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Gimenes, Fernanda Raphael Escobar, Marta Cristiane Alves Pereira, Patricia Rezende do Prado, Rhanna Emanuela Fontenele Lima de Carvalho, Janine Koepp, Ligia Menezes de Freitas, Thalyta Cardoso Alux Teixeira, and Adriana Inocenti Miasso. "Nasogastric/Nasoenteric tube-related incidents in hospitalised patients: a study protocol of a multicentre prospective cohort study." BMJ Open 9, no. 7 (July 2019): e027967. http://dx.doi.org/10.1136/bmjopen-2018-027967.
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IntroductionHospitalised patients with nasogastric/nasoenteric tube (NGT/NET) are at constant risk of incidents; therefore, healthcare professionals need to routinely monitor risks and adopt strategies for patient safety and quality of care.AimThis study aimed to evaluate the NGT/NET-related incidents in hospitalised patients and associated factors.MethodsThis is a multicentre study, with a prospective cohort design. Data will be collected at the general medical ward of seven Brazilian hospitals in the north, northeast, southeast and south. The sample will consist of 391 patients that require an NGT/NET during hospitalisation. Three different methods will be used to identify the incidents: (1) healthcare professionals and patients/caregivers will be required to report any NGT/NET-related incidents; (2) researchers will visit the wards to get information about the incidents with healthcare professionals and patients/caregivers; (3) the researchers will review the medical records looking for information on the occurrence of any NGT/NET-related incidents. Demographic, clinical and therapeutic details will be obtained from the medical records and will be registered in an electronic data collection tool developed for the purposes of this study. The complexity of patients will be assessed by the Patient Classification System, and the severity of comorbid diseases will be assessed through the Charlson Comorbidity Index.Implication for practiceThe results may encourage the use of evidence effectively to influence the scientific foundation for clinical practice and the development of evidence-based policies that will prevent, manage and eliminate complications caused by NGT/NET-related incidents, and improve the quality and safety of care provided to hospitalised patients.Ethics and disseminationThe study has been approved by the Research Ethics Committee. Detailed information about the study can be provided by the principal investigator. The findings will be reported through academic journals, seminar and conference presentations, social media, print media, the internet and community/stakeholder engagement activities.
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de Lint, Vanja. "NGT classifier constructions." Sign Language and Linguistics 21, no. 1 (October 19, 2018): 3–39. http://dx.doi.org/10.1075/sll.00011.lin.
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Abstract This paper seeks to find empirical evidence for categorical associations between classifier types and argument structure in Sign Language of the Netherlands (Nederlandse Gebarentaal – NGT), based on an influential proposal by Benedicto & Brentari (2004). In the light of (sign) language typology and possible modality effects, it is of interest to investigate whether the morpho-phonological similarities of sign language classifier predicates are associated with the same syntactic-semantic properties cross-linguistically. This paper offers three additions to the quest: data from another sign language, an empirical approach, and a more fine-grained distinction of verb types. In an elicitation study, signers produced classifier descriptions of verbs with different argument structures. Their responses were analyzed for phonological handshape and classifier type. Based on the results, I conclude that (i) NGT classifier constructions show categorical associations between argument structure and classifier type, that (ii) specifically, NGT handling and whole entity classifier predicates may take part in a transitive-intransitive alternation, and that (iii) with respect to NGT classifier constructions, we need to distinguish manner verbs from causative verbs.
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Pereira, Rosana Aparecida, Fabiana Bolela de Souza, Mayara Carvalho Godinho Rigobello, José Rafael Pereira, Laís Rosa Moreno da Costa, and Fernanda Raphael Escobar Gimenes. "Quality improvement programme reduces errors in oral medication preparation and administration through feeding tubes." BMJ Open Quality 9, no. 1 (February 2020): e000882. http://dx.doi.org/10.1136/bmjoq-2019-000882.
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BackgroundPatients with nasogastric/nasoenteric tube (NGT/NET) are at increased risk of adverse outcomes due to errors occurring during oral medication preparation and administration.AimTo implement a quality improvement programme to reduce the proportion of errors in oral medication preparation and administration through NGT/NET in adult patients.MethodsAn observational study was carried out, comparing outcome measures before and after implementation of the integrated quality programme to improve oral medication preparation and administration through NGT/NET. A collaborative approach based on Plan-Do-Study-Act (PDSA) cycle was used and feedback was given during multidisciplinary meetings.InterventionsGood practice guidance for oral medication preparation and administration through NGT/NET was developed and implemented at the hospital sites; nurses were given formal training to use the good practice guidance; a printed list of oral medications that should never be crushed was provided to all members of the multidisciplinary team, and a printed table containing therapeutic alternatives for drugs that should never be crushed was provided to prescribers at the prescribing room.ResultsImprovement was observed in the following measures: crushing enteric-coated tablets and mixing drugs during medication preparation (from 54.9% in phase I to 26.2% in phase II; p 0.0010) and triturating pharmaceutical form of modified action or dragee (from 32.8 in phase I to 19.7 in phase II; p 0.0010). Worsening was observed though in the following measures: crush compressed to a fine and homogeneous powder (from 7.4%% in phase I to 95% phase II; p 0.0010) and feeding tube obstruction (from 41.8% in phase I to 52.5% phase II; p 0.0950).ConclusionOur results highlight how a collaborative quality improvement approach based on PDSA cycles can meet the challenge of reducing the proportion of errors in oral medication preparation and administration through NGT/NET in adult patients. Some changes may lead to unintended consequences though. Thus, continuous monitoring for these consequences will help caregivers to prevent poor patient outcomes.
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Nguyen, Ninh T., Johnathan Slone, James Wooldridge, Brian R. Smith, Kevin M. Reavis, and David Hoyt. "Minimally Invasive Esophagectomy without the Use of Postoperative Nasogastric Tube Decompression." American Surgeon 75, no. 10 (October 2009): 929–31. http://dx.doi.org/10.1177/000313480907501014.
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A nasogastric tube (NGT) is commonly used in the postoperative period after esophagectomy for decompression of the gastric conduit. The aim of this study was to evaluate the safety of a minimally invasive esophagectomy without the use of NGT decompression. We performed a retrospective review of 124 patients who underwent minimally invasive esophagectomy. Ninety-eight patients had an NGT placed for postoperative decompression and 26 patients did not. The main outcome measure was postoperative complications in regard to the gastric conduit and esophageal anastomosis. There were 96 males with a mean age of 65 ± 11 years. Three (3%) of 98 patients with operative NGT placement developed postoperative complications directly related to the NGT, which included perforation of the gastric conduit (n = 1) and perforation of the anastomosis (n = 2). In the 26 patients without operative NGT decompression, one patient (3.8%) had distention of the gastric conduit requiring placement of a NGT under fluoroscopic guidance on postoperative Day 1. There was no significant difference in the leak rate between the groups with NGT decompression compared with the group without NGT decompression (9.2 vs 7.7%, respectively). In conclusion, the use of NGT decompression during minimally invasive esophagectomy can be safely omitted. In cases with postoperative gastric conduit distention, an NGT can be safely placed under fluoroscopic guidance.
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Briker, Sara M., Thomas Hormenu, Christopher W. DuBose, Lilian S. Mabundo, Stephanie T. Chung, Joon Ha, Arthur Sherman, Marshall K. Tulloch-Reid, Michael Bergman, and Anne E. Sumner. "Metabolic characteristics of Africans with normal glucose tolerance and elevated 1-hour glucose: insight from the Africans in America study." BMJ Open Diabetes Research & Care 8, no. 1 (January 2020): e000837. http://dx.doi.org/10.1136/bmjdrc-2019-000837.
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IntroductionRisk of insulin resistance, dyslipidemia, diabetes and cardiac death is increased in Asians and Europeans with normal glucose tolerance (NGT) and 1-hour glucose ≥8.6 mmol/L. As African descent populations often have insulin resistance but a normal lipid profile, the implications for Africans with NGT and glucose ≥8.6 mmol/L (NGT-1-hour-high) are unknown.ObjectiveWe performed oral glucose tolerance tests (OGTTs) in 434 African born-blacks living in Washington, DC (male: 66%, age 38±10 years (mean±SD)) and determined in the NGT group if either glucometabolic or lipid profiles varied according to a 1-hour-glucose threshold of 8.6 mmol/L.MethodsGlucose tolerance category was defined by OGTT criteria. NGT was subdivided into NGT-1-hour-high (glucose ≥8.6 mmol/L) and NGT-1-hour-normal (glucose <8.6 mmol/L). Second OGTT were performed in 27% (119/434) of participants 10±7 days after the first. Matsuda Index and Oral Disposition Index measured insulin resistance and beta-cell function, respectively. Lipid profiles were obtained. Comparisons were by one-way analysis of variance with Bonferonni corrections for multiple comparisons. Duplicate tests were assessed by к-statistic.ResultsOne-hour-glucose ≥8.6 mmol/L occurred in 17% (47/272) with NGT, 72% (97/134) with pre-diabetes and in 96% (27/28) with diabetes. Both insulin resistance and beta-cell function were worse in NGT-1-hour-high than in NGT-1-hour-normal. Dyslipidemia occurred in both the diabetes and pre-diabetes groups but not in either NGT group. One-hour glucose concentration ≥8.6 mmol/L showed substantial agreement for the two OGTTs (к=0.628).ConclusionsAlthough dyslipidemia did not occur in either NGT group, insulin resistance and beta-cell compromise were worse in NGT-1 hour-high. Subdividing the NGT group at a 1-hour glucose threshold of 8.6 mmol/L may stratify risk for diabetes in Africans.
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Hsu, Chung Y., Jung-Nien Lai, Woon-Man Kung, Chao-Hsien Hung, Hei-Tung Yip, Yu-Chen Chang, and Cheng-Yu Wei. "Nationwide Prevalence and Outcomes of Long-Term Nasogastric Tube Placement in Adults." Nutrients 14, no. 9 (April 22, 2022): 1748. http://dx.doi.org/10.3390/nu14091748.
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Tube feeding (TF) is commonly used for patients with severe swallowing disturbance, and patients with chronic dysphagia are often provided with a long-term nasogastric tube (NGT). However, nationwide epidemiological data on long-term NGT placement are limited. The present study identified the prevalence and outcomes of patients with long-term NGT placement in Taiwan. Data were obtained from the Longitudinal Health Insurance Database. Patients with NGT placement for more than 3 months between 2000 and 2012 were enrolled in this cohort study. An NGT cohort of 2754 patients was compared with 11,016 controls matched for age, sex, residential area, and comorbidities. The prevalence rate of long-term NGT reached 0.063% in 2005 and then remained stable at 0.05–0.06%. The major causes of NGT placement were stroke (44%), cancer (16%), head injury (14%), and dementia (12%). Men (63%) were more likely to have long-term NGT placement than women (37%). The adjusted hazard ratios were 28.1 (95% CI = 26.0, 30.3) for acute and chronic respiratory infections; 26.8 (95% CI = 24.1, 29.8) for pneumonia, 8.84 (95% CI = 7.87, 9.93) for diseases of the esophagus, stomach, and duodenum; and 7.5 (95% CI = 14.7, 20.8) for mortality. Patients with NGT placement for more than 6 months had a higher odds ratio (1.58, 95% CI = 1.13, 2.20) of pneumonia than those with NGT placement for less than 6 months. Only 13% and 0.62% of the patients underwent rehabilitation therapy and percutaneous endoscopic gastrostomy, respectively. Long-term NGT use was associated with a higher risk of comorbidities and mortality. Stroke was the main illness contributing to long-term NGT use. Further interventions are necessary to improve the negative effects of long-term TF.
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Muslu, Bunyamin, Rüveyda I. Demircioglu, Muhammet Gözdemir, and Burhanettin Usta. "Comparison of neck ultrasonography with a pH meter to confirm correct position of nasogastric tube." Clinical & Investigative Medicine 39, no. 6 (December 1, 2016): 153. http://dx.doi.org/10.25011/cim.v39i6.27520.
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Purpose: The aim of this study was to compare pH meter and neck ultrasonograph for evaluation of nasogastric tube (NGT) position. Methods: A total of 35 adult patients who required NGT insertion were included. The NGT was inserted by an anesthetist after endotracheal intubation, and the transducer was placed transversely on the neck, just superior to the suprasternal notch. The passage of the NGT in the esophagus was evaluated by a sonographer, and the stomach was emptied by nasogastric suction. Secretion from inside the NGT was analyzed using a pH meter. The tip of the NGT was accepted as being in the stomach if the pH measured between 1 and 5. Neck ultrasonography was compared with the pH meter analysis for confirmation of NGT position. Results: Ultrasonography was highly sensitive (100% (95% CI 89.6–100%) and specific (97.2% (95% CI 85.4–99.5%) for evaluation of NGT position. The specificity for the pH meter was 100% (95% CI 16.6–100%), while the sensitivity was 76.5% (95% CI 58.8–89.2%). Conclusions: This study showed that neck ultrasonography is more sensitive than the pH meter for confirmation of NGT position.
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Cassano, Velia, Sofia Miceli, Giuseppe Armentaro, Gaia Chiara Mannino, Vanessa Teresa Fiorentino, Maria Perticone, Elena Succurro, et al. "Oxidative Stress and Left Ventricular Performance in Patients with Different Glycometabolic Phenotypes." Nutrients 14, no. 6 (March 18, 2022): 1299. http://dx.doi.org/10.3390/nu14061299.
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The aim of the present study was to evaluate the possible correlation between oxidative stress and subclinical myocardial damage, assessed with speckle tracking echocardiography (STE), in normal glucose tolerance (NGT) patients with one-hour plasma glucose values ≥ 155 mg/dL (NGT ≥ 155), comparing them to NGT < 155 subjects, impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM) newly diagnosed patients. We enrolled 100 Caucasian patients. All subjects underwent OGTT. The serum values of oxidative stress markers (8-isoprostane and Nox-2) were assessed with an ELISA test. Echocardiographic recordings were performed using an E-95 Pro ultrasound system. We observed significant differences, among the four groups, for fasting plasma glucose (p < 0.0001), one-hour postload (p < 0.0001), and two-hour postload plasma glucose (p < 0.0001). As compared with NGT < 155, NGT ≥ 155 exhibited significantly worse insulin sensitivity and higher values of hs-CRP. No significant differences were observed between NGT ≥ 155 and IGT patients. There was a significant increase in 8-isoprostane (p < 0.0001) and Nox-2 (p < 0.0001), from the first to fourth group, indicating an increase in oxidative stress with the worsening of the metabolic status. Serum levels of 8-isoprostane and Nox-2 were significantly increased in NGT ≥ 155 compared to the NGT < 155 group, but similar to IGT. The global longitudinal strain (GLS) appeared progressively lower proceeding from the NGT < 155 to T2DM group (p < 0.0001). For similar values of left ventricular ejection fraction (LVEF), NGT ≥ 155 exhibited reduced GLS compared to NGT < 155 (p = 0.001), but similar to IGT patients. Our study demonstrated that NGT ≥ 155 subjects exhibit early functional impairment of myocardial contractile fibres, these alterations are correlated with increased oxidative stress.
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Chuang, Shu-Ting, Ya-Hui Yen, Honda Hsu, Ming-Wei Lai, Yu-Fang Hung, and Sen-Wei Tsai. "Predictive Factors for Nasogastric Tube Removal in Post-Stroke Patients." Medicina 59, no. 2 (February 14, 2023): 368. http://dx.doi.org/10.3390/medicina59020368.
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Background and Objectives: Stroke patients have different levels of functional impairment, and rehabilitation is essential to achieving functional recovery. Many post-stroke patients transition from acute treatment to post-acute care (PAC) with nasogastric tubes (NGTs) for rehabilitation. However, long-term NGT placement can lead to several complications, and its earlier removal can effectively reduce the incidence of mortality. This study aimed to use a PAC–cerebrovascular disease (CVD) program and physical functional evaluation scale tools to demonstrate the factors associated with NGT removal before post-stroke patient discharge. Materials and Methods: In this retrospective cohort study, data were collected between January 2017 and August 2022. We divided patients who had NGTs at admission into discharged with and without NGT groups to compare their baseline characteristics and physical functional status. Logistic regression analysis was used to detect the predictive factors for NGT removal. Results: There were 63 participants: 22 without NGT removal and 41 with NGT removal. The NGT removal rate was 65%. Age and scores for the activities of daily living by the Barthel index (BI), Functional Oral Intake Scale (FOIS), Mini-Mental State Examination, and Concise Chinese Aphasia Test were significantly different in terms of NGT removal status, but only the BI and FOIS were significantly correlated with NGT removal. Patients’ BI scores indicating severe to moderate dependence (21–90) had a 4.55 times greater chance of NGT removal (odds ratio, 4.55; p < 0.05) than patients who had total dependence (<20). Every one-point increase in FOIS score indicated a 3.07 times greater chance of NGT removal (odds ratio, 3.07; p < 0.05). Conclusions: The BI and FOIS evaluations may indicate the probability of NGT removal in patients.
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Sáfár, Anna, and Vadim Kimmelman. "Weak hand holds in two sign languages and two genres." Sign Language and Linguistics 18, no. 2 (December 31, 2015): 205–37. http://dx.doi.org/10.1075/sll.18.2.02saf.
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In this paper, we provide a quantitative analysis of weak hand holds based on corpus data. We include both a cross-linguistic analysis of these holds in narrative data from Russian Sign Language (RSL) and Sign Language of the Netherlands (NGT), and a language-internal, cross-genre analysis comparing NGT narrative and conversational data. We classified the functions of all holds found in two corpora of RSL and NGT, and analyzed their formal characteristics. We found that holds in RSL and NGT have similar functions. However, holds are significantly more frequent in RSL than in NGT. In addition, we found that the distribution of holds across different functions varies between different genres in NGT. The similarities between RSL and NGT in the domain of holds may be attributed to modality effects. The differences in frequency of holds ask for a language-specific explanation, and we discuss several possible scenarios.
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Tsolaki, Vasiliki, George E. Zakynthinos, Paris Zygoulis, Fotini Bardaka, Aikaterini Malita, Vasileios Aslanidis, Epaminondas Zakynthinos, and Demosthenes Makris. "Ultrasonographic Confirmation of Nasogastric Tube Placement in the COVID-19 Era." Journal of Personalized Medicine 12, no. 3 (February 23, 2022): 337. http://dx.doi.org/10.3390/jpm12030337.
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Background: Nasogastric tube (NGT) placement is a daily routine in the Intensive Care Unit (ICU), and misplacement of the NGT can cause serious complications. In COVID-19 ARDS patients, proning has emerged the need for frequent NGT re-evaluations. The gold standard technique, chest X-ray, is not always feasible. In the present study we report our experience with the use of ultrasonographic confirmation of NGT position. Methods: A prospective study in 276 COVID-19 ARDS patients admitted after intubation in the ICU. Ultrasonographic evaluation was performed using longitudinal or sagittal epigastric views. Examinations were performed during the initial NGT placement and every time the patients returned to the supine position after they had been proned or whenever critical care physicians or nurses considered that reconfirmation was necessary. Results: Ultrasonographic confirmation of correct NGT placement was feasible in 246/276 (89.13%) patients upon ICU admission. In 189/246 (76.8%) the tube could be visualized in the stomach (two parallel lines), in 172/246 (69.9%) the ultrasonographic whoosh test (“flash” due to air instillation through the tube, seen with ultrasonography) was evident, while in 164/246 (66.7%) both tests confirmed correct NGT placement. During ICU stay 590 ultrasonographic NGT evaluations were performed, and in 462 (78.14%) cases correct NGT placement were confirmed. In 392 cases, a chest X-ray was also ordered. The sensitivity of ultrasonographic NGT confirmation in these cases was 98.9%, specificity 57.9%, PPV 96.2%, and NPV 3.8%. The time for the full evaluation was 3.8 ± 3.4 min. Conclusion: Ultrasonographic confirmation of correct NGT placement is feasible in the initial placement, but also whenever needed thereafter, especially in the COVID-19 era, when changes in posture have become a daily practice in ARDS patients.
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Fiorentino, Teresa Vanessa, Evelina Suraci, Gaetano Paride Arcidiacono, Antonio Cimellaro, Chiara Mignogna, Ivan Presta, Francesco Andreozzi, et al. "Duodenal Sodium/Glucose Cotransporter 1 Expression Under Fasting Conditions Is Associated With Postload Hyperglycemia." Journal of Clinical Endocrinology & Metabolism 102, no. 11 (September 11, 2017): 3979–89. http://dx.doi.org/10.1210/jc.2017-00348.
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Abstract Context Type 2 diabetes (T2DM) is associated with a higher intestinal expression of the glucose transporters sodium/glucose cotransporter 1 (SGLT-1) and glucose transporter 2 (GLUT-2). It is currently unsettled whether prediabetes conditions characterized by postprandial hyperglycemia, such as impaired glucose tolerance (IGT) and normal glucose tolerance (NGT) with 1-hour postload glucose ≥155 mg/dL (8.6 mmol/L) (NGT-1h-high) are associated with increased expression of these glucose carriers in the intestine. Objective We evaluated whether duodenal abundance of SGLT-1 and GLUT-2 is augmented in subjects with IGT and NGT-1h-high, in comparison with subjects with NGT and 1-hour postload glucose ˂155 mg/dL (NGT-1h-low). Design Cross-sectional. Patients A total of 54 individuals underwent an upper gastrointestinal endoscopy. Main Outcome Measures Duodenal SGLT-1 and GLUT-2 protein and messenger RNA levels were assessed by Western blot and reverse transcription polymerase chain reaction, respectively. Results Of the 54 subjects examined, 18 had NGT-1h-low, 12 had NGT-1h-high, 12 had IGT, and 12 had T2DM. Duodenal SGLT-1 protein and messenger RNA levels were significantly higher in individuals with NGT-1h-high, IGT, or T2DM in comparison with NGT-1h-low subjects. GLUT-2 abundance was higher in individuals with T2DM in comparison with NGT-1h-low subjects; no substantial increase in GLUT-2 expression was observed in NGT-1h-high or IGT individuals. Univariate correlations showed that duodenal SGLT-1 abundance was positively correlated with 1-hour postload plasma glucose levels (r = 0.44; P = 0.003) but not with fasting or 2-hour postload glucose levels. Conclusions Duodenal SGLT-1 expression is increased in individuals with 1-hour postload hyperglycemia or IGT, as well as in subjects with T2DM, and it positively correlates with early postload glucose excursion.
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Fiorentino, Teresa Vanessa, Maria Adelaide Marini, Francesco Andreozzi, Franco Arturi, Elena Succurro, Maria Perticone, Angela Sciacqua, Marta Letizia Hribal, Francesco Perticone, and Giorgio Sesti. "One-Hour Postload Hyperglycemia Is a Stronger Predictor of Type 2 Diabetes Than Impaired Fasting Glucose." Journal of Clinical Endocrinology & Metabolism 100, no. 10 (October 1, 2015): 3744–51. http://dx.doi.org/10.1210/jc.2015-2573.
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Context: Subjects with normal glucose tolerance (NGT) but 1-h postload glucose ≥ 155 mg/dL (NGT-1h-high) exhibit an intermediate cardiometabolic risk profile between individuals with NGT and impaired glucose tolerance (IGT). Objective: This study aimed to evaluate whether NGT-1h-high subjects have different cardiometabolic characteristics and an increased risk of type 2 diabetes compared with individuals with isolated impaired fasting glucose (IFG). Setting, Design, and Patients: A cross-sectional analysis was performed on 595 nondiabetic subjects who underwent an oral glucose tolerance test and an euglycemic hyperinsulinemic clamp in an ambulatory care setting. In addition, a longitudinal analysis was performed on 392 individuals, who were reexamined after a followup of 5.2 ± 0.9 y. Main Outcome Measures: Insulin sensitivity, beta-cell function, and risk of developing diabetes were measured. Results: Subjects with NGT-1h-high have a significant reduction of peripheral insulin sensitivity and beta-cell function, assessed by the disposition index, compared with either 1-h postload glucose < 155 mg/dL (NGT-1h-low) or IFG individuals, but not compared with IGT. Among the 392 subjects studied in the longitudinal analysis the incidence rate of type 2 diabetes over the follow-up period was 2.9, 16.7, 12.5, and 31.4% for subjects with NGT-1h-low, NGT-1h-high, IFG, and IGT, respectively. In a Cox proportional hazard regression analysis the risk of developing diabetes for NGT-1h-high subjects was 4.02 (95% confidence interval [CI] 1.06–15.26); an even higher risk (6.67; 95% CI, 2.09–21.24) was observed in subjects with IGT, but not in the isolated IFG group (1.91; 95% CI, 0.44–8.29). Conclusions: NGT-1h-high subjects exhibit a higher risk of developing diabetes than those with IFG or NGT-1h-low, likely due to decreased insulin sensitivity and beta-cell function.
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Ali Mashar, Kholiq Hernawan, Maula Zahara Firdausi. "Prancangan sistem grounding generator untuk skema proteksi belitan stator generator 100% menggunakan NGT." Jurnal Teknik Energi 9, no. 1 (November 30, 2019): 87–92. http://dx.doi.org/10.35313/energi.v9i1.1650.
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Untuk menerapkan sistem proteksi stator generator 100% seperti skema neutral overvoltage fundamental (59Gn), undervoltage third harmonics (27N3) perlu perancangan sistem pembumian impedansi tinggi menggunakan Neutral Grounding Transformer (NGT). NGT harus bisa mereduksi arus gangguan tanah. Paper ini akan mengkaji bagaimana merancang NGT untuk keperluan seperti di atas. Dalam perangan ini dimulai dari spesifikasi generator, trafo-trafo dan perlengkapan jaringan lainnya. Dalam paper ini akan dikaji penentuan kapasitas trafo NGT dan resitansi sekundernya. Untuk dapat mendemonstrasikan metode perancangan ini dengan baik, paper ini menggunakan pokok kajian generator dari salah satu PLTU di Indonesia dengan kapasitas 802 MVA, 22,8 kV. Dari hasil studi diperoleh bahwa NGT hasil rancangan memiliki kapasitas hanya 37 kVA, 15000 V/240 V dengan resistor sekunder sebesar 0,38 Ω, 150 kW.
Kata kunci: proteksi stator generator 100%, NGT, kapasitas, resistansi sekunder
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Pruccoli, Jacopo, Martina Pelusi, Giorgia Romagnoli, Elisabetta Malaspina, Filomena Moscano, and Antonia Parmeggiani. "Timing of Psychopharmacological and Nutritional Interventions in the Inpatient Treatment of Anorexia Nervosa: An Observational Study." Brain Sciences 11, no. 9 (September 19, 2021): 1242. http://dx.doi.org/10.3390/brainsci11091242.
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This study aims to investigate possible different outcomes in the inpatient treatment of anorexia nervosa (AN) related to different timings of psychopharmacological and nutritional interventions. A retrospective observational study was conducted, involving young patients hospitalized for AN, treated with naso-gastric tube feeding (NGT). Participants were divided into five groups according to early (0–7 days) or late (8+ days) introduction of atypical antipsychotics (AAP) and NGT: early AAP-early NGT (EE), early AAP-late NGT (EL), late AAP-early NGT (LE), late AAP-late NGT (LL) and a control group treated with NGT only (NGT). Concurrent clinical and treatment variables were analyzed. AN psychopathology was measured with the Eating Disorder Inventory-3 (EDI-3) EDRC score. Outcomes were assessed as admission-discharge body-mass index (BMI) improvement and length of hospital stay (LOS). Contributions of variables related to outcomes were assessed with multifactorial-analyses of variance (MANOVA). Seventy-nine patients were enrolled in the study. LOS was different among treatment groups (F (4, 75) = 5.993, p < 0.001), and EE patients showed lower LOS than LE (p < 0.001) and LL (p = 0.025) patients. BMI improvement was not significantly different among treatment groups but correlated negatively with age (F (1, 72) = 10.130, p = 0.002), and admission BMI (F (1, 72) = 14.681, p < 0.001). In conclusion, patients treated with early AAP and early NGT showed lower LOS than those treated with late AAP. Prognostic treatment variables should be investigated in wider samples.
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Lauria, Marcio Weissheimer, Isabela Nacif Bastos Dias, Maria Marta Sarquis Soares, Giovana Vignoli Cordeiro, Victor Eurípedes Barbosa, and Adauto Versiani Ramos. "Análise de fatores que se associam a alterações no teste de tolerância oral à glicose, independentemente dos valores da glicemia de jejum." Arquivos Brasileiros de Endocrinologia & Metabologia 55, no. 9 (December 2011): 708–13. http://dx.doi.org/10.1590/s0004-27302011000900007.
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OBJETIVO: Identificar fatores associados a alterações do teste oral de tolerância à glicose (TOTG), independentemente da glicemia de jejum (GJ). SUJEITOS E MÉTODOS: 377 pacientes (53,8 ± 15,2 anos; 77,7% mulheres e IMC = 31,4 ± 5,9 kg/m²), sem história de diabetes melito (DM), foram submetidos ao TOTG e comparados de acordo com o resultado: normal (NGT), intolerantes (IGT) e DM. RESULTADOS: 202 pacientes (53,6%) apresentaram TOTG alterado, sendo identificados 69 com DM (18,3%) e 133 com IGT (35,3%). Na análise multivariada, os fatores, além da GJ, que se associaram (P < 0,05) ao TOTG alterado foram: idade (DM = 58,7 ± 12,9; IGT = 56,7 ± 14,3; NGT = 49,6 ± 15,6 anos), hipertensão arterial (DM = 69,6%; IGT = 63,9%; NGT = 43,4%), GJ (DM = 111,9 ± 9,2; IGT = 103,5 ± 10,3; NGT = 96,6 ± 11,1 mg/dL), HbA1C (DM = 6,1 ± 0,7%; IGT = 6,1 ± 0,5%; NGT = 5,8 ± 0,4%), triglicérides (DM = 179,3 ± 169,9; IGT = 154,2 ± 84,1; NGT = 129,1 ± 71,9 mg/dL), HDL-c (DM = 44,7 ± 9,2; IGT = 47,5 ± 12,3; NGT = 50,6 ± 13,4 mg/dL) e ácido úrico em mulheres (DM = 5,3 ± 1,5; IGT = 5,3 ± 1,3; NGT = 4,7 ± 1,3 mg/dL). CONCLUSÃO: Idade, hipertensão arterial, níveis elevados de triglicérides, de HbA1C e de ácido úrico (em mulheres) e baixos níveis de HDL-c se associam a alterações do TOTG em pacientes com sobrepeso/obesidade, independentemente da GJ.
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Jing, Shenhong, Xuan Gao, Bo Yu, and Hong Qiao. "Evaluation of plaque characteristics in coronary artery patients with impaired glucose tolerance through optical coherence tomography." Revista da Associação Médica Brasileira 64, no. 5 (May 2018): 433–37. http://dx.doi.org/10.1590/1806-9282.64.05.433.
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SUMMARY OBJECTIVE With the adoption of optical coherence tomography (OCT), this study targets the impacts on plaque characteristics brought about by impaired glucose tolerance (IGT) in patients with coronary artery disease. METHODS For this study, 150 patients with coronary artery disease were recruited. Regarding glycosylated hemoglobin (HbAlc), the patients were sectioned into normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and diabetes mellitus (DM) groups. Coronary angiography (CAG) and OCT were conducted for 150 patients. RESULTS There were 186 plaques discovered in 150 patients (37, 40, 44, and 65 in the NGT, IFG, IGT, and DM groups, respectively). Compared to the NGT group, the lipid core size, which is presented as the average angle of the lipid arc, was markedly larger in the IFG,IGT and DM groups ( 135.7 ± 32.7 Ê, 161.2 ± 55.7 Ê, 162.5 ± 55.8 Ê, and 170.2 ± 59.7 Ê, respectively, all P values< 0.05). Meanwhile, the fibrous cap over the lipid core in the NGT group was remarkably thicker than that in the IFG, IGT, and DM groups (115.7 ± 47.7 μm vs. 77.7 ± 23.5 μm, 75.1 ± 23.2 µm, 71.2 ± 22.1 µm, all P values<0.05). CONCLUSION Coronary plaques in coronary artery patients with NDT are more stable than in those with IGT and DM.
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Roy, Vaskar, Sanjay Maitra, Sangita Mandal, Soma Chakraborty, Arpita Laha, and Mohanchandra Mandal. "Nasogastric tube insertion in anesthetized, intubated adult patients: A comparison between conventional blind insertion technique and “throat pack in situ” technique." Asian Journal of Medical Sciences 14, no. 3 (March 1, 2023): 46–53. http://dx.doi.org/10.3126/ajms.v14i3.50003.
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Background: Correct placement of nasogastric tube (NGT) placement often becomes difficult in anesthetized, intubated adult patients due to lack of cooperation from patient and the propensity of the tube to travel the same course of path. Preexisting throat pack is supposed to resist the normal passage of the NGT as per common belief. Only one study has evaluated this in pediatric population and the result is encouraging. Aims and Objectives: Hence, the present study has been carried out in adult population to compare the success rate of correct placement of NGT in anesthetized intubated adult patients with the pharyngeal (throat) pack in its position in comparison with no throat pack. This is to examine the effect of preexisting throat pack whether it assists or resists the normal passage of the NGT. Materials and Methods: One hundred and eighty patients were recruited for this interventional and single-blind study. After induction of anesthesia and intubation, the patients were randomized to receive NGT insertion following either blind insertion of the NGT without a pharyngeal pack (group A, n=90) or receive the NGT placement in the same technique but after placement of a pharyngeal pack. The success rate of correct placement of NGT in the first attempt (primary outcome), the procedure time, and adverse events was recorded. Results: Successful insertion of NGT in first attempt was considerably higher in throat pack in situ group compared to blind insertion without a throat pack 81 (90%) versus 63 (70%), respectively (P=0.001). The procedure time for successful placement of NGT was found comparable between the two groups. Significant decrease in coiling is seen in “throat pack in situ” group compared with blind insertion technique (P=0.003). Conclusion: In view of considerable higher success rate and reduced adverse events, it can be concluded that the pre-existing appropriately placed throat pack can facilitate the placement of NGT instead of putting any hindrance.
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Pino, Urbano, Scicali, Mauro, Filippello, Scamporrino, Piro, Purrello, and Rabuazzo. "1 h Postload Glycemia Is Associated with Low Endogenous Secretory Receptor for Advanced Glycation End Product Levels and Early Markers of Cardiovascular Disease." Cells 8, no. 8 (August 16, 2019): 910. http://dx.doi.org/10.3390/cells8080910.
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We investigated the correlation of the soluble receptor for advanced glycation end products (sRAGE) and endogenous secretory RAGE (esRAGE) with markers of cardiovascular disease in subjects with normal glucose tolerance (NGT) and 1 h postload glucose ≥155 mg/dL after an oral glucose tolerance test. We stratified 282 subjects without a previous diagnosis of diabetes into three groups: 123 controls (NGT and 1 h postload glycemia <155 mg/dL), 84 NGT and 1 h postload glycemia ≥155 mg/dL (NGT 1 h high), and 75 subjects with impaired fasting glucose and/or impaired glucose tolerance (IFG/IGT). NGT 1 h high subjects exhibited lower esRAGE (0.36 ± 0.18 vs. 0.4 5 ± 0.2, p < 0.05) and higher S100A12 levels than controls (5684 (3193.2–8295.6) vs. 3960.1 (2101.8–7419), p < 0.05). Furthermore, they showed an increased pulse wave velocity (PWV) and intima–media thickness (IMT). No differences were found between the NGT 1 h high group and the IFG/IGT group regarding cardiometabolic profiles. After multiple regression analyses, esRAGE was associated with glycated hemoglobin (HbA1c) and high-sensitivity C-reactive protein (hs-CRP). Age, HbA1c, and esRAGE were the determinants of IMT, whereas S100A12 and systolic pressure were the determinants of PWV. The NGT 1 h high group exhibited low esRAGE levels and an altered cardiometabolic profile. HbA1c, S100A12, and hs-CRP were associated with these alterations. In conclusion, subjects with NGT are not a homogeneous population, and they present different cardiovascular and glycometabolic risks.
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Rahendra, Aida Rosita Tantri, and Liliana Mangkuwerdojo. "A randomized clinical trial of nasogastric tube insertion in intubated patient: comparison between finger method and reverse Sellick maneuver." Medical Journal of Indonesia 28, no. 4 (December 13, 2019): 311–5. http://dx.doi.org/10.13181/mji.v28i4.2704.
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BACKGROUND Finger method is a new simple technique of nasogastric tube (NGT) insertion for intubated patients which only requires the practitioner’s own fingers. This study was aimed to compare the feasibility of finger method and the standard reverse Sellick maneuver in NGT insertion for intubated patients.
METHODS This was a single-blinded, randomized clinical trial that included 210 patients aged 18–65 years old who were intubated under general anesthesia and needed NGT insertion. Initially, subjects were randomly allocated by the third party into two groups: subjects who had NGT insertion with finger method and those with reverse Sellick maneuver. Success rate of NGT insertion at the first attempt, duration of the procedure, and complication rate of blood spots were all recorded. Chi-square test and Mann–Whitney analysis were used to analyze the data.
RESULTS Success rate of NGT insertion at the first attempt in finger method group was higher in comparison with reverse Sellick maneuver group (81.6% versus 60%, respectively, p = 0.002). Likewise, the median of NGT insertion duration was longer in finger group compared to reverse Sellick maneuver group (13 sec versus 12 sec, respectively, p < 0.001) but it was not clinically significant. Moreover, the complication rate of blood spots found during the procedure was lower in subjects with finger method than with reverse Sellick maneuver (10.7% versus 28%, respectively, p = 0.003).
CONCLUSIONS Using finger method was more feasible than reverse Sellick maneuvers in NGT insertion.
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Duck, Lionel, Gauthier Demolin, Lionel A. D'Hondt, Catherine Dopchie, Koenraad Hendrickx, Beatrice Lannoye, Fabienne Bastin, et al. "Efficacy and safety of lanreotide 120 mg in the treatment of clinical symptoms associated with inoperable malignant intestinal obstruction (IMIO): Results from a phase II multicenter study." Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): 4118. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.4118.
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4118 Background: Intestinal obstruction is a severe complication in patients (pts) with digestive or gynecological cancers. For inoperable pts, there is a need to relieve symptoms and limit nasogastric tube (NGT) use. Previous studies have suggested the efficacy of somatostatin analogues in relieving obstruction-related symptoms such as nausea, vomiting and pain. Methods: This was a single arm, prospective study (NCT02275338). Pts with IMIO received one deep subcutaneous injection of LAN 120mg at day 0 (D0). Evaluations were performed on D7, 14 and 28. The primary endpoint was the proportion of responders before or at D7. Response was defined as ≤2 vomiting episodes/day (for pts without NGT at baseline) or no vomiting recurrence (after NGT removal), during at least 3 consecutive days at any time point between the D0 and D7. In line with the literature, a proportion of 30% responders was used as reference for defining statistical significance. Responders at D28 were offered a second LAN 120 mg injection. Results: 52 pts with advanced GI or ovarian malignancies were included in 15 Belgian sites. 17 pts without NGT and 35 with NGT. 21 pts received a second dose of LAN. Median age was 68.0 (59.5; 76.0) years. On D7 the proportion of responders in the ITT population was 24/52 (46.2%), significantly greater than the reference proportion of 30% (one-sided binomial test: p = 0.006). Pts without NGT responded better (15/17, 88.2%) than pts with NGT (9/35, 25.7%). Pts without ascites responded better (57.7% vs 34.6%). Pts with NGT showed a steady trend for clinical improvement leading to sustainable responses of 45.7% on D14. Median time to response was 9 days for the overall population; 3 days for patients without NGT vs 14 days for patients with NGT (p < 0.001). The most frequently reported AEs were GI disorders (in 34 pts). The most common events were diarrhoea and abdominal pain. Conclusions: Our study is the first using long acting LAN 120mg in patients with IMIO and suggests an effect in controlling clinical symptoms in pts with and without NGT at baseline. LAN 120 mg safety profile was similar to that reported for the other indications. Clinical trial information: NCT02275338.
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de Jesús Garduno-Garcia, José, Amalia Gastaldelli, Ralph A. DeFronzo, Raweewan Lertwattanarak, Jens J. Holst, and Nicolas Musi. "Older Subjects With β-Cell Dysfunction Have an Accentuated Incretin Release." Journal of Clinical Endocrinology & Metabolism 103, no. 7 (April 16, 2018): 2613–19. http://dx.doi.org/10.1210/jc.2018-00260.
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Abstract Objective Insulin secretion (IS) declines with age, which increases the risk of impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM) in older adults. IS is regulated by the incretin hormones glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP). Here we tested the hypotheses that incretin release is lower in older adults and that this decline is associated with β-cell dysfunction. Research Design A total of 40 young (25 ± 3 years) and 53 older (74 ± 7 years) lean nondiabetic subjects underwent a 2-hour oral glucose tolerance test (OGTT). Based on the OGTT, subjects were divided into three groups: young subjects with normal glucose tolerance (Y-NGT; n = 40), older subjects with normal glucose tolerance (O-NGT; n = 32), and older subjects with IGT (O-IGT; n = 21). Main Outcome Measures Plasma insulin, C-peptide, GLP-1, and GIP concentrations were measured every 15 to 30 minutes. We quantitated insulin sensitivity (Matsuda index) and insulin secretory rate (ISR) by deconvolution of C-peptide with the calculation of β-cell glucose sensitivity. Results Matsuda index, early phase ISR (0 to 30 minutes), and parameters of β-cell function were lower in O-IGT than in Y-NGT subjects but not in O-NGT subjects. GLP-1 concentrations were elevated in both older groups [GLP-1 area under the curve (AUC)0–120 was 2.8 ± 0.1 in Y-NGT, 3.8 ± 0.5 in O-NGT, and 3.7 ± 0.4 nmol/L∙120 minutes in O-IGT subjects; P < 0.05], whereas GIP secretion was higher in O-NGT than in Y-NGT subjects (GIP AUC0–120 was 4.7 ± 0.3 in Y-NGT, 6.0 ± 0.4 in O-NGT, and 4.8 ± 0.3 nmol/L∙120 minutes in O-IGT subjects; P < 0.05). Conclusions Aging is associated with an exaggerated GLP-1 secretory response. However, it was not sufficient to increase insulin first-phase release in O-IGT and overcome insulin resistance.
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Reutrakul, Sirimon, Nausheen Zaidi, Kristen Wroblewski, Helen H. Kay, Mahmoud Ismail, David A. Ehrmann, and Eve Van Cauter. "Interactions Between Pregnancy, Obstructive Sleep Apnea, and Gestational Diabetes Mellitus." Journal of Clinical Endocrinology & Metabolism 98, no. 10 (October 1, 2013): 4195–202. http://dx.doi.org/10.1210/jc.2013-2348.
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Abstract Context: Questionnaire studies linked symptoms of obstructive sleep apnea (OSA) to the risk of gestational diabetes mellitus (GDM). Whether this association is present when OSA is assessed objectively by polysomnography is not known. Objective: The objective of the study was to assess the relationship between pregnancy, OSA, and GDM. Design, Setting, and Participants: We conducted observational case-control studies using polysomnography in 15 nonpregnant, nondiabetic women (NP-NGT), 15 pregnant women with normal glucose tolerance (P-NGT), and 15 pregnant women with GDM (P-GDM). The groups were frequency matched for age and race/ethnicity. Pregnant women were studied during the late second to early third trimester. Main Outcome Measures: Comparisons of OSA diagnosis and sleep parameters between NP-NGT and P-NGT to assess the impact of pregnancy and between P-NGT and P-GDM to explore the association between GDM and OSA were measured. Results: Compared with NP-NGT, P-NGT women had a higher apnea hypopnea index (AHI) (median 2.0 vs 0.5, P = .03) and more disrupted sleep as reflected by a higher wake time after sleep onset (median 66 vs 21 min, P < .01) and a higher microarousal index (median 16.4 vs 10.6, P = .01). Among the pregnant women, P-GDM had markedly lower total sleep time (median 397 vs 464 min, P = .02) and a higher AHI (median 8.2 vs 2.0, P = .05) than P-NGT women. OSA was more prevalent in P-GDM than in P-NGT women (73% vs 27%, P = .01). After adjustment for prepregnancy body mass index, the diagnosis of GDM was associated with a diagnosis of OSA [odds ratio 6.60 (95% confidence interval 1.15–37.96)]. In pregnancy, after adjusting for prepregnancy body mass index, higher microarousal index significantly associated with higher hemoglobin A1c and fasting glucose levels. Higher oxygen desaturation index was associated with higher fasting glucose levels. Conclusion: Pregnancy is associated with sleep disturbances. Sleep is more disturbed in GDM than in P-NGT women. There is a strong association between GDM and OSA.
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Gimenes, Fernanda Raphael Escobar, Flávia Fernanda Luchetti Rodrigues Baracioli, Adriane Pinto de Medeiros, Patricia Rezende do Prado, Janine Koepp, Marta Cristiane Alves Pereira, Camila Baungartner Travisani, Soraia Assad Nasbine Rabeh, Fabiana Bolela de Souza, and Adriana Inocenti Miasso. "Factors associated with mechanical device-related complications in tube fed patients: A multicenter prospective cohort study." PLOS ONE 15, no. 11 (November 19, 2020): e0241849. http://dx.doi.org/10.1371/journal.pone.0241849.
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Aims To identify the types of nasogastric/nasoenteric tube (NGT/NET)-related adverse events and to analyze the degree of harm and the factors associated with mechanical device-related complications. Materials and methods A prospective cohort study was conducted from October 2017 to April 2019 in seven Brazilian hospitals. Data from 447 adult patients with NGT/NET were collected through electronic forms. Three methods were used to assess the NGT/NET-related adverse events: (1) encouraging spontaneous reports; (2) regular visits to the wards; and (3) review of medical records. The events were classified as mechanical device-related complications and other events. The degree of harm was classified according to the World Health Organization’s International Classification for Patient Safety. Data were analyzed using the R program, version 3.5.3. The following tests were applied to identify associations between the explanatory and response variables: Cochran-Armitage Chi-Square test, Fisher’s exact test, and Linear-by-linear Chi-Square test. Logistic regression analysis was performed to verify the predictors of mechanical device-related complications. All analyses were performed considering a 5% significance level. Results 191 NGT/NET-related adverse events were identified in 116 patients; the majority were mechanical device-related complications and resulted in mild harm to the patient. At the moment of the event, patients had a mean of 3.27 comorbidities, were highly dependent on nursing care, with high risk of death and altered level of consciousness. There was no association between the degree of harm and the care complexity, disease severity or level of consciousness. Intensive care was the strongest predictor for mechanical device-related complications and critical patients had a four times greater likelihood of presenting this type of event when compared to patients receiving minimal care. Conclusion Intensive care patients should receive special attention as the complexity of care is an important predictor for mechanical device-related complications in tube fed patients.
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Massimino, Mattia, Giuseppe Monea, Giuseppe Marinaro, Mariangela Rubino, Elettra Mancuso, Gaia Chiara Mannino, and Francesco Andreozzi. "The Triglycerides and Glucose (TyG) Index Is Associated with 1-Hour Glucose Levels during an OGTT." International Journal of Environmental Research and Public Health 20, no. 1 (December 31, 2022): 787. http://dx.doi.org/10.3390/ijerph20010787.
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Background and Objectives: Among individuals with normal glucose tolerance (NGT), subjects with high levels of plasma glucose (≥155 mg/dL) at sixty minutes during an oral glucose tolerance test (1h-OGTT) are at an increased risk of developing type 2 diabetes. We investigated the association between the triglycerides and glucose (TyG) index, a novel marker of insulin resistance, with 1h-OGTT glucose plasma concentrations. Material and Methods: 1474 non-diabetic Caucasian subjects underwent a 75 g OGTT and were divided into two groups according to the cutoff 1h-OGTT plasma glucose < 155 mg/dL (NGT-1h-low) and ≥ 155 mg/dL (NGT-1h-high). The TyG index was calculated as ln [fasting triglycerides (milligrams per deciliter) × fasting blood glucose (milligrams per deciliter)/2]. Multivariable linear and logistic regression analyses were used to establish the contribution of the TyG index to the variability of 1h-OGTT glucose, and how the former affected the risk of being NGT-1h-high. Results: 1004 individuals were NGT-1h-low and 470 were NGT-1h-high. The TyG index was higher for NGT-1h-high (p = 0.001) individuals, and it was an independent factor influencing 1h-OGTT glycemia (β = 0.191, p < 0.001) after correcting for age, sex, and BMI. The TyG index was the strongest marker associated with the risk of being NGT-1h-high (OR = 1.703, CI 95% 1.34–2.17, p < 0.001) when compared with FPG (OR = 1.054, CI 95% 1.04–1.07, p < 0.001) and the HOMA-IR (OR = 1.156, CI 95% 1.08–1.23, p < 0.001). Conclusions: Our study demonstrated that the TyG index, an efficient and cost-effective marker of insulin resistance, is associated with the variability of early post-challenge glucose levels and is an independent marker of being NGT-1h-high.
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Massacesi, Cristian, and Giordano Galeazzi. "Sustained release octreotide may have a role in the treatment of malignant bowel obstruction." Palliative Medicine 20, no. 7 (October 2006): 715–16. http://dx.doi.org/10.1191/0269216306070751.
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Daily or continuous infusion octreotide is effective in relieving the gastrointestinal symptoms associated with inoperable malignant bowel obstruction (MBO). The sustained release (LAR) formulation of octreotide provides sustained exposure of the drug. This preliminary study aimed to investigate the efficacy of octreotide LAR (20 mg) for reducing gastrointestinal symptoms or nasogastric tube (NGT) secretions in patients with MBO. In patients with NGT (n = 8), octreotide LAR reduced NGT secretions from day one onwards, and NGT was removed in one patient. In patients without NGT (n = 4), octreotide LAR reduced episodes of vomiting and the severity of nausea, and this reduction was maintained throughout the study. Tolerability was good. In conclusion, the more convenient dosing schedule and potential activity of octreotide LAR may have a role in controlling MBO symptoms, and, therefore, it deserves further studies.
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Ansari, Khursheed, Rafique Umer Harvitkar, Saiprasad Shetty, Tushar P. Raut, and Shabnam Qureshi. "Accidental Placement of Nasogastric Tube into the Brain: Case Report and Review of the Literature." International Journal of Recent Surgical and Medical Sciences 6, no. 02 (September 22, 2020): 74–76. http://dx.doi.org/10.1055/s-0040-1716802.
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AbstractThe nasogastric tube (NGT) plays a very vital role in the early resuscitation of head injury patients for various reasons. Though considered a simple procedure, it can be associated with multiple dreadful complications. Our patient was a 44-year-old male, referred from a peripheral health center for further management of severe head and faciomaxillary injuries following a motor vehicular accident. On arrival at the hospital, the endotracheal tube and NGT were in situ. A computed tomography scan of the brain revealed the NGT piercing through the cribriform plate of ethmoid and coiling into the cranial cavity with pneumocephalus. The NGT was retrieved under C-arm guidance and his injuries were managed respectively. The patient was discharged after prolong hospitalization with an acceptable outcome. With this case report, we want to remind emergency health care providers to avoid this catastrophic complication of NGT insertion in a faciomaxillary trauma patient by doing it transorally. We report a novel method of safely removing NGT which has not been reported in the past.
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Mengen, Eda, and Seyit Ahmet Uçaktürk. "Evaluation of the relationship between the one-hour plasma glucose concentration and beta-cell functions and cardiometabolic parameters during oral glucose tolerance test in obese children and adolescents." Journal of Pediatric Endocrinology and Metabolism 33, no. 6 (May 24, 2020): 767–75. http://dx.doi.org/10.1515/jpem-2020-0016.
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AbstractBackgroundIn this study, we aimed to evaluate the relationship between the 1-h plasma glucose (PG) level in the oral glucose tolerance test (OGTT) and conventional glycemic parameters, indices evaluating beta-cell functions, and cardiometabolic risk factors.MethodsThe records of 532 obese patients who were followed up in the Pediatric Endocrinology Polyclinic and who underwent standard OGTT were evaluated retrospectively. All patients were divided into two groups according to OGTT data as the 1-h plasma glucose concentration <155 mg/dL (n=329) and ≥155 mg/dL (n=203). Patients with normal glucose tolerance (NGT) were divided into two groups according to the 1-h PG level, as 218 patients with NGT 1 h-low (<155 mg/dL) and 53 patients with high NGT 1 h-high (≥155 mg/dL).ResultsThere was a statistically significant difference between the lipid profiles of individuals with NGT 1 h-low (<155 mg/dL) and individuals with NGT 1 h-high (≥155 mg/dL) (p<0.001). Total cholesterol, LDL cholesterol, and triglyceride levels were higher, while HDL cholesterol levels were lower in individuals with NGT 1 h-high (≥155 mg/dL). The indices evaluating beta-cell functions were significantly higher in individuals with NGT 1 h-low (<155 mg/dL).ConclusionAs a result, a plasma glucose concentration above or equal to 155 mg/dL at 1 h during an OGTT is associated with a worse clinical phenotype characterized by changes in insulin sensitivity and β-cell function. Therefore, this threshold value can predict the progression of prediabetes in obese young people with NGT.
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Yoshida, Akihiro, Takao Kimura, Katsuhiko Tsunekawa, Yoshifumi Shoho, Yoshimaro Yanagawa, Osamu Araki, Tomoyuki Aoki, Takayuki Ogiwara, and Masami Murakami. "Age-Related Sex Differences in Glucose Tolerance by 75 g Oral Glucose Tolerance Test in Japanese." Nutrients 14, no. 22 (November 17, 2022): 4868. http://dx.doi.org/10.3390/nu14224868.
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To elucidate the age-related sex difference in glucose tolerance, we conducted 75 g oral glucose tolerance tests in 1156 participants. Participants were divided into four groups, namely, young (22–29) males, young females, middle-aged (>50) males, and middle-aged females. According to the Japanese Clinical Practice Guideline for Diabetes 2019, the prevalence of normal glucose tolerance (NGT) was significantly lower in middle-aged than in young participants. The prevalence of high-normal fasting plasma glucose (FPG) was higher, and NGT was lower in young males (high-normal FPG 15.2%, NGT 82.0%) than young females (high-FPG 3.9%, NGT 94.3%). Combined glucose intolerance (CGI) was higher and NGT was lower in middle-aged males (CGI 10.2%, NGT 25.2%) than in middle-aged females (CGI 3.3%, NGT 39.8%). FPG and body mass index (BMI) were the lowest and Homeostatic model assessment beta cell function (HOMA-β) was the highest in young females, followed by young males, middle-aged females, and middle-aged males. Multiple linear regression analysis revealed that BMI weakly correlated with HOMA-β and Matsuda index in all subjects except young females. The superior glucose tolerance in females was apparent in young, but attenuated in middle-aged females. The differences are due to the higher insulin secretion potential and lower BMI in young females.
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Aulinger, Benedikt A., Torsten P. Vahl, Ron L. Prigeon, David A. D'Alessio, and Deborah A. Elder. "The incretin effect in obese adolescents with and without type 2 diabetes: impaired or intact?" American Journal of Physiology-Endocrinology and Metabolism 310, no. 9 (May 1, 2016): E774—E781. http://dx.doi.org/10.1152/ajpendo.00496.2015.
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The incretin effect reflects the actions of enteral stimuli to promote prandial insulin secretion. Impairment of this measure has been proposed as an early marker of β-cell dysfunction and described in T2D, IGT, and even obesity without IGT. We sought to determine the effects of obesity and diabetes on the incretin effect in young subjects with short exposures to metabolic abnormalities and a few other confounding medical conditions. Subjects with T2D ( n = 10; 18.0 ± 0.4 yr) or NGT, either obese ( n = 11; 17.7 ± 0.4 yr) or lean ( n = 8; 26.5 ± 2.3 yr), had OGTT and iso-iv. The incretin effect was calculated as the difference in insulin secretion during these tests and was decreased ∼50% in both the NGT-Ob and T2D subjects relative to the NGT-Ln group. The T2D group had impaired glucose tolerance and insulin secretion during the OGTT, whereas the lean and obese NGT subjects had comparable glucose excursions and β-cell function. During the iso-iv test, the NGT-Ob subjects had significantly greater insulin secretion than the NGT-Ln and T2D groups. These findings demonstrate that in young subjects with early, well-controlled T2D the incretin effect is reduced, similar to what has been described in diabetic adults. The lower incretin effect calculated for the obese subjects with NGT is driven by a disproportionately greater insulin response to iv glucose and does not affect postprandial glucose regulation. These findings confirm that the incretin effect is an early marker of impaired insulin secretion in persons with abnormal glucose tolerance but suggest that in obese subjects with NGT the incretin effect calculation can be confounded by exaggerated insulin secretion to iv glucose.
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Laila, R., N. Mahmud, M. Nargis, and TA Chowdhury. "Changing patterns of Insulin Resistance in Polycystic Ovary Syndrome." Bangladesh Journal of Obstetrics & Gynaecology 29, no. 2 (November 27, 2016): 73–77. http://dx.doi.org/10.3329/bjog.v29i2.30483.
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Objective (s):Aim of the study was to explore the changing patterns of insulin resistance in PCOS women.Methods: The study was conducted at CARE, department of Obstetrics and Gynecology and Biomedical Research Group, BIRDEM hospital. A total number of 103 PCOS women of 15- 36 years were included in the present study. They were grouped into NGT (n=68), IGT (n=30), type 2 DM (n=5) according to nature of glucose tolerance. Fasting and glucose stimulated insulin was measured.Results: In IGT group, fasting and glucose-stimulated insulin level were higher when compared with NGT, but no difference between type 2 DM and NGT group was found. Insulin-glucose ratio (after glucose load) was significantly lower in type 2 DM when compared with NGT group (p=0.049), but there was no difference of insulin-glucose ratio (fasting) between type 2 DM and NGT group. PCOS with IGT or Type 2 DM women were more insulin resistant than NGT group. (p=0.015, p=0.042 respectively).Conclusion: Insulin resistance is a major pathophysiologic feature of PCOS with IGT; however â cell secretory defect is associated with type 2 DM in these subjects.Bangladesh J Obstet Gynaecol, 2014; Vol. 29(2) : 73-77
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Pruccoli, J., M. Pelusi, G. Romagnoli, and A. Parmeggiani. "The impact of nasogastric tube feeding on Drive for Thinness and Body Dissatisfaction in children and adolescents with Anorexia Nervosa." European Psychiatry 65, S1 (June 2022): S384—S385. http://dx.doi.org/10.1192/j.eurpsy.2022.975.
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Introduction The use of nasogastric-tube feeding (NGT) in the treatment of Anorexia Nervosa (AN) in children and adolescents is recommended by current guidelines. Nonetheless, the literature lacks studies assessing prognostic factors for modifications of AN-specific psychopathology treated with NGT. Objectives To assess potential prognostic affecting improvement in AN-specific psychopathology in children and adolescents hospitalized for AN, treated with NGT. Methods Retrospective study assessing young inpatients with AN, treated with NGT. Considered outcomes (admission vs discharge) were AN-specific psychopathology (Eating Disorder Inventory-3 (EDI-3): Drive for Thinness (DT); Body Dissatisfaction (BD); Eating-Disorders Risk (EDRC)) and body-mass index (BMI). Considered potential predictors were demographics, duration of untreated illness (DUI), severity (admission BMI), diagnoses, early vs late (0-7 vs 8+ days after admission) start of NGT, drugs). Models for specific contributions of predictors related to outcomes were assessed with analysis of covariance (ANCOVA). Results Fifty-three inpatients (F=53, mean age 15.1±2.0 years) were enrolled. Both higher DT (F(1,22)=15.07, p<0.001) and BD improvement (F(1,22)=7.73, p=0.011) were predicted by lower admission BMI. Higher BMI improvement was predicted by lower admission BMI (F(1,47)=10.39, p<0.001) and age (F(1.47)=6.12, p=0.011. AN subtypes, comorbidities, antidepressants, and different antipsychotics did not predict any outcome. Conclusions In this study, greater improvement in AN-specific psychopathology (DT and BD) and weight in patients treated with NGT was predicted by lower admission BMI. These results suggest that young patients with greater severity may highly benefit from NGT. These findings, if confirmed in wider and controlled samples, could help in optimizing the treatment with NGT in young inpatients with AN. Disclosure No significant relationships.
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Shah, Janki, Dennis Tang, Kevin Grafmiller, Zachary J. Cappello, Christopher Roxbury, and Raj Sindwani. "Using the Middle Turbinate to Protect the Skull Base in Endoscopic Transsphenoidal Surgery: A Cadaver Study." American Journal of Rhinology & Allergy 35, no. 1 (June 19, 2020): 59–63. http://dx.doi.org/10.1177/1945892420933173.
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Objectives Inadvertent intracranial injury from nasogastric tube (NGT) placement is a described and potentially fatal complication following endoscopic transsphenoidal hypophysectomy (TSH). This cadaver study assessed the role of middle turbinate (MT) preservation and medialization in preventing accidental skull base injury from NGT insertion after TSH. Methods: Standard approach for TSH was performed on 3 human cadavers. MTs were placed into neutral position (MTN), then medialized via suture pexy to the septum (MTP), and subsequently resected (MTR). After each stage, 3 blinded individuals passed a 10 F Dobhoff and a 16 F NGT on each side of each cadaver (5 passes per side). Using endoscopic visualization, each pass was scored by a blinded reviewer based on the first contact point of the tube (0 = nasopharynx, 1 = inferior sphenoid face, 2 = sphenoid sinus), with higher scores suggestive of increased risk of intracranial injury. Results: There were 270 Dobhoff and 270 NGT passes scored. Data was divided into 3 groups based on presence and position of the MT. Significant differences were demonstrated between all three groups [one-way ANOVA: Dobhoff F(2,267) = 6.981, p = 0.001], [NGT F(2,267) = 17.582, p < 0.001]. There were significant differences between means for MTN versus MTP groups [Dobhoff (0.43 vs 0.22, p = 0.007), NGT (0.73 vs 0.28, p < 0.001)] and MTP versus MTR groups [Dobhoff (0.22 vs 0.55, p < 0.001), NGT (0.28 vs 0.81, p < 0.001)], indicating that the presence and position of the MT can significantly affect the accessibility of the sphenoid sinus interior after TSH. There was a trend toward lower means in the MTN group compared to the MTR group. Conclusion: MT preservation and deliberate medialization against the septum may reduce risk of inadvertent intracranial NGT injury in postop TSH patients. This simple maneuver should be considered in all routine TSH procedures.
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Cuccui, Jon, Vanessa S. Terra, Janine T. Bossé, Andreas Naegeli, Sherif Abouelhadid, Yanwen Li, Chia-Wei Lin, et al. "The N -linking glycosylation system from Actinobacillus pleuropneumoniae is required for adhesion and has potential use in glycoengineering." Open Biology 7, no. 1 (January 2017): 160212. http://dx.doi.org/10.1098/rsob.160212.
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Actinobacillus pleuropneumoniae is a mucosal respiratory pathogen causing contagious porcine pleuropneumonia. Pathogenesis studies have demonstrated a major role for the capsule, exotoxins and outer membrane proteins. Actinobacillus pleuropneumoniae can also glycosylate proteins, using a cytoplasmic N -linked glycosylating enzyme designated NGT, but its transcriptional arrangement and role in virulence remains unknown. We investigated the NGT locus and demonstrated that the putative transcriptional unit consists of rimO , ngt and a glycosyltransferase termed agt. From this information we used the A. pleuropneumoniae glycosylation locus to decorate an acceptor protein, within Escherichia coli, with a hexose polymer that reacted with an anti-dextran antibody. Mass spectrometry analysis of a truncated protein revealed that this operon could add up to 29 repeat units to the appropriate sequon. We demonstrated the importance of NGT in virulence, by creating deletion mutants and testing them in a novel respiratory cell line adhesion model. This study demonstrates the importance of the NGT glycosylation system for pathogenesis and its potential biotechnological application for glycoengineering.
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Schreiber, Jens, Thomas Hachenberg, Sebastian Föllner, and Sandra Riedel. "Bronchopulmonary Complications of Nasogastric tube Placement." Global Journal of Respiratory Care 1, no. 1 (February 5, 2014): 13–16. http://dx.doi.org/10.12974/2312-5470.2014.01.01.3.
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Importance: Nasogastric tube (NGT) placement can cause severe thoracic and non-thoracic complications, which can cause severe morbidity and mortality. The knowledge of predisposing factors is crucial for prevention of these complications. Design: We report on three different cases of severe complication of NGT placement, which have not yet been described. Results: In the first case, intrathoracic malposition of a NGT in a sliding gastric hiatus herniation and repeated insufflations of air for localization control resulted in compression and laceration of the lungs with massive pulmonary hemorrhage. In the second, there was a perforation of both the esophagus and the membranous part of the trachea from the gullet site by a guidewire-containing NGT. In the third case, severe pleuropulmonary complications occurred after short-term intrabronchial malposition. Conclusions: These cases are intended to encourage vigilance to reasons and the clinical course of thoracic complications of NGT placement. Predisposing factors and preventive measures are discussed.
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Barroso Oquendo, Morgana, Dorothea Siegel-Axel, Felicia Gerst, Estela Lorza-Gil, Anja Moller, Robert Wagner, Jürgen Machann, et al. "Pancreatic fat cells of humans with type 2 diabetes display reduced adipogenic and lipolytic activity." American Journal of Physiology-Cell Physiology 320, no. 6 (June 1, 2021): C1000—C1012. http://dx.doi.org/10.1152/ajpcell.00595.2020.
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Obesity, especially visceral fat accumulation, increases the risk of type 2 diabetes (T2D). The purpose of this study was to investigate the impact of T2D on the pancreatic fat depot. Pancreatic fat pads from 17 partial pancreatectomized patients (PPP) were collected, pancreatic preadipocytes isolated, and in vitro differentiated. Patients were grouped using HbA1c into normal glucose tolerant (NGT), prediabetic (PD), and T2D. Transcriptome profiles of preadipocytes and adipocytes were assessed by RNAseq. Insulin sensitivity was estimated by quantifying AKT phosphorylation on Western blots. Lipogenic capacity was assessed with oil red O staining, lipolytic activity via fatty acid release. Secreted factors were measured using ELISA. Comparative transcriptome analysis of preadipocytes and adipocytes indicates defective upregulation of genes governing adipogenesis ( NR1H3), lipogenesis ( FASN, SCD, ELOVL6, and FADS1), and lipolysis ( LIPE) during differentiation of cells from T2D–PPP. In addition, the ratio of leptin/adiponectin mRNA was higher in T2D than in NGT–PPP. Preadipocytes and adipocytes of NGT–PPP were more insulin sensitive than T2D–PPP cells in regard to AKT phosphorylation. Triglyceride accumulation was similar in NGT and T2D adipocytes. Despite a high expression of the receptors NPR1 and NPR2 in NGT and T2D adipocytes, lipolysis was stimulated by ANP 1.74-fold in NGT cells only. This stimulation was further increased by the PDE5 inhibitor dipyridamole (3.09-fold). Dipyridamole and forskolin increased lipolysis receptor independently 1.88-fold and 1.48-fold, respectively, solely in NGT cells. In conclusion, the metabolic status persistently affects differentiation and lipolysis of pancreatic adipocytes. These alterations could aggravate the development of T2D.
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Walker, Jeremey, Nathan Gundacker, Martin Rodriguez, and Ellen Eaton. "Cost Effectiveness Analysis of Fecal Transplant Delivery Methods for Recurrent Clostridium difficile Infections in Outpatients." Open Forum Infectious Diseases 4, suppl_1 (2017): S386. http://dx.doi.org/10.1093/ofid/ofx163.960.
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Abstract Background Clostridium difficile infection (CDI) accounts for more than $1 billion annually in US health care costs. Recurrent CDI (RCDI, recurrence within 8 weeks of initial treatment) contributes substantially to this cost. The objective of the study was to compare the cost effectiveness of FMT delivered via colonoscopy vs. blind nasogastric tube (NGT) in outpatients. We hypothesized that FMT by NGT would be cost-effective given its low risk and simplicity. Methods A decision-analytic simulation model compared the cost effectiveness of FMT by colonoscopy vs. NGT from a third-party payer perspective. Our base case cure rates were derived from a cohort receiving outpatient RCDI treatment at our institution. Cure was defined as resolution of symptoms for ≥ 90 days. Procedural cost and consultation was defined by average reimbursement to a large southeastern medical center in 2016 USD based on current procedural terminology (CPT) codes, and cost of disease states were derived from published literature. Health utilities were defined by quality of life year (QALY) based on published literature. Incremental Cost Effectiveness ratio (ICER) was defined as the cost per additional QALY gained. We assumed a 90 day time horizon. One-way sensitivity analysis was performed on all variables using ranges defined by published literature. We used TreeAge Software (Williamstown, MA). Results In the base case, FMT by colonoscopy was dominant (more effective and less costly) than NGT, with cost of $1,568/QALY vs. $1,910/QALY respectively. Cure rates of FMT by colonoscopy vs. NGT (100% vs. 87%) had the largest impact on ICER based on one-way sensitivity analysis. Therefore, a subsequent two-way sensitivity analysis was conducted to compare cure rates of both delivery methods and found that NGT delivery is cost effective as cure rates approach colonoscopy delivery cure rates within 5 percentage points. Conclusion Contrary to our hypothesis, our decision model supports FMT by colonoscopy as the preferred delivery method in outpatients with RCDI relative to NGT delivery. Additional costs of colonoscopy delivery are off-set by the improved cure rate leading to lower overall costs. As cure rates from NGT delivery are optimized, NGT may become the preferred method for FMT delivery. Disclosures All authors: No reported disclosures.
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Clayton, M. A. "Massive NGT and spherically symmetric systems." Journal of Mathematical Physics 37, no. 1 (January 1996): 395–420. http://dx.doi.org/10.1063/1.531397.
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Miyasaka, Muneaki, Hao Li, Kon Voi Tay, and Soo Jay Phee. "A Low-Cost, Point-of-Care Test for Confirmation of Nasogastric Tube Placement via Magnetic Field Tracking." Sensors 21, no. 13 (June 30, 2021): 4491. http://dx.doi.org/10.3390/s21134491.
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In this work, we aim to achieve low-cost real-time tracking for nasogastric tube (NGT) insertion by using a tracking method based on two magnetic sensors. Currently, some electromagnetic (EM) tracking systems used to detect the misinsertion of the NGT are commercially available. While the EM tracking systems can be advantageous over the other conventional methods to confirm the NGT position, their high costs are a factor hindering such systems from wider acceptance in the clinical community. In our approach, a pair of magnetic sensors are used to estimate the location of a permanent magnet embedded at the tip of the NGT. As the cost of the magnet and magnetic sensors is low, the total cost of the system can be less than one-tenth of that of the EM tracking systems. The experimental results exhibited that tracking can be achieved with a root mean square error (RMSE) of 2–5 mm and indicated a great potential for use as a point-of-care test for NGT insertion, to avoid misplacement into the lung and ensure correct placement in the stomach.
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Kalava, Arun, Kirpal Clark, John McIntyre, Joel M. Yarmush, and Teresita Lizardo. "Mistaken Endobronchial Placement of a Nasogastric Tube During Mandibular Fracture Surgery." Anesthesia Progress 62, no. 3 (September 1, 2015): 114–17. http://dx.doi.org/10.2344/13-00021r1.1.
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Abstract A 64-year-old male had an awake right nasal fiber-optic intubation with an endotracheal tube for open reduction and internal fixation of bilateral displaced mandibular fractures. After induction of anesthesia, an 18 Fr nasogastric tube (NGT) was inserted through the left nostril and was secured. The patient required high flow rates to deliver adequate tidal volumes with the ventilator. A chest x-ray done in the postanesthesia care unit revealed a malpositioned NGT in the left lower lobe bronchus, which was immediately removed. The patient was extubated on postoperative day 2. Various traditional methods, such as aspiration of gastric contents, auscultation of gastric insufflations, and chest x-ray are in use to detect or prevent the misplacement of an NGT. These methods can be unreliable or impractical. Use of capnography to detect an improperly placed NGT should be considered in the operating room as a simple, cost-effective method with high sensitivity to prevent possibly serious sequelae of an NGT placed within the bronchial tree.
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Salam, Nasir Abdus, Fabian Audu Ugbe, and Abiola Victoria Ikudayisi Ugbe. "OPTIMIZATION AND SORPTION ISOTHERMS ANALYSIS OF ANIONIC DYE EOSIN YELLOW DECONTAMINATION BY GOETHITE ADSORBENTS." Acta Scientifica Malaysia 4, no. 2 (September 18, 2020): 75–81. http://dx.doi.org/10.26480/asm.02.2020.75.81.
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In this work, removal of Eosin Yellow (EY) using Natural Goethite (NGT) and Synthetic Goethite (SGT) particles was studied using batch equilibrium technique. Different parameters such as initial dye concentration, particle size (NGT only), pH, and adsorbent dose were optimized to investigate the sorbents efficiency for the dye. The experimental data were tested for fitness into five common adsorption isotherm models. The various equilibrium parameters studied were found to have remarkable influence on the adsorption processes, showing optimum removal at dye concentration (150 mg/L for EY-NGT and 200 mg/L for EY-SGT), NGT particle size (0.112mm), pH (2), and dosage (0.05g), with SGT exhibiting relatively higher adsorption efficiency. The sorption data fitted well the various isotherm models in the order; Freundlich (R2 = 0.9032) > Temkin (0.8294) > Langmuir (0.8268) > DKR (0.6431) > Flory Huggins (0.616) for EY-NGT, and Langmuir (0.9831) > Flory Huggins (0.9639) > Freundlich (0.9597) > Temkin (0.8944) > DKR (0.5993) for EY-SGT. The monolayer adsorption capacity (qm) was calculated as 1.17 and 20.80 mgg-1 for NGT and SGT respectively. Additionally, combined information obtained from the isotherm study revealed that the processes were favourable, spontaneous and proceeded by a multilayer physical adsorption on already chemisorbed layer. Conclusively, the results of this study have provided useful information on the optimum working condition and mechanism of EY uptake onto goethite surfaces.
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Ahrén, Bo, and Giovanni Pacini. "Impaired adaptation of first-phase insulin secretion in postmenopausal women with glucose intolerance." American Journal of Physiology-Endocrinology and Metabolism 273, no. 4 (October 1, 1997): E701—E707. http://dx.doi.org/10.1152/ajpendo.1997.273.4.e701.
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This study examined whether insulin secretion, insulin sensitivity, glucose effectiveness, and hepatic extraction of insulin are altered in subjects with impaired glucose tolerance (IGT). The frequently sampled intravenous glucose tolerance test was performed in postmenopausal women (age 63 yr, body mass index range 21.6–28.9 kg/m2) with IGT ( n = 10) or normal glucose tolerance (NGT; n = 10). Insulin sensitivity (SI) was significantly lower in IGT than in NGT ( P = 0.030). In contrast, insulin secretion was not significantly different between the two groups as determined by area under the curve for insulin and C-peptide, acute insulin response to glucose (AIRG), and glucose sensitivity of first-phase (φ1) or of second-phase (φ2) insulin secretion. In NGT ( r = −0.68, P = 0.029) but not in IGT ( r = −0.05, not significant), SIcorrelated negatively with φ1. The B-cell “adaptation index” (SI × φ1) was lower in IGT than in NGT [83 ± 25 vs. 171 ± 29 min−2/(mmol/l), P = 0.042]. Also, the B-cell “disposition index” (SItimes AIRG) was lower in IGT (83 ± 25 10−4min−1) than in NGT (196 ± 30 10−4min−1, P = 0.011). In contrast, glucose effectiveness or hepatic extraction of insulin was not different between IGT and NGT. We conclude that postmenopausal women with IGT fail to adequately adapt to lowered SI by increasing first-phase insulin secretion.
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Ceruti, Samuele, Simone Dell’Era, Francesco Ruggiero, Giovanni Bona, Andrea Glotta, Maira Biggiogero, Edoardo Tasciotti, Christoph Kronenberg, Gianluca Lollo, and Andrea Saporito. "Nasogastric tube in mechanical ventilated patients: ETCO2 and pH measuring to confirm correct placement. A pilot study." PLOS ONE 17, no. 6 (June 2, 2022): e0269024. http://dx.doi.org/10.1371/journal.pone.0269024.
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Introduction Nasogastric tube (NGT) placement is a procedure commonly performed in mechanically ventilated (MV) patients. Chest X-Ray is the diagnostic gold-standard to confirm its correct placement, with the downsides of requiring MV patients’ mobilization and of intrinsic actinic risk. Other potential methods to confirm NGT placement have shown lower accuracy compared to chest X-ray; end-tidal CO2 (ETCO2) and pH analysis have already been singularly investigated as an alternative to the gold standard. Aim of this study was to determine threshold values in ETCO2 and pH measurement at which correct NGT positioning can be confirmed with the highest accuracy. Materials & methods This was a prospective, multicenter, observational trial; a continuous cohort of eligible patients was allocated with site into two arms. Patients underwent general anesthesia, orotracheal intubation and MV; in the first and second group we respectively assessed the difference between tracheal and esophageal ETCO2 and between esophageal and gastric pH values. Results From November 2020 to March 2021, 85 consecutive patients were enrolled: 40 in the ETCO2 group and 45 in the pH group. The ETCO2 ROC analysis for predicting NGT tracheal misplacement demonstrated an optimal ETCO2 cutoff value of 25.5 mmHg, with both sensitivity and specificity reaching 1.0 (AUC 1.0, p < 0.001). The pH ROC analysis for predicting NGT correct gastric placement resulted in an optimal pH cutoff value of 4.25, with mild diagnostic accuracy (AUC 0.79, p < 0.001). Discussion In patients receiving MV, ETCO2 and pH measurements respectively identified incorrect and correct NGT placement, allowing the identification of threshold values potentially able to improve correct NGT positioning. Trial registration NCT03934515 (www.clinicaltrials.gov).
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Chavez, Alberto O., Dawn K. Coletta, Subhash Kamath, Douglas T. Cromack, Adriana Monroy, Franco Folli, Ralph A. DeFronzo, and Devjit Tripathy. "Retinol-binding protein 4 is associated with impaired glucose tolerance but not with whole body or hepatic insulin resistance in Mexican Americans." American Journal of Physiology-Endocrinology and Metabolism 296, no. 4 (April 2009): E758—E764. http://dx.doi.org/10.1152/ajpendo.90737.2008.
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Retinol-binding protein-4 (RBP4), a novel protein secreted mainly by adipose tissue, has been associated with insulin resistance in obese subjects and in individuals with type 2 diabetes mellitus (T2DM). We examined the relationship between plasma RBP4 levels, expression of RBP4 in skeletal muscle and adipose tissue, and insulin sensitivity in Mexican Americans with varying degrees of obesity and glucose tolerance. Seventy-two subjects [16 lean normal-glucose-tolerant (NGT), 17 obese NGT, and 39 subjects with impaired fasting glucose/impaired glucose tolerance/T2DM] received an oral glucose tolerance test (OGTT) and euglycemic-hyperinsulinemic clamp. Insulin secretion was measured as insulinogenic index during OGTT. In a subset of subjects, hepatic glucose production was measured by 3-[3H]glucose infusion, biopsies of the vastus lateralis muscle and subcutaneous adipose tissue were obtained under basal conditions, and quantitative RT-PCR was performed to measure the RBP4 mRNA gene expression. Plasma RBP4 was significantly elevated in impaired glucose tolerance/T2DM compared with NGT lean or obese subjects. Plasma RBP4 levels correlated with 2-h glucose, triglycerides, and hemoglobin A1c. There was no association between RBP4 levels and whole body insulin sensitivity measured with either the euglycemic insulin clamp or OGTT, basal hepatic glucose production rates, and the hepatic insulin resistance index. There was no correlation between plasma RBP4 levels and indexes of insulin secretion. RBP4 mRNA expression in skeletal muscle was similar in lean NGT subjects, obese NGT subjects, and T2DM subjects. There was no difference in RBP4 mRNA expression in adipose tissue between lean and obese NGT subjects or between NGT and T2DM individuals. Plasma RBP4 levels are elevated in T2DM and associated with impaired glucose tolerance, but not associated with obesity or insulin resistance or impaired insulin secretion in Mexican Americans.
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Roy, Mrinal Kanti, Sanjay Maitra, Sangita Mandal, Arpita Laha, and Mohanchandra Mandal. "Nasogastric tube insertion in anesthetized intubated adult patients: A comparison between the “reverse Sellick’s maneuver with throat pack in situ” and reverse Sellick’s maneuver alone." Asian Journal of Medical Sciences 14, no. 2 (February 1, 2023): 39–45. http://dx.doi.org/10.3126/ajms.v14i2.49599.
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Background: Nasogastric tube (NGT) insertion is an essential procedure in the operating room for which the anesthesiologists often take the responsibility. This simple procedure often becomes difficult in anesthetized patients. Literature reveals the flooding of studies and novel techniques are in the pipeline, indicating that quest for the best is still on. Aims and Objectives: The aim of the study was to determine the proportion of patients in whom successful NGT insertion would be possible in the first attempt using either the “Reverse Sellick’s maneuver (RSM) with throat pack in situ” technique or RSM alone; and to compare the proportions between the two groups. Materials and Methods: This interventional study was performed on 222 adult patients (≥18 years), undergoing abdominal surgeries requiring intraoperative NGT insertion. Patients received NGT insertion using the combined RSM with “throat pack in situ” technique (Group A, n=111) or RSM alone (Group B, n=111). The proportion of patients in whom successful NGT insertion was possible in the first attempt using either of the techniques and the time taken for correct placement of NGT in both the groups. In addition, the incidence of adverse events was noted. Results: Although, NGT placement was possible in higher proportions of patients in Group A in first attempt compared with Group B (91% vs. 83.8%), it was not significant on analysis (P=0.106). The procedure time in both the groups was comparable (30.0±4.0 vs. 29.9±4.3, P=0.859). Coiling was found to be significantly more in the RSM alone technique as compared to the combined method. (P=0.04). Conclusion: With comparable success rate and lesser incidence of adverse events, it can be commented that the RSM with throat pack in situ technique appears to be a better alternative to RSM alone.
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Ercan, Şerif, Nihal Yücel, and Asuman Orçun. "The Comparison of Glycated Hemoglobin and Homeostasis Model Assessment Values to 30, 60 and 90-Min Glucose Levels During OGTT in Subjects with Normal Glucose Tolerance." Journal of Medical Biochemistry 33, no. 3 (July 1, 2014): 237–44. http://dx.doi.org/10.2478/jomb-2014-0017.
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Abstract Background: The subjects with impaired glucose tolerance have an increased risk for future type 2 diabetes (T2DM); however, a significant number of individuals who develop T2DM have normal glucose tolerance (NGT) at baseline. The study aims to compare glycated hemoglobin (HbA1C) and homeostasis model assessment (HOMA-IR) levels to 30, 60 and 90-min glucose levels in subjects with NGT. Methods: A 75-g oral glucose tolerance test (OGTT) at 0, 30, 60, 90 and 120-min was performed in 1118 subjects without known T2DM. Blood samples were also drawn for fasting insulin and HbA1C levels. Results: Forty percent of the subjects with NGT had increased post-challenge values above the determined optimal glucose levels (10.2, 10.3 and 8.9 mmol/L at 30, 60 and 90-min, respectively). Compared to the subjects with NGT whose glucose levels were below the determined optimal values at 30, 60 and 90-min, we found significantly elevated HbA1C and HOMA-IR levels in the subjects with NGT whose glucose levels were above the determined optimal values (p<0.001). Conclusions: We conclude that the subjects with NGT have different HbA1C and HOMA-IR levels considering glucose levels measured earlier than at 2-h during OGTT. Further well-designed prospective studies are needed to define the significance of 30-min, 60-min and 90-min glucose levels in the prediction of disease in subjects with T2DM.
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Chang, Wei-Kuo, Hsin-Hung Huang, Hsuan-Hwai Lin, and Chen-Liang Tsai. "Percutaneous Endoscopic Gastrostomy versus Nasogastric Tube Feeding: Oropharyngeal Dysphagia Increases Risk for Pneumonia Requiring Hospital Admission." Nutrients 11, no. 12 (December 5, 2019): 2969. http://dx.doi.org/10.3390/nu11122969.
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Background: Aspiration pneumonia is the most common cause of death in patients with percutaneous endoscopic gastrostomy (PEG) and nasogastric tube (NGT) feeding. This study aimed to compare PEG versus NGT feeding regarding the risk of pneumonia, according to the severity of pooling secretions in the pharyngolaryngeal region. Methods: Patients were stratified by endoscopic observation of the pooling secretions in the pharyngolaryngeal region: control group (<25% pooling secretions filling the pyriform sinus), pharyngeal group (25–100% pooling secretions filling the pyriform sinus), and laryngeal group (pooling secretions entering the laryngeal vestibule). Demographic data, swallowing level scale score, and pneumonia requiring hospital admission were recorded. Results: Patients with NGT (n = 97) had a significantly higher incidence of pneumonia (episodes/person-years) than those patients with PEG (n = 130) in the pharyngeal group (3.6 ± 1.0 vs. 2.3 ± 2.1, P < 0.001) and the laryngeal group (3.8 ± 0.5 vs. 2.3 ± 2.2 vs, P < 0.001). The risk of pneumonia was significantly higher in patients with NGT than in patients with PEG (adjusted hazard ratio = 2.85, 95% CI: 1.46–4.98, P < 0.001). Cumulative proportion of pneumonia was significantly higher in patients with NGT than with PEG for patients when combining the two groups (pharyngeal + laryngeal groups) (P = 0.035). Conclusion: PEG is a better choice than NGT feeding due to the decrease in risk of pneumonia requiring hospital admission, particularly in patients with abnormal amounts of pooling secretions accumulation in the pyriform sinus or leak into the laryngeal vestibule.
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Li, Ming, Dan Feng, Kui Zhang, Shan Gao, and Juming Lu. "Disproportionately Elevated Proinsulin Levels as an Early Indicator ofβ-Cell Dysfunction in Nondiabetic Offspring of Chinese Diabetic Patients." International Journal of Endocrinology 2016 (2016): 1–9. http://dx.doi.org/10.1155/2016/4740678.
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Objective.To study the characteristics ofβ-cell dysfunction and insulin resistance (IR) in the first-degree relatives (FDRs) of T2DM in Chinese population and to examine the usefulness of proinsulin (PI) for evaluatingβ-cell dysfunction.Methods. 229 subjects of nondiabetic FDRs, 71 newly diagnosed T2DM, and 114 with normal glucose tolerance (NGT) but not FDRs (NGT-non-FDRs) were verified by a 2-hour oral glucose tolerance test. Specific insulin (SI) and PI were measured by highly sensitive ELISA.Results. Compared to NGT-non-FDRs, NGT-FDRs showed higher levels of fasting and 2-hour PI, fasting PI-to-SI ratio (FPI/SI), and HOMA-IR (p<0.01). Meanwhile, fasting PI, FPI/SI, and HOMA-IR were increased steadily from NGT-FDRs to prediabetes-FDRs and were highest in T2DM group (p<0.001), whereas a significant decrease in HOMA-B could be observed only in T2DM group. Moreover, a progressive deterioration ofβ-cell function in NGT-FDRs, prediabetes-FDRs, and T2DM could be identified by FPI/SI even after adjusting for HOMA-IR: relative to non-FDRs controls, mean FPI/SI levels were increased 1.5, 2.0, and 4.7-fold, respectively (allp<0.01).Conclusions. β-cell dysfunction as assessed by disproportionate secretion of proinsulin and IR by HOMA (using specific insulin assay) already exist in FDRs of T2DM even with normal glucose status. Compared with HOMA-B, FPI/SI could detectβ-cell failure in earlier stage of diabetes development.
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Cormican, Orlaith, and Maura Dowling. "Using nominal group technique to compare patients’ and clinicians’ perspectives on symptoms in multiple myeloma to inform the development of a self management tool for patients with relapsed myeloma." HRB Open Research 1 (February 16, 2021): 21. http://dx.doi.org/10.12688/hrbopenres.12863.2.
Full textAbstract:
Background: The nominal group technique (NGT) allows stakeholders to directly generate items for needs assessment. The objective was to demonstrate the use of NGT to inform the development of a healthcare app in patients with relapsed myeloma. Healthcare professionals with experience in the care of patients with relapsed/refractory myeloma were invited to participate. Methods: One NGT group was conducted. In the group, health care professionals working in haematology were asked to vote anonymously in order of highest priority, on symptoms previously highlighted by relapsed/refractory myeloma patients in four focus groups. Results: A total of 18 healthcare professionals working in the area of haematology participated in the NGT discussion; consultants (n=6), haematology registrars (n=2), specialist nurses [Advanced Nurse Practitioner/Clinical Nurse Specialist] (haematology) (n=3), staff nurse (n=1), and “other” health care professionals (n=6). Participants ranged in experience of working with myeloma patients from 2 years to over 27 years. The symptoms voted in highest priority were: Pain, Fatigue, Peripheral Neuropathy, Infection Risk and Steroid Induced Side Effects. Conclusions: The NGT was an efficient method for obtaining information to inform a healthcare app.
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Cormican, Orlaith, and Maura Dowling. "Using nominal group technique to inform the development of a self-management app for patients with relapsed myeloma." HRB Open Research 1 (August 31, 2018): 21. http://dx.doi.org/10.12688/hrbopenres.12863.1.
Full textAbstract:
Background: The nominal group technique (NGT) allows stakeholders to directly generate items for needs assessment. The objective was to demonstrate the use of NGT to inform the development of a healthcare app in patients with relapsed myeloma. Healthcare professionals with experience in the care of patients with relapsed/refractory myeloma were invited to participate. Methods: One NGT group was conducted. In the group, health care professionals working in haematology were asked to vote anonymously in order of highest priority, on symptoms previously highlighted by relapsed/refractory myeloma patients in four focus groups. Results: A total of 18 healthcare professionals working in the area of haematology participated in the NGT discussion; consultants (n=6), haematology registrars (n=2), specialist nurses [Advanced Nurse Practitioner/Clinical Nurse Specialist] (haematology) (n=3), staff nurse (n=1), and “other” health care professionals (n=6). Participants ranged in experience of working with myeloma patients from 2 years to over 27 years. The symptoms voted in highest priority were: Pain, Fatigue, Peripheral Neuropathy, Infection Risk and Steroid Induced Side Effects. Conclusions: The NGT was an efficient method for obtaining information to inform a healthcare app.