Successful transvenous lead extraction of abandoned lead implanted through persistent left superior vena cava

Persistent left superior vena cava, the most common thoracic venous anomaly, may complicate transvenous lead extraction (TLE). We report a successful case of TLE in a patient with persistent left superior vena cava, despite a long dwelling time and several pocket revisions due to pocket infection. The lead was removed via a hand-powered mechanical extraction sheath, and postoperative complications did not occur. Complicated TLE cases may have a better outcome if performed in a high-volume center with experienced specialists.

AGRICULTURE 4.0

The Fourth Industrial Revolution has stimulated the development of new technologies and techniques that are changing the global production system. The objective of this paper is to analyze the stream of innovation of Agriculture 4.0, such as its origin, features and consequences. Agriculture 4.0 is a digital model of agricultural production guided by high-performance manufacturing and is a result of a long historical process of technological development. The innovation in the agricultural sector in Brazil is essential to the maintenance of its competitiveness. However, the 4.0 concept of production is still a challenge the country needs to overcome. Agtech startups are working as a solution for technology diffusion. The Piracicaba Valley Agtech, in the state of São Paulo, is a successful case of Agriculture 4.0 concept development.

Gas Wells with Carbon Steel Completion, Can it Handle Sour Gas Production, Case Study

Title Gas wells with Carbon steel completion, Can it handle sour Gas production, Case Study. Objective/Scope It is a successful case of producing sour gas (up to 18% H2S and 9.2% CO2) since 2016 wells with carbon steel tubing with maintaining downhole chemical injection of corrosion inhibitor. Methods, Procedures, Process During 2014 a group of new wells has been drilled in X giant onshore gas reservoir under ADNOC onshore company operating area to maximize gas production and to meet production mandate. Majority of wells has been drilled within the North and peripheral Area of the reservoir. All wells has been completed with a standard completion with a Top completion (+/-7000 ft.) in carbon steel with downhole chemical injection valve, and a corrosion resistant alloy section below the CIV. After wells commissioning, high H2S contents were observed (Up to 18%), and Management initially instructed operations to shut in 9 wells and formulated a task force to study the applicable options and analyze the data to ensure asset integrity. The TF recommendation was to flow the wells with close monitoring of wells integrity, in particular annulus pressure A comprehensive downhole exercise has been done by Results/Observation/Conclusion Carbon steel completion with downhole chemical injection is a validated completion solution for such conditions. Novel/ Additive information Clearly, case is as a solid reference for sour gas production using conventional completion, sustaining Long-term production is adding more weight to the case conclusion.

Production Enhancement in Intermittent Gas Lift Wells Using Sweeping Pipe Bend - Successful Case Histories from Various Onshore Fields in India

Objectives In wells which are producing on intermittent gas lift (IGL), the injected gas cannot sweep the entire liquid volume to the surface from the bottom of the tubing as there is continuously some fluid falling back in the tubing. The fallback can be described as the difference between the volume of the slug at the start of the gas injection and the volume of the actual produced slug at the surface. This fallback of liquid happens due to the fact that the gas has a tendency to flow through the liquid slug and letting the liquid to fall. The intensity of the liquid fallback increases more when there is increase in back pressure at wellhead. In order to minimize this liquid falling back in wells on intermittent gas lift, the sweeping pipe bend technology has been used in the various onshore fields operated by ONGC which has resulted in substantial gains and has been brought out in the paper. Process Gas break through and fallback are affected by three factors including the development of the gas bubble, the velocity of the slug flowing upward in the tubing, and wellhead restrictions caused due to presence of many 90-degree bends. To prevent gas breakthrough and to optimize the liquid fallback to minimum 5-7 % per 1000 feet of lift, it is recommended to maintain 1000 feet/min of minimum velocity of slug. Slower is the velocity of the slug which is moving up in the tubing, the longer time it takes for the gas to break through the liquid. At 1000 feet/min velocity, the wellhead restrictions can result in fallback losses due to breakthrough of gas in the well. In general, the flow path through the Christmas tree into the flowline is rather tortuous, moving first through a tee to the wing valve, then through other 90-degree ells before finally reaching the flowline. These restrictions further result in slowdown of the velocity of the slug thus resulting in more liquid to fallback and subsequently in significant production losses. Results In order to overcome the aforementioned problem and to reduce fallback in an intermittent gas lift well, sweeping pipe bend technology was considered and in the first phase implemented in 5 identified wells of different fields of ONGC Assets. With the help of sweeping pipe bend, the flow pattern becomes streamlined and number of 90-degree bends reduces or eliminates resulting in substantial reduction in the back pressure thus reducing the fall back. The implementation of the technology has resulted in an average liquid gain of 20.3% per well. Various guidelines for successful application of sweeping pipe bend have also been brought out in the paper. Additive Information 650 candidate wells operating on intermittent gas lift have been identified for the implementation of Sweeping Pipe Bends. As per the analysis, the implementation of Sweeping Pipe Bend is likely to result in a liquid gain of about 1000 m3/day from these wells.

Successful Case of Resin-Based Chemical Sand Consolidation as a Remedial Sand Control Treatment

The Mahakam delta in east Kalimantan, Indonesia, yields gas as the main hydrocarbon production with giant reservoirs ranging from shallow to very deep zones. Reservoirs consists of clean sandstone with high permeability. Due to the field maturity, production gradually moved from the deep, consolidated zones into very shallow, unconsolidated zones. Sand production often causes significant problems at the surface when the well is online. The best approach to sand control is to keep it inside the reservoir, because it could create problems not only at surface but within the wellbore as well. Sand consolidation has been a common approach applied in Mahakam field for more than a decade. Several products have been utilized, including laboratory testing and field trials. The case history is based on a well that had been treated using 2 different sand consolidation products in the past, but both eventually produced inadequate results. Sand continued to break through after each treatment, hence the reserves could not be drained in full. Since the reservoir still had promising reserves, another remedial sand consolidation treatment was planned. This treatment was executed by utilizing a tension packer with a J-slot mechanism in order to focus injection of the resin into the zone of interest. Additionally, there was a challenge with another open zone above the subject interval. The remedial sand consolidation treatment using a resin-based chemical delivered excellent results. Even though this reservoir had been exposed to 2 different chemical treatments in the past, by using the resin-based sand consolidation product, the well was still able to be produced at target rates without sand production. In conclusion, resin-based sand consolidation solutions can unlock prolific reserves that may have been a significant challenge with traditional methods.

Danger signs and management of suspected severe malaria cases at community level and in referral health facilities: an operational study in the Democratic Republic of the Congo

BackgroundEvidence from one trial in Africa suggests that pre-referral Rectal Artesunate (RAS) can be a life-saving intervention for severe malaria in remote settings, where parenteral treatment is not available. Recognition of danger signs indicative of severe malaria is critical for prompt and appropriate case management.MethodsAn observational study was conducted in the Democratic Republic of the Congo (DRC) in the frame of the multi-country CARAMAL project, to assess the effectiveness of RAS under real-world conditions. Severely ill feverish children <5 years seeking care from a community-based healthcare provider were recruited in three rural health zones into a patient surveillance system. They were subsequently followed within the healthcare system and at home after 28 days to determine care seeking, antimalarial treatment provision and health outcomes.ResultsOverall, 66.4% of patients had iCCM general danger signs, as well as more specific danger signs. Children aged 2-5 years (aOR=1.58, 95% CI 1.20–2.08) and those presenting iCCM general danger signs were more likely to receive RAS (aOR = 2.77, 95% CI 2.04–3.77). Injectable treatment was less likely with RAS pre-referral treatment (aOR=0.21, 95% 0.13– 0.33). In the post-RAS phase, the case fatality ratio was 7.1%. Children not receiving RAS had a higher risk of dying, but this was not statistically significant (aOR = 1.50, 95% CI 0.86– 2.60). The odds of dying were reduced in patients without iCCM general danger signs, but just not statistically so (aOR = 0.64, 95% CI 0.38–1.06). Full oral therapy at a RHF was highly protective (aOR = 0.13, 95% CI 0.07-0.26), while a full treatment of severe malaria (injectable + oral) was shown to also decrease massively the odds of dying (aOR = 0.26, 95% CI 0.09– 0.79) compared to injectable treatment alone.ConclusionsBetter understanding the determinants of successful case management, and targeted improvements of the health system (especially the provision of a full course of an oral antimalarial) are crucial for improving health oucomes of children with suspected severe malaria.