Short-Term Effects of a Resistance Training Program Using Elastic Tubing in Patients with Heart Disease

Abstract Background Resistance training is effective in cardiac rehabilitation; however, it is conventionally performed using free weights or machines, which can pose logistic challenges to patients with restricted mobility. For its ease of access and cost-effectiveness, elastic tubing is a particularly appealing alternative, but it remains underutilized for this purpose. Objective To evaluate muscle strength, functional capacity, aerobic capacity, and quality of life in patients with heart disease in phase II of cardiovascular rehabilitation after a resistance training intervention based solely on elastic tubing. Methods Thirteen patients with heart disease (age 63.33±10.80 years) trained with elastic tubing twice weekly for 6 weeks, with progressive load increase every 15 days. The following muscle groups were evaluated and trained: shoulder abductors and flexors, elbow flexors, and knee flexors and extensors. Muscle strength was evaluated using a dynamometer; functional capacity, with a 6-minute walk test and cardiopulmonary exercise test; and quality of life, using the SF-36 questionnaire. Data normality was assessed using the Shapiro-Wilk test. The paired Student's t-test was used for comparisons before and after training, at a significance level of <5%. Results There were significant differences in muscle strength (except for elbow flexion) and functional capacity (485.5 ± 123.3 vs 578.7 ± 110.5; p=0.0399) after the intervention. No statistical differences were found in cardiorespiratory fitness or quality of life. Conclusions Short-term resistance training with elastic tubing improved peripheral muscle strength and functional capacity in patients with heart disease, and should be encouraged for this population. (Int J Cardiovasc Sci. 2020; xx(x):xxx-xxx)

Methodology, safety and applications of colonic transendoscopic enteral tubing (with video) / 中华消化内镜杂志

Objective@#To evaluate the methodology, safety and clinical applications of colonic transendoscopic enteral tubing (TET) as a new method of fecal microbiota transplantation (FMT) and colonic administration.@*Methods@#This prospective study included patients who underwent colonic TET for FMT and(or) colonic administration in the Second Affiliated Hospital of Nanjing Medical University from October 2014 to December 2018. The TET procedure time, success rate, retention time of TET tube, factors influencing TET tube retention, adverse events and satisfaction degree were evaluated.@*Results@#A total of 257 patients underwent TET, among whom 130 patients (50.6%) for microbiota tronsplantation, 8 patients (3.1%) for colon-drip medication, 118 patients (45.9%) for FMT and colon-drip medication, and 1 patient (0.4%) without treatment after TET. The TET procedure time was 10.0±2.8 min. The number of endoscopic clips used was 3.5±1.0. The success rate of the TET procedure was 100.0% (257/257). The retention time of TET tube for 160 patients maintaining the tube for treatment was 9.3±3.8 days. Multivariate analysis indicated that endoscopic clip type (P=0.001) was an independent influencing factor for the retention time of the tube. A total of 9 patients (3.5%) reported adverse events of mild anus discomfort, 4 patients (1.6%) of mobile inconvenience, 3 (1.2%) of anal pain, 2 (0.8%) of mild abdominal pain, 2 (0.8%) of mild bloating, and 1 (0.4%) of mild anal bleeding. No severe adverse events were observed in this study. The total satisfaction degree on colonic TET was 97.3% (250/257) in all patients.@*Conclusion@#The colonic TET, a safe and easy-operating endoscopic interventional technology with a high degree of patients satisfaction, can be used for colonic delivering of FMT and medications for various diseases.

Advances in Study on Fecal Microbiota Transplantation System and Inflammatory Bowel Disease / 胃肠病学

Fecal microbiota transplantation (FMT) is an emerging therapeutic technology system, mainly involving the strict donor screening, improvement of fecal microbiota preparation, and proper route of transplantation. This article reviewed the advances in study on FMT system and inflammatory bowel disease (IBD).

Rediseño del sistema de distribución de vapor del área de lavandería del Hospital Carlos Andrade Marín / Redesign of the steam distribution system in the laundry area of Carlos Andrade Marin Hospital

Introducción: Esta investigación plantea una propuesta de rediseño para el sistema de distribución de vapor y de retorno de condensado en el área de lavandería del hospital. Materiales y Métodos: En el desarrollo del proyecto se realizó el levantamiento de información que comprende los diferentes requerimientos de los equipos de consumo de vapor, trazado de la tubería del sistema actual y deficiencias energéticas. Resultados: Para el rediseño se implementaron conexiones superiores a los equipos, piernas colectoras y finales de línea, garantizando así que no ingrese condensado a los equipos y que no afecte a la tubería por el golpe de ariete. El condensado drenado de las líneas de vapor y a la salida de los arreglos de trampeo de los equipos de consumo, antes de dirigirse al tanque de condensado, pasa por un tanque de revaporizado donde se obtiene revaporizado a baja presión, el mismo que puede ser utilizado en otro proceso con estos requerimientos. Discusión: Se determinó el costo del proyecto y se realizó un análisis económico, tomando en cuenta el ahorro energético-económico que se obtendrá con la implementación del rediseño, así como la reducción en las emisiones de CO2. Palabras clave: Tuberías, vapor, lavandería.

Introduction: This research proposes to redesign the steam distribution and condensate return systems in the hospital laundry area. Methods: During the project development, we gather information from steam consumer equipment, piping layout of the current system and energy deficiencies. Results: For the redesign, it has been implemented upward connections to equipment, drain pockets and line endings, thus, guarantying that condensate does not get into the laundry equipments and pipes to avoid being damaged by the water hammer. The drained condensate from the steam lines, before being trapped in the tank of condensate, is conducted to a flash tank creating a low-pressure flash steam that can be used in other process with these requirements. Discusion: The cost of the project was obtained and an economic analysis was undertaken bearing in mind the energy and economic saving that will be obtained with the redesign as well as the CO2 emissions reduction.

Maintaining ventilator tubing at low position for prevention of ventilator-associated pneumonia / 中华急诊医学杂志

Objective To study the role of maintaining ventilator tubing at low position in prevention of ventilator-associated pneumonia (VAP).Methods From January 2010 through December 2011,110 cases with invasive mechanical ventilation in Intensive Care Unit (ICU) were randomly divided into observation group (n =55) and control group (n =55).The patients of control group were given conventional prevention method including the head elevated 30°-45°.The patients of observation group were given prevention method of keeping ventilator tubing at low position in addition to conventional prevention method so as to avoid the condensate in ventilator tubing into the airway.After mechanical ventilation support for 28 days,the incidence of VAP,duration of mechanical ventilation,length of ICU stay,incidence of condensate flowing back,clinical pulmonary infection score (CPIS) and mortality were respectively recorded.At the same time,risk of mistakenly extubation by nurses was recorded.Results The comparison between two groups showed the incidence of VAP (16.36％ vs.34.55％),duration of mechanical ventilation (5.86 ± 2.66) d vs.(11.24 ± 3.80) d,length of stay in the ICU (13.60 ± 4.83) d vs.(19.58 ±5.27) d,incidence of condensate backflow (3.64％ vs.49.09％),presenting significant differences between two groups (P ＜ 0.05).The CPIS of observation group was lower than that of the control group (P ＜0.05),and the mortality in observation group (21.82％) was lower than that in the control group (27.27％),but the difference was not significant (P ＞0.05).There was no statistically significant difference in risk of mistakenly extubation between two groups (P ＞ 0.05).Conclusion Maintaining the ventilator tubing at low position can reduce the incidence of VAP,improve the prognosis,and the risk of mistakenly extubation did not increase compared with the conventional methods

Novel Laparoscopic Gastric Tubing with Pyloromyotomy for Treatment of Esophageal Cancer

PURPOSE: We report on a novel method and outcomes of laparoscopic gastric tubing with pyloromyotomy. METHODS: The abdominal procedure includes laparoscopic gastric mobilization, celiac axis lymph node dissection, formation of the gastric tube, and pyloromyotomy. Between January 2009 and April 2013, our minimally invasive esophagectomy (MIE) was performed on 54 patients with esophageal cancer. The short-term outcomes, including postoperative complications, were analyzed. RESULTS: There were no cases of conversion to open surgery. Of 54 patients, 52 patients had squamous cell carcinoma (SCC) and two had adenocarcinoma. The total operative time was 349.8+/-77.4 minutes, of which 90.6+/-27.6 minutes was required for the abdominal procedure. The mean estimated operative blood loss during the abdominal procedure was 40.0+/-355.5 ml. The postoperative complication rate was 24.1%; three patients died of pneumonia. CONCLUSION: Laparoscopic gastric tubing with pyloromyotomy is a feasible and safe treatm ent option for patients with esophageal cancer.

Application of percutaneous transesophageal gastro-tubing in palliative treatment of malignant bowel obstruction

Percutaneous transesophageal gastro-tubing (PTEG) is considered a safe and effective treatment technique for drainage or feeding in patients with malignant bowel obstruction. We report six cases with malignant bowel obstruction due to recurrent gastric cancer whose bowel symptoms were satisfactory improved with PTEG. Ileus tubes were inserted in three of the six patients for decompression of the alimentary tract, a feeding tube was inserted in one patient for enteral feeding, and double elementary diet tubes (W-ED tube) were inserted in other two for decompression and enteral feeding. The median indwelling duration was 52days (rang; 24-460days). Home enteral nutrition was possible for the three patients with feeding tube and W-ED tube. Regarding decompression of alimentary tract, PTEG relieved the symptoms of all patients. One patient suffered from dermatitis around the inserted part of ileus tube because of the leakage of gastro-intestinal juice, and the ileus tube was removed. In two cases, the inserted tubes were exchanged because of the tube obstruction. PTEG made possible to use various types of tube depending on the state of the disease. From our experience, it is suggested that PTEG technique is an effective and useful procedure of choice for long-term drainage or feeding in patients with malignant bowel obstruction. Palliat Care Res 2008; 3(2): 335-342

Correction of Lop Ear Deformity by Antihelical Tubing and / or Cartilage Graft

This paper presents the corrective surgical methods of lop ear deformities based on the degree of helical constriction. The deformities were corrected by antihelical tubing procedure and/or cartilage graft. The additional skin coverage, if required, was obtained by postauricular V-Y advancement flap or Grotting flap. Total 22 lop ear deformities were corrected including nine tubing procedures, three cartilage grafts and ten cartilage grafts combined with tubing procedure. All patients were followed up more than one year and most of them maintained natural auricular appearances.

A comparision study between autogenous nerve graft and Silicone tubing method in segmental defect of sciatic nerve in rats / 대한정형외과학회잡지

Recently autogenous nerve graft was usually used for segmental defect of peripheal nerve injury. In case of inappropriate size or amount of donor nerve graft, there were many studies included nerve regeneration with special nerve conduit material. To compare the result of autogenous nerve graft with that of silicone tubing method in segmental defect of sciatic nerve, the experiments were carried out on adult rats with autogenous nerve graft on the left side and silicone tubing on the right side. The results were as follows; 1. Myelinated nerve fibers were larger in silicone tubing method than autogenous nerve graft at postop. 4 weeks. 2. There was no difference in nerve regeneration in both groups at postop. 12 weeks. 3. Some atrophic changes were showed in denervated muscles in both groups at postop. 4 weeks. Skeletal muscle changes between the two groups were meagre. 4. Perineural adhension was rare in silicone tubing group in contrast to autogenous nerve graft group. 5. Nerve Conduction Velocity was similar between autogenous nerve graft and silicone tubing method after 4 weeks postoperatively. In conclusion, this study suggests that silicone tubing can be useful method to repair the large nerve gaps and has a potential clinical utilization in large segmental nerve defect.

The Effects of Sample Dilutions between Gould and Cook Pressure Connecting Tubes on Arterial Blood Gas Determinations / 대한마취과학회지

Although heparin solution is widely used as an anticoagulant in blood gas analysis, alterations in blood gas measurements may occur when small sample volumes are diluted by heparin. Cook pressure tubing for infants and children and Gould pressure line for adults were applied to each of 10 adult patients whose cardiovascular fuction was normal. Arterial blood gases were measured serially after withdrawing 2,4,6,8,10 and 12 ml of flus-blood solutions from the Gould pressure connecting tubing, and 1,2,3,4,5 and 6 ml from the Cook pressure line, which were connected to a transducer through a 3way stopcock. In the Gould pressure tubing, the pH was unchanged from sample 2 and PaCO2, HCO3- and base excess were unchanged from sample 3. PaO2 did not change between the samples. In the Cook pressure line, the pH and base excess were unchanged from sample 2 and PaCO2, HCO3- and PaO2 from sample 3. We conclude that arterial blood should be withdrawn in volumes of at least 4ml by the Gould pressure connecting tubing and 3ml by the Cook pressure line to obtaine accurate results in blood gas analysis.

The Influence of Deadspace of Pressure Connecting Tubing on Arterial Blood Gas Determinations

This study was undertaken to determine the effect on blood gas determinations of an incomplete purging of the heparinized flush solution from an indwelling arterial catheter and pressure tubing. Arterial blood gases were measured serially after withdrawing 2,4,6,8,10, and 12 ml of flush-blood solution from a 20-gauge radial artery catheter which was connected to one of two kinds of pressure tubing (4-ft and 6-ft Cobe pressure lines). In those samples from the 4-ft Cobe pressure tubing the pH was nearly unchanged in samples 2 thru 6, while the PaCO2, PaO2, actual bicarbonate, and base excess remained approximately constant in samples 3 thru 6. The results of samples taken from the 6-ft tubing were that the pH remained unchanged from samples 3 to 6, and PaCO2, actual bicarbonate, and base excess remained the same from samples 4 onward. PaO2 was unchanged in all sample. In conclusion we suggest that at least 4 ml of blood from a 4-ft Cobe pressure tubing and 6 ml from a 6-ft tubing should be withdrawn prior to arterial blood gas measurements.