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Query: UMLS:C0016382 (flushing)
 6,387 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

When performing vasectomies, surgeons should have 3 goals: 1) to reduce the failure rate due to spontaneous reanastomosis from current levels of 1 in 100 to 1 in 1000, 2) to prevent complications such as hematoma through the use of autramatic plastic surgical instruments, and 3) to maximize the potential for future microsurgical reversal. Achievement of these aims requires an understanding of the region, magnification for the identification of tissue layers, and sterile instruments. Although each vasectomist makes minor variations in technique, there are certain rules that should always be followed: do not use local anesthesia with adrenalin inside the scrotum, avoid testicle strangulation by not rotating the testicle 180 degrees out of normal alignment or operate on one side twice, do not use black braided silk sutures on Fallope rings inside the scrotum, use cremasteric fascial separation of the cut vas ends to prevent spontaneous reanastomosis, leave the testicular end open to the scrotum to reduce back pressure on the epididymis, use a water rather than spirit-based skin antiseptic, and adhere to all sterile procedures. The author outlines the steps involved in vasectomy, from preoperative assessment, skin preparation, anesthesia, isolation of the vas, incision, identification of the vas in the sheath, securing the cremasteric sheath, isolating only the vas, flushing the vas, severing the vas, cautery, open ended vasectomy, to skin closure. Also presented are guidelines for the postoperative period and the management of complications such as bleeding, hematomas, infection, adhesions, epididymitis and sperm granuloma, and neuritis.
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PMID:Vasectomy technique. 240 10

Felodipine lowers blood pressure by reducing peripheral vascular resistance through a highly selective action on smooth muscle in arteriolar resistance vessels. The selective action may be considered a safeguard against untoward effects on cardiac contractility and conduction. Felodipine does not cause orthostatic hypotension since it has no effect in clinical doses on venous smooth muscle. Felodipine has a natriuretic/diuretic effect, which counteracts the salt and water retention that is often seen during treatment with other potent vasodilators. In clinical studies, felodipine has proved more effective than several established antihypertensive drugs. The combination of felodipine and a beta-adrenergic blocker appears to be a good alternative to standard triple treatment, and felodipine is often effective in patients with previously "refractory" hypertension. The antihypertensive effect of felodipine is dose related. In patients with moderate hypertension, a dose regimen of 5 mg twice a day is usually sufficient, and doses greater than 10 mg twice a day are not often required. Felodipine is generally well tolerated. The most common adverse effects are those expected from a potent arteriolar dilator: ankle swelling, headache, dizziness, flushing, etc. Adverse effects are usually transient or diminish in intensity with continued treatment. The overall frequency of adverse effects with felodipine appears to be similar to that for the established antihypertensive drugs, although the adverse effects differ. Felodipine is a potent arteriolar dilator with therapeutic advantages, especially for patients with moderate to severe hypertension.
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PMID:Felodipine in hypertension--a review. 244 9

Changes in serum and tissue and urinary levels of fluoride, calcium and other biochemical consequences were investigated in rats after experimental hydrofluoric acid (HF) burns, to obtain adequate method of emergency treatment for the injury. Increases in ionized fluoride and decreases in total and ionized calcium, in the sera were observed after contact with HF. Hyponatremia and hyperkalemia were observed over a 24 hour period. Parathyroid hormone (PTH) concentrations were elevated in the sera taken within 24 hours after burn and fell to reference range once the calcium concentration had been raised. Electrocardiographic changes including severe bradycardia were observed. These results indicate that an HF skin burn results in systemic fluoride poisoning followed by hypocalcemia, hypersecretion of PTH, hyponatremia, hyperkalemia and other electrolytes imbalance. Flushing with running water was effective for HF burns. By applying 2.5% calcium gluconate jelly, concentrations of fluoride in the urine and the tissues surrounding the injured region were reduced. Thus, the present results proved that the irrigation with running water and the jelly applications was evaluated as the most effective therapy among various methods tested for the HF burn.
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PMID:Studies on the treatment of hydrofluoric acid burn. 248 42

Enteral feedings are safely tolerated by most patients. When complications occur, gastrointestinal disturbances are most frequently encountered, followed by mechanical and metabolic complications. Nurses can prevent many of the problems associated with enteral feeding through careful monitoring. Based on the current literature, the authors make the following recommendations: 1. All patients receiving tube feedings should be placed on a protocol that provides guidelines for (a) confirming correct tube placement; (b) preventing/managing tube obstruction; (c) handling and selecting formulas; (d) administering formulas; and (e) monitoring patients. 2. Fine-bore tubes are easily misplaced or dislodged; ensure correct positioning both before and during feeding. Food coloring should be added to all feedings to help detect aspiration/tube displacement. 3. Multiple factors can cause diarrhea in tube-fed patients and, therefore, require periodic assessment. These factors include concomitant drug therapy; malnutrition/hypoalbuminemia; formula-related factors (for example, lactose content, osmolality); and bacterial contamination. 4. Urine sugar and acetone levels should be checked every 6 hours (until stable). Vital signs and fluid intake and output should be determined every 8 hours, and weight should be measured on a daily basis. Serum electrolytes, blood urea nitrogen, and glucose levels should be determined daily, until serum levels stabilize. Weekly measurements of trace elements should be made to ensure adequate mineral replacement. 5. Use a controller pump to administer continuous feedings at a constant rate or to administer formulas that are viscous. Flush feeding tubes with water every 4 hours during continuous feedings, after giving intermittent feedings, after giving medications, and after checking for gastric residuals. If tube obstruction occurs, attempt to irrigate the tube with either water or cola. 6. Select feedings that contain appropriate nutrient sources, caloric density, and osmolality; handle feedings in a way that minimizes bacterial contamination. 7. Ongoing nutritional assessments are necessary to provide information about the overall adequacy of the enteral feeding in restoring or maintaining nutrition.
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PMID:Enteral nutrition. Potential complications and patient monitoring. 249 46

As a result of occasional water discolouration, the hydrotherapy pool of a large teaching hospital was monitored for free and combined chlorine, alkalinity, calcium hardness, total dissolved solids and cyanuric acid levels together with bacteriological analysis. The hose pipe supplying the pool and the dual water pumps were also examined as potential sources of bacterial contamination. The pool water yielded high counts of Pseudomonas vesicularis, Pseudomonas aeruginosa, and CDC Group IV C2, even in the presence of adequate levels of free chlorine. This was found to be due to high concentrations of cyanuric acid which resulted in a 'chlorine lock'. The source of the P. vesicularis and CDC Group IV C2 was found to be the pool hose and this problem was alleviated by flushing it with water each day before use. The source of the P. aeruginosa was the pool pumps, and was eradicated by regularly shock dosing them with 6-8 ppm of free chlorine.
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PMID:Two sources of contamination of a hydrotherapy pool by environmental organisms. 257 27

Malignant ascites is often refractory to therapy and rapidly deteriorating the nutritional and physical state of the cancer patient. Nevertheless, ascites does not always implicate preterminal state of the cancer process (e.g. ovarian carcinoma). A short review is made of the pathophysiology of ascites in cirrhosis and in malignancy, and different modes of treatment are discussed. The results of medical therapy of malignant ascites (salt and water restriction, diuretics, intraperitoneal cytostatics or radiocolloids) are not convincing. The immunotherapy with OK-432, as worked out by Katano (16-46) has to prove its value. The best and most hopeful results in cases of massive previously resistant ascites, are obtained with a peritoneojugular shunt, improving immediately the nutritional status and life condition, providing excellent palliation. The superiority of the Denver shunt versus the Le Veen shunt has been assessed recently, especially for malignant ascites. Some technical and perioperative details merit more attention, to limit the high risk ratio. Control of the intrathoracic position of the catheter tip, the maintenance of the bloodflow in the jugular vein, the intramuscular tunnelisation of the peritoneal catheter, the discard of 3 or 5 liters ascitic fluid and the substitution of part of it by physiological fluid, perioperative prophylactic antibiotics and heparinisation, flow-rate control in the postoperative period by changing patients position, respiratory exercises, daily flushing, all those measures limit the risk of fibrinolysis (DIC), shunt occlusion, fluid overload and infection. The fear of metastasis by shunt is unfounded, since the survival of the primary tumor is mostly too short (41). The postoperative follow up in an intensive care unit is necessary during 24-72 hours.
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PMID:[The Denver shunt in malignant ascites]. 258 Apr 8

Street catch basins in western Cook County, IL, were examined regularly June through August of 1987 to determine their seasonal larval production, adult mosquito harborage and the influence of abiotic factors on the associated mosquito population. Only larvae of Culex pipiens (63% of total) and Cx. restuans (37% of total) were recovered. These 2 species and Cx. erraticus were the most frequently collected adults. The abundance of mosquito larvae within catch basins was not correlated with water pH and only showed a weak, positive correlation with water temperature. Only a partial flushing of larvae (22-34% reduction) from catch basins by normal rainfall (less than 25 mm) was generally recorded. Treatments with larvicide oil (mineral seal oil/kerosene 175/tergitol) at a rate of 60-90 ml/catch basin resulted in a mean larval reduction of 97%. Adult females showed a mean reduction of 87%.
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PMID:Seasonal abundance and control of Culex spp. in catch basins in Illinois. 261 4

Drinking water microbiology has emerged from decades of relative complacency to recognize there can be major concerns with potable water quality. Many of these issues are a result of an explosion of information on new waterborne agents, treatment problems with raw-source water qualities, biofilm development in some distribution systems and specialized requirements in water quality unique to hospitals and industries. Protozoan cyst survival after some disinfection practices involving surface water impoundments and virus occurrence in poorly protected groundwaters have provided reasons for expanding minimum treatment of surface waters and for requiring disinfection of all groundwaters unless there is a demonstrative data base to support exceptions in treatment requirements. Official monitoring of small water supplies must be increased on a monthly basis and a rapid alert established to inform water plant operators of unsatisfactory water qualities. As an option, application of operational tests to analyse water quality in terms of chlorine residual, turbidity, total coliforms and heterotrophic bacterial counts in small water plant operations should be encouraged. This would provide the operator at remote locations with the opportunity to utilize the information to make necessary treatment adjustments or corrections in water distribution deficiencies promptly and be a supplement to the official regional monitoring program. Application of drinking water alternative sources (bottled water and water from point-of-use treatment devices) should be viewed by the health authorities as only a temporary solution, not as a permanent fix for a public water supply known to present some established health risk to consumers. The public must also recognize that bottled water is not frequently monitored by health laboratories for acceptable quality and the use of home treatment devices places the responsibility of proper maintenance on the user. Microbial quality improvements in drinking water to hospitals and food industries can frequently be achieved through a routine, systematic flushing program for building plumbing networks and associated attachment devices. In other situations, use of booster disinfection or point-of-use devices may provide the important special water quality requirements for certain industrial applications. In any event, these supplemental treatment measures will require careful in-plant monitoring and maintenance to prevent reversals in water quality enhancement.
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PMID:Drinking water microbiology--new directions toward water quality enhancement. 270 59

General theories of stress ecology were applied to aquatic communities in the floodplain of the polluted River Rhine. These communities inhabited (i) a brackish section of the Ems-Dollard estuary with large intertidal flats, (ii) the coastal waters of the North Sea and the adjacent Wadden Sea, (iii) a former estuary of the Rivers Rhine and Meuse: the newly endiked Lake Grevelingen, (iv) the shallow Loosdrecht Lakes, and (v) the lower River Rhine. These systems are characterized by natural perturbations, such as suspension of sediments and flushing of the shallow waters. Organic pollution, eutrophication and chemical pollution reinforce the natural tendency to severe selection in the communities, in extreme cases leading to an abundance of small and opportunistic species participating in relatively simple food chains. Signs of ecosystem distress, as defined by Rapport et al., were detectable in all five ecosystems. The application of the theory of Odum et al. on stimulation and inhibition of ecosystems helped in identifying the positive impact of man. The role of stress in natural aquatic ecosystems in the delta, together with observations on ecological recovery under reduced man-made perturbation, suggest that there is scope for effective water management that exploits the resilience of these ecosystems.
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PMID:Environmental stress in five aquatic ecosystems in the floodplain of the River Rhine. 271 27

The antihypertensive efficacy and effects on body fluid composition of monotherapy with the calcium antagonist nifedipine were investigated in 15 patients with essential hypertension. The systolic as well as the diastolic blood pressure decreased significantly, by approximately 12%, during nifedipine treatment with a mean dose of 56 mg. Glomerular filtration rate, plasma volume, extracellular fluid volume, and the ratio plasma to interstitial fluid volume did not change significantly. The most frequently observed side-effects were flushing and peripheral oedema which occurred in four and three patients, respectively. These results indicate that sodium and water retention, which is often observed during long-term treatment with vasodilators, does not seem to be the explanation of the development of peripheral oedema seen with nifedipine.
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PMID:Effect of long-term nifedipine treatment on body fluid composition in essential hypertension. 276 76


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