho. El tamaño del área muestreada debe cubrir varias desviaciones estándar del penacho para evitar perder parte de la masa. Las simulaciones numricas en un penacho dispersivo, comparando los cálculos basados en 9000 nudos con las 30 medidas, mostraron que las posiciones de los centros de masa y las varianzas en dirección horizontal se predijeron bien independientemente del grado de heterogeneidad. Las varianzas verticales, sin embargo, fueron más susceptibles a errores de predicción, pero las estimaciones eran del mismo orden de magnitud que los valores reales.

High-Throughput Screening Assay for Laccase Engineering toward Lignosulfonate Valorization

PubMed Central

Rodríguez-Escribano, David; de Salas, Felipe; Camarero, Susana

2017-01-01

Lignin valorization is a pending issue for the integrated conversion of lignocellulose in consumer goods. Lignosulfonates (LS) are the main technical lignins commercialized today. However, their molecular weight should be enlarged to meet application requirements as additives or dispersing agents. Oxidation of lignosulfonates with fungal oxidoreductases, such as laccases, can increase the molecular weight of lignosulfonates by the cross-linking of lignin phenols. To advance in this direction, we describe here the development of a high-throughput screening (HTS) assay for the directed evolution of laccases, with lignosulfonate as substrate and the Folin–Ciocalteau reagent (FCR), to detect the decrease in phenolic content produced upon polymerization of lignosulfonate by the enzyme. Once the reaction conditions were adjusted to the 96-well-plate format, the enzyme for validating the assay was selected from a battery of high-redox-potential laccase variants functionally expressed in S. cerevisiae (the preferred host for the directed evolution of fungal oxidoreductases). The colorimetric response (absorbance at 760 nm) correlated with laccase activity secreted by the yeast. The HTS assay was reproducible (coefficient of variation (CV) = 15%) and sensitive enough to detect subtle differences in activity among yeast clones expressing a laccase mutant library obtained by error-prone PCR (epPCR). The method is therefore feasible for screening thousands of clones during the precise engineering of laccases toward valorization of lignosulfonates. PMID:28820431

Project VALOR: design and methods of a longitudinal registry of post-traumatic stress disorder (PTSD) in combat-exposed veterans in the Afghanistan and Iraqi military theaters of operations.

PubMed

Rosen, Raymond C; Marx, Brian P; Maserejian, Nancy N; Holowka, Darren W; Gates, Margaret A; Sleeper, Lynn A; Vasterling, Jennifer J; Kang, Han K; Keane, Terence M

2012-03-01

Few studies have investigated the natural history of post-traumatic stress disorder (PTSD). Project VALOR (Veterans' After-discharge Longitudinal Registry) was designed as a longitudinal patient registry assessing the course of combat-related PTSD among 1600 male and female Veterans who served in Operation Enduring Freedom (OEF) in Afghanistan or Operation Iraqi Freedom (OIF). Aims of the study include investigating patterns and predictors of progression or remission of PTSD and treatment utilization. The study design was based on recommendations from the Agency for Healthcare Quality and Research for longitudinal disease registries and used a pre-specified theoretical model to select the measurement domains for data collection and interpretation of forthcoming results. The registry will include 1200 male and female Veterans with a recent diagnosis of PTSD in the Department of Veteran Affairs (VA) electronic medical record and a comparison group of 400 Veterans without a medical record-based PTSD diagnosis, to also allow for case-control analyses. Data are collected from administrative databases, electronic medical records, a self-administered questionnaire, and a semi-structured diagnostic telephone interview. Project VALOR is a unique and timely registry study that will evaluate the clinical course of PTSD, psychosocial correlates, and health outcomes in a carefully selected cohort of returning OEF/OIF Veterans. Copyright © 2011 John Wiley & Sons, Ltd.

High-Throughput Screening Assay for Laccase Engineering toward Lignosulfonate Valorization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rodriguez-Escribano, David; de Salas, Felipe; Pardo, Isabel

Lignin valorization is a pending issue for the integrated conversion of lignocellulose in consumer goods. Lignosulfonates (LS) are the main technical lignins commercialized today. However, their molecular weight should be enlarged to meet application requirements as additives or dispersing agents. Oxidation of lignosulfonates with fungal oxidoreductases, such as laccases, can increase the molecular weight of lignosulfonates by the cross-linking of lignin phenols. To advance in this direction, we describe here the development of a high-throughput screening (HTS) assay for the directed evolution of laccases, with lignosulfonate as substrate and the Folin-Ciocalteau reagent (FCR), to detect the decrease in phenolic contentmore » produced upon polymerization of lignosulfonate by the enzyme. Once the reaction conditions were adjusted to the 96-well-plate format, the enzyme for validating the assay was selected from a battery of high-redox-potential laccase variants functionally expressed in S. cerevisiae (the preferred host for the directed evolution of fungal oxidoreductases). The colorimetric response (absorbance at 760 nm) correlated with laccase activity secreted by the yeast. The HTS assay was reproducible (coefficient of variation (CV) = 15%) and sensitive enough to detect subtle differences in activity among yeast clones expressing a laccase mutant library obtained by error-prone PCR (epPCR). As a result, the method is therefore feasible for screening thousands of clones during the precise engineering of laccases toward valorization of lignosulfonates.« less

High-Throughput Screening Assay for Laccase Engineering toward Lignosulfonate Valorization

DOE PAGES

Rodriguez-Escribano, David; de Salas, Felipe; Pardo, Isabel; ...

2017-08-18

Lignin valorization is a pending issue for the integrated conversion of lignocellulose in consumer goods. Lignosulfonates (LS) are the main technical lignins commercialized today. However, their molecular weight should be enlarged to meet application requirements as additives or dispersing agents. Oxidation of lignosulfonates with fungal oxidoreductases, such as laccases, can increase the molecular weight of lignosulfonates by the cross-linking of lignin phenols. To advance in this direction, we describe here the development of a high-throughput screening (HTS) assay for the directed evolution of laccases, with lignosulfonate as substrate and the Folin-Ciocalteau reagent (FCR), to detect the decrease in phenolic contentmore » produced upon polymerization of lignosulfonate by the enzyme. Once the reaction conditions were adjusted to the 96-well-plate format, the enzyme for validating the assay was selected from a battery of high-redox-potential laccase variants functionally expressed in S. cerevisiae (the preferred host for the directed evolution of fungal oxidoreductases). The colorimetric response (absorbance at 760 nm) correlated with laccase activity secreted by the yeast. The HTS assay was reproducible (coefficient of variation (CV) = 15%) and sensitive enough to detect subtle differences in activity among yeast clones expressing a laccase mutant library obtained by error-prone PCR (epPCR). As a result, the method is therefore feasible for screening thousands of clones during the precise engineering of laccases toward valorization of lignosulfonates.« less

Chlorine-36 and the initial value problem

NASA Astrophysics Data System (ADS)

Davis, Stanley N.; Cecil, DeWayne; Zreda, Marek; Sharma, Pankaj

Chlorine-36 is a radionuclide with a half-life of 3.01×105a. Most 36Cl in the hydrosphere originates from cosmic radiation interacting with atmospheric gases. Large amounts were also produced by testing thermonuclear devices during 1952-58. Because the monovalent anion, chloride, is the most common form of chlorine found in the hydrosphere and because it is extremely mobile in aqueous systems, analyses of both total Cl- as well as 36Cl have been important in numerous hydrologic studies. In almost all applications of 36Cl, a knowledge of the initial, or pre-anthropogenic, levels of 36Cl is useful, as well as essential in some cases. Standard approaches to the determination of initial values have been to: (a) calculate the theoretical cosmogenic production and fallout, which varies according to latitude; (b) measure 36Cl in present-day precipitation and assume that anthropogenic components can be neglected; (c) assume that shallow groundwater retains a record of the initial concentration; (d) extract 36Cl from vertical depth profiles in desert soils; (e) recover 36Cl from cores of glacial ice; and (f) calculate subsurface production of 36Cl for water that has been isolated from the atmosphere for more than one million years. The initial value from soil profiles and ice cores is taken as the value that occurs directly below the depth of the easily defined bomb peak. All six methods have serious weaknesses. Complicating factors include 36Cl concentrations not related to cosmogenic sources, changes in cosmogenic production with time, mixed sources of chloride in groundwater, melting and refreezing of water in glaciers, and seasonal groundwater recharge that does not contain average year-long concentrations of 36Cl. Résumé Le chlore-36 est un radionucléide de période 3.01×105a. Pour l'essentiel, le 36Cl dans l'hydrosphère provient des effets du rayonnement cosmique sur les gaz atmosphériques. De grandes quantités de 36Cl ont aussi été produites au cours des essais thermonucléaires entre 1952 et 1958. Du fait que l'anion chlorure est la forme la plus courante de chlore rencontrée dans l'hydrosphère et parce qu'il est extrêmement mobile en solution aqueuse, les analyses à la fois de Cl- total et de 36Cl ont montré leur intérêt dans de nombreuses études hydrologiques. Dans presque toutes les applications du 36Cl, une connaissance des teneurs initiales, ou "pré-anthropogéniques", en 36Cl est utile, sinon même nécessaire dans certains cas. Les approches classiques pour déterminer les teneurs initiales ont été: (a) le calcul de la production cosmique théorique et la retombée, variable en fonction de la latitude; (b) la mesure de 36Cl dans les précipitations actuelles et l'hypothèse que les composantes anthropogéniques peuvent être négligées (c) l'hypothèse que l'eau souterraine peu profonde est marquée par la concentration initiale; (d) l'extraction de 36Cl d'un profil vertical dans des sols de régions désertiques (e) l'extraction de 36Cl de carottes de glace; et (f) le calcul de la production souterraine de 36Cl pour de l'eau qui a été isolée de l'atmosphère pendant plus d'un million d'années. La valeur initiale tirée des profils de sol et de glace est prise comme la valeur qui apparaît immédiatement au-dessous du pic facilement identifiable des essais thermonucléaires. Ces six méthodes présentent toutes des défauts majeurs. Des facteurs de complication concernent des teneurs en 36Cl indépendantes de la production cosmique, des changements dans la production cosmique au cours du temps, des mélanges de chlorures d'origines différentes dans l'eau souterraine, la fonte et le regel de l'eau des glaciers, la recharge saisonnière des nappes dont la teneur en 36Cl est différente de la moyenne annuelle. Resumen El Cloro-36 es un radionúclido con una vida media de 3.01×105 años. La mayoría del 36Cl en la hidrosfera se origina por la interacción de la radiación cósmica con los gases atmosféricos. También se produjeron grandes cantidades en las pruebas termonucleares que tuvieron lugar entre 1952-58. Al tratarse de un anión monovalente, el cloruro es la forma más común en que se presenta el cloro en la hidrosfera, y al ser extremadamente móvil en sistemas acuosos, los análisis tanto de Cl- total como de 36Cl han tenido gran importancia en muchos estudios hidrológicos. En la mayoría de aplicaciones del 36Cl, el conocimiento de los niveles iniciales (pre-antropogénicos) de 36Cl es esencial. Los métodos tradicionales para la determinación de los valores iniciales han sido: (a) calcular la producción cosmogénica teórica y su aporte a la superficie de la Tierra, que varía en función de la latitud; (b) medir el 36Cl en las precipitaciones actuales, asumiendo que las contribuciones antropogénicas son despreciables; (c) asumir que las aguas subterráneas más superficiales mantienen la concentración inicial; (d) extraer los contenidos de 36Cl en perfiles verticales profundos en suelos desérticos (e) realizar la misma operación en muestras de hielo glaciar; y (f) calcular la producción subsuperficial de 36Cl para un agua que lleva sin contacto con la atmósfera durante más de un millón de años. El valor inicial de los perfiles de suelo y de las muestras de hielo se toma como el valor que se presenta directamente por debajo del punto que marca el pico producido por las bombas, y que es fácilmente identificable. Los seis métodos tienen sus puntos débiles. Entre los factores que complican la interpretación se incluyen las concentraciones de 36Cl no relacionadas con fuentes cosmogénicas, las variaciones temporales en la producción cosmogénica, la mezcla de fuentes de cloruro en las aguas subterráneas, el deshielo y recongelación del agua en los glaciares, y la recarga estacional que contiene concentraciones de 36Cl que no se corresponden con el promedio anual.

Geostatistical mapping of leakance in a regional aquitard, Oak Ridges Moraine area, Ontario, Canada

NASA Astrophysics Data System (ADS)

Desbarats, A. J.; Hinton, M. J.; Logan, C. E.; Sharpe, D. R.

2001-01-01

The Newmarket Till forms a regionally extensive aquitard separating two major aquifer systems in the Greater Toronto area, Canada. The till is incised, and sometimes eroded entirely, by a network of sand- and gravel-filled channels forming productive aquifers and, locally, high-conductivity windows between aquifer systems. Leakage through the till may also be substantial in places. This study investigates the spatial variability of aquitard leakance in order to assess the relative importance of recharge processes to the lower aquifers. With a large database derived from water-well records and containing both hard and soft information, the Sequential Indicator Simulation method is used to generate maps of aquitard thickness and window probability. These can be used for targeting channel aquifers and for identifying potential areas of recharge to the lower aquifers. Conductivities are modeled from sparse data assuming that their correlation range is much smaller than the grid spacing. Block-scale leakances are obtained by upscaling nodal values based on simulated conductivity and thickness fields. Under the "aquifer-flow'' assumption, upscaling is performed by arithmetic spatial averaging. Histograms and maps of upscaled leakances show that heterogeneities associated with aquitard windows have the largest effect on regional groundwater flow patterns. Résumé. La moraine glaciaire de Newmarket constitue un imperméable d'extension régionale séparant deux systèmes aquifères dans la région du Grand Toronto (Canada). La moraine est entaillée, et parfois entièrement érodée, par un réseau de chenaux comblés de sables et de graviers formant des aquifères productifs et, localement, des «fenêtres», zones à forte conductivité hydraulique reliant les systèmes aquifères. Une drainance au travers de la moraine peut également être significative par endroits. Cette étude s'intéresse à la variabilité spatiale de la drainance au travers de l'imperméable, dans le but d'évaluer l'importance relative des processus d'alimentation des aquifères inférieurs. À partir d'une vaste base de données constituée par les mesures faites dans les puits et contenant des informations à la fois certaines et incertaines, la méthode de simulation par indicateur séquentiel est utilisée pour créer des cartes d'épaisseur de l'imperméable et de probabilité d'existence des fenêtres. Ces cartes peuvent être utilisées pour mettre en évidence les aquifères de chenaux et pour identifier les zones potentielles de recharge des aquifères inférieurs. Les conductivités hydrauliques sont modélisées à partir de données clairsemées en supposant que leur gamme de corrélation est beaucoup plus faible que le pas de la grille. La drainance à l'échelle des blocs est obtenue par accroissement du niveau d'échelle des valeurs nodales basé sur les champs de conductivité simulée et des épaisseurs. À partir de l'hypothèse d'écoulement dans l'aquifère, l'accroissement d'échelle est réalisé en faisant une moyenne arithmétique spatiale. Des histogrammes et des cartes de drainance avec accroissement d'échelle montrent que les hétérogénéités associées aux fenêtres dans l'imperméable constituent l'effet le plus important dans l'organisation des écoulements souterrains régionaux. Resumen. El Till de Newmarket forma un acuitardo de extensión regional que separa dos sistemas acuíferos principales en la zona de Greater Toronto (Canadá). El till está horadado, y a veces completamente erosionado, por una red de canales rellenos de arena y grava. Estos constituyen acuíferos productivos y, localmente, conexiones de alta permeabilidad entre sistemas acuíferos. El goteo a través del till puede ser fundamental en ciertos lugares. Este estudio investiga la variabilidad espacial del goteo desde el acuitardo con el fin de establecer la importancia relativa de los procesos de recarga hacia los acuíferos inferiores. Se ha utilizado el método de la Simulación Indicadora Secuencial, soportado por una gran base de datos que contiene registros de sondeos e incluye información blanda y dura, para generar mapas de espesor del acuitardo y mapas de probabilidad de discontinuidades laterales en el acuitardo. Estos resultados se pueden emplear para identificar canales y las zonas de recarga potencial a los acuíferos inferiores. Se han modelado las conductividades a partir de datos dispersos, suponiendo que la distancia de correlación es mucho menor que el espaciado de la malla. Se han calculado valores de goteo a escala de bloque por medio del escalado de los valores nodales, basándose en los campos simulados de conductividad y espesor. El escalado se calcula mediante un promedio aritmético espacial, bajo la hipótesis de "flujo en el acuífero". Los histogramas y mapas de goteos escalados muestran que las heterogeneidades asociadas a las discontinuidades en el acuitardo producen el efecto más notable en la distribución regional del flujo de aguas subterráneas.

An Estimate of the Tidal Effects in the Dynamics of the Binary Galaxies

NASA Astrophysics Data System (ADS)

Junqueira, S.; de Freitas Pacheco, J. A.

1990-11-01

RESUMEN. Se ha estimado los efectos de marea en los pares dinamicos de galaxias elipticas. Para poder estudiar tales efectos hernos expandido el potencial gravitacional en potencias del cociente plr hasta en el orden 3 correspondientes a las fuerzas de marea. Hemos examina- do la influencia de este termino en el movimiento orbital. Se encon- tr6 el valor de M/LB = 10+7 (en unidades solares) para un ejemplo de 46 pares E-E usando Ia aproximaci6n de marea. De este resultado, no podemos concluir que existen alrededor de las galaxias halos grandes y obscuros. Hemos encontrado tambien que la suposici6n de masas puntuales es una buena aproximaci6n para el sistema fisico. Sin embargo, tal aproximaci6n sobreestima ligeramente el cociente masa-lurninosidad. ABSTRACT. In the present work we have estimated the tidal effects in the dynamics of pairs of elliptical galaxies. In order to study such effects we have expanded the gravitational potential in power of the ratio p/r up to order 3 corresponding to tidal forces. We examined the influence of this term in the orbital motion. The value of M/LB =lOi7 (in solar units) was found for a sample of 46 E-E pairs using the tidal approximation. From this result, we cannot conclude that large dark haloes exist around galaxies. We have also found that the assump- tion of point masses is a good approximation for the physical system. However, such an approximation overestimates slightly the mass-luminosity ratio. Keq wo't : GALAXIES-DYNAMICS

Impacts | Bioenergy | NREL

Science.gov Websites

Conversion NREL Overcomes Obstacles in Lignin Valorization Novel Combination of Enzyme Systems Could Lower Cellulosic Ethanol Can Be Cost Competitive Reducing Enzyme Costs Increases the Market Potential of Biofuels

Bacterial dye-decolorizing peroxidases: biochemical ...

EPA Pesticide Factsheets

In biorefineries, processing biomass begins with separating lignin from cellulose and hemicellulose. The latter two are depolymerized to give monosaccharides (e.g. glucose and xylose), which can be converted to fuels or chemicals. In contrast, lignin presents a challenging target for further processing due to its inherent heterogeneity and recalcitrance. Therefore, it has only been used in low-value applications. For example, lignin is burnt to recover energy in cellulosic ethanol production. Valorization of lignin is critical for biorefineries as it may generate high revenue. Lignin is the obvious candidate to provide renewable aromatic chemicals. As long as it can be depolymerized, the phenylpropane units can be converted into useful phenolic chemicals, which are currently derived from fossil fuels. This is a survey of an emerging group of enzymes that may have applications in lignin valorization.

Capnography as a tool to detect metabolic changes in patients cared for in the emergency setting.

PubMed

Cereceda-Sánchez, Francisco José; Molina-Mula, Jesús

2017-05-15

to evaluate the usefulness of capnography for the detection of metabolic changes in spontaneous breathing patients, in the emergency and intensive care settings. in-depth and structured bibliographical search in the databases EBSCOhost, Virtual Health Library, PubMed, Cochrane Library, among others, identifying studies that assessed the relationship between capnography values and the variables involved in blood acid-base balance. 19 studies were found, two were reviews and 17 were observational studies. In nine studies, capnography values were correlated with carbon dioxide (CO2), eight with bicarbonate (HCO3), three with lactate, and four with blood pH. most studies have found a good correlation between capnography values and blood biomarkers, suggesting the usefulness of this parameter to detect patients at risk of severe metabolic change, in a fast, economical and accurate way. avaliar a utilidade da capnografia para a detecção de alterações metabólicas em pacientes com respiração espontânea, no contexto das emergências e dos cuidados intensivos. pesquisa bibliográfica estruturada aprofundada, nas bases de dados EBSCOhost, Biblioteca Virtual em Saúde, PubMed, Cochrane Library, entre outras, identificando estudos que avaliavam a relação entre os valores da capnografia e as variáveis envolvidas no equilíbrio ácido-base sanguíneo. foram levantados 19 estudos, dois eram revisões e 17 eram estudos observacionais. Em nove estudos, os valores capnográficos foram correlacionados com o dióxido de carbono (CO2), em oito com o bicarbonato (HCO3), em três com o lactato, e em quatro com o pH sanguíneo. na maioria dos estudos foi observada uma correlação adequada entre os valores capnográficos e os biomarcadores sanguíneos, sugerindo a utilidade deste parâmetro para a identificação de pacientes com risco de sofrer uma alteração metabólica grave, de uma forma rápida, econômica e precisa. explorar la utilidad de la capnografía para la detección de alteraciones metabólicas ante pacientes en respiración espontánea, en el ámbito de las emergencias y los cuidados críticos. búsqueda bibliográfica estructurada en profundidad, en bases de datos EBSCOhost, Biblioteca Virtual de la Salud, PubMed, Cochrane Library, entre otras, identificando estudios que evaluaban la relación entre valores de la capnografía y variables implicadas en el equilibrio ácido-base sanguíneo. se recopilaron 19 estudios, dos eran revisiones y 17 observacionales. En nueve estudios, se correlacionaron los valores capnográficos junto al dióxido de carbono (CO2), en ocho con el bicarbonato (HCO3), tres con el lactato, y cuatro con el pH sanguíneo. la mayoría de estudios han obtenido una correlación adecuada entre los valores capnográficos y biomarcadores sanguíneos, sugiriendo la utilidad de este parámetro para la detección de pacientes en riesgo de padecer una alteración metabólica grave, de forma rápida, económica y precisa.

Geochemical and stable isotopic evolution of the Guarani Aquifer System in the state of São Paulo, Brazil

NASA Astrophysics Data System (ADS)

Sracek, Ondra; Hirata, Ricardo

2002-09-01

The purpose of this report is to explain geochemical and stable isotopes trends in the Brazilian unit of the Guarani Aquifer System (Botucatu and Piramboia aquifers) in São Paulo State, Brazil. Trends of dissolved species concentrations and geochemical modeling indicated a significant role of cation exchange and dissolution of carbonates in downgradient evolution of groundwater chemistry. Loss of calcium by the exchange for sodium drives dissolution of carbonates and results in Na-HCO3 type of groundwater. The cation-exchange front moves downgradient at probably much slower rate compared to the velocity of groundwater flow and at present is located near to the cities of Sertãozinho and Águas de Santa Barbara (wells PZ-34 and PZ-148, respectively) in a shallow confined area, 50-70 km from the recharge zone. Part of the sodium probably enters the Guarani Aquifer System. together with chloride and sulfate from the underlying Piramboia Formation by diffusion related to the dissolution of evaporates like halite and gypsum. High concentrations of fluorine (up to 13.3 mg/L) can be explained by dissolution of mineral fluoride also driven by cation exchange. However, it is unclear if the dissolution takes place directly in the Guarani Aquifer System or in the overlying basaltic Serra Geral Formation. There is depletion in δ2H and δ18O values in groundwater downgradient. Values of δ13C(DIC) are enriched downgradient, indicating dissolution of calcite under closed system conditions. Values of δ13C(DIC) in deep geothermal wells are very high (>-6.0‰) and probably indicate isotopic exchange with carbonates with δ13C about -3.0‰. Future work should be based on evaluation of vertical fluxes and potential for penetration of contamination to the Guarani Aquifer System. Résumé. Cet article a pour objet d'expliquer l'évolution de la géochimie et des isotopes stables dans l'unité brésilienne du système aquifère du Guarani (aquifères de Botucatu et Piramboia), dans l'État de Sao Paulo (Brésil). L'évolution des concentrations des espèces dissoutes et la modélisation géochimique ont fait apparaître le rôle notable des échanges de cations et de la dissolution des carbonates de l'amont vers l'aval des nappes. La perte de calcium par échange de cation avec le sodium pilote la dissolution des carbonates et donne naissance à des eaux souterraines à faciès Na-HCO3. Le front d'échange de cation se déplace vers l'aval probablement plus lentement que la vitesse d'écoulement de l'eau souterraine et est actuellement situé à proximité des villes de Sertaozinho et de Aguas de Santa Barbara (respectivement puits PZ-34 et PZ-148), dans une zone captive proche de la surface, à 50-70 km de la zone de recharge. Une partie du sodium provient probablement du système aquifère du Guarani, associée aux chlorures et aux sulfates de la formation Piramboia sous-jacente, par diffusion liée à la dissolution d'évaporites comme la halite et le gypse. De fortes concentrations en fluorures (jusqu'à 13,3 mg/L) peuvent être expliquées par la dissolution d'un minéral fluoré également pilotée par l'échange de cations. Cependant, on ne sait pas bien si la dissolution intervient directement dans le système aquifère du Guarani ou dans la formation basaltique sus-jacente de Serra Geral. Les valeurs de δ2H et δ18O décroissent vers l'aval de la nappe. Les valeurs de δ13C du carbone minéral dissous sont enrichies vers l'aval, indiquant qu'il se produit une dissolution de calcite en système fermé. Les valeurs de δ13C du carbone minéral dissous dans les puits géothermaux profonds sont très élevées (supérieures à -6,0‰) et rendent probablement compte d'échanges isotopiques avec des carbonates possédant un δ13C d'environ -3,0‰. De prochaines études devront s'attacher à évaluer les flux verticaux et le potentiel de pénétration de contamination du système aquifère du Guarani. Resumen. El propósito de este informe es explicar las tendencias geoquímicas y de los isótopos estables en la unidad brasileña del Sistema Acuífero Guaraní (acuíferos de Botucatu y Piramboya), en el Estado de Sao Paulo. Las concentraciones de especies disueltas y los resultados de modelaciones geoquímicas indican que el intercambio catiónico y la disolución de carbonatos desempeñan un papel importante en la evolución aguas abajo del acuífero. La disminución de calcio por el intercambio con sodio origina la disolución de carbonatos, dando lugar a aguas subterráneas de tipo bicarbonatado sódico. El frente de intercambio catiónico se desplaza a una velocidad probablemente mucho más lenta que la del flujo de agua; actualmente, se halla cerca de las ciudades de Sertaozinho y Aguas de Santa Bárbara (pozos PZ-34 y PZ-148, respectivamente), en una zona confinada somera que dista entre 50 y 70 km del área de recarga. Parte del sodio entra probablemente en el Sistema Acuífero Guaraní junto con el cloruro y el sulfato procedentes de la Formación Piramboia inferior, debido a la difusión relacionada con la disolución de evaporitas como la halita y los yesos. Se puede explicar las elevadas concentraciones de flúor (hasta 13,3 mg/L) por la disolución de fluoruro mineral, que sucede también por intercambio catiónico. Sin embargo, no está claro si la disolución ocurre directamente en el Sistema Acuífero Guaraní o en la Formación basáltica superior de Serra Geral. Hay una reducción de δ2H y de δ18O a favor del gradiente hidráulico. Hay un enriquecimiento en δ13C inorgánico aguas abajo, lo que indica que la calcita se disuelve en condiciones de sistema cerrado. Los valores de δ13C inorgánico en pozos geotérmicos profundos son muy altos (mayores que -6,0‰), y probablemente apuntan a un intercambio isotópico con carbonatos de δ13C que tiene un valor del orden del -3,0‰. Las líneas de investigación deberían centrarse en evaluar los flujos verticales y el potencial de penetración de contaminantes en el Sistema Acuífero Guaraní.

Implementing apportionment strategy to identify costs in a multidisciplinary clinic.

PubMed

Ferraz, Renato Ribeiro Nogueira; Neri, Anna Sofia Costa; Barbosa, Estela Capelas; Silva, Marcus Vinícius Cesso da

2017-01-01

To present the implementation of an apportionment strategy proportional to the productive areas of a multidisciplinary clinic, defining the minimum values to be passed monthly to health professionals who work there. A study of the clinic structure was carried out, in which the area of occupation of each service was defined. Later the cost was prorated, allocating a value to each room, proportional to the space occupied. The apportionment implementation allowed the clinic managers to visualize the cost of each room, providing a value base for formation of a minimum amount necessary to be passed monthly to each professional, as a form of payment for rent of using their facilities. The risk of financial loss of the clinic was minimized due to variation of its productivity, as well as the conditions of transference at the time of hiring by professionals were clear, promoting greater confidence and safety in contract relations. Apresentar a implantação de uma estratégia de rateio proporcional às áreas produtivas de uma clínica multidisciplinar, definindo valores mínimos a serem repassados mensalmente aos profissionais de saúde que as ocupam. Estudo da estrutura da clínica, no qual foi definida, em metros quadrados, a área de ocupação de cada serviço. Em seguida, o custo foi rateado, alocando um valor a cada sala, proporcional ao espaço ocupado. A implantação do rateio possibilitou aos gestores da clínica estudada visualizar o custo de cada sala, fornecendo uma base de valor para formação de um valor mínimo necessário a ser repassado mensalmente para cada profissional, como forma de pagamento pelo aluguel de utilização de suas instalações. Minimizou-se o risco de prejuízo da clínica pela variação de sua produtividade, bem como ficaram claras as condições de repasse no momento de contratação do aluguel pelos profissionais, promovendo maior confiança e segurança na relação contratual.

Lignolytic-consortium omics analyses reveal novel genomes and pathways involved in lignin modification and valorization.

PubMed

Moraes, Eduardo C; Alvarez, Thabata M; Persinoti, Gabriela F; Tomazetto, Geizecler; Brenelli, Livia B; Paixão, Douglas A A; Ematsu, Gabriela C; Aricetti, Juliana A; Caldana, Camila; Dixon, Neil; Bugg, Timothy D H; Squina, Fabio M

2018-01-01

Lignin is a heterogeneous polymer representing a renewable source of aromatic and phenolic bio-derived products for the chemical industry. However, the inherent structural complexity and recalcitrance of lignin makes its conversion into valuable chemicals a challenge. Natural microbial communities produce biocatalysts derived from a large number of microorganisms, including those considered unculturable, which operate synergistically to perform a variety of bioconversion processes. Thus, metagenomic approaches are a powerful tool to reveal novel optimized metabolic pathways for lignin conversion and valorization. The lignin-degrading consortium (LigMet) was obtained from a sugarcane plantation soil sample. The LigMet taxonomical analyses (based on 16S rRNA) indicated prevalence of Proteobacteria , Actinobacteria and Firmicutes members, including the Alcaligenaceae and Micrococcaceae families, which were enriched in the LigMet compared to sugarcane soil. Analysis of global DNA sequencing revealed around 240,000 gene models, and 65 draft bacterial genomes were predicted. Along with depicting several peroxidases, dye-decolorizing peroxidases, laccases, carbohydrate esterases, and lignocellulosic auxiliary (redox) activities, the major pathways related to aromatic degradation were identified, including benzoate (or methylbenzoate) degradation to catechol (or methylcatechol), catechol ortho-cleavage, catechol meta-cleavage, and phthalate degradation. A novel Paenarthrobacter strain harboring eight gene clusters related to aromatic degradation was isolated from LigMet and was able to grow on lignin as major carbon source. Furthermore, a recombinant pathway for vanillin production was designed based on novel gene sequences coding for a feruloyl-CoA synthetase and an enoyl-CoA hydratase/aldolase retrieved from the metagenomic data set. The enrichment protocol described in the present study was successful for a microbial consortium establishment towards the lignin and aromatic metabolism, providing pathways and enzyme sets for synthetic biology engineering approaches. This work represents a pioneering study on lignin conversion and valorization strategies based on metagenomics, revealing several novel lignin conversion enzymes, aromatic-degrading bacterial genomes, and a novel bacterial strain of potential biotechnological interest. The validation of a biosynthetic route for vanillin synthesis confirmed the applicability of the targeted metagenome discovery approach for lignin valorization strategies.

Separation of Lignin from Corn Stover Hydrolysate with Quantitative Recovery of Ionic Liquid

PubMed Central

Underkofler, Kaylee A.; Teixeira, Rodrigo E.; Pietsch, Stephen A.; Knapp, Kurtis G.; Raines, Ronald T.

2015-01-01

Abundant lignocellulosic biomass could become a source of sugars and lignin, potential feedstocks for the now emergent bio-renewable economy. The production and conversion of sugars from biomass have been well-studied, but far less is known about the production of lignin that is amenable to valorization. Here we report the isolation of lignin generated from the hydrolysis of biomass dissolved in the ionic liquid 1-butyl-3-methylimidazolium chloride. We show that lignin can be isolated from the hydrolysate slurry by simple filtration or centrifugation, and that the ionic liquid can be recovered quantitatively by a straightforward wash with water. The isolated lignin is not only free from ionic liquid, but also lacks cellulosic residues and is substantially depolymerized, making it a promising feedstock for valorization by conversion into fuels and chemicals. PMID:25866701

Valorization of glycerol through the production of biopolymers: the PHB case using Bacillus megaterium.

PubMed

Naranjo, Javier M; Posada, John A; Higuita, Juan C; Cardona, Carlos A

2013-04-01

In this work technical and economic analyses were performed to evaluate the glycerol transformation into Polyhydroxybutyrate using Bacillus megaterium. The production of PHB was compared using glycerol or glucose as substrates and similar yields were obtained. The total production costs for PHB generation with both substrates were estimated at an industrial scale. Compared to glucose, glycerol showed a 10% and 20% decrease in the PHB production costs using two different separation schemes respectively. Moreover, a 20% profit margin in the PHB sales price using glycerol as substrate resulted in a 166% valorization of crude glycerol. In this work, the feasibility of glycerol as feedstock for the production of PHB at laboratory (up to 60% PHB accumulation) and industrial (2.6US$/kgPHB) scales is demonstrated. Copyright © 2013 Elsevier Ltd. All rights reserved.

Solid state fermentation (SSF): diversity of applications to valorize waste and biomass.

PubMed

Lizardi-Jiménez, M A; Hernández-Martínez, R

2017-05-01

Solid state fermentation is currently used in a range of applications including classical applications, such as enzyme or antibiotic production, recently developed products, such as bioactive compounds and organic acids, new trends regarding bioethanol and biodiesel as sources of alternative energy, and biosurfactant molecules with environmental purposes of valorising unexploited biomass. This work summarizes the diversity of applications of solid state fermentation to valorize biomass regarding alternative energy and environmental purposes. The success of applying solid state fermentation to a specific process is affected by the nature of specific microorganisms and substrates. An exhaustive number of microorganisms able to grow in a solid matrix are presented, including fungus such as Aspergillus or Penicillum for antibiotics, Rhizopus for bioactive compounds, Mortierella for biodiesel to bacteria, Bacillus for biosurfactant production, or yeast for bioethanol.

Innovative approach for the valorization of useful metals from waste electric and electronic equipment (WEEE)

NASA Astrophysics Data System (ADS)

Soare, V.; Burada, M.; Dumitrescu, D. V.; Constantin, I.; Soare, V.; Popescu, A.-M. J.; Carcea, I.

2016-08-01

Waste electric and electronic equipment are an important secondary source of rare and precious metals and their processing through ecological technologies constitutes a major concern in the European Union and significantly contributes to the reduction of environmental pollution and to the preservation of valuable resources of nonferrous metals. The paper presents an innovative approach for the complex valorization of useful metals contained in WEEE. The method consists in the melting of WEEE in a furnace in a microwave field at temperatures of 1000 ÷1200°C, for the complete separation of the metallic fraction from the organic components. The gases resulting from the melting process were also treated/neutralized in a microwave environment and the obtained metallic bulk (multi-component alloy) was processed through combined hydrometallurgical and electrochemical methods. The major elements in the metallic bulk (Cu, Sn, Zn, Pb) were separated/recovered by anodic dissolution, respectively by leaching in nitric acid followed by cementation using various agents, or by electrodeposition. Depending on the electrochemical parameters, cathodic deposits consisting of Cu, with a purity higher than 99.9%, or of Cu-Sn and Cu-Sn-Zn alloys were obtained. Silver was valorized by leaching/precipitation with NaCl and the gold concentrated in the anodic slime will be recovered by thiourea extraction. The experiments performed demonstrate the possibility of ecological and efficient processing of WEEE in a microwave field and the recovery of nonferrous and precious metals through combined hydrometallurgical and electrochemical methods.

A proposed new framework for valorization of geoheritage in Norway

NASA Astrophysics Data System (ADS)

Dahl, Rolv; Bergengren, Anna; Heldal, Tom

2015-04-01

The geological history of Norway is a complex one, . The exploitation of geological resources of different kinds has always provided the backbone of the Norwegian community. Nevertheless, the perception of geology and the geological processes that created the landscape is little appreciated, compared to bio-diversity and cultural heritage. Some geological localities play an important role in our perception and scientific understanding of the landscape. Other localities are, or could be, important tourist destinations. Other localities can in turn be important for geoscience education on all levels, whereas other plays a major role in the understanding of geodiversity and geoheritage and should be protected as natural monuments. A database based on old registrations has been compiled and a web mapping server is recently launched based on old and new registrations. However, no systematical classification and identification of important sites has been done for the last thirty years. We are now calling for a crowdsourcing process in the geological community in order to validate and valorize the registrations, as well as defining new points and areas of interest. Furthermore, we are developing a valorization system for these localities. The framework for this system is based on studies from inventories in other countries, as well as suggestions from ProGeo. The aim is to raise awareness of important sites, and how they are treated and utilized for scientific, or educational purposes, as tourist destinations or heritage sites. Our presentation will focus on the development of the framework and its implications.

The novel complex allele [A238V;F508del] of the CFTR gene: clinical phenotype and possible implications for cystic fibrosis etiological therapies.

PubMed

Diana, Anna; Polizzi, Angela Maria; Santostasi, Teresa; Ratclif, Luigi; Pantaleo, Maria Giuseppina; Leonetti, Giuseppina; Iusco, Danila Rosa; Gallo, Crescenzio; Conese, Massimo; Manca, Antonio

2016-06-01

Few mutations in cis have been annotated for F508del homozygous patients. Southern Italy patients who at a first analysis appeared homozygous for the F508del mutation (n=63) or compound heterozygous for the F508del and another mutation in the cystic fibrosis transmembrane conductance regulator gene (n=155) were searched for the A238V mutation in exon 6. The allelic frequency of the complex allele [A238V;F508del] was 0.04. When the whole data set was used (comprised also of 56 F508del/F508del and 34 F508del/other mutation controls), no differences reached the statistical significance in the clinical parameters, except chloride concentrations which were lower in [A238V;F508del]/other mutation compared with F508del/other mutation (P=0.03). The two study groups presented less complications than the control groups. Within the minimal data set (34 F508del/F508del, 27 F508del/other mutation, 4 [A238V;F508del]/F508del cases and 5 [A238V;F508del]/other mutation cases); that is, presenting all the variables in each patient, forced expiratory volume in 1 s and forced vital capacity presented a trend to lower levels in the study groups in comparison with the F508del/F508del group, and C-reactive protein approximated statistically significant higher levels in the [A238V;F508del]/other mutation as compared with F508del/F508del patients (P=0.09). The analysis of statistical dependence among the variables showed a significant anticorrelation between chloride and body mass index in the [A238V;F508del]/other mutation group. In conclusion, the complex allele [A238V;F508del] seems to be associated with less general complications than in the control groups, on the other hand possibly giving a worse pulmonary phenotype and higher systemic/local inflammatory response. These findings have implications for the correct recruitment and clinical response of F508del patients in the clinical trials testing the new etiological drugs for cystic fibrosis.

Rebamipide promotes healing of colonic ulceration through enhanced epithelial restitution.

PubMed

Takagi, Tomohisa; Naito, Yuji; Uchiyama, Kazuhiko; Okuda, Toshimitsu; Mizushima, Katsura; Suzuki, Takahiro; Handa, Osamu; Ishikawa, Takeshi; Yagi, Nobuaki; Kokura, Satoshi; Ichikawa, Hiroshi; Yoshikawa, Toshikazu

2011-09-07

To investigate the efficacy of rebamipide in a rat model of colitis and restitution of intestinal epithelial cells in vitro. Acute colitis was induced with trinitrobenzene sulfonic acid (TNBS) in male Wistar rats. Rats received intrarectal rebamipide treatment daily starting on day 7 and were sacrificed on day 14 after TNBS administration. The distal colon was removed to evaluate the various parameters of inflammation. Moreover, wound healing assays were used to determine the enhanced restitution of rat intestinal epithelial (RIE) cells treated with rebamipide. Intracolonic administration of rebamipide accelerated TNBS-induced ulcer healing. Increases in the wet weight of the colon after TNBS administration were significantly inhibited by rebamipide. The wound assay revealed that rebamipide enhanced the migration of RIE cells through phosphorylation of extracellular signal-regulated kinase (ERK) and activation of Rho kinase. Rebamipide enema healed intestinal injury by enhancing restitution of RIE cells, via ERK activation. Rebamipide might be a novel therapeutic approach for inflammatory bowel disease.

Rebamipide promotes healing of colonic ulceration through enhanced epithelial restitution

PubMed Central

Takagi, Tomohisa; Naito, Yuji; Uchiyama, Kazuhiko; Okuda, Toshimitsu; Mizushima, Katsura; Suzuki, Takahiro; Handa, Osamu; Ishikawa, Takeshi; Yagi, Nobuaki; Kokura, Satoshi; Ichikawa, Hiroshi; Yoshikawa, Toshikazu

2011-01-01

AIM: To investigate the efficacy of rebamipide in a rat model of colitis and restitution of intestinal epithelial cells in vitro. METHODS: Acute colitis was induced with trinitrobenzene sulfonic acid (TNBS) in male Wistar rats. Rats received intrarectal rebamipide treatment daily starting on day 7 and were sacrificed on day 14 after TNBS administration. The distal colon was removed to evaluate the various parameters of inflammation. Moreover, wound healing assays were used to determine the enhanced restitution of rat intestinal epithelial (RIE) cells treated with rebamipide. RESULTS: Intracolonic administration of rebamipide accelerated TNBS-induced ulcer healing. Increases in the wet weight of the colon after TNBS administration were significantly inhibited by rebamipide. The wound assay revealed that rebamipide enhanced the migration of RIE cells through phosphorylation of extracellular signal-regulated kinase (ERK) and activation of Rho kinase. CONCLUSION: Rebamipide enema healed intestinal injury by enhancing restitution of RIE cells, via ERK activation. Rebamipide might be a novel therapeutic approach for inflammatory bowel disease. PMID:21987622

Successful management of a benign anastomotic colonic stricture with self-expanding metallic stents: A case report

PubMed Central

Guan, Yong-Song; Sun, Long; Li, Xiao; Zheng, Xiao-Hua

2004-01-01

AIM: To assess the effectiveness of and complications associated with metallic stent placement for treatment of anastomotic colonic strictures. METHODS: A 46-year-old man underging two procedures of surgery for perforation of descending colon due to a traffic accident presented with pain, abdominal distention, and inability to defecate. Single-contrast barium enema radiograph showed a severe stenosis in the region of surgical anastomosis and the patient was too weak to accept another laparotomy. Under fluoroscopic and endoscopic guidance, we placed two metallic stents in the stenosis site of the anastomosis of the patient with anastomotic colonic strictures. RESULTS: In this case of postsurgical stenosis, the first stent relieved the symptoms of obstruction, but stent migration happened on the next day so an additional stent was required to deal with the stricture and relieve the symptoms. CONCLUSION: This case confirms that metallic stenting may represent an effective treatment for anastomotic colonic strictures in the absence of other therapeutic alternatives. PMID:15526381

[Chronic recurrent volvulus of the colonic splenic flexure associated with the eventration of left diaphragm].

PubMed

Kim, Hee Sun; Yoo, Jeong Seon; Han, Seok Joo; Park, Hyojin

2007-01-01

The eventration of diaphragm is usually found incidentally on chest X-ray or sometimes presented as acute gastric volvulus. However, colonic volvulus on splenic flexure area complicated by diaphragmatic eventration is extremely rare. A 25 year old man complained of upper abdominal pain for three days. He had a history of brain injury during infant period, and had epilepsy and mental retardation. Plain chest X-ray showed left diaphragmatic eventration and marked dilatation of colon on splenic flexure area which had not been changed for last three years. Barium enema showed bird beak appearance on distal colon near the splenic flexure. Colonoscopic reduction failed. After decompression with rectal and nasogastric tubes, colonic volvulus was relieved. To prevent the recurrence of volvulus, we performed segmental resection of left colon including splenic flexure area and repaired the left diaphragmatic eventration. After the operation, the patient had no further recurrent episode of volvulus although ileus persisted.

Acceptability of potential rectal microbicide delivery systems for HIV prevention: a randomized crossover trial.

PubMed

Pines, Heather A; Gorbach, Pamina M; Weiss, Robert E; Hess, Kristen; Murphy, Ryan; Saunders, Terry; Brown, Joelle; Anton, Peter A; Cranston, Ross D

2013-03-01

We assessed the acceptability of three of over-the-counter products representative of potential rectal microbicide (RM) delivery systems. From 2009 to 2010, 117 HIV-uninfected males (79 %) and females (21 %) who engage in receptive anal intercourse participated in a 6-week randomized crossover acceptability trial. Participants received each of three products (enema, lubricant-filled applicator, suppository) every 2 weeks in a randomized sequence. CASI and T-ACASI scales assessed product acceptability via Likert responses. Factor analysis was used to identify underlying factors measured by each scale. Random effects models were fit to examine age and gender effects on product acceptability. Three underlying factors were identified: Satisfaction with Product Use, Sexual Pleasure, and Ease of Product Use. For acceptability, the applicator ranked highest; however, differences between product acceptability scores were greatest among females and younger participants. These findings indicate that RM delivery systems impact their acceptability and should be considered early in RM development to enhance potential use.

Acceptability of Potential Rectal Microbicide Delivery Systems for HIV Prevention: A Randomized Crossover Trial

PubMed Central

Gorbach, Pamina M.; Weiss, Robert E.; Hess, Kristen; Murphy, Ryan; Saunders, Terry; Brown, Joelle; Anton, Peter A.; Cranston, Ross D.

2012-01-01

We assessed the acceptability of three of over-the-counter products representative of potential rectal microbicide (RM) delivery systems. From 2009 to 2010, 117 HIV-uninfected males (79 %) and females (21 %) who engage in receptive anal intercourse participated in a 6-week randomized crossover acceptability trial. Participants received each of three products (enema, lubricant-filled applicator, suppository) every 2 weeks in a randomized sequence. CASI and T-ACASI scales assessed product acceptability via Likert responses. Factor analysis was used to identify underlying factors measured by each scale. Random effects models were fit to examine age and gender effects on product acceptability. Three underlying factors were identified: Satisfaction with Product Use, Sexual Pleasure, and Ease of Product Use. For acceptability, the applicator ranked highest; however, differences between product acceptability scores were greatest among females and younger participants. These findings indicate that RM delivery systems impact their acceptability and should be considered early in RM development to enhance potential use. PMID:23114512

THE POWER OF POOP: FECAL MICROBIOTA TRANSPLANTATION FOR CLOSTRIDIUM DIFFICILE INFECTION

PubMed Central

EDMOND, MICHAEL B.

2016-01-01

The human gut is colonized with 200 to 1,000 bacterial species. Administration of antibiotics reduces the diversity of the intestinal microbiota, reduces colonization resistance, and can lead to infection with Clostridium difficile. These infections have become more prevalent and increasingly patients are experiencing multiple recurrences that are incurable with standard treatment. Although fecal microbiota transplantation (FMT) has been used for centuries in human and veterinary medicine, only recently has it be shown to be highly effective for recurrent C. difficile infection. The goal of FMT is to re-introduce a complete, stable community of gut microorganisms to repair or replace the disrupted native microbiota. FMT can be delivered via nasoenteric tube, colonoscopy, or enema. Despite a cure rate approximating 90%, many barriers to FMT have limited its availability to patients. The recent development of a not-for-profit stool bank has helped to make this therapy more accessible. Additional indications for FMT are currently under investigation. PMID:28066039

THE POWER OF POOP: FECAL MICROBIOTA TRANSPLANTATION FOR CLOSTRIDIUM DIFFICILE INFECTION.

PubMed

Edmond, Michael B

2016-01-01

The human gut is colonized with 200 to 1,000 bacterial species. Administration of antibiotics reduces the diversity of the intestinal microbiota, reduces colonization resistance, and can lead to infection with Clostridium difficile . These infections have become more prevalent and increasingly patients are experiencing multiple recurrences that are incurable with standard treatment. Although fecal microbiota transplantation (FMT) has been used for centuries in human and veterinary medicine, only recently has it be shown to be highly effective for recurrent C. difficile infection. The goal of FMT is to re-introduce a complete, stable community of gut microorganisms to repair or replace the disrupted native microbiota. FMT can be delivered via nasoenteric tube, colonoscopy, or enema. Despite a cure rate approximating 90%, many barriers to FMT have limited its availability to patients. The recent development of a not-for-profit stool bank has helped to make this therapy more accessible. Additional indications for FMT are currently under investigation.

Long-term safety and efficacy of budesonide in the treatment of ulcerative colitis

PubMed Central

Iborra, Marisa; Álvarez-Sotomayor, Diego; Nos, Pilar

2014-01-01

Ulcerative colitis (UC) is a chronic, relapsing, and remitting inflammatory disease involving the large intestine (colon). Treatment seeks to break recurrent inflammation episodes by inducing and maintaining remission. Historically, oral systemic corticosteroids played an important role in inducing remission of this chronic disease; however, their long-term use is limited and can lead to adverse events. Budesonide is a synthetic steroid with potent local anti-inflammatory effects and low systemic bioavailability due to high first-pass hepatic metabolism. Several studies have demonstrated oral budesonide’s usefulness in treating active mild to moderate ileocecal Crohn’s disease and microscopic colitis and in an enema formulation for left sided UC. However, there is limited information regarding oral budesonide’s efficacy in UC. A novel oral budesonide formulation using a multimatrix system (budesonide-MMX) to extend drug release throughout the colon has been developed recently and seems to be an effective treatment in active left sided UC patients. This article summarizes budesonide’s long-term safety and efficacy in treating UC. PMID:24523594

Ulcerative colitis with acute pleurisy

PubMed Central

Lu, Shuming; Wang, Lihua; Zhang, Weisheng; Zhang, Zhuqing; Liu, Lina; Wang, Yingde; Meng, Hua

2017-01-01

Abstract Rationale: Inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn's disease, are associated with a large number of extraintestinal manifestations. Pulmonary manifestations are infrequently seen in patients with IBD. Moreover, serositis including pleural and pericardial manifestations in UC is rare. Patient concerns: We report a case of UC with acute pleurisy in a 43-year-old man; review literature; and discuss the diagnosis, differential diagnosis, and treatment. Diagnoses: Active duodenal ulcer was found using gastroscopy. Multiple ulcers in segmented pattern were noticed in the left hemi-colon using colonoscopy. An UC in active stage was confirmed subsequently by histology. Intervention: The patient was treated with bifidobacterium tetravaccine tablets, oral mesalazine and mesalazine enemas. The omeprazole and mucosal protective agents were given to treat the duodenal ulcer. Outcomes: As follow-up, the therapy including oral mesalazine and infliximab regularly was continued and the patient condition was stabilized. Main lesson: Pulmonary involvement should be considered in patients who develop pleurisy in UC. Infliximab is considered the better available treatment for patients presenting with pleurisy in UC. PMID:28746225

Intermittent intussusception caused by colonic lipoma.

PubMed

Chan, K C; Lin, N H; Lien, H C; Chan, S L; Yu, S C

1998-01-01

Colonic lipomas are rare, usually small, and occur most often in the right colon, particularly in the cecum. They are most common in elderly women. Intermittent episodes of intussusception are not uncommon in patients with colonic lipoma, but they are usually caused by larger pedunculated lipomas. We report a 43-year-old woman with a large colonic submucosal lipoma that induced intermittent colocolic intussusception. The patient presented with symptoms of peptic ulcer, including intractable upper abdominal pain, which did not resolve with treatment. Abdominal sonography showed typical findings of intussusception caused by a lipoma, but the manifestations on barium enema and computed tomography mimicked a malignant colonic tumor. The patient's abdominal pain disappeared after right hemicolectomy and the tumor was demonstrated to be a lipoma. The postoperative course was uneventful; there was no evidence of recurrence at follow-up 6 months later. Physicians should be aware that surrounding organs should also be evaluated in cases of chronic peptic ulcer with intractable upper abdominal pain.

Management of patients with faecal incontinence

PubMed Central

Duelund-Jakobsen, Jakob; Worsoe, Jonas; Lundby, Lilli; Christensen, Peter; Krogh, Klaus

2016-01-01

Faecal incontinence, defined as the involuntary loss of solid or liquid stool, is a common problem affecting 0.8–8.3% of the adult population. Individuals suffering from faecal incontinence often live a restricted life with reduced quality of life. The present paper is a clinically oriented review of the pathophysiology, evaluation and treatment of faecal incontinence. First-line therapy should be conservative and usually include dietary adjustments, fibre supplement, constipating agents or mini enemas. Biofeedback therapy to improve external anal sphincter function can be offered but the evidence for long-term effect is poor. There is good evidence that colonic irrigation can reduce symptoms and improve quality of life, especially in patients with neurogenic faecal incontinence. Surgical interventions should only be considered if conservative measures fail. Sacral nerve stimulation is a minimally invasive procedure with high rate of success. Advanced surgical procedures should be restricted to highly selected patients and only performed at specialist centres. A stoma should be considered if other treatment modalities fail. PMID:26770270

Technical Aspects of Fecal Microbial Transplantation (FMT).

PubMed

Bhutiani, N; Schucht, J E; Miller, K R; McClave, Stephen A

2018-06-09

Fecal microbial transplantation (FMT) has become established as an effective therapeutic modality in the treatment of antibiotic-refractory recurrent Clostridium difficile colitis. A number of formulations and methods of delivery of FMT are currently available, each with distinct advantages. This review aims to review donor and patient selection for FMT as well as procedural aspects of FMT to help guide clinical practice. FMT can be obtained in fresh, frozen, lyophilized, and capsule-based formulations for delivery by oral ingestion, nasoenteric tube, colonoscopy, or enema (depending on the formulation used). Choosing the optimal method relies heavily on patient-related factors, including underlying pathology and severity of illness. As potential applications for FMT expand, careful donor screening and patient selection are critical to minimizing risk to patients and physicians. FMT represents an excellent therapeutic option for treatment of recurrent Clostridium difficile colitis and holds promise as a possible treatment modality in a variety of other conditions. The wide array of delivery methods allows for its application in various disease states in both the inpatient and outpatient setting.

[Fecal bacteriotherapy for the treatment of recurrent Clostridium difficile colitis used in the Clinic of Infectious Diseases of the University Hospital Brno in 2010-2014 - a prospective study].

PubMed

Polák, P; Freibergerová, M; Husa, P; Juránková, J; Svačinka, R; Mikešová, L; Kocourková, H; Mihalčin, M; Skalická, R; Stebel, R; Porubčanová, M

2015-10-01

The aim of the study is to assess the efficacy of fecal bacteriotherapy in the treatment of Clostridium difficile colitis. A prospective study of fecal bacteriotherapy in 80 adult patients hospitalized in the Clinic of Infectious Diseases, University Hospital Brno between 1 January 2010 and 31 December 2014. During the study period, 80 patients were treated with fecal bacteriotherapy. The majority of the study group received fecal bacteriotherapy via a nasojejunal tube (n=78) and two patients via a rectal enema. Six patients were instilled with 20 g of feces, with a success rate of 50 %. The outcomes of nine patients were unevaluable. In the rest of 65 patients, the success rate with 40 g of feces was 83.1 %. There were no severe adverse events or mortality associated with fecal bacteriotherapy. Fecal bacteriotherapy is a safe and effective treatment modality in Clostridium difficile colitis.

Single port laparoscopic right hemicolectomy for ileocolic intussusception

PubMed Central

Chen, Jia-Hui; Wu, Jhe-Syun

2013-01-01

A 36-year-old male was admitted with right lower abdominal pain and diarrhea for more than 3 mo. Colonoscopy and a barium enema study revealed a submucosal tumor over the cecum, but computed tomography showed an ileal lipoma. There was no definitive diagnosis preoperatively, but ileocolic intussusception was noted during surgery. Single port laparoscopic radical right hemicolectomy was performed because intra-operative reduction failed. The histological diagnosis of the resected tumor was lipoma. Single port laparoscopic surgery has recently been proven to be safe and feasible. There are advantages compared with conventional laparoscopic surgery, such as smaller incision wounds, fewer port site complications, and easier conversion. However, there are some drawbacks which need to be overcome, such as difficulties in triangulation and instrument clashing. If there are no contraindications to laparoscopy, single port laparoscopic surgery can be performed safely and should be considered for diagnosis and treatment of intussusception in adults. Here, we report the first case of ileocolic intussusception successfully treated by single port laparoscopic surgery. PMID:23538552

Predictive value of impaired evacuation at proctography in diagnosing anismus.

PubMed

Halligan, S; Malouf, A; Bartram, C I; Marshall, M; Hollings, N; Kamm, M A

2001-09-01

We aimed to determine the positive predictive value of impaired evacuation during evacuation proctography for the subsequent diagnosis of anismus. Thirty-one adults with signs of impaired evacuation (defined as the inability to evacuate two thirds of a 120 mL contrast enema within 30 sec) during evacuation proctography underwent subsequent anorectal physiologic testing for anismus. A physiologic diagnosis of anismus was based on a typical clinical history of the condition combined with impaired rectal balloon expulsion or abnormal surface electromyogram. Twenty-eight (90%) of the 31 patients with impaired proctographic evacuation were found to have anismus at subsequent physiologic testing. Among the 28 were all 10 patients who evacuated no contrast medium and all 11 patients with inadequate pelvic floor descent, giving evacuation proctography a positive predictive value of 90% for the diagnosis of anismus. A prominent puborectal impression was seen in only three subjects during proctography, one of whom subsequently showed no physiologic sign of anismus. Impaired evacuation during evacuation proctography is highly predictive for diagnosis of anismus.

MRI facilitated a diagnosis of endometriosis of the rectum.

PubMed

Eguchi, S; Komuta, K; Haraguchi, M; Furui, J; Kanematsu, T

2000-01-01

A 51-year-old pre-menopausal Japanese woman suffering from chronic lower abdominal pain was referred to our hospital. A barium enema showed a stenotic lesion in the recto-sigmoid region, and a pelvic computed axial tomography (CAT) scan revealed a thickened rectal wall. A colonoscopic examination showed the rectum to be constrictive, but the mucosa appeared to be intact. Magnetic resonance imaging (MRI) with T1 high-intensity revealed a cystic lesion in the thickened wall of the rectum, which led us to suspect possible bowel endometriosis. Part of the biopsy specimen showed endometrial epithelium within the interstitial layer of histologically normal mucosa; finally, endometriosis of the rectum was diagnosed. The patient became asymptomatic after the initiation of hormonal treatment and later experienced spontaneous menopause. MRI was effective for diagnosis and the patient did not undergo unnecessary laparotomy. Although bowel endometriosis is generally diagnosed by means of resected specimens, in our patient, diagnosis was made using MRI and biopsy, and hormonal therapy had an effective role as a bridge to menopause.

[Radical resective surgery for the management of rectosigmoidal endometriosis. Clinical case].

PubMed

Bannura, G; Valencia, C; Corredoira, Y

1998-11-01

We report a 35 years old female with a profound rectosigmoidal endometriosis, who had been subjected to multiple laparoscopic procedures and open surgery due to infertility in the last five years. Main presenting symptoms were cyclic hematochezia during the menstrual periods associated to pelvic pain. Colonoscopy was inconclusive, barium enema showed a marked stenosis of the zone, appearing as an extrinsic compression. CAT scan showed a homogeneous, solid parauterine mass. During surgery, an inflammatory mass with multiple endometriotic foci was found. A low anterior resection with mechanical anastomosis was done, preserving the uterus and left adnexa. Two months later, the patient became pregnant and an elective cesarean section was done at 38 weeks of gestation, giving birth to a healthy newborn. Radical resective surgery for rectosigmoidal endometriosis is indicated in patients with intense and recurrent symptoms in whom hormonal treatment has failed and when a tumor cannot be discarded. The fertility rate, when adnexa and uterus are preserved, is 40% and symptomatic improvement is achieved in 85% of patients.

Knowledge of colorectal cancer screening among young Malaysians.

PubMed

Al-Naggar, Redhwan Ahmed; Bobryshev, Yuri V

2013-01-01

The objective of this study was to determine the knowledge and associated factors regarding colorectal cancer screening among university students in Malaysia. The questionnaire consisted of three parts: socio-demographic characteristics, lifestyle practice and knowledge of colorectal screening. A cross-sectional study was conducted among 300 students (21.3±1.4 years old). The majority of the participants were Malay with a monthly family income of less than 5,000 Ringgit Malaysia (equal to 1,700 USD) (67.0% and 76.0%, respectively). Regarding their lifestyle practices, the majority were non-smokers and had never consumed alcohol (83.7%, and 88.0%, respectively). The majority of the participants had no knowledge of digital rectal examination, colonoscopy, barium enema and fecal occult blood screening (63.3%, 60.7%, 74.0% and 62.3%, respectively). Univariate and multivariate analysis revealed that their age and the discipline which the students were studying significantly influenced their level of knowledge about colorectal screening. The present study results indicate that education campaigns about colorectal cancer should be promoted.

Morbidity in a juvenile green sea turtle (Chelonia mydas) due to ocean-borne plastic.

PubMed

Stamper, M Andrew; Spicer, Chad W; Neiffer, Donald L; Mathews, Kristin S; Fleming, Gregory J

2009-03-01

An emaciated 2.36-kg juvenile green sea turtle, Chelonia mydas, was found floating off of Melbourne Beach, Florida, USA (28 degrees 2'4"N, 80 degrees 32'32"W). The turtle exhibited signs of cachexia, positive buoyancy, lethargy, and obstipation; was covered with barnacles; and was anorexic at the time of presentation. Dorsal-ventral radiographs with positive contrast confirmed obstruction of the gastrointestinal tract. Serum chemistry abnormalities reflected metabolic/nutritional deficiencies. Gastrointestinal prokinetics and oral/enema mineral oil applications were effective in relieving gastrointestinal obstruction with the turtle defecating a total of 74 foreign objects over a period of a month. After the removal of the foreign material, the turtle quickly regained normal behavior and health. The lack of blood parameters demonstrating infection or inflammation; the failure to respond to antibiotic and antifungal treatment as well as the parallel improvement in behavior and health after incremental evacuation of the plastic is highly suggestive of a cause and effect association.

Malignant sigmoidoduodenal fistula

PubMed Central

Shapey, I.M.; Mahmood, K.; Solkar, M.H.

2014-01-01

INTRODUCTION Duodenocolic fistula is a rare complication of malignant colonic disease especially when involving and originating from the sigmoid colon. We aim to discuss the unusual clinical presentation of this case as well as the investigation and management of duodenocolic fistulas. PRESENTATION OF CASE A 91 year old lady presented as an emergency to a general surgical service at a District General Hospital with diarrhoea, vomiting and weight loss. Computed Tomography (CT) reported a large ovarian cyst elevating the sigmoid colon into immediate proximity of the duodenum. Adenocarcinoma was confirmed on histology obtained by colonoscopy. A classic apple core lesion with fistulating tract from the sigmoid colon to the duodenum was synchronously demonstrated on barium enema. DISCUSSION Sigmoido-duodenal fistulae represent a complex manifestation of gastrointestinal pathologies. CONCLUSION Management options must be considered in the context of patient wishes, their co-morbidities, and predicted post-operative outcome. In most cases this is likely to represent a non-operative approach, however surgical resection may benefit selected cases on occasion. PMID:25460456

Malignant sigmoidoduodenal fistula.

PubMed

Shapey, I M; Mahmood, K; Solkar, M H

2014-01-01

Duodenocolic fistula is a rare complication of malignant colonic disease especially when involving and originating from the sigmoid colon. We aim to discuss the unusual clinical presentation of this case as well as the investigation and management of duodenocolic fistulas. A 91 year old lady presented as an emergency to a general surgical service at a District General Hospital with diarrhoea, vomiting and weight loss. Computed Tomography (CT) reported a large ovarian cyst elevating the sigmoid colon into immediate proximity of the duodenum. Adenocarcinoma was confirmed on histology obtained by colonoscopy. A classic apple core lesion with fistulating tract from the sigmoid colon to the duodenum was synchronously demonstrated on barium enema. Sigmoido-duodenal fistulae represent a complex manifestation of gastrointestinal pathologies. Management options must be considered in the context of patient wishes, their co-morbidities, and predicted post-operative outcome. In most cases this is likely to represent a non-operative approach, however surgical resection may benefit selected cases on occasion. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Therapeutic effect of lyophilized, Kefir-fermented milk on constipation among persons with mental and physical disabilities.

PubMed

Maki, Rumiko; Matsukawa, Mayumi; Matsuduka, Atsuko; Hashinaga, Masahiko; Anai, Hirofumi; Yamaoka, Yoshio; Hanada, Katsuhiro; Fujii, Chieko

2017-11-06

Constipation is a serious problem for persons with mental and physical disabilities in Japan. However, prophylaxis is extremely difficult because the major causes of constipation in these individuals are related to their mental and physical disabilities. Constipation can be successfully treated with glycerol enemas (GEs) and other aperients. As constipation is a lifetime issue for these persons, dietary regimens to prevent constipation can be important. This study evaluated the probiotic effects of kefir-fermented milk for preventing constipation in 42 persons with mental and physical disabilities. The participants were administered 2 g of lyophilized kefir with each meal for 12 weeks and their bowel movements, the administration of GE and other aperients, and stool shape were recorded. The intake of kefir significantly reduced constipation, compared with the baseline status. Some individuals showed complete relief of constipation, whereas others showed no effect. Despite individual variations, consuming kefir daily could prevent constipation. © 2017 Japan Academy of Nursing Science.

Tribosystems based on multilayered micro/nanocrystalline CVD diamond coatings =

NASA Astrophysics Data System (ADS)

Shabani, Mohammadmehdi

A combinacao das caracteristicas do diamante microcristalino (MCD) e nanocristalino (NCD), tais como elevada adesao do MCD e a baixa rugosidade superficial e baixo coeficiente de atrito do NCD, e ideal para aplicacoes tribologicas exigentes. Deste modo, o presente trabalho centrou-se no desenvolvimento de revestimentos em multicamada MCD/NCD. Filmes com dez camadas foram depositados em amostras de cerâmicos de Si3N4 pela tecnica de deposicao quimica em fase vapor assistida por filamento quente (HFCVD). A microestrutura, qualidade do diamante e adesao foram investigadas usando tecnicas como SEM, AFM, espectroscopia Raman, DRX, indentacao Brale e perfilometria otica 3D. Diversas geometrias para aplicacoes distintas foram revestidas: discos e esferas para testes tribologicos a escala laboratorial, e para testes em servico, aneis de empanques mecânicos e pastilhas de corte para torneamento. Nos ensaios tribologicos esfera-sobre-plano em movimento reciproco, sob 10-90% de humidade relativa (RH), os valores medios dos coeficientes de atrito maximo e em estado estacionario sao de 0,32 e 0,09, respetivamente. Em relacao aos coeficientes de desgaste, observou-se um valor minimo de cerca de 5,2x10-8 mm3N-1m-1 para valores intermedios de 20-25% de RH. A humidade relativa tem um forte efeito sobre o valor da carga critica que triplica a partir de 40 N a 10% RH para 120 N a 90% de RH. No intervalo de temperaturas 50-100 °C, as cargas criticas sao semelhantes as obtidas em condicoes de baixa RH ( 10-25%). A vida util das ferramentas com revestimento de dez camadas alternadas MCD/NCD e 24 mum de espessura total no torneamento de um composito de matriz metalica Al- 15 vol% Al2O3 (Al-MMC) e melhor do que a maioria das ferramentas de diamante CVD encontradas na literatura, e semelhante a maioria das ferramentas de diamante policristalino (PCD). A formacao de cratera ocorre por desgaste sucessivo das varias camadas, atrasando a delaminacao total do revestimento de diamante do substrato, ao contrario do que acontece com os revestimentos monocamada. Os aneis de empanque testados com biodiesel apresentaram coeficientes de desgaste (4,1x10-10 mm3N-1m-1) duas ordens de grandeza menores do que em ensaios esfera-sobre-plano em movimento reciproco (k = 5,0x10-8 mm3N-1m-1), mas nao foi possivel obter vedacao completa devido a sobreaquecimento do fluido. Esta condicao foi obtida com agua sob pressao, para condicoes P.V na gama 0,72-5,3 MPa.ms-1. Um coeficiente de atrito em estado estacionario de 0,04 e um valor de coeficiente de desgaste de 6,0x10-10 mm3N-1m-1, caracteristico de um regime desgaste ultra-suave, revelam o alto desempenho deste tribossistema.

Cultural adaptation and the Clavien-Dindo surgical complications classification translated to Brazilian Portuguese.

PubMed

Moreira, Luis Fernando; Pessôa, Marcelo Castro Marçal; Mattana, Diego Sachet; Schmitz, Fernando Fernandes; Volkweis, Bernardo Silveira; Antoniazzi, Jorge Luiz; Ribeiro, Liacyr

2016-01-01

to generate a translated and validated version of the Clavien-Dindo Classification of Surgical Complications (CDC) to Brazilian Portuguese (CDC-BR). the process of translation and adaptation followed the guideline of Beaton et al., 2000. We divided 76 participating surgeons, in different levels of experience, from the Department Surgery of the Hospital de Clínicas de Porto Alegre, into two groups: Group I applied the original version (CDC, n=36);r Group II used the modified version (CDC-BR, n=40). Each group classified 15 clinical cases of surgical complications. We compared performance between the groups (Mann-Whitney test) relating to the level of experience of the surgeon (Kruskal-Wallis test), considering p value <0.05 as significant. the performance of the Group II (CDC-BR) was higher, with 85% accuracy, compared with 79% of Group I (CDC), p-value =0.012. The performance of the groups as for surgeons experience displayed p=0.171 for Group I, p=0.528 for Group II, and p=0.135 for overall performance. we produced a translated and validated version of the CDC for Brazilian Portuguese. The instrument will be a useful tool in the production of evidence on surgical outcomes. gerar uma versão traduzida e validada da Classificação de Complicações Cirúrgicas de Clavien-Dindo (CCD) para o Português-Brasileiro (CCD-BR). o processo de tradução e adaptação seguiu a diretriz de Beaton et al., de 2000. Formaram-se dois grupos, Grupo I, que utilizou a versão original (CCD, n=36) testado em relação ao Grupo II, com a versão modificada (CCD-BR, n=40), com um total de 76 cirurgiões participantes em níveis de experiência distintos do Departamento de Cirurgia do Hospital de Clínicas de Porto Alegre. Quinze casos clínicos de complicações cirúrgicas foram classificados em cada grupo. Comparou-se o desempenho entre grupos (teste de Mann-Whitney) relacionando ao nível de experiência dos cirurgiões (teste de Kruskal-Wallis). Valor de p<0,05 como significativo. o desempenho do Grupo II (CCD-BR) foi superior, com 85% de acertos, contra 79% do Grupo I (CCD), p-valor=0,012 do teste de Mann-Whitney. O desempenho dos grupos em relação à experiência dos cirurgiões foi p-valor=0,171 para o Grupo I, p-valor=0,528 para o Grupo II, e p-valor=0,135 para o desempenho geral, teste de Kruskal-Wallis. foi produzida uma versão traduzida e validada da CCD para o Português-Brasileiro. O instrumento produzido será ferramenta útil na produção de evidências sobre os resultados cirúrgicos.

77 FR 31032 - National Institute on Aging; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-24

... applications. Place: Marina del Rey Hotel, 13534 Bali Way, Marina del Rey, CA 90292. Contact Person: Bita... applications. Place: Marina del Rey Hotel, 13534 Bali Way, Marina del Rey, CA 90292. Contact Person: Ramesh... and evaluate grant applications. Place: Marina del Rey Hotel, 13534 Bali Way, Marina del Rey, CA 90292...

Biorefineries of carbon dioxide: From carbon capture and storage (CCS) to bioenergies production.

PubMed

Cheah, Wai Yan; Ling, Tau Chuan; Juan, Joon Ching; Lee, Duu-Jong; Chang, Jo-Shu; Show, Pau Loke

2016-09-01

Greenhouse gas emissions have several adverse environmental effects, like pollution and climate change. Currently applied carbon capture and storage (CCS) methods are not cost effective and have not been proven safe for long term sequestration. Another attractive approach is CO2 valorization, whereby CO2 can be captured in the form of biomass via photosynthesis and is subsequently converted into various form of bioenergy. This article summarizes the current carbon sequestration and utilization technologies, while emphasizing the value of bioconversion of CO2. In particular, CO2 sequestration by terrestrial plants, microalgae and other microorganisms are discussed. Prospects and challenges for CO2 conversion are addressed. The aim of this review is to provide comprehensive knowledge and updated information on the current advances in biological CO2 sequestration and valorization, which are essential if this approach is to achieve environmental sustainability and economic feasibility. Copyright © 2016 Elsevier Ltd. All rights reserved.

Lignin‐Derived Thioacidolysis Dimers: Reevaluation, New Products, Authentication, and Quantification

PubMed Central

Yue, Fengxia; Regner, Matt; Sun, Runcang

2017-01-01

Abstract Lignin structural studies play an essential role both in understanding the development of plant cell walls and for valorizing lignocellulosics as renewable biomaterials. Dimeric products released by selectively cleaving β–aryl ether linkages between lignin units reflect the distribution of recalcitrant lignin units, but have been neither absolutely defined nor quantitatively determined. Here, 12 guaiacyl‐type thioacidolysis dimers were identified and quantified using newly synthesized standards. One product previously attributed to deriving from β–1‐coupled units was established as resulting from β–5 units, correcting an analytical quandary. Another longstanding dilemma, that no β–β dimers were recognized in thioacidolysis products from gymnosperms, was resolved with the discovery of two such authenticated compounds. Individual GC response factors for each standard compound allowed rigorous quantification of dimeric products released from softwood lignins, affording insight into the various interunit‐linkage distributions in lignins and thereby guiding the valorization of lignocellulosics. PMID:28125766

Separation of lignin from corn stover hydrolysate with quantitative recovery of ionic liquid

DOE PAGES

Underkofler, Kaylee A.; Teixeira, Rodrigo E.; Pietsch, Stephen A.; ...

2015-02-20

Abundant lignocellulosic biomass could become a source of sugars and lignin, potential feedstocks for the now emergent biorenewable economy. The production and conversion of sugars from biomass have been well-studied, but far less is known about the production of lignin that is amenable to valorization. In this paper, we report the isolation of lignin generated from the hydrolysis of biomass dissolved in the ionic liquid 1-butyl-3-methylimidazolium chloride. We show that lignin can be isolated from the hydrolysate slurry by simple filtration or centrifugation, and that the ionic liquid can be recovered quantitatively by a straightforward wash with water. Finally, themore » isolated lignin is not only free from ionic liquid but also lacks cellulosic residues and is substantially depolymerized, making it a promising feedstock for valorization by conversion into fuels and chemicals.« less

33 CFR 80.1118 - Marina Del Rey, CA.

Code of Federal Regulations, 2010 CFR

2010-07-01

... NAVIGATION RULES COLREGS DEMARCATION LINES Pacific Coast § 80.1118 Marina Del Rey, CA. (a) A line drawn from Marina Del Rey Breakwater South Light 1 to Marina Del Rey Light 4. (b) A line drawn from Marina Del Rey... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Marina Del Rey, CA. 80.1118...

33 CFR 80.1118 - Marina Del Rey, CA.

Code of Federal Regulations, 2012 CFR

2012-07-01

... NAVIGATION RULES COLREGS DEMARCATION LINES Pacific Coast § 80.1118 Marina Del Rey, CA. (a) A line drawn from Marina Del Rey Breakwater South Light 1 to Marina Del Rey Light 4. (b) A line drawn from Marina Del Rey... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Marina Del Rey, CA. 80.1118...

33 CFR 80.1118 - Marina Del Rey, CA.

Code of Federal Regulations, 2013 CFR

2013-07-01

... NAVIGATION RULES COLREGS DEMARCATION LINES Pacific Coast § 80.1118 Marina Del Rey, CA. (a) A line drawn from Marina Del Rey Breakwater South Light 1 to Marina Del Rey Light 4. (b) A line drawn from Marina Del Rey... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Marina Del Rey, CA. 80.1118...

33 CFR 80.1118 - Marina Del Rey, CA.

Code of Federal Regulations, 2011 CFR

2011-07-01

... NAVIGATION RULES COLREGS DEMARCATION LINES Pacific Coast § 80.1118 Marina Del Rey, CA. (a) A line drawn from Marina Del Rey Breakwater South Light 1 to Marina Del Rey Light 4. (b) A line drawn from Marina Del Rey... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Marina Del Rey, CA. 80.1118...

33 CFR 80.1118 - Marina Del Rey, CA.

Code of Federal Regulations, 2014 CFR

2014-07-01

... NAVIGATION RULES COLREGS DEMARCATION LINES Pacific Coast § 80.1118 Marina Del Rey, CA. (a) A line drawn from Marina Del Rey Breakwater South Light 1 to Marina Del Rey Light 4. (b) A line drawn from Marina Del Rey... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Marina Del Rey, CA. 80.1118...

Hydrochemical tracers in the middle Rio Grande Basin, USA: 2. Calibration of a groundwater-flow model

NASA Astrophysics Data System (ADS)

Sanford, Ward E.; Plummer, L. Niel; McAda, Douglas P.; Bexfield, Laura M.; Anderholm, Scott K.

The calibration of a groundwater model with the aid of hydrochemical data has demonstrated that low recharge rates in the Middle Rio Grande Basin may be responsible for a groundwater trough in the center of the basin and for a substantial amount of Rio Grande water in the regional flow system. Earlier models of the basin had difficulty reproducing these features without any hydrochemical data to constrain the rates and distribution of recharge. The objective of this study was to use the large quantity of available hydrochemical data to help calibrate the model parameters, including the recharge rates. The model was constructed using the US Geological Survey's software MODFLOW, MODPATH, and UCODE, and calibrated using 14C activities and the positions of certain flow zones defined by the hydrochemical data. Parameter estimation was performed using a combination of nonlinear regression techniques and a manual search for the minimum difference between field and simulated observations. The calibrated recharge values were substantially smaller than those used in previous models. Results from a 30,000-year transient simulation suggest that recharge was at a maximum about 20,000 years ago and at a minimum about 10,000 years ago. Le calibrage d'un modèle hydrogéologique avec l'aide de données hydrochimiques a démontré que la recharge relativement faible dans le Grand Bassin du Middle Rio est vraisemblablement responsable d'une dépression des eaux souterraines dans le centre du bassin et de la présence d'une quantité substantielle d'eau du Rio Grande dans l'aquifère du Groupe de Santa Fe. Les modèles antérieurs avaient des difficultés à reproduire ses conclusions sans l'aide de données hydrochimiques pour contraindre les taux et la distribution de la recharge. L'objectif de cette étude était d'utiliser une grande quantité de données hydrochimiques permettant de calibrer les paramètres du modèle, et notamment les taux de recharge. Le modèle a été construit avec les logiciels MODFLOW, MODPATH et UCODE, et calibré en utilisant les concentrations en 14C et la position de certaines zones définies par les données hydrochimiques. L'estimation de certains paramètres a été réalisée en utilisant une combinaison de techniques de régression non linéaire et une méthode de recherche exhaustive (Brute Force Search) de l'erreur minimum entre les résultats des observations et les simulations. Les valeurs de la recharge calibrée sont substantiellement plus basses que celles estimées dans les modèles antérieurs. Les résultats d'une simulation en régime transitoire sur 30.000 ans suggèrent que la recharge au maximum de la dernière glaciation (last glacial maximum, LGM) était 10 fois supérieure au taux actuel, mais que la recharge qui a suivit la LGM était plus bas que la recharge actuelle. La calibración de un modelo de aguas subterráneas con el apoyo de datos hidroquímicos ha demostrado que la recarga relativamente baja en la cuenca media del Río Grande es probablemente responsable de una depresión de aguas subterráneas en el centro de la cuenca y de la presencia de una cantidad considerable de agua del Río Grande en el acuífero del Grupo Santa Fe. Los modelos propuestos con anterioridad para la cuenca tenían dificultades para reproducir estas características ya que no tenían datos hidroquímicos que permitieran delimitar los ritmos y distribución de recarga. El objetivo del presente estudio consistió en utilizar una gran cantidad de datos hidroquímicos disponibles para ayudar a calibrar los parámetros del modelo, incluyendo los ritmos de recarga. El modelo se construyó utilizando los modelos MODFLOW, MODPATH, y UCODE del USGS, mientras que la calibración se realizó en base a concentraciones de 14C y a la posición de ciertas zonas definidas con los datos hidroquímicos. La estimación de parámetros se realizó en base a una combinación de técnicas de regresiones no lineares y a una búsqueda a viva fuerza del error mínimo entre los datos observados y los simulados. Los valores de recarga calibrados fueron significativamente más bajos que los estimados en los modelos anteriores. Los resultados de una simulación transitoria de 30,000 años sugieren que la recarga durante la última glacial máxima (LGM) fue diez veces el ritmo moderno, pero que la recarga que ocurrió inmediatamente después de la LGM fue más baja que el ritmo moderno.

Cysteamine-colon and cysteamine-duodenum lesions in rats. Attenuation by gastric pentadecapeptide BPC 157, cimetidine, ranitidine, atropine, omeprazole, sulphasalazine and methylprednisolone.

PubMed

Sikiric, P; Seiwerth, S; Grabarevic, Z; Balen, I; Aralica, G; Gjurasin, M; Komericki, L; Perovic, D; Ziger, T; Anic, T; Prkacin, I; Separovic, J; Stancic-Rokotov, D; Lovric-Bencic, M; Mikus, D; Staresinic, M; Aralica, J; DiBiaggio, N; Simec, Z; Turkovic, B; Rotkvic, I; Mise, S; Rucman, R; Petek, M; Sebecic, B; Ivasovic, Z; Boban-Blagaic, A; Sjekavica, I

2001-01-01

Recently, we showed cysteamine-duodenal lesions without gastric acid, since they were induced also in gastrectomized rats, as in naive rats, and they were inhibited by the novel stomach pentadecapeptide BPC 157 as well as standard antiulcer drugs (i.e. cimetidine, ranitidine, omeprazole, bromocriptine, atropine). Therefore, as an advantage of considering cysteamine as a directly acting cytotoxic agent and mentioned agents as direct cytoprotective agents, the present focus was on the ulcerogenic effect of cysteamine and protective effect of gastroduodenal antiulcer agents outside upper gastrointestinal tract (i.e. in colon). Intrarectal administration of the cysteamine (200 or 400 mg/kg b.w) produced severe colon lesions (i.e. transmural inflammation with serosal involvement) in rats (30 min-72 h-experimental period), apparently distinctive from smaller lesions after non-specific irritant enema [diluted HCl solution, pH 3.8 (adjusted to pH of cysteamine solution (pH 3.8)]. All of the tested antiulcer agents were applied simultaneously with cysteamine enema (8 cm from the anus, in a volume of the 1.0 ml/rat) intraperitoneally (i.p.), intragastrically (i.g.) or intrarectally (i.r.). Pentadecapeptide BPC 157 (10 microg or 10 ng/kg b.w.), given in either regimen, previously shown to have, besides others, a particular beneficial activity just in the intestinal mucosa, inhibited these cysteamine colon lesions (assessed after 30 min, 60 min, 180 min, 24 h, 48 h, 72 h following cysteamine in a dose of either 200 or 400 mg/kg i.r.). Cysteamine-colon lesions were also attenuated by standard antiulcer agents (mg/kg b.w.), given i.p., i.g., or i.r., such as ranitidine (10), cimetidine (50), omeprazole (10), atropine (10), together with methylprednisolone (1), and sulphasalazine (50, i.r.), assessed 30 min following application of 200 mg of cysteamine. Finally, standard cysteamine duodenal lesions (assessed 24 h after a subcutaneous application of 400 mg/kg of cysteamine) were also attenuated by these agents application (given in the same doses, i.p., 1 h before cysteamine), with only exception to sulphasalazine. Thus, the extended cysteamine specific ulcerogenic effect, cysteamine colon/duodenum lesion-link and an extenuation of agents protection from upper to lower part of gastrointestinal tract (i.e. stomach pentadecapeptide BPC 157, standard antiulcer agents, cimetidine, ranitidine, atropine, omeprazole) and vice versa (remedies for inflammatory bowel disease) evidenced in the present study may be potentially important for both further experimental and clinical research.

Standardization of barostat procedures for testing smooth muscle tone and sensory thresholds in the gastrointestinal tract. The Working Team of Glaxo-Wellcome Research, UK.

PubMed

Whitehead, W E; Delvaux, M

1997-02-01

An international working team of 13 investigators met on two occasions to develop guidelines for standardizing the procedures used to test gastrointestinal muscle tone and sensory thresholds using a barostat. General recommendations were: (1) Use a thin-walled plastic bag that is infinitely compliant until its capacity is reached. Maximum diameter of the bag should be much greater than the maximum diameter of the viscus. (2) The pump should be able to inflate the bag at up to 40 ml/sec. (3) Pressure should be monitored inside the bag, not in the pump or inflation line. (4) Subjects should be positioned so that the bag is close to the uppermost surface of the body. (5) For rectal tests, bowel cleansing should be limited to a tap water enema to minimize rectal irritation. Oral colonic lavage is recommended for studies of the proximal colon, and magnesium citrate enemas for the descending colon and sigmoid. (6) If sedation is required for colonic probe placement, allow at least one hour for drug washout and clearance of insufflated air. Ten to 20 min of adaptation before testing is adequate if no air or drugs were used. (7) The volumes reported must be corrected for the compressibility of gas and the compliance of the pump, which is greater for bellows pumps than for piston pumps. (8) Subjects should be tested in the fasted state. For evaluation of muscle tone: (9) The volume of the bag should be monitored for at least 15 min. For evaluation of sensory thresholds; (10) It is recommended that phasic distensions be > or = 60 sec long and that they be separated by > or = 60 sec. (11) Sensory thresholds should be reported as bag pressure rather than (or in addition to) bag volume because pressure is less vulnerable to measurement error. (12) Tests for sensory threshold should minimize psychological influences on perception by making the amount of each distension unpredictable to the subject. (13) Pain or other sensations should be reported on a graduated scale; not "yes-no." The working team recommends verbal descriptor scales, containing approximately seven steps, or visual analog scales in which subjects place a mark on a straight line marked "none" on one end and "maximum" on the other end. (14) It is recommended that subjects should be asked to rate the unpleasantness of distensions separately from their intensity.

Managing fecal incontinence in patients with myelomeningocele in Sub-Saharan Africa: Role of antegrade continence enema (ACE).

PubMed

Ibrahim, Musa; Ismail, Nasiru Jinjiri; Mohammad, Mohammad Aminu; Ismail, Hassan; Ahmed, Misbahu Haruna; Femi, Owolabi Lukman; Suwaid, Mohammed Abba

2017-04-01

Neural tube defects (NTDs) are among the major causes of sphincter dysfunctions. Fecal incontinence (FI) because of myelomeningocele (MMC) leads to problems with social acceptability and decreased quality of life (QOL), life satisfaction in addition to other morbidities. This is a report of experience with antegrade continence enema (ACE) in the management of FI in patients with MMC in an African set-up. A retrospective review of 23 children and young adults with FI because of MMC managed with ACE from October 2008 to September 2015 from African Specialist Hospital. The clinical outcomes have been analyzed. From October 2008 to September 2015, a total of thirty-two n=32 patients underwent ACE procedure after repair of MMC associated with FI. Available data of 23 (71.87%) patients were reviewed retrospectively. Mean age at which ACE was created was 6.43±3.83years, range (3.5-17.8) years, median 5years. Follow-up after ACE creation was (0.5-6.9) years, median 2.6years. There were full continence in 13 (56.52%), partial continence in 8 (34.78%) and failure in 2 (8.69%). There were 16 (69.56%) complications and 4 (17.39%) minor post ACE surgery revisions. Mean PedQOL ( ™ ) score before ACE and then 5, 10, and 15months after ACE were 47.86±13.83, range (20.4-66.0) vs 88.34±7.11, range (77.9-98.6); p=0.000, 88.9±6.44 range (76.9-98.5); p=0.000, 89.01±6.50, range (76.9-98.88) p=0.000 respectively. Mean parental/caregiver satisfaction score for 15 (65.21%) patients aged 6years and below using modified visual analogue scale (VAS) 1 to 10 before ACE and after were 3.06±0.79, range (2-4), median 3 vs 8.0±1.30, range (5-10), median 8; (p=0.000) while 8 (34.78%) patients aged above 6years were able to assess their satisfactions score before and after ACE creation with mean of 1.75±0.70, range (1-3), median 2 vs 7.75±1.03, range (6-9) median 8; (p=0.000). ACE has satisfactory outcomes in an African set-up in patients with MMC associated with FI. Multidisciplinary approach to neurogenic FI should be encouraged in such set-ups. Copyright © 2017 Elsevier Inc. All rights reserved.

Daily Sodium Butyrate Enema for the Prevention of Radiation Proctitis in Prostate Cancer Patients Undergoing Radical Radiation Therapy: Results of a Multicenter Randomized Placebo-Controlled Dose-Finding Phase 2 Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Maggio, Angelo, E-mail: maggio.angelo@gmail.com; Magli, Alessandro; Rancati, Tiziana

2014-07-01

Purpose: To evaluate the efficacy of sodium butyrate enemas (NABUREN) in prostate cancer radiation therapy (RT) in reducing the incidence, severity, and duration of acute RT-induced proctitis. Methods and Materials: 166 patients, randomly allocated to 1 of 4 groups (rectal sodium butyrate 1 g, 2 g, or 4 g daily or placebo), were treated with NABUREN during and 2 weeks after RT. The grade of proctitis was registered in a daily diary. The correlation between NABUREN and proctitis was investigated through χ{sup 2} statistics. The toxicity endpoints considered were as follows: total number of days with grade ≥1 proctitis (≥G1); total number of daysmore » with grade ≥2 proctitis (≥G2); ≥G1 and ≥G2 proctitis lasting at least 3 and 5 consecutive days starting from week 4 (≥G1+3d, ≥G2+3d); damaging effects of RT on rectal mucosa as measured by endoscopy. The relationship between endpoints and pretreatment morbidities, hormonal therapy, presence of diabetes or hypertension, abdominal surgery, or hemorrhoids was investigated by univariate analysis. Results: The patients were randomly allocated to the 4 arms. No difference in the distribution of comorbidities among the arms was observed (P>.09). The mean ≥G1 and ≥G2 proctitis were 7.8 and 4.9 for placebo and 8.9 and 4.7 for the NABUREN group, respectively. No favorable trend in reduction of incidence, severity, and duration of ≥G1 and ≥G2 proctitis was observed with NABUREN use. In univariate analysis, ≥G1+3d toxicity was found to be related to hemorrhoids (P=.008), and a slight correlation was found between ≥G2 proctitis and hormonal therapy (P=.06). The RT effects on rectal mucosa as based on endoscopic assessment were mainly related to diabetes (P<.01). Endoscopy data at 6 week showed no significant difference between the placebo and butyrate arms. The other investigated endpoints were not correlated with any of the clinical risk factors analyzed. Conclusion: There was no evidence of efficacy of NABUREN in reducing the incidence, severity, and duration of acute radiation proctitis. There was a correlation between some endpoints and clinical risk factors.« less

8th Argentinean Bioengineering Society Conference (SABI 2011) and 7th Clinical Engineering Meeting

NASA Astrophysics Data System (ADS)

Meschino, Gustavo Javier; Ballarin, Virginia L.

2011-12-01

In September 2011, the Eighteenth Edition of the Argentinean Bioengineering Society Conference (SABI 2011) and Seventh Clinical Engineering Meeting were held in Mar del Plata, Argetina. The Mar del Plata SABI Regional and the School of Engineering of the Universidad Nacional de Mar del Plata invited All bioengineers, engineers, physicists, mathematicians, biologists, physicians and health professionals working in the field of Bioengineering to participate in this event. The overall objectives of the Conference were: To provide discussion of scientific research results in Bioengineering and Clinical Engineering. To promote technological development experiences. To strengthen the institutional and scientific communication links in the area of Bioengineering, mainly between Universities of Latin America. To encourage students, teachers, researchers and professionals to establish exchanges of experiences and knowledge. To provide biomedical engineering technology solutions to the society and contributing ideas for low cost care. Conference photograph Conference photograph Conference photograph Conference photograph EXECUTIVE COMMITTEE SABI 2011 Chair Dra Virginia L Ballarin Universidad Nacional de Mar del Plata Co-Chair Dra Teresita R Cuadrado Universidad Nacional de Mar del Plata - CONICET Local Comittee Dr Gustavo Abraham Universidad Nacional de Mar del Plata - CONICET Dra Josefina Ballarre Universidad Nacional de Mar del Plata - CONICET Dr Eduardo Blotta Universidad Nacional de Mar del Plata Dra Agustina Bouchet Universidad Nacional de Mar del Plata Dr Marcel Brun Universidad Nacional de Mar del Plata Dra Silvia Ceré Universidad Nacional de Mar del Plata - CONICET Dra Mariela Azul Gonzalez Universidad Nacional de Mar del Plata - CONICET Dra Lucia Isabel Passoni Universidad Nacional de Mar del Plata Dr Juan Ignacio Pastore Universidad Nacional de Mar del Plata - CONICET Dra Adriana Scandurra Universidad Nacional de Mar del Plata SCIENTIFIC ADVISORY COMMITTEE President Dr Gustavo Meschino Universidad Nacional de Mar del Plata Comittee Dr Gustavo Abraham Universidad Nacional de Mar del Plata - CONICET Mg Rubén Acevedo Universidad Nacional de Entre Ríos Ing Pablo Agüero Universidad Nacional de Mar del Plata Ing Mariela Ambrustolo Universidad Nacional de Mar del Plata Dr Ricardo Armentano Universidad Favaloro Dra Virginia L Ballarin Universidad Nacional de Mar del Plata Dra Josefina Ballarre Universidad Nacional de Mar del Plata - CONICET Dr Eduardo Blotta Universidad Nacional de Mar del Plata Ing Marco Benalcázar Universidad Nacional de Mar del Plata Mg Freddy Geovanny Benalcázar Palacios Escuela Superior Politécnica de Chimborazo, Ecuador Dr Roberto Boeri Universidad Nacional de Mar del Plata - CONICET - INTEMA Dra Agustina Bouchet Universidad Nacional de Mar del Plata Dr Ariel Braidot Universidad Nacional de Entre Ríos Dr Marcel Brun Universidad Nacional de Mar del Plata Dra Silvia Ceré Universidad Nacional de Mar del Plata - CONICET Ing Fernando Clara Universidad Nacional de Mar del Plata Dr Raúl Correa Prado Universidad Nacional de San Juan Bioing Pablo Cortez Universidad Nacional de Mar del Plata Dra Teresita R Cuadrado Universidad Nacional de Mar del Plata - CONICET Ing Eduardo De Forteza Universidad Favaloro Dra Mariana Del Fresno Universidad Nacional del Centro de la Provincia de Buenos Aires Dr Martín Diaz Informática Médica Hospital Aleman de Buenos Aires - GIBBA Ing Julio César Doumecq Universidad Nacional de Mar del Plata Mg Ana María Echenique Universidad Nacional de San Juan Bioing Pedro Escobar Universidad Nacional del Centro, Olavarría, Pcia de Buenos Aires Dr Fernando Daniel Farfán Universidad Nacional de Tucumán Dr Carmelo Felice Universidad Nacional de Tucumán - CONICET Dr Elmer Fernández Universidad Católica de Córdoba - CONICET Ing José Flores Universidad Nacional de Entre Ríos Dr Arturo Gayoso Universidad Nacional de Mar del Plata Dra Bioing Agustina Garcés Universidad Nacional de San Juan ¬- CONICET Bioing Luciano Gentile Universidad Favaloro Mg María Eugenia Gómez Universidad Nacional de San Juan Dr Claudio González Universidad Nacional de Mar del Plata Mg Esteban González Universidad Nacional de Mar del Plata Dra Mariela A Gonzalez Universidad Nacional de Mar del Plata - CONICET Dr Juan Pablo Graffigna Universidad Nacional de San Juan Dra Myriam Herrera Universidad Nacional de Tucumán - CONICET Dr Roberto Hidalgo Universidad Nacional de Mar del Plata Dr Roberto Isoardi Fundación Escuela de Medicina Nuclear de Mendoza - CNEA Dra Susana Jerez Universidad Nacional de Tucumán Dr Eric Laciar Universidad Nacional de San Juan - CONICET Bioing Roberto Leonarduzzi Universidad Nacional de Entre Ríos Mg Norberto Lerendegui Instituto Tecnológico de Buenos Aires Dra Natalia López Universidad Nacional de San Juan - CONICET Dra Rossana Madrid Universidad Nacional de Tucuman - CONICET Ing Florencia Montini Ballarin Universidad Nacional de Mar del Plata - CONICET Dra Emilce Moler Universidad Nacional de Mar del Plata Dr Jorge Castiñieira Moreira Universidad Nacional de Mar del Plata Dr Silvia Murialdo Universidad Nacional de Mar del Plata - CIC Dr Juan Manuel Olivera Universidad Nacional de Tucumán Dra Lucia Isabel Passoni Universidad Nacional de Mar del Plata Dr Juan Ignacio Pastore Universidad Nacional de Mar del Plata - CONICET Dra María Elisa Pérez Universidad Nacional de San Juan Mg Franco M Pessana Universidad Favaloro Dr Julio Politti Universidad Nacional de Tucumán Dr Marcelo Risk Universidad Nacional de Buenos Aires - CONICET Ing Raúl Rivera Universidad Nacional de Mar del Plata Mg Luis Rocha Universidad Nacional de Tucumán - SIPROSA Dra Silvia Rodrigo Universidad Nacional de San Juan Dra Viviana Rotger Universidad Nacional de Tucumán Dr Leonardo Rufiner Universidad Nacional de Entre Rios - CONICET Dra Estela Ruiz Universidad Nacional de Tucumán Dr Martín Santiago Universidad Nacional del Centro de la Provincia de Buenos Aires Dra Adriana Scandurra Universidad Nacional de Mar del Plata Ing Graciela Secreto Universidad Favaloro Mg Pablo Solarz Universidad Nacional de Tucumán Mg Carolina Tabernig Universidad Nacional de Entre Ríos Ing Ricardo Taborda Universidad Nacional de Córdoba Dra María Eugenia Torres Universidad Nacional de Entre Ríos - CONICET Ing Juan Carlos Tulli Universidad Nacional de Mar del Plata Dr Gerardo Tusman Hospital Privado de Comunidad, Mar del Plata Dr Santiago Urquiza Universidad Nacional de Mar del Plata Mg Andrés Valdez Universidad Nacional de San Juan Dr Máximo Valentinuzzi INSIBIO - CONICET - Universidad Nacional de Tucumán

TENDENCIA DE LA TUBERCULOSIS EN LA REGIÓN SANITARIA V DE LA PROVINCIA DE BUENOS AIRES, AÑOS 2000–2011

PubMed Central

CHIRICO, CRISTINA; SANJURJO, MYRIAM; IRIBARREN, SARAH; APPENDINO, ANDREA; ZERBINI, ELSA; ETCHEVARRIA, MIRTA

2016-01-01

El objetivo del presente trabajo fue analizar la situación epidemiológica de la tuberculosis (TB) en la Región Sanitaria V (RSV), provincia de Buenos Aires. El estudio de tendencia permitió conocer un valor promedio de las variaciones de la tasa de incidencia (TI), calculadas por regresión lineal simple y expresadas como variación anual promedio (VAP). Se analizaron el número de casos notificados y TI por 100 000 habitantes de todas las formas de TB, los casos de TB pulmonar (TBP) y TBP confirmados por bacteriología, total casos por grupos de edad: 0 – 14; 15 – 29 y mayores de 64 años, entre el 1° de enero de 2000 al 31 de diciembre de 2011. La declinación de la TI fue menor al 5% para todas las formas de TB e inferior en las TBP confirmadas bacteriológicamente. Los casos de TBP y TI más elevadas, se concentraron en el grupo de 15 a 29 años, con tendencia estable o ligeramente ascendente de la TI en la TBP bacilífera. El mismo comportamiento presentaron los casos de TBP infantil con confirmación bacteriológica. La mayor velocidad de descenso en la TI de la TBP se produjo en este grupo de edad, mientras que en mayores de 64 años, el descenso fue sostenido en el tiempo. La TB persiste como un riesgo de salud en la RSV, con casos en edades jóvenes, por lo que sigue siendo necesario fortalecer el control de la TB en esta región. PMID:26117604

PubMed

Müller Velázquez, Lucía; Bobadilla, Fernando; Novosak, Marina; Cortese, Iliana; Laczeski, Margarita

2018-03-20

Streptococcus agalactiae (SGB) es causa de infecciones severas en menores de tres meses. Meningitis, neumonía y sepsis son los principales cuadros en estos niños. Estas infecciones se encuentran entre las más graves que puede sufrir un individuo en sus primeras doce horas de vida. El niño adquiere la infección por transmisión vertical de la madre colonizada. Para prevenir la enfermedad neonatal se recomienda penicilina como droga de elección en la profilaxis intraparto (PIP) en embarazadas colonizadas. Sin embargo, actualmente se han detectado cepas con sensibilidad disminuida a penicilina por lo que resulta importante realizar la vigilancia de la sensibilidad al mismo para asegurar su utilidad durante la profilaxis. El objetivo de este trabajo fue determinar la sensibilidad a penicilina en cepas de SGB recuperados de mujeres embarazadas de 35-37 semanas de gestación. Se estudiaron 96 aislamientos y se determinó la sensibilidad por método epsilométrico Etest® (LIOFILCHEM, Italia), siguiendo las recomendaciones del Clinical Laboratory Standards Institute (CLSI). Se obtuvo la Concentración Inhibitoria Mínima (CIM) para cada aislamiento bacteriano. El 100% (96) de las cepas estudiadas fue sensible a penicilina con valores de CIM comprendidos entre 0,012 y 0,094 µg mL-1. Estos resultados indican que penicilina sigue siendo el antimicrobiano de elección durante la profilaxis intraparto, para la prevención de la enfermedad neonatal causada por SGB en nuestra región. Se destaca la importancia de la vigilancia epidemiológica de la sensibilidad a penicilina y a otros antimicrobianos para alertar sobre nuevos mecanismos de resistencia y adecuar estrategias de tratamiento.

Aplicación de la metodología Molecular de Orbitales de Defecto Cuántico (MQDO) al cálculo de intensidades vibrónicas y vidas medias de niveles vibracionales

NASA Astrophysics Data System (ADS)

María Velasco Sanz, Ana

Desde que se formuló, en 1996, la metodología Molecular de Orbitales de Defecto Cuántico (MQDO) [1], se han obtenido datos de calidad relativos a intensidades de bandas electrónicas que implican estados Rydberg para una gran variedad de sistemas moleculares [2]. Animados por los buenos resultados obtenidos, recientemente hemos abordado el estudio de transiciones vibrónicas, es decir aquellas que ocurren entre estados vibracionales que pertenecen a distintos estados Rydberg electrónicos. Como prototipo adecuado para nuestros propósitos hemos elegido la molécula de NO, importante en la química de la atmósfera, y para la cual existen en la bibliografía datos experimentales de calidad suficiente para contrastar la validez de nuestros resultados. En concreto, hemos calculado las fuerzas de oscilador y coeficientes de Einstein para transiciones electrónicas y vibrónicas de las principales bandas del NO, al igual que vidas medias radiativas de niveles vibracionales de dicha molécula. Las propiedades estudiadas son esenciales para la comprensión de los aspectos teóricos de los procesos físicos básicos relativos a la dispersión electrónica en moléculas heteronucleares con capas abiertas. Además, valores fiables de probabilidades de transición moleculares tienen importantes aplicaciones en Astrofísica, en la modelización de procesos fotodinámicos moleculares, etc., al igual que para evaluar más profundamente la validez de nuestra metodología teórica.

Total number of planetary nebulae in different galaxies and the PN distance scale.

NASA Astrophysics Data System (ADS)

Peimbert, M.

1990-12-01

RESUMEN A partir de una muestra de quince galaxias se encuentra que la tasa de natalidad de nebulosas planetarias por unidad de luminosidad, , disminuye al aumentar la luminosidad y al aumentar (B - V)0. Se discuten posibles explicaciones para estos resultados. Se estima el valor de para la Galaxia y a partir de el se encuentra que el numero total de nebulosas planetarias en nuestra galaxia con R < 0.64 pc- es de 7200 j 1800. El valor galactico de implica que la mayorfa de las estrellas de masa intermedia pasa por la etapa de nebulosa planetaria. El valor galactico de , la tasa de mortalidad estelar por unidad de luminosidad y la tasa de natalidad de enanas blancas favorecen escalas de distancias largas para nebulosas planetarias, como la de Cudworth (1974) y la de Mallik y Peimbert (1988). ABSTRACT From a sample of fifteen galaxies it is found that the birth rate of PN per unit luminosity, , decreases with increasing luminosity and with increasing (B - V)0 possible reasons for these relationships are discussed. The value for the Galaxy is estimated and, from it, a total number of PN of 7200 # 1800 wid R < 0.64 pc is obtained. The galactic value implies that most of the intermediate mass stars go through the PN stage. The galactic value, the stellar death rate per unit luminosity and the white dwarf birth rate are in favor of long distance scales to PN like those of Cudworth (1974) and Mallik and (1988). Key wonis: NEBULAE.PLANETARY - STARS-EVOLUTION - STARS-SThLIAR STA. S

Valorization of starchy, cellulosic, and sugary food waste into hydroxymethylfurfural by one-pot catalysis.

PubMed

Yu, Iris K M; Tsang, Daniel C W; Yip, Alex C K; Chen, Season S; Ok, Yong Sik; Poon, Chi Sun

2017-10-01

This study aimed to produce a high-value platform chemical, hydroxymethylfurfural (HMF), from food waste and evaluate the catalytic performance of trivalent and tetravalent metals such as AlCl 3 , CrCl 3 , FeCl 3 , Zr(O)Cl 2 , and SnCl 4 for one-pot conversion. Starchy food waste, e.g., cooked rice and penne produced 4.0-8.1 wt% HMF and 46.0-64.8 wt% glucose over SnCl 4 after microwave heating at 140 °C for 20 min. This indicated that starch hydrolysis was effectively catalyzed but subsequent glucose isomerization was rate-limited during food waste valorization, which could be enhanced by 40-min reaction to achieve 22.7 wt% HMF from cooked rice. Sugary food waste, e.g., kiwifruit and watermelon, yielded up to 13 wt% HMF over Sn catalyst, which mainly resulted from naturally present fructose. Yet, organic acids in fruits may hinder Fe-catalyzed dehydration by competing for the Lewis sites. In contrast, conversion of raw mixed vegetables as cellulosic food waste was limited by marginal hydrolysis at the studied conditions (120-160 °C and 20-40 min). It is interesting to note that tetravalent metals enabled HMF production at a lower temperature and shorter time, while trivalent metals could achieve a higher HMF selectivity at an elevated temperature. Further studies on kinetics, thermodynamics, and reaction pathways of food waste valorization are recommended. Copyright © 2017 Elsevier Ltd. All rights reserved.

Search for a new economic optimum in the management of household waste in Tiaret city (western Algeria).

PubMed

Asnoune, M; Abdelmalek, F; Djelloul, A; Mesghouni, K; Addou, A

2016-11-01

In household waste matters, the objective is always to conceive an optimal integrated system of management, where the terms 'optimal' and 'integrated' refer generally to a combination between the waste and the techniques of treatment, valorization and elimination, which often aim at the lowest possible cost. The management optimization of household waste using operational methodologies has not yet been applied in any Algerian district. We proposed an optimization of the valorization of household waste in Tiaret city in order to lower the total management cost. The methodology is modelled by non-linear mathematical equations using 28 variables of decision and aims to assign optimally the seven components of household waste (i.e. plastic, cardboard paper, glass, metals, textiles, organic matter and others) among four centres of treatment [i.e. waste to energy (WTE) or incineration, composting (CM), anaerobic digestion (ANB) or methanization and landfilling (LF)]. The analysis of the obtained results shows that the variation of total cost is mainly due to the assignment of waste among the treatment centres and that certain treatment cannot be applied to household waste in Tiaret city. On the other hand, certain techniques of valorization have been favoured by the optimization. In this work, four scenarios have been proposed to optimize the system cost, where the modelling shows that the mixed scenario (the three treatment centres CM, ANB, LF) suggests a better combination of technologies of waste treatment, with an optimal solution for the system (cost and profit). © The Author(s) 2016.

The Human 343delT HSPB5 Chaperone Associated with Early-onset Skeletal Myopathy Causes Defects in Protein Solubility*

PubMed Central

Mitzelfelt, Katie A.; Limphong, Pattraranee; Choi, Melinda J.; Kondrat, Frances D. L.; Lai, Shuping; Kolander, Kurt D.; Kwok, Wai-Meng; Dai, Qiang; Grzybowski, Michael N.; Zhang, Huali; Taylor, Graydon M.; Lui, Qiang; Thao, Mai T.; Hudson, Judith A.; Barresi, Rita; Bushby, Kate; Jungbluth, Heinz; Wraige, Elizabeth; Geurts, Aron M.; Benesch, Justin L. P.; Riedel, Michael; Christians, Elisabeth S.; Minella, Alex C.; Benjamin, Ivor J.

2016-01-01

Mutations of HSPB5 (also known as CRYAB or αB-crystallin), a bona fide heat shock protein and molecular chaperone encoded by the HSPB5 (crystallin, alpha B) gene, are linked to multisystem disorders featuring variable combinations of cataracts, cardiomyopathy, and skeletal myopathy. This study aimed to investigate the pathological mechanisms involved in an early-onset myofibrillar myopathy manifesting in a child harboring a homozygous recessive mutation in HSPB5, 343delT. To study HSPB5 343delT protein dynamics, we utilize model cell culture systems including induced pluripotent stem cells derived from the 343delT patient (343delT/343delT) along with isogenic, heterozygous, gene-corrected control cells (WT KI/343delT) and BHK21 cells, a cell line lacking endogenous HSPB5 expression. 343delT/343delT and WT KI/343delT-induced pluripotent stem cell-derived skeletal myotubes and cardiomyocytes did not express detectable levels of 343delT protein, contributable to the extreme insolubility of the mutant protein. Overexpression of HSPB5 343delT resulted in insoluble mutant protein aggregates and induction of a cellular stress response. Co-expression of 343delT with WT prevented visible aggregation of 343delT and improved its solubility. Additionally, in vitro refolding of 343delT in the presence of WT rescued its solubility. We demonstrate an interaction between WT and 343delT both in vitro and within cells. These data support a loss-of-function model for the myopathy observed in the patient because the insoluble mutant would be unavailable to perform normal functions of HSPB5, although additional gain-of-function effects of the mutant protein cannot be excluded. Additionally, our data highlight the solubilization of 343delT by WT, concordant with the recessive inheritance of the disease and absence of symptoms in carrier individuals. PMID:27226619

Incentivizing Monitoring and Compliance in Trophy Hunting

PubMed Central

BUNNEFELD, NILS; EDWARDS, CHARLES T T; ATICKEM, ANAGAW; HAILU, FETENE; MILNER-GULLAND, E J

2014-01-01

Conservation scientists are increasingly focusing on the drivers of human behavior and on the implications of various sources of uncertainty for management decision making. Trophy hunting has been suggested as a conservation tool because it gives economic value to wildlife, but recent examples show that overharvesting is a substantial problem and that data limitations are rife. We use a case study of trophy hunting of an endangered antelope, the mountain nyala (Tragelaphus buxtoni), to explore how uncertainties generated by population monitoring and poaching interact with decision making by 2 key stakeholders: the safari companies and the government. We built a management strategy evaluation model that encompasses the population dynamics of mountain nyala, a monitoring model, and a company decision making model. We investigated scenarios of investment into antipoaching and monitoring by governments and safari companies. Harvest strategy was robust to the uncertainty in the population estimates obtained from monitoring, but poaching had a much stronger effect on quota and sustainability. Hence, reducing poaching is in the interests of companies wishing to increase the profitability of their enterprises, for example by engaging community members as game scouts. There is a threshold level of uncertainty in the population estimates beyond which the year-to-year variation in the trophy quota prevented planning by the safari companies. This suggests a role for government in ensuring that a baseline level of population monitoring is carried out such that this level is not exceeded. Our results illustrate the importance of considering the incentives of multiple stakeholders when designing frameworks for resource use and when designing management frameworks to address the particular sources of uncertainty that affect system sustainability most heavily. Incentivando el Monitoreo y el Cumplimiento en la Caza de Trofeos Resumen Científicos conservacionistas cada vez se enfocan más en los conductores del comportamiento humano y en las implicaciones de varias fuentes de incertidumbre en la toma de decisiones de manejo. La cacería de trofeos ha sido sugerida como una herramienta de conservación porque le otorga valor económico a la vida silvestre, pero ejemplos recientes muestran que la sobrecolecta es un problema sustancial y que las limitaciones de datos son abundantes. Usamos el estudio de caso de la cacería de trofeos de un antílope en peligro, el nyala de las montañas (Tragelaphus buxtoni), para explorar como las incertidumbres generadas por el monitoreo de poblaciones y el tráfico de especies interactúan con la toma de decisiones de 2 actores clave: las compañías de safari y el gobierno. Construimos un modelo de evaluación de estrategia de manejo que incluye la dinámica poblacional del nyala de las montañas, un modelo de monitoreo y un modelo de toma de decisiones de una compañía. Investigamos escenarios de inversión en el combate del tráfico de especies y el monitoreo por el gobierno y las compañías de safari. La estrategia de colecta fue robusta hacia la incertidumbre en los estimados de población obtenidos del monitoreo, pero el tráfico de especies tuvo un efecto más fuerte sobre la cuota y la sustentabilidad; por esto, reducir el tráfico de especies está dentro de los intereses de compañías que desean incrementar la rentabilidad de las empresas, por ejemplo al hacer participar a los miembros de la comunidad como guías de caza. Hay un nivel umbral de incertidumbre en los estimados de población más allá del cual la variación anual en la cuota de trofeos previene la planeación por parte de las compañías de safari. Esto sugiere un papel para el gobierno asegurando que un nivel base de monitoreo de población se lleve a cabo para que este nivel no sea excedido. Nuestros resultados ilustran la importancia de considerar los incentivos de partes interesadas múltiples al designar marcos de trabajo para el uso de recursos y que al designar marcos de trabajo de manejo dirigirse a las fuentes particulares de incertidumbre que afecten más al sistema de sustentabilidad. PMID:24001054

Intertextual Sexual Politics: Illness and Desire in Enrique Gomez Carrillo's "Del amor", "del dolor y del vicio" and Aurora Caceres's "La rosa muerta"

ERIC Educational Resources Information Center

LaGreca, Nancy

2012-01-01

This study explores the intertextuality between Aurora Caceres's "La rosa muerta" (1914) and the novel "Del amor, del dolor y del vicio" (1898) by her ex-husband, Enrique Gomez Carrillo. Caceres strategically mentions Gomez Carrillo's novel in "La rosa muerta" to invite a reading of her work in dialogue with his. Both narratives follow the sexual…

Needs of Parents in Caring for Their Children in a Pediatric Intensive Care Unit.

PubMed

Valderrama Sanabria, Mery Luz; Muñoz de Rodríguez, Lucy

2016-04-01

This work sought to describe the needs of parents to participate in caring for their children hospitalized in a pediatric intensive care unit (PICU). This is a qualitative study based on the ethno-nursing research method proposed by Leininger. For data collection and analysis, in-depth open interviews were used, along with field notes and enabler guidelines proposed by Leininger: stranger-friend, observation, participation, reflexion, and the Sunrise model. Parents of children hospitalized in a PICU in the city of Tunja (Boyacá, Colombia) participated between February 2012 and October 2013. The needs of parents to care for their children were described in the following themes: clear and timely communication, familiarization with technology, the value of the family, favoring the parent-children interaction during visits, and valuing and respecting generic (folk) knowledge. The study provides knowledge, from the cultural perspective of parents with children hospitalized in PICU, as input to plan and develop care actions with them, according to their own needs.Objetivo.Describir las necesidades de padres para participar del cuidado de sus hijos hospitalizados en la Unidad de Cuidado Intensivo Pediátrico (UCIP). Métodos. Investigación cualitativa basada en el método de la etnoenfermería propuesto por Leininger. Para la recolección y análisis de la información se utilizaron la entrevista abierta a profundidad, las notas de campo y guías facilitadoras propuestas por Leininger: Extraño amigo, Observación, Participación Reflexión y el modelo del sol naciente. Participaron los padres de niños hospitalizados en una UCIP de Tunja (Boyacá, Colombia) entre febrero de 2012 y Octubre de 2013. Resultados. Se describen las necesidades de los padres para cuidar a sus hijos en los siguientes temas: Comunicación clara y oportuna, Familiarización con la Tecnología, El valor de la familia, Favorecer la interacción de padres-hijos durante la visita y Valorar y respetar el conocimiento genérico. Conclusión. Se describieron las necesidades de los padres en el cuidado de sus hijos internados en una UCIP. La enfermera debe tener en cuenta el conocimiento genérico de las personas y respetar las creencias que ellas tengan, con el fin de fortalecer su desempeño como profesional mediante la aplicación de teorías en enfermería.

Parámetros sagitales espino-pélvicos en una población asintomática Argentina

PubMed Central

Guiroy, Alfredo; Gagliardi, Martín; Sícoli, Alfredo; Masanés, Nicolás Gonzalez; Ciancio, Alejandro Morales; Jalón, Pablo; Mezzadri, Juan José

2018-01-01

Resumen Introducción: Analizar y describir los parámetros sagitales espinales y pelvianos de una serie de 100 voluntarios argentinos. Métodos: Se realizaron prospectivamente espinogramas digitalizados de perfil a 100 voluntarios (30 hombres y 70 mujeres), con un promedio de edad 34,14 años. Todos los voluntarios eran asintomáticos al momento de realizarse el estudio. Los espinogramas se hicieron en un equipo Kodak Elite CR. Se realizaron las mediciones usando el software Surgimap®, versión 2.2.9.9.2. Se tomaron los siguientes parámetros: C7 SVA, C2-C7 CL, TK, LL, TPA, T1 tilt, PI, PT, SS, ángulo L4-S1, ángulo L1-L4, PI-LL y CTPA. Los datos fueron analizados empleando el paquete estadístico Medcalc 11.2. Se determinaron las estadísticas descriptivas adecuadas para cada variable según su escala de medición y distribución. Se realizó la estimación de intervalos de referencia del 95% y de intervalos de confianza del 95% para todas las variables. Así, el nivel de significación obtenido fue igual a 0.05. Se dividió a los voluntarios según la clasificación morfométrica de Roussouly en cuatro tipos. Resultados: El promedio para cada variable fue CL −10.04, TK 30.14, T1SPi −6.5, L1-L4 −12.45, L4-S1 −46.16, CTPA 2.5, TPA 4.65, PT 11.22, PI 48.04, LL −59.10, PI-LL −11.11, C7 SVA mm −23.68. Los ±2 desvíos estándar para cada variable fueron: CL (−33.26, 13.12); TK (17.15, 43.30); T1SPi (−11.78, −1.25), L1-L4 (−25.55, 0.25), L4-S1 (−64.44, −27.55), CTPA (0.33, 4.80), TPA (−8.64, 18.22), PT (−1.99, 24.75), PI (25.23, 71.44), LL (−78.74, −39.89), PI-LL (−29.10, 7.04), C7 SVA mm (−79.45, 32.08). Conclusión: En esta serie prospectiva de 100 adultos voluntarios se determinaron los valores de normalidad de los parámetros sagitales espinales y pelvianos en una población de Argentina. PMID:29430329

Associations between uncoupling protein 2, body composition, and resting energy expenditure in lean and obese African American, white, and Asian children.

PubMed

Yanovski, J A; Diament, A L; Sovik, K N; Nguyen, T T; Li, H; Sebring, N G; Warden, C H

2000-06-01

Little is known about genes that affect childhood body weight. The objective of this study was to examine the association between alleles of the mitochondrial uncoupling protein 2 (UCP2) gene and obesity because UCP2 may influence energy expenditure. We related UCP2 genotype to body composition and resting energy expenditure in 105 children aged 6-10 y. Overweight children and nonoverweight children of overweight parents were genotyped for a 45-base pair deletion/insertion (del/ins) in 3'-untranslated region of exon 8 and for an exon 4 C to T transition. Eighty-nine children were genotyped for the exon 8 allele: 50 children had del/del, 33 had del/ins, and 6 had ins/ins. Mean (+/-SD) body mass index (BMI; in kg/m(2)) was greater for children with del/ins (24.1 +/- 5.9) than for children with del/del (20.4 +/- 4.8; P < 0.001). BMI of ins/ins children (23.7 +/- 7.8) was not significantly different from that of del/ins children. A greater BMI in del/ins children was independent of race and sex. Body composition was also different according to UCP2 genotype. All body circumferences and skinfold thicknesses examined were significantly greater in del/ins than in del/del children. Body fat mass as determined by dual-energy X-ray absorptiometry was also greater in del/ins than in del/del children (P < 0.005). For 104 children genotyped at exon 4, no significant differences in BMI or body composition were found among the 3 exon 4 genotypes. Neither resting energy expenditure nor respiratory quotient were different according to UCP2 exon 4 or exon 8 genotype. The exon 8 ins/del polymorphism of UCP2 appears to be associated with childhood-onset obesity. The UCP2/UCP3 genetic locus may play a role in childhood body weight.

Women of Valor in the American Civil War

DTIC Science & Technology

1999-04-01

Newcomb and Agnes Scott. Coeducational universities were Cornell, Michigan, Wisconsin, Kansas, Missouri, California, Texas and Kentucky. To meet the...courses separate from men. By the 1890’s Syracuse, California, Iowa and Howard Universities were among the dozen coeducational medical colleges

Antagonistic effects of IL-17 and D-resolvins on endothelial Del-1 expression through a GSK-3β-C/EBPβ pathway.

PubMed

Maekawa, Tomoki; Hosur, Kavita; Abe, Toshiharu; Kantarci, Alpdogan; Ziogas, Athanasios; Wang, Baomei; Van Dyke, Thomas E; Chavakis, Triantafyllos; Hajishengallis, George

2015-09-16

Del-1 is an endothelial cell-secreted anti-inflammatory protein. In humans and mice, Del-1 expression is inversely related to that of IL-17, which inhibits Del-1 through hitherto unidentified mechanism(s). Here we show that IL-17 downregulates human endothelial cell expression of Del-1 by targeting a critical transcription factor, C/EBPβ. Specifically, IL-17 causes GSK-3β-dependent phosphorylation of C/EBPβ, which is associated with diminished C/EBPβ binding to the Del-1 promoter and suppressed Del-1 expression. This inhibitory action of IL-17 can be reversed at the GSK-3β level by PI3K/Akt signalling induced by D-resolvins. The biological relevance of this regulatory network is confirmed in a mouse model of inflammatory periodontitis. Intriguingly, resolvin-D1 (RvD1) confers protection against IL-17-driven periodontal bone loss in a Del-1-dependent manner, indicating an RvD1-Del-1 axis against IL-17-induced pathological inflammation. The dissection of signalling pathways regulating Del-1 expression provides potential targets to treat inflammatory diseases associated with diminished Del-1 expression, such as periodontitis and multiple sclerosis.

DEL phenotype.

PubMed

Kwon, Dong H; Sandler, S G; Flegel, Willy A

2017-09-01

DEL red blood cells (RBCs) type as D- by routine serologic methods and are transfused routinely, without being identified as expressing a very weak D antigen, to D- recipients. DEL RBCs are detected only by adsorption and elution of anti-D or by molecular methods. Most DEL phenotypes have been reported in population studies conducted in East Asia, although DEL phenotypes have been detected also among Caucasian individuals. Approximately 98 percent of DEL phenotypes in East Asians are associated with the RHD*DEL1 or RHD*01EL.01 allele. The prevalence of DEL phenotypes has been reported among D- Han Chinese (30%), Japanese (28%), and Korean (17%) populations. The prevalence of DEL phenotypes is significantly lower among D- Caucasian populations (0.1%). Among the 3-5 percent of African individuals who are D-, there are no reports of the DEL phenotype. Case reports from East Asia indicate that transfusion of DEL RBCs to D- recipients has been associated with D alloimmunization. East Asian immigrants constitute 2.1 percent of the 318.9 million persons residing in the United States, and an estimated 2.8 percent are blood donors. Using these statistics, we estimate that 68-683 units of DEL RBCs from donors of East Asian ancestry are transfused as D- annually in the United States. Given the reports from East Asia of D alloimmunization attributed to transfusion of DEL RBCs, one would expect an occasional report of D alloimmunization in the United States following transfusion of DEL RBCs to a D- recipient. If such cases do occur, the most likely reason that they are not detected is the absence of active post-transfusion monitoring for formation of anti-D.

ASSOCIATIONS BETWEEN UNCOUPLING PROTEIN 2, BODY COMPOSITION, AND RESTING ENERGY EXPENDITURE IN LEAN AND OBESE AFRICAN AMERICAN, CAUCASIAN, AND ASIAN CHILDREN

PubMed Central

Yanovski, J.A.; Diament, A.L.; Sovik, K.N.; Nguyen, T.T.; Li, H.; Sebring, N.G.; Warden, C.H.

2015-01-01

Background Little is known about genes affecting childhood body weight. Objective To examine alleles of the mitochondrial uncoupling protein-2 (UCP2) gene for association with obesity, since UCP2 may influence energy expenditure. Design We related UCP2 genotype to body composition, and to resting energy expenditure, in 105 children aged 6–10y. Overweight children and non-overweight children of overweight parents were genotyped for a 45 bp deletion/insertion (del/ins) in 3’ UTR of exon 8 and for an exon 4 C to T transition. Results 89 children were genotyped for the exon 8 allele: 50 children had del/del, 33 del/ins, and 6 ins/ins. Body mass index (BMI) was greater for del/ins (24.1 ± 5.9 kg/m2) than for del/del (20.4 ± 4.8 kg/m2, p<0.001). BMI of ins/ins (23.7 ± 7.8 kg/m2) was not different from del/ins. This effect was independent of race and gender (ANOVAs, p< 0.05). Body composition was also different according to UCP2 genotype. All body circumferences and skin fold thicknesses examined were significantly greater in del/ins than in del/del. DXA body fat mass (p<0.005) was also greater in del/ins than del/del. For 104 children genotyped at exon 4, no significant differences in BMI or body composition were found among the three exon 4 genotypes. Neither resting energy expenditure nor respiratory quotient were different according to UCP2 exon 4 or exon 8 genotype. Conclusion The exon 8 ins/del polymorphism of UCP2 appears to be associated with childhood-onset obesity. The UCP2/UCP3 genetic locus may play a role in childhood body weight. PMID:10837279

Vigilando la Calidad del Agua de los Grandes Rios de la Nacion: El Programa NASQAN del Rio Grande (Rio Bravo del Norte)

USGS Publications Warehouse

Lurry, Dee L.; Reutter, David C.; Wells, Frank C.; Rivera, M.C.; Munoz, A.

1998-01-01

La Oficina del Estudio Geologico de los Estados Unidos (U.S. Geological Survey, 0 USGS) ha monitoreado la calidad del agua de la cuenca del Rio Grande (Rio Bravo del Norte) desde 1995 como parte de la rediseiiada Red Nacional para Contabilizar la Calidad del Agua de los Rios (National Stream Quality Accounting Network, o NASOAN) (Hooper and others, 1997). EI programa NASOAN fue diseiiado para caracterizar las concentraciones y el transporte de sedimento y constituyentes quimicos seleccionados, encontrados en los grandes rios de los Estados Unidos - incluyendo el Misisipi, el Colorado y el Columbia, ademas del Rio Grande. En estas cuatro cuencas, el USGS opera actualmente (1998) una red de 40 puntos de muestreo pertenecientes a NASOAN, con un enfasis en cuantificar el flujo en masa (la cantidad de material que pasa por la estacion, expresado en toneladas por dial para cada constituyente. Aplicacando un enfoque consistente, basado en la cuantificacion de flujos en la cuenca del Rio Grande, el programa NASOAN esta generando la informacion necesaria para identificar fuentes regionales de diversos contaminantes, incluyendo sustancias qui micas agricolas y trazas elementos en la cuenca. EI efecto de las grandes reservas en el Rio Grande se puede observar segun los flujos de constituyentes discurren a 10 largo del rio. EI analisis de los flujos de constituyentes a escala de la cuenca proveera los medios para evaluar la influencia de la actividad humana sobre las condiciones de calidad del agua del Rio Grande.

Philip T. Pienkos | NREL

Science.gov Websites

Valorization: Development of a Methane-to-Adipic Acid Bioprocess (consultant) Areas of Expertise Molecular engineering Enzyme and protein engineering Techno-economic analysis Education Ph.D., Molecular Biology Principal Research Supervisor, NREL, Aug. 2007-May 2011 Research Director, Molecular Logix, Inc., The

75 FR 79445 - Unblocking of Specially Designated Nationals and Blocked Persons Pursuant to Executive Order 12978

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-20

... DEPOSITO POPULAR DE DROGAS S.A., Cali, Colombia; c/o INVERSIONES Y CONSTRUCCIONES ABC S.A., Cali, Colombia... KRESSFOR DE COLOMBIA S.A., Bogota, Colombia; c/o INVERSIONES ARA LTDA., Cali, Colombia; c/o VALORES...

An Investigation of the Valorization of Durian Biomass

NASA Astrophysics Data System (ADS)

Ng, C.

2016-12-01

The unsustainable exploitation of limited resources has made the valorization of biomass to obtain a higher value from waste a particular area of interest in green chemistry. Much research has been done on the conversion of food waste to valuable chemicals. This study investigates the conversion of the biomass of durian (durio zibethinus), a fruit widely consumed particularly in Southeast Asia, to gamma-valerolactone (GVL). In the presence of sulfuric acid catalyst, the process occurs via four consecutive reactions, including the dehydration of carbohydrates such as fructose (C6H12O6) and cellulose ((C6H10O5)n) to 5-(hydroxymethyl)furfural (HMF), the hydration of HMF to levulinic acid (LA) and formic acid (FA), the hydrogenation of LA to 4-hydroxyvaleric acid (4-HVA), and ultimately the dehydration to gamma-valerolactone (GVL). It is hypothesized that, throughout an 8 hour period, there will be an initial peak in HMF concentration, followed by a steady decrease in its concentration due to hydration of HMF to LA and FA. Concentrations of HMF, LA, FA, and ammonium ion will be measured by running NMR analyses of the durian skin, meat, and seed samples taken at intervals of 0, 1, 2, 4, and 8 hours elapsed. Many of the impressive physical and chemical properties of GVL, including its nontoxicity, miscibility with water, and low vapor pressure, make it highly suitable as a sustainable liquid for use as a solvent, a transportation fuel, and a versatile feedstock for further derivatization. For example, addition of GVL to a diesel-biodiesel mixture results in a significant reduction in smoke and carbon monoxide emissions. Therefore, our aim in this study is to identify the concentrations of various valuable compounds in durian waste, and thereby assess the viability of the valorization of durian biomass.

The novel c.247_249delTTC (p.F83del) GJB2 mutation in a family with prelingual sensorineural deafness.

PubMed

Petersen, Michael B; Grigoriadou, Maria; Koutroumpe, Maria; Kokotas, Haris

2012-07-01

Non-syndromic hearing loss is one of the most common hereditary determined diseases in human, and the disease is a genetically heterogeneous disorder. Mutations in the GJB2 gene, encoding connexin 26 (Cx26), are a major cause of non-syndromic recessive hearing impairment in many countries and are largely dependent on ethnic groups. Due to the high frequency of the c.35delG GJB2 mutation in the Greek population, we have previously suggested that Greek patients with sensorineural, non-syndromic deafness should be tested for the c.35delG mutation and the coding region of the GJB2 gene should be sequenced in c.35delG heterozygotes. Here we present on the clinical and molecular genetic evaluation of a family suffering from prelingual, sensorineural, non-syndromic deafness. A novel c.247_249delTTC (p.F83del) GJB2 mutation was detected in compound heterozygosity with the c.35delG GJB2 mutation in the proband and was later confirmed in the father, while the mother was homozygous for the c.35delG GJB2 mutation. We conclude that compound heterozygosity of the novel c.247_249delTTC (p.F83del) and the c.35delG mutations in the GJB2 gene was the cause of deafness in the proband and his father. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Modelo semi-empírico de protuberancia solar a partir del diagnóstico de densidades

NASA Astrophysics Data System (ADS)

Cirigliano, D.; Vial, J. C.; Rovira, M.

A partir de la observación del espectro del quintuplete de C III alrededor de 1175 Å, se ha realizado el diagnóstico de la densidad y presión electrónica, basado en el cálculo del cociente de las intensidades observadas. Una vez establecida la densidad electrónica, y con el cálculo de las velocidades Doppler, hemos investigado el flujo de masa en la protuberancia en función de la temperatura. Estableciendo como hipótesis la conservación del número de partículas que ingresan y salen del cuerpo de la protuberancia, se investiga la variación del área de un tubo de flujo semi-empírico en función de la temperatura. A partir de dicho diagnóstico, se examina el comportamiento del radio del tubo magnético en función de la temperatura, los que dan cuenta de la abertura de las líneas de campo magnético que confinan el plasma y de la divergencia del campo magnético en diferentes alturas de la atmósfera solar.

Del(20q) in patients with chronic lymphocytic leukemia: a therapy-related abnormality involving lymphoid or myeloid cells.

PubMed

Yin, C Cameron; Tang, Guilin; Lu, Gary; Feng, Xiaoli; Keating, Michael J; Medeiros, L Jeffrey; Abruzzo, Lynne V

2015-08-01

Deletion 20q (Del(20q)), a common cytogenetic abnormality in myeloid neoplasms, is rare in chronic lymphocytic leukemia. We report 64 patients with chronic lymphocytic leukemia and del(20q), as the sole abnormality in 40, a stemline abnormality in 21, and a secondary abnormality in 3 cases. Fluorescence in situ hybridization (FISH) analysis revealed an additional high-risk abnormality, del(11q) or del(17p), in 25/64 (39%) cases. In most cases, the leukemic cells showed atypical cytologic features, unmutated IGHV (immunoglobulin heavy-chain variable region) genes, and ZAP70 positivity. The del(20q) was detected only after chemotherapy in all 27 cases with initial karyotypes available. With a median follow-up of 90 months, 30 patients (47%) died, most as a direct consequence of chronic lymphocytic leukemia. Eight patients developed a therapy-related myeloid neoplasm, seven with a complex karyotype. Combined morphologic and FISH analysis for del(20q) performed in 12 cases without morphologic evidence of a myeloid neoplasm localized the del(20q) to the chronic lymphocytic leukemia cells in 5 (42%) cases, and to myeloid/erythroid cells in 7 (58)% cases. The del(20q) was detected in myeloid cells in all 4 cases of myelodysplastic syndrome. In aggregate, these data indicate that chronic lymphocytic leukemia with del(20q) acquired after therapy is heterogeneous. In cases with morphologic evidence of dysplasia, the del(20q) likely resides in the myeloid lineage. However, in cases without morphologic evidence of dysplasia, the del(20q) may represent clonal evolution and disease progression. Combining morphologic analysis with FISH for del(20q) or performing FISH on immunomagnetically selected sub-populations to localize the cell population with this abnormality may help guide patient management.

Del(20q) in patients with chronic lymphocytic leukemia: A therapy-related abnormality involving lymphoid or myeloid cells

PubMed Central

Yin, C. Cameron; Tang, Guilin; Lu, Gary; Feng, Xiaoli; Keating, Michael J.; Medeiros, L. Jeffrey; Abruzzo, Lynne V.

2015-01-01

Del(20q), a common cytogenetic abnormality in myeloid neoplasms, is rare in chronic lymphocytic leukemia. We report 64 patients with chronic lymphocytic leukemia and del(20q), as the sole abnormality in 40, a stemline abnormality in 21, and a secondary abnormality in 3 cases. FISH analysis revealed an additional high-risk abnormality, del(11q) or del(17p), in 27/64 (42%) cases. In most cases, the leukemic cells showed atypical cytologic features, unmutated IGHV genes and ZAP70 positivity. The del(20q) was detected only after chemotherapy in all 27 cases with initial karyotypes available. With a median follow-up of 90 months, 30 patients (47%) died, most as a direct consequence of chronic lymphocytic leukemia. Eight patients developed a therapy-related myeloid neoplasm, seven with a complex karyotype. Combined morphologic and FISH analysis for del(20q) performed in 12 cases without morphologic evidence of a myeloid neoplasm localized the del(20q) to the chronic lymphocytic leukemia cells in 5 (42%) cases, and to myeloid/erythroid cells in 7 (58)% cases. The del(20q) was detected in myeloid cells in all 4 cases of myelodysplastic syndrome. In aggregate, these data indicate that chronic lymphocytic leukemia with del(20q) acquired after therapy is heterogeneous. In cases with morphologic evidence of dysplasia, the del(20q) likely resides in the myeloid lineage. However, in cases without morphologic evidence of dysplasia, the del(20q) may represent clonal evolution and disease progression. Combining morphologic analysis with FISH for del(20q) or performing FISH on immunomagnetically-selected subpopulations to localize the cell population with this abnormality may help guide patient management. PMID:25953391

Increasing Naval Security Cooperation between the U.S., Chile and Peru

DTIC Science & Technology

2009-03-01

del Mar: La Marina de Guerra en la historia del Perú (Lima: Marina de Guerra del Perú, 1994), 184. 108 Ibid., 188. 109 Ibid., 191-193. 42 “the...La Marina de Guerra en la historia del Perú, 205. 111 Ibid. 112 Ibid., 210. 113 Ibid., 229. 114 Ibid., 230. 115 Ibid., 246. 43 contributed to...la Puente Brunke, Los Hombres del Mar: La Marina de Guerra en la historia del Perú, 252. 117 Ibid., 264. 118 Ibid., 302. 119 Ibid., 342. 44

Predicting lignin depolymerization yields from quantifiable properties using fractionated biorefinery lignins

USDA-ARS?s Scientific Manuscript database

Lignin depolymerization to aromatic monomers with high yields and selectivity is essential for the economic feasibility of many lignin-valorization strategies within integrated biorefining processes. Importantly, the quality and properties of the lignin source play an essential role in impacting the...

SOCIAL ROLE VALORIZATION IN COMMUNITY MENTAL HEALTH HOUSING: DOES IT CONTRIBUTE TO THE COMMUNITY INTEGRATION AND LIFE SATISFACTION OF PEOPLE WITH PSYCHIATRIC DISABILITIES?

PubMed Central

Aubry, Tim; Flynn, Robert J; Virley, Barb; Neri, Jaclynne

2013-01-01

Despite its importance as a theory in the development of programs for populations with disabilities, social role valorization (SRV) has received relatively little attention in community mental health research. We present findings of a study that examined the relationship of housing-related SRV to community integration and global life satisfaction of persons with psychiatric disabilities. The housing environments and associated supports of a group of 73 persons with psychiatric disabilities living in a mid-sized city were assessed using the PASSING rating system on the extent that their housing environments facilitated SRV. In addition, in-person interviews were conducted to determine the levels of physical integration, psychological integration, social integration, and life satisfaction of study participants. Results showed SRV contributing directly to all three types of community integration. Psychological integration was found to mediate the relationship between SRV and life satisfaction. Implications of the findings are discussed. © 2013 Wiley Periodicals, Inc. PMID:23658470

Biodegradation of kraft lignin by newly isolated Klebsiella pneumoniae, Pseudomonas putida, and Ochrobactrum tritici strains.

PubMed

Xu, Zhaoxian; Qin, Ling; Cai, Mufeng; Hua, Wenbo; Jin, Mingjie

2018-05-01

Bacterial systems have drawn an increasing amount of attention on lignin valorization due to their rapid growth and powerful environmental adaptability. In this study, Klebsiella pneumoniae NX-1, Pseudomonas putida NX-1, and Ochrobactrum tritici NX-1 with ligninolytic potential were isolated from leaf mold samples. Their ligninolytic capabilities were determined by measuring (1) the cell growth on kraft lignin as the sole carbon source, (2) the decolorization of kraft lignin and lignin-mimicking dyes, (3) the micro-morphology changes and transformations of chemical groups in kraft lignin, and (4) the ligninolytic enzyme activities of these three isolates. To the best of our knowledge, this is the first report that Ochrobactrum tritici species can depolymerize and metabolize lignin. Moreover, laccase, lignin peroxidase, and Mn-peroxidase showed high activities in P. putida NX-1. Due to their excellent ligninolytic capabilities, these three bacteria are important supplements to ligninolytic bacteria library and could be valuable in lignin valorization.

Lignin-Derived Thioacidolysis Dimers: Reevaluation, New Products, Authentication, and Quantification

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yue, Fengxia; Lu, Fachuang; Regner, Matt

2017-01-26

Lignin structural studies play an essential role both in understanding the development of plant cell walls and for valorizing lignocellulosics as renewable biomaterials. Dimeric products released by selectively cleaving β–aryl ether linkages between lignin units reflect the distribution of recalcitrant lignin units, but have been neither absolutely defined nor quantitatively determined. Here in this work, 12 guaiacyl-type thioacidolysis dimers were identified and quantified using newly synthesized standards. One product previously attributed to deriving from β–1-coupled units was established as resulting from β–5 units, correcting an analytical quandary. Another longstanding dilemma, that no β–β dimers were recognized in thioacidolysis products frommore » gymnosperms, was resolved with the discovery of two such authenticated compounds. Finally, individual GC response factors for each standard compound allowed rigorous quantification of dimeric products released from softwood lignins, affording insight into the various interunit-linkage distributions in lignins and thereby guiding the valorization of lignocellulosics.« less

The environmental sustainability of anaerobic digestion as a biomass valorization technology.

PubMed

De Meester, Steven; Demeyer, Jens; Velghe, Filip; Peene, Andy; Van Langenhove, Herman; Dewulf, Jo

2012-10-01

This paper studies the environmental sustainability of anaerobic digestion from three perspectives. First, reference electricity is compared to electricity production from domestic organic waste and energy crop digestion. Second, different digester feed possibilities in an agricultural context are studied. Third, the influence of applying digestate as fertilizer is investigated. Results highlight that biomass is converted at a rational exergy (energy) efficiency ranging from 15.3% (22.6) to 33.3% (36.0). From a life cycle perspective, a saving of over 90% resources is achieved in most categories when comparing biobased electricity to conventional electricity. However, operation without heat valorization results in 32% loss of this performance while using organic waste (domestic and agricultural residues) as feedstock avoids land resources. The use of digestate as a fertilizer is beneficial from a resource perspective, but causes increased nitrogen and methane emissions, which can be reduced by 50%, making anaerobic digestion an environmentally competitive bioenergy technology. Copyright © 2012 Elsevier Ltd. All rights reserved.

Deep eutectic solvent-based valorization of spent coffee grounds.

PubMed

Yoo, Da Eun; Jeong, Kyung Min; Han, Se Young; Kim, Eun Mi; Jin, Yan; Lee, Jeongmi

2018-07-30

Spent coffee grounds (SCGs) are viewed as a valuable resource for useful bioactive compounds, such as chlorogenic acids and flavonoids, and we suggest an eco-friendly and efficient valorization method. A series of choline chloride-based deep eutectic solvents (DESs) were tested as green extraction solvents for use with ultrasound-assisted extraction. Extraction efficiency was evaluated based on total phenolic content (TPC), total flavonoid content, total chlorogenic acids, and/or anti-oxidant activity. A binary DES named HC-6, which was composed of 1,6-hexanediol:choline chloride (molar ratio 7:1) was designed to produce the highest efficiency. Experimental conditions were screened and optimized for maximized efficiency using a two-level fractional factorial design and a central composite design, respectively. As a result, the proposed method presented significantly enhanced TPC and anti-oxidant activity. In addition, phenolic compounds could be easily recovered from extracts at high recovery yields (>90%) by adsorption chromatography. Copyright © 2018 Elsevier Ltd. All rights reserved.

Fed-batch anaerobic valorization of slaughterhouse by-products with mesophilic microbial consortia without methane production.

PubMed

Pessiot, J; Nouaille, R; Jobard, M; Singhania, R R; Bournilhas, A; Christophe, G; Fontanille, P; Peyret, P; Fonty, G; Larroche, C

2012-07-01

This work aimed at setting up a fully instrumented, laboratory-scale bioreactor enabling anaerobic valorization of solid substrates through hydrogen and/or volatile fatty acid (VFA) production using mixed microbial populations (consortia). The substrate used was made of meat-based wastes, especially from slaughterhouses, which are becoming available in large amounts as a consequence of the growing constraints for waste disposal from meat industry. A reconstituted microbial mesophilic consortium without Archaebacteria (methanogens), named PBr, was cultivated in a 5-L anaerobic bioreactor on slaughterhouse wastes. The experiments were carried out with sequential fed-batch operations, including liquid medium removal from the bioreactor and addition of fresh substrate. VFAs and nitrogen were the main metabolites observed, while hydrogen accumulation was very low and no methane production was evidenced. After 1,300 h of culture, yields obtained for VFAs reached 0.38 g/g dry matter. Strain composition of the microbial consortium was also characterized using molecular tools (temporal temperature gradient gel electrophoresis and gene sequencing).

Lignin-Derived Thioacidolysis Dimers: Reevaluation, New Products, Authentication, and Quantification.

PubMed

Yue, Fengxia; Lu, Fachuang; Regner, Matt; Sun, Runcang; Ralph, John

2017-03-09

Lignin structural studies play an essential role both in understanding the development of plant cell walls and for valorizing lignocellulosics as renewable biomaterials. Dimeric products released by selectively cleaving β-aryl ether linkages between lignin units reflect the distribution of recalcitrant lignin units, but have been neither absolutely defined nor quantitatively determined. Here, 12 guaiacyl-type thioacidolysis dimers were identified and quantified using newly synthesized standards. One product previously attributed to deriving from β-1-coupled units was established as resulting from β-5 units, correcting an analytical quandary. Another longstanding dilemma, that no β-β dimers were recognized in thioacidolysis products from gymnosperms, was resolved with the discovery of two such authenticated compounds. Individual GC response factors for each standard compound allowed rigorous quantification of dimeric products released from softwood lignins, affording insight into the various interunit-linkage distributions in lignins and thereby guiding the valorization of lignocellulosics. © 2015 The Authors. Published by Wiley-VCH Verlag GmbH & Co. KGaA.

Waking Up from Four Decades' Long Dream of Valorizing Agro-Food Byproducts: Toward Practical Applications of the Gained Knowledge.

PubMed

Domínguez-Perles, Raúl; Moreno, Diego A; García-Viguera, Cristina

2018-03-28

The late 1970s was the onset of literature about the first research outputs on alternatives to create added-value to agro-food byproducts focused on the reduction of the dependency on raw materials and, simultaneously, helping to reduce the environmental impacts of the agricultural activities. This trend, increased over the years and during the past decade, has been boosted by the growing concern of the socio-economic impact of wastes from agro-food activities, however, with little success of the proposed applications. Throughout four decades an array of studies have emerged, aimed to gain evidence on the relevance of innovation in the agro-food industry, as well as to overcome this situation. To our knowledge, only a few cases, summarized in the present perspective, represent the main alternatives currently available for the valorization of agro-food byproducts, with indications of some constraints that need to be addressed, in the coming years, to obtain a real profit from these products.

Valorization of residual Empty Palm Fruit Bunch Fibers (EPFBF) by microfluidization: production of nanofibrillated cellulose and EPFBF nanopaper.

PubMed

Ferrer, Ana; Filpponen, Ilari; Rodríguez, Alejandro; Laine, Janne; Rojas, Orlando J

2012-12-01

Different cellulose pulps were produced from sulfur-free chemical treatments of Empty Palm Fruit Bunch Fibers (EPFBF), a by-product from palm oil processing. The pulps were microfluidized for deconstruction into nanofibrillated cellulose (NFC) and nanopaper was manufactured by using an overpressure device. The morphological and structural features of the obtained NFCs were characterized via atomic force and scanning electron microscopies. The physical properties as well as the interactions with water of sheets from three different pulps were compared with those of nanopaper obtained from the corresponding NFC. Distinctive chemical and morphological characteristics and ensuing nanopaper properties were generated by the EPFBF fibers. The NFC grades obtained compared favorably with associated materials typically produced from bleached wood fibers. Lower water absorption, higher tensile strengths (107-137 MPa) and elastic modulus (12-18 GPa) were measured, which opens the possibility for valorization of such widely available bioresource. Copyright © 2012 Elsevier Ltd. All rights reserved.

Savior siblings, parenting and the moral valorization of children.

PubMed

Strong, Kimberly; Kerridge, Ian; Little, Miles

2014-05-01

Philosophy has long been concerned with 'moral status'. Discussions about the moral status of children, however, seem often to promote confusion rather than clarity. Using the creation of 'savior siblings' as an example, this paper provides a philosophical critique of the moral status of children and the moral relevance of parenting and the role that formative experience, regret and relational autonomy play in parental decisions. We suggest that parents make moral decisions that are guided by the moral significance they attach to children, to sick children and most importantly, to a specific sick child (theirs). This moral valorization is rarely made explicit and has generally been ignored by both philosophers and clinicians in previous critiques. Recognizing this, however, may transform not only the focus of bioethical discourse but also the policies and practices surrounding the care of children requiring bone marrow or cord blood transplantation by better understanding the values at stake behind parental decision making. © 2012 John Wiley & Sons Ltd.