scholarly journals Colonic transendoscopic tube-delivered enteral therapy (with video): a prospective study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ting Zhang ◽  
Chuyan Long ◽  
Bota Cui ◽  
Heena Buch ◽  
Quan Wen ◽  
...  
Keyword(s):  
Retention Time ◽  
Fecal Microbiota ◽  
Endoscopic Clip ◽  
Factors Affecting ◽  
Retention Group ◽  
Endoscopic Clips ◽  
Delivery Technique ◽  
Colonic Lumen ◽  
A Prospective Study ◽  
High Degree

Abstract Background Colonic transendoscopic enteral tubing (TET) refers to colonic transendoscopic tube-delivered enteral therapy. Colonic TET has been successfully used for frequent colonic administration of drugs or multiple fecal microbiota transplantations (FMTs). This prospective observational study aimed to evaluate possible factors affecting methodology, feasibility and safety of colonic TET. Methods Patients who underwent colonic TET at our center from October 2014 to November 2018 were included. The feasibility, efficacy, and safety of TET were evaluated. Results In total, 224 patients were analyzed. The success rate of TET was 100%. The median retention time of TET tube within the colonic lumen was 8.5 (IQR 7–11) days in 158 patients with tube falling out spontaneously, and the maximum retention time was up to 28 days. These patients were divided into the short-retention group (≤ 8.5 days) and the long-retention group (> 8.5 days). Univariate and multivariate analysis demonstrated that the type of endoscopic clip (p = 0.001) was an independent factor for the retention time. The larger clips as well as a greater number of clips significantly affected the retention time (p = 0.013). No severe adverse event was observed during and after TET. Conclusions Colonic TET is a feasible, practical, and safe colon-targeted drug delivery technique with a high degree of patients’ satisfaction. Two to four large endoscopic clips are recommended to maintain stability of the TET tube within the colon for over 7 days.

scholarly journals Factors Affecting Effectiveness of Fecal Microbiota Transplant

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S386-S386 ◽  
Author(s):  
Danielle Mosby ◽  
Patty Mcgraw ◽  
Chad Duffalo ◽  
Marci Drees ◽  
Fedele Depalma ◽  
...  
Keyword(s):  
Pulmonary Disease ◽  
Retention Time ◽  
Fecal Microbiota ◽  
Index Number ◽  
Fecal Microbiota Transplant ◽  
Specific Patient ◽  
Factors Affecting ◽  
Academic Center ◽  
History Of ◽  
Bowel Prep

Abstract Background Fecal microbiota transplant (FMT) is an effective treatment for relapsing Clostridium difficile infection (CDI). With more widespread use of this intervention, variable cure rates (70–95%) have been observed. We conducted this study to identify specific patient- and procedure-level factors affecting FMT effectiveness, hypothesizing that those patients with higher comorbidity, inadequate bowel preparation, and shorter retention of transplant would fail more frequently. Methods At our 2-hospital, >1100-bed community-based academic center, we prospectively followed patients pre/post-FMT between June 2014-April 2017. To undergo FMT, patients must have ≥2 CDI relapses and failed vancomycin taper. We entered all FMT patients into a registry and followed them regularly for up to 1 year, collecting age, Charlson Comorbidity Index, number of CDI relapses, Boston bowel prep score, and stool retention time. FMT donor stool was obtained from OpenBiome (Boston, MA). We defined failure as recurrent CDI requiring treatment ≤8 weeks after FMT. We used 1-sided t-tests to test our hypotheses. Results During the study period, 41 patients (mean age 65 years, SD 17.6) underwent FMT. Most (37, 90%) were performed via colonoscopy, 1 via upper endoscopy, and 3 via oral preparation (capsules). FMT failure occurred in 10 patients (24.4%). Nearly half (n = 20) reported adverse events, including constipation, gas, abdominal pain, blood in stool, and fatigue. Three patients expired from comorbid disease, and 3 were lost to follow-up. Patients with higher Charlson scores failed more frequently (P = 0.04), and history of tumor (P = 0.03) and pulmonary disease (P = 0.04) were both associated with failure. No other factors, including age, retention time, and Boston bowel prep score, were associated with failure. Conclusion This study found that patients with multiple comorbid conditions, as defined by the Charlson index, are at risk for FMT failure. However, quality of bowel prep and retention time did not predict FMT failure. Future studies should include larger samples of FMT patients to determine whether specific comorbidities such as history of tumor and pulmonary disease are clinically significant predictors of FMT failure. Disclosures All authors: No reported disclosures.

scholarly journals Colonic Transendoscopic Enteral Tubing: Route for a Novel, Safe, and Convenient Delivery of Washed Microbiota Transplantation in Children

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Min Zhong ◽  
Heena Buch ◽  
Quan Wen ◽  
Chuyan Long ◽  
Bota Cui ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Adverse Events ◽  
Retention Time ◽  
Fecal Microbiota Transplantation ◽  
Fecal Microbiota ◽  
Colonic Delivery ◽  
Endoscopic Clip ◽  
First Time ◽  
Maximum Retention

Aim. Colonic transendoscopic enteral tubing (TET) has been used for delivering fecal microbiota transplantation by washed preparation since 2015, which was recently named as washed microbiota transplantation (WMT). However, there are few reports available regarding the feasibility and safety of these studies in low-age population. This study is aimed at evaluating the safety, feasibility, and value of colonic TET in 3-7 years old children. Methods. All patients aged 3-7 years who underwent colonic TET in our center for WMT or medication were prospectively evaluated. The feasibility and safety of TET were evaluated. A questionnaire was completed by the children’s parents to evaluate the children’s response to the colonic TET as well as the parent’s satisfaction. Results. Forty-seven children were included (mean age 5 years). TET was implemented into the colon of all the patients, and the success rate of the procedure was 100%. The median retention time of TET tube within the colon was 6 (IQR 5-7) days in 45 patients with tube falling out spontaneously, and the maximum retention time was up to 21 days. Multivariate analysis demonstrated that endoscopic clip number ( P = 0.009 ) was an independent contributing factor for the retaining time of tube. With increase in the number of large clips, the retention time of TET tube was prolonged. No discomfort was reported during injection of the microbiota or medication suspension through the TET tube. During the follow-up, no severe adverse events were observed. All children’s parents were satisfied with TET. Interestingly, the proportion of children’s parents choosing TET as the delivery way of WMT increased from 29.79% before to 70.21% after TET ( P < 0.001 ). Conclusions. This study, for the first time, demonstrates that colonic TET is a novel, safe, and convenient colonic delivery way for WMT and medication in children aged 3-7 years.

scholarly journals Abrupt Temporal Fluctuations in the Chicken Fecal Microbiota Are Explained by Its Gastrointestinal Origin

2012 ◽  
Vol 78 (8) ◽  
pp. 2941-2948 ◽  
Author(s):  
M. Sekelja ◽  
I. Rud ◽  
S. H. Knutsen ◽  
V. Denstadli ◽  
B. Westereng ◽  
...  
Keyword(s):  
Barrier Function ◽  
16S Rrna Gene Sequencing ◽  
Fecal Microbiota ◽  
Pathogen Transmission ◽  
Rrna Gene ◽  
Multivariate Statistical ◽  
Content Type ◽  
Factors Affecting ◽  
Temporal Fluctuations ◽  
Gastric Barrier

ABSTRACTOne of the main challenges in understanding the composition of fecal microbiota is that it can consist of microbial mixtures originating from different gastrointestinal (GI) segments. Here, we addressed this challenge for broiler chicken feces using a direct 16S rRNA gene-sequencing approach combined with multivariate statistical analyses. Broiler feces were chosen because of easy sampling and the importance for pathogen transmission to the human food chain. Feces were sampled daily for 16 days from chickens with and without a feed structure-induced stimulation of the gastric barrier function. Overall, we found four dominant microbial phylogroups in the feces. Two of the phylogroups were related to clostridia, one to lactobacilli, and one toEscherichia/Shigella. The relative composition of these phylogroups showed apparent stochastic temporal fluctuations in feces. Analyses of dissected chickens at the end of the experiment, however, showed that the two clostridial phylogroups were correlated to the microbiota in the cecum/colon and the small intestine, while the upper gut (crop and gizzard) microbiota was correlated to the lactobacillus phylogroup. In addition, chickens with a stimulated gizzard also showed less of the proximate GI dominating bacterial group in the feces, supporting the importance of the gastric barrier function. In conclusion, our results suggest that GI origin is a main determinant for the chicken fecal microbiota composition. This knowledge will be important for future understanding of factors affecting shedding of both harmful and beneficial gastrointestinal bacteria through feces.

Effect of the amount and form of roughage in the diet on digestibility of whole maize grain in cows and steers

1976 ◽  
Vol 87 (1) ◽  
pp. 213-219 ◽  
Author(s):  
M. Nordin ◽  
R. C. Campling
Keyword(s):  
Retention Time ◽  
Whole Grain ◽  
Factors Affecting ◽  
Lactating Cows ◽  
Maize Grain

SUMMARYFour experiments investigated some of the factors affecting the digestion of whole maize grain in non-lactating cows and yearling steers. With steers, but not cows, maize in diets containing small amounts of hay (14%) and large amounts of whole grain were better digested than those with 37 or 48% hay. The higher digestibility of maize in steers was associated with a greater time spent ruminating per kg feed and a longer retention time of maize in the gut than in cows. Replacing long roughage with ground and pelleted roughage in diets for steers improved the digestion of whole maize but not as well as reducing the hay to 14% of the diet. Finely grinding the maize produced a large increase in digestibility of the feed in cows and steers and both digested it to the same extent. It was concluded that the motility of the reticulo-rumen during eating and ruminating largely determines the extent of the digestion of whole maize grain.

Historical Dynamics

2018 ◽  
Author(s):  
Peter Turchin
Keyword(s):  
Religious Conversion ◽  
Synthetic Approach ◽  
Dynamical Processes ◽  
Factors Affecting ◽  
Historical Processes ◽  
Wide Range ◽  
Historical Dynamics ◽  
State Breakdown ◽  
Political Economic ◽  
High Degree

Many historical processes are dynamic. Populations grow and decline. Empires expand and collapse. Religions spread and wither. Natural scientists have made great strides in understanding dynamical processes in the physical and biological worlds using a synthetic approach that combines mathematical modeling with statistical analyses. Taking up the problem of territorial dynamics—why some polities at certain times expand and at other times contract—this book shows that a similar research program can advance our understanding of dynamical processes in history. The book develops hypotheses from a wide range of social, political, economic, and demographic factors: geopolitics, factors affecting collective solidarity, dynamics of ethnic assimilation/religious conversion, and the interaction between population dynamics and sociopolitical stability. It then translates these into a spectrum of mathematical models, investigates the dynamics predicted by the models, and contrasts model predictions with empirical patterns. The book's highly instructive empirical tests demonstrate that certain models predict empirical patterns with a very high degree of accuracy. For instance, one model accounts for the recurrent waves of state breakdown in medieval and early modern Europe. And historical data confirm that ethno-nationalist solidarity produces an aggressively expansive state under certain conditions (such as in locations where imperial frontiers coincide with religious divides). The strength of the book's results suggests that the synthetic approach advocated can significantly improve our understanding of historical dynamics.

scholarly journals Factors Affecting Radiation Exposure during Lumbar Epidural Steroid Injection: A Prospective Study in 759 Patients

2016 ◽  
Vol 17 (3) ◽  
pp. 405 ◽  
Author(s):  
Suyoung Kim ◽  
Joon-Ho Shin ◽  
Joon Woo Lee ◽  
Heung Sik Kang ◽  
Guen Young Lee ◽  
...  
Keyword(s):  
Prospective Study ◽  
Radiation Exposure ◽  
Steroid Injection ◽  
Epidural Steroid Injection ◽  
Factors Affecting ◽  
Epidural Steroid ◽  
A Prospective Study

Simultaneous removal of nitrogen and phosphorus in a two-biofilter system

2000 ◽  
Vol 41 (12) ◽  
pp. 101-106 ◽  
Author(s):  
D. Pak ◽  
W. Chang
Keyword(s):  
Retention Time ◽  
Phosphorus Removal ◽  
Hydraulic Retention Time ◽  
Loading Rate ◽  
Aerobic Condition ◽  
Nitrogen Loading ◽  
Simultaneous Removal ◽  
Nitrogen And Phosphorus ◽  
Nitrogen And Phosphorus Removal ◽  
Factors Affecting

A two-biofilter system operated under alternate conditions of anaerobic/aerobic was tested to simultaneously remove nitrogen and phosphorus from sewage. The factors affecting simultaneous removal of nitrogen and phosphorus by the two-biofilter system were investigated. Those factors appeared to be influent COD/T-N and COD/T-P ratio, nitrogen loading rate and hydraulic retention time. Nitrite and nitrate produced in the biofilter in aerobic condition affected phosphorus removal by the two-biofilter system. The amount of biomass wasted during the backwash procedure also affected total nitrogen and phosphorus removal by the system.

Factors affecting vascular access complications in children undergoing congenital cardiac catheterization

2011 ◽  
Vol 22 (2) ◽  
pp. 136-144 ◽  
Author(s):  
Alaa M. Roushdy ◽  
Noha Abdelmonem ◽  
Azza A. El Fiky
Keyword(s):  
Body Weight ◽  
Adverse Events ◽  
Cardiac Catheterization ◽  
Vascular Access ◽  
Vascular Complications ◽  
P Value ◽  
Factors Affecting ◽  
Vein Thrombosis ◽  
Access Complications ◽  
A Prospective Study

AbstractBackgroundComplications at the vascular access sites are among the most common adverse events in congenital cardiac catheterization. The use of small-gauge catheters may reduce these events; however, other factors can contribute to the development of vascular complications.ObjectivesTo determine factors associated with the development of vascular access complications in children undergoing congenital cardiac catheterization.MethodsWe performed a prospective study of 403 patients who underwent diagnostic (62.5%) or interventional (37.5%) cardiac catheterization over a period of 6 months, and analysed the vascular complications during and immediately after the procedure.ResultsThe most common access-related adverse event was transient loss of pulsation (17.6%). Other less common access-related adverse events included subcutaneous haematoma (2%), bleeding (3%), vessel tear (0.2%), and vein thrombosis (0.2%). Patients who had no access-related adverse events had significantly higher age and body weight compared with those who had one or more access problems. Among 81 patients who had vascular access established in unplanned access sites, 30 patients (37%) had lost pulsations. Among the 322 patients who had vascular access established in planned access sites, however, only 41 patients had lost pulsation (13%). In addition, patients who had lost pulsations had significantly longer puncture time compared to those who had normal pulsations (p value 0.01).ConclusionFactors other than sheath size can contribute to access-related adverse events in children undergoing cardiac catheterization. Obtaining vascular access in unplanned access sites and longer puncture times increases the incidence of lost pulsations after catheterization. Younger age and smaller body weight are also associated with significant increase in access-related adverse events.

scholarly journals What are the Most Effective Factors in Determining Future Exacerbations, Morbidity Weight and Mortality In Patients Hospitalized wıth COPD Attack? A Prospective Study

2021 ◽  
Author(s):  
Çağla Koç ◽  
Füsun Şahin
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Blood Gases ◽  
Distribution Width ◽  
Factors Affecting ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Arterial Blood ◽  
Gold Stage ◽  
A Prospective Study

INTRODUCTION: The aim of this study was to investigate the important factors affecting the COPD prognosis. MATERIAL AND METHODS: We included 160 hospitalized patients with COPD exacerbation in the study. Hemoglobin-HB, hematocrit-HCT, leukocyte, red cell distribution width- RDW, mean platelet volume, platelet distribution width, plateletcrit, platelet, neutrophil / lymphocyte ratio, platelet / lymphocyte ratio, eosinophil, uric acid, albumin, CRP, procalcitonin, arterial blood gases (PO2, PCO2) pulmonary function test (FEV1, FVC), echocardiography (ejection fraction-EF) GOLD stage, MMRC and BORG scales, Charlson comorbidity index, body mass index-BMI, length of hospital stay were examined on the first day of hospitalization. Admission to the hospital with a new attack, hospitalization in the intensive care unit-ICU, and mortality during the 6 months after discharge were evaluated. RESULTS: High CRP and procalcitonin values were observed in the group with long hospital stay. In mortality group, HB, HCT, BMI and PO2 values were significantly lower than the group without mortality while age and GOLD stage were higher. The age, BORG and MMRC scores, number of exacerbations experienced in the previous 1 year, RDW, eosinophil count, PCO2 were significantly higher in the ICU group than without ICU. HCT, EF values were lower in the ICU group than without ICU. FEV1, FVC values were significantly lower in follow-up attack group than without attack; the duration of COPD and the number of experienced in the previous 1 year were high. CONCLUSION: It has been concluded that the scoring combining selected biomarkers and other factors will be stronger in determining the prognosis.

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