Made available in DSpace on 2014-12-02T11:16:33Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-10-16Bitstream added on 2014-12-02T11:21:14Z : No. of bitstreams: 1 000609546.pdf: 1464260 bytes, checksum: 34305688869576b88d9034d68dc81109 (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / As técnicas biomagnéticas vêm sendo empregadas com sucesso no estudo do trato gastrintestinal (TGI). Elas podem medir o campo magnético originado pela atividade elétrica dos órgãos, o campo de marcadores magnetizados ou a resposta de marcadores ou traçadores a um campo magnético de excitação. Este trabalho apresenta uma coletânea de instrumentações desenvolvidas para aplicações no trato gastrintestinal. Os equipamentos desenvolvidos utilizaram sensor anisotrópico magnetorresistivo (AMR) para medir campo magnético e conversores de tensão true rms-to-dc objetivando a redução de custo das técnicas que empregam excitação magnética alternada (AC). Foram desenvolvidos um método de localização magnética de sonda nasoenteral, uma solução para substituição dos amplificadores lock-in’s por conversores true rms, uma instrumentação com sensor AMR com um eixo de detecção para avaliar o trânsito faringiano, uma instrumentação com sensor AMR com três eixos de detecção para avaliar o trânsito esofagiano e uma instrumentação com 36 sensores que foi aplicada para obter imagens magnéticas de diferentes fantomas e para avaliar a atividade de contração gástrica em um modelo in vivo – ratos. As instrumentações foram avaliadas em testes in vitro e in vivo e apresentaram sensibilidade para o emprego no trato gastrintestinal. Os equipamentos desenvolvidos são de baixo custo, livre de radiação ionizante, portáteis e que possibilitam aplicações em gastroenterologia, farmacologia, farmacotécnica e na clínica médica. / Biomagnetic techniques have been employed successfully to study gastrointestinal (GI) tract. They are enable to measure the magnetic field of magnetized markers, the markers and tracers responses to applied magnetic field excitation, and the magnetic field occurred by GI electrical activity. This work presents some instrumentation developed to evaluate different parameters of GI tract. The equipment built uses anisotropic magnetoresistive (AMR) sensor to measure magnetic field and true rms-to-dc voltage converter in order to reduce the cost of techniques that employ alternate (AC) magnetic excitation. In this work were developed: a magnetic method for localization of enteral feeding tube, a solution to replace lock-in amplifier for true rms converter, an instrumentation using AMR sensor (one axis-sensing) to evaluate the pharyngeal transit time, another instrumentation using AMR sensor (three axis-sensing) to evaluate esophageal transit time and finally, a equipment consisted of 36 AMR sensors to evaluate the gastric motor activity from rats and in order to obtain magnetic images from different kinds of phantoms. All equipments were tested and showed sensitivity to be employed in GI studies. The equipments developed are low cost, radiation free, portable and enable to applications in gastroenterology, pharmacology, pharmaceutical and medical clinic.

Orientador: José Ricardo de Arruda Miranda / Banca: Oswaldo Baffa Filho / Banca: José Carlos Rossi / Banca: Carlos Antônio Caramori / Banca: Roberto Morato Fernandez / Resumo: Não disponível. / Abstract: Not available. / Doutor

Thesis (M.A.)--Catholic Theological Union at Chicago, 1996. / Vita. Includes bibliographical references (leaves 80-85).

Thesis (M.S.)--University of Michigan, 1984.

Thesis (M.A.)--Catholic Theological Union at Chicago, 1996. / Vita. Includes bibliographical references (leaves 80-85).

Thesis (M.S.)--University of Michigan, 1984.

Thesis (M.A.)--Catholic Theological Union at Chicago, 1996. / Vita. Includes bibliographical references (leaves 80-85).

Background: The incidence of neonatal opioid withdrawal syndrome (NOWS), a drug withdrawal syndrome mainly associated with opioid exposure in-utero has significantly increased in the United States over the last decade with infants with NOWS staying longer in the hospital than those without NOWS. Objectives: To determine if feeding tube use while on admission is associated with length of hospital stay among infants diagnosed with NOWS. We also compared the differences between infants with NOWS who required the use of feeding tubes while on admission, and those that did not, based on infant and maternal characteristics. Methods: This was a retrospective cohort study of infants delivered between July 1, 2011 and June 30, 2016 at Ballad Health System. Our inclusion criteria were infants who were exposed to opioids in-utero and received a diagnosis of NOWS based on 2 consecutive Finnegan scores of 10, or 3 consecutive scores of 8, or treatment with morphine. Medical chart record of 294 infants who met these criteria were reviewed for infant and maternal characteristics. Our outcome variable was infant length of hospital stay and our predictor variable was feeding tube use an indicator for feeding difficulties. Chi-square test and t-test were used to compare infant and maternal characteristics by feeding tube use. Simple linear regression models were used to assess the effect of feeding tube use and infant and maternal characteristics on infant length of hospital stay. Multiple linear regression was used to model infant length of hospital stay predicted by feeding tube use, while adjusting for neonatal intensive care unit (NICU) admission, treatment with morphine, and maternal benzodiazepine use during pregnancy. All analyses were done using SAS 9.4. Results: Of the 294 infants diagnosed with NOWS, 22.11% had feeding difficulties that necessitated use of feeding tubes. Infants who used feeding tubes were significantly more likely to be born preterm (20.31% vs 8.73%, p=0.0096) to be admitted into the NICU (98.46% vs 51.09%, p=

No description available.

Background: Ventilator associated pneumonia (VAP) is a major cause of morbidity, longer intensive care unit (ICU) stay, increased duration of mechanical ventilation, and increased healthcare cost in critically ill patients. Critically ill patients are at increased risk for malnutrition, which is associated with impaired immune function, impaired ventilator drive and weakened respiratory muscles. Malnutrition has been thought to increase the risk of VAP due to bacterial translocation from the gastrointestinal tract to the lungs. Previous research that has evaluated the effect of enteral nutrition on malnutrition associated with VAP has been inconsistent in part because of the subjectivity of the old definition of VAP. In 2013, the Center for Disease Control and Prevention (CDC) developed a new definition for the diagnosis of VAP, which includes three tiers of a ventilator associated event (VAE); ventilator associated condition, infection-related ventilator-associated complication, or possible or probable VAP). The purpose of this study is to retrospectively examine the relationship between enteral formula, tube-feeding placement site, time of tube feeding initiation and the incidence of VAE using this new CDC definition. Objective: The aim of the study was to retrospectively examine the relationship between enteral formula, tube-feeding placement site, time of tube feeding initiation and the incidence of VAE using this new CDC definition. Participants/setting: The medical records of 162 adult patients admitted to one of the ICUs (Medical ICU, Surgical ICU, Neurological ICU, Burn ICU) at Grady Memorial Hospital (GMH) in Atlanta, GA in 2013 Main outcome measures: Demographic and baseline medical characteristics including the type of enteral formula used (standard, immune-modulating, hydrolyzed, immune-modulating and hydrolyzed, or mixed), enteral tube feeding placement (gastric or small bowel), and timing of enteral nutrition (never fed, fed48 hours after admission) were collected. Statistical analysis: Demographic and baseline medical characteristics were described using frequency statistics and compared by VAE status using the Mann-Whitney U and Kruskal-Wallis tests. The relationship between tube placement, enteral formula, timing of feeding and the diagnosis of a VAE was evaluated using the Chi-square test. Results: In 2013, 81 patients admitted to the ICU at GMH were diagnosed with a VAE. The median age of the study population (n=162) was 50 years (range, 19 to 88 years) and the median BMI was 27.6 kg/m2 (range, 13.2 to 83.2 kg/m2). The majority of the population was African American (53.1%) and male (64.2%). Most patients were fed through a gastric tube (86.4%), were given an immune-modulating enteral formula (32.1%) and were fed after 48 hours of admission (44.4%). After subdividing by ICU location, 12 of 14 patients (86%) in the Medical ICU who were diagnosed with a VAE were either never fed or fed >48 hours after admission vs. 7 of 13 (54%) of patients in the Medical ICU who were not diagnosed with a VAE (p=0.031). No other relationships between the type of feeding initiation, tube placement, and enteral formula were found by VAE status for the population or by ICU location. Conclusion: Adults admitted to the Medical ICU may have a reduced risk of developing a VAE if fed within 48 hours of admission. The type of enteral formula provided and the route of administration was not associated with the diagnosis of VAE. Future prospective studies should include all critical care patients to further evaluate the effect of nutrition on VAE outcome.