Did you mean: litter
-
International Breastfeeding Journal Dec 2022To date, 40 Human Milk Banks (HMB) have been established in Italy; however, recent cost analysis data for operating an HMB in Italy are not available in the literature.
BACKGROUND
To date, 40 Human Milk Banks (HMB) have been established in Italy; however, recent cost analysis data for operating an HMB in Italy are not available in the literature.
METHODS
This study was a cross-sectional study performed at "Bambino Gesù" Children's Hospital in Rome, Italy in 2019. We assessed the one-year operational costs and, the per liter unit costs at our HMB.
RESULTS
During the 2019 year we collected 771 l of human milk supplied by 128 donors. The total cost was € 178,287.00 and the average cost was € 231.00 per liter. € 188,716.00 would have been spent had the maximum capacity for 904 l been reached. We found a significant difference (€ 231.00 vs € 209.00 per liter, p = 0.016) comparing the cost for collected liters in the year 2019 and the cost for the maximum capacity of the bank for that year of activity. Analyzing each cost item that determines the charge of donor human milk (DHM), the highest costs are the salaries of medical and paramedical staff, and then the costs related to transporting. If the HMB works at maximum capacity and manages a greater number of liters of milk, this can represent an important saving. Conversely, the price of consumables is modest (i.e., the price of a single-use kit for breast pumps was € 0.22 per unit).
CONCLUSION
The costs for a liter of DHM are quite high, but they must be related to the benefits, especially for preterm infants. Comparing the cost for collected liters in 2019 and the costs for the 2019 maximum capacity of the HMB, we calculated how much fixed costs of collection and distribution of DHM can be reduced, by increasing the volume of milk collected. To the best of our knowledge, this is the first complete cost analysis for an Italian Milk Bank. A thorough analysis could help to abate fixed costs and reduce the cost of a liter of DHM. The centralization of DHM can allow savings, rather than creating small HMBs scattered throughout the territory that would operate with lower milk volumes.
Topics: Infant; Female; Child; Humans; Infant, Newborn; Milk, Human; Milk Banks; Infant, Premature; Breast Feeding; Cross-Sectional Studies; Costs and Cost Analysis; Italy
PubMed: 36539788
DOI: 10.1186/s13006-022-00530-4 -
Indian Journal of Plastic Surgery :... Oct 2008Advent of the tumescent technique in 1987 has allowed for safe contouring in ambulatory single session liposuction under regional or general anaesthesia. Safety and...
Advent of the tumescent technique in 1987 has allowed for safe contouring in ambulatory single session liposuction under regional or general anaesthesia. Safety and aesthetic issues define MegaLiposuction to be in Volume in litres of more than 10% of Body weight in Kgs. 870 cases of liposuction were performed between September 2000 and August 2008. In (65%) cases, the total volume of aspirate was greater then 5 liters. (Range: 5 to 25 liters). In 24% cases, the large volume liposuction was combined with a limited or a total block lipectomy. Regional anaesthesia with conscious sedation was preferred except where liposuction was for above the subcostal region (the Upper Trunk, Lateral Chest, Back, Gynaecomastia, Breast, Arms and Face) or when the patient so desired. Tumescent infiltration with Lactated ringer, adrenalin, triamcinalone and hyalase was made in all cases. This approach has clinically shown less tissue edema in the post operative period than when the conventional physiological saline was being used in place of Ringer Lactate. The amount injected varied from 1,000 ml to 12,500 ml depending on the size, site and area. Local anesthetic was included only to the terminal portion of the tumescent mixture while infiltrating the sub-costal regions, or when above costal region was combined with below costal region being anaesthetized with Spinal Anaesthesia. The aspirate was restricted to the unstained white / yellow fat and the amount of fat aspirated did not have any bearing to the amount of solution infiltrated. There was no major complication. Blood transfusion was given only on one occasion when the patient had been on aspirin and had also received Low Molecular weight Heparin intra-operative. The hospital stay ranged from 8 to 24 hours for liposuction as well as for liposuction with a lipectomy. Serous discharge from access sites, sero-sanguinous fluid accumulation requiring drainage were necessitated in less than 10% cases. Minor re-contouring touch ups were requested in 5% cases. Early ambulation was encouraged for mobilization of third space fluid shifts to expedite recovery and to prevent deep vein thrombosis. More than 10% patients were operated on for Liposuction of other areas, after a gap of 7 days to 6 months. Meticulous perioperative monitoring of systemic functions ensures safety in tumescent megaliposuction for the obese and rewarding results can be achieved in a single sitting.
PubMed: 20174540
DOI: No ID Found -
British Journal of Nursing (Mark Allen... Jul 2020A clean colon is required for a colonoscopy to be effective. Therefore, patients undergo a bowel preparation in advance of the procedure to clear the colon. Typically,...
A clean colon is required for a colonoscopy to be effective. Therefore, patients undergo a bowel preparation in advance of the procedure to clear the colon. Typically, this involves drinking 2 litres of polyethylene glycol or macrogol (PEG) solution, but dislike of the taste or having to drink such a large volume causes some patients not to adhere to this regimen. To address this, a PEG solution has been developed that requires patients to drink only 1 litre of bowel preparation in two flavours. The hope is this will increase patient adherence.
Topics: Cathartics; Colon; Colonoscopy; Humans; Polyethylene Glycols; Therapeutic Irrigation
PubMed: 32870720
DOI: 10.12968/bjon.2020.29.Sup13.S3 -
Saudi Journal of Biological Sciences Jan 2021Microbial surfactants are amphipathic molecules that consist of hydrophilic and hydrophobic domains, which allow partition of two fluid phases of varying degree of... (Review)
Review
Microbial surfactants are amphipathic molecules that consist of hydrophilic and hydrophobic domains, which allow partition of two fluid phases of varying degree of polarity. They are classified into two main groups: bioemulsifier and biosurfactant, depending on their molecular weight. Microbial surfactants occur in various categories according to their chemical nature and producing organisms. These biomolecules are produced by diverse groups of microorganisms including fungi, bacteria, and yeasts. Their production is significantly influenced by substrate type, fermentation technology and microbial strains. Owing to inherent multifunctional properties and assorted synthetic aptitude of the microbes, microbial surfactants are mostly preferred than their chemical counterparts for various industrial and biomedical applications including bioremediation, oil recovery; as supplements in laundry formulations and as emulsion-stabilizers in food and cosmetic industries as well as therapeutic agents in medicine. The present review discusses on production of microbial surfactants as promising and alternative broad-functional biomolecules for various biotechnological applications.
PubMed: 33424354
DOI: 10.1016/j.sjbs.2020.10.058 -
Contributions To Nephrology 2017Peritoneal dialysis has a long and tortuous history. First done in animals in the late 1800s, it became clinically practical in the early 1960s. Peritoneal access was... (Review)
Review
Peritoneal dialysis has a long and tortuous history. First done in animals in the late 1800s, it became clinically practical in the early 1960s. Peritoneal access was first achieved by intermittent abdominal puncture, and then through the development of a 'permanent access' when Silastic became available. The early design is appropriately named for Dr. Henry Tenckhoff. Successful peritoneal dialysis was performed intermittently with infusion of 2 liters of balanced fluid followed by a dwell time of 30-45 min, which in turn was followed by drainage and new infusion. The procedure was used almost exclusively in the intensive care setting but failed to achieve success when applied on a long-term basis. The new concept of extending the dwell time of the dialysis fluid to allow equilibration between an acceptable blood level of urea and the level of urea in the dialysis fluid remarkably reduced the fluid volume required to control uremic toxins and symptoms. This change also allowed the patient to be disconnected from all devices and freely move about as dialysis took place. It was concluded that an acceptable blood level of urea nitrogen was 70 mg %. Equilibration with dialysis fluid, five 2-liter exchanges for 10 liters per day, would allow the removal of 7,000 mg of urea, the average quantity generated on a diet of a 70-kg person eating 1 g of protein per kg of body weight per day. The procedure was originally called 'equilibrium peritoneal dialysis', but was later changed to 'continuous ambulatory peritoneal dialysis'.
Topics: Animals; Biological Transport; Dialysis Solutions; History, 19th Century; History, 20th Century; History, 21st Century; Humans; Peritoneal Dialysis; Peritoneal Dialysis, Continuous Ambulatory; Time Factors; Urea
PubMed: 27951554
DOI: 10.1159/000450689 -
The American Surgeon Oct 2006In an attempt to improve patient tolerance for colon cleaning, a reduced-volume regimen with a 2-liter electrolyte lavage solution plus 20 mg of oral bisacodyl was... (Comparative Study)
Comparative Study Randomized Controlled Trial
In an attempt to improve patient tolerance for colon cleaning, a reduced-volume regimen with a 2-liter electrolyte lavage solution plus 20 mg of oral bisacodyl was compared with the standard 4-liter lavage for efficacy and safety. Three hundred patients were prospectively randomized into two study groups. One group of 150 patients was given four tablets of 5 mg bisacodyl at 12:00 PM the day before their colonoscopy, followed by 2 liters of electrolyte lavage by mouth at 6:00 PM the evening before their colonoscopy. Another group of 150 patients were given 4 liters of electrolyte lavage at 6:00 PM the evening before their colonoscopy. All patients were on a clear liquid diet the day before their colonoscopy. No enema was given in either groups. The bowel cleanliness was accessed by one colonoscopist. One registered nurse accessed the comfort of patient. In the 2-liter group, only one (0.6%) patient could not finish the laxative. Colon cleanliness was 80 per cent to 100 per cent, with an average of 95.9 per cent. In the 4-liter group, 11 (7.3%) patients could not finish the laxative preparation. Colon cleanliness was 78 per cent to 100 per cent, with an average of 95.3 per cent. The study that found the 2-liter electrolyte lavage solution with four tablets of bisacodyl can achieve equally good results in bowel preparation and favorable acceptance by patients compared with the 4-liter lavage.
Topics: Abdominal Pain; Adolescent; Adult; Aged; Aged, 80 and over; Bisacodyl; Cathartics; Colon; Colonoscopy; Electrolytes; Female; Humans; Male; Middle Aged; Nausea; Patient Satisfaction; Polyethylene Glycols; Prospective Studies; Single-Blind Method; Therapeutic Irrigation; Vomiting
PubMed: 17058733
DOI: No ID Found -
Therapeutische Umschau. Revue... Mar 2000A sports diet is qualitatively similar to a diet of a healthy adult. Its main aspects are meeting the energy and fluid requirements, which in contrast to sedentary... (Review)
Review
A sports diet is qualitatively similar to a diet of a healthy adult. Its main aspects are meeting the energy and fluid requirements, which in contrast to sedentary people can vary to a large degree in sportsmen. The relative contribution of the macronutrients to the energy consumption should make up 55 to 60% carbohydrates (mainly derived from low glycemic food), 10 to 15% protein, and 25 to 30% fat. The main focus of a diet for most recreational sport activities should be on an optimal carbohydrate and fluid intake, which are the two main limiting factors of most physical activities. Related to the body mass, the carbohydrate intake should amount to 5 to 7 grams per kilogram. During the days before and after an intense exercise session or competition, however, the intake should be raised to about 10 grams per kilogram body mass to ensure an optimal energetic preparation of and regeneration from the exercise bout. The water intake should be about 2 to 3 liters per day with an extra 1.2 to 1.5 liters to balance each liter of exercise-induced sweat loss.
Topics: Adult; Energy Intake; Energy Metabolism; Humans; Nutritional Requirements; Sports; Water-Electrolyte Balance
PubMed: 10756689
DOI: 10.1024/0040-5930.57.3.110 -
Human Gene Therapy Aug 2011The large amounts of recombinant adeno-associated virus (rAAV) vector needed for clinical trials and eventual commercialization require robust, economical, reproducible,...
The large amounts of recombinant adeno-associated virus (rAAV) vector needed for clinical trials and eventual commercialization require robust, economical, reproducible, and scalable production processes compatible with current good manufacturing practice. rAAV produced using baculovirus and insect cells satisfies these conditions; however, recovering rAAV particles from 200-liter bioreactors is more complicated than bench-scale vector preparations. Using a variety of processing media, we developed a reliable and routine downstream procedure for rAAV production that is scalable from 0.02- to 200-liter cultures. To facilitate the upstream process, we adapted the titerless infected-cell preservation and scale-up process for rAAV production. Single-use aliquots of cryopreserved baculovirus-infected insect cells (BIIC) are thawed and added to the suspension culture to achieve the desired ratio of BIIC to rAAV-producer cells. By using conditions established with small-scale cultures, rAAV was produced in larger volume cultures. Strikingly consistent rAAV yields were attained in cultures ranging from 10 liters to 200 liters. Based on the final yield, each cell produced 18,000 ± 6,800 particles of purified rAAV in 10-, 20-, 100-, and 200-liter cultures. Thus, with an average cell density of 4.32 × 10(6) cells/ml, ≥ 10(16) purified rAAV particles are produced from 100 to 200 liters. The downstream process resulted in about 20% recovery estimated from comparing the quantities of capsid protein antigen in the crude bioreactor material and in the final, purified product. The ease and reproducibility of rAAV production in 200-liter bioreactors suggest that the limit has not been reached, and 500-liter productions are planned.
Topics: Animals; Baculoviridae; Bioreactors; Cell Count; Cell Culture Techniques; Cell Line; Dependovirus; Genetic Vectors; Invertebrates; Reproducibility of Results
PubMed: 21381980
DOI: 10.1089/hum.2010.250 -
Antimicrobial Agents and Chemotherapy Nov 2014Teicoplanin is frequently administered to treat Gram-positive infections in pediatric patients. However, not enough is known about the pharmacokinetics (PK) of... (Clinical Trial)
Clinical Trial
Teicoplanin is frequently administered to treat Gram-positive infections in pediatric patients. However, not enough is known about the pharmacokinetics (PK) of teicoplanin in children to justify the optimal dosing regimen. The aim of this study was to determine the population PK of teicoplanin in children and evaluate the current dosage regimens. A PK hospital-based study was conducted. Current dosage recommendations were used for children up to 16 years of age. Thirty-nine children were recruited. Serum samples were collected at the first dose interval (1, 3, 6, and 24 h) and at steady state. A standard 2-compartment PK model was developed, followed by structural models that incorporated weight. Weight was allowed to affect clearance (CL) using linear and allometric scaling terms. The linear model best accounted for the observed data and was subsequently chosen for Monte Carlo simulations. The PK parameter medians/means (standard deviation [SD]) were as follows: CL, [0.019/0.023 (0.01)] × weight liters/h/kg of body weight; volume, 2.282/4.138 liters (4.14 liters); first-order rate constant from the central to peripheral compartment (Kcp), 0.474/3.876 h(-1) (8.16 h(-1)); and first-order rate constant from peripheral to central compartment (Kpc), 0.292/3.994 h(-1) (8.93 h(-1)). The percentage of patients with a minimum concentration of drug in serum (Cmin) of <10 mg/liter was 53.85%. The median/mean (SD) total population area under the concentration-time curve (AUC) was 619/527.05 mg · h/liter (166.03 mg · h/liter). Based on Monte Carlo simulations, only 30.04% (median AUC, 507.04 mg · h/liter), 44.88% (494.1 mg · h/liter), and 60.54% (452.03 mg · h/liter) of patients weighing 50, 25, and 10 kg, respectively, attained trough concentrations of >10 mg/liter by day 4 of treatment. The teicoplanin population PK is highly variable in children, with a wider AUC distribution spread than for adults. Therapeutic drug monitoring should be a routine requirement to minimize suboptimal concentrations. (This trial has been registered in the European Clinical Trials Database Registry [EudraCT] under registration number 2012-005738-12.).
Topics: Adolescent; Adult; Anti-Bacterial Agents; Child; Child, Preschool; Creatinine; Female; Humans; Infant; Male; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; Monte Carlo Method; Staphylococcal Infections; Teicoplanin
PubMed: 25224001
DOI: 10.1128/AAC.03685-14 -
Asia Pacific Journal of Clinical... 2009Water is vital to food production: every calorie of plant food requires at least one litre of water, while one calorie of meat or dairy product can require up to 10... (Review)
Review
Water is vital to food production: every calorie of plant food requires at least one litre of water, while one calorie of meat or dairy product can require up to 10 litres of water. Water is supplied either through rainfall or through irrigation. Irrigated agriculture uses 18 per cent of agricultural land, and produces 40 per cent of agricultural products. But urbanisation, agricultural land degradation, the mandating of biofuels, drought and climate change are reducing the amount of water available to agriculture. The green revolution of last century doubled cereal production with only a very small increase in land. This century we need a blue revolution, a dramatic increase in the amount of food produced from irrigation or blue water. The blue revolution must be based on knowledge, with that knowledge accessible, and useful, to farmers in both the developed and developing world.
Topics: Agriculture; Animals; Australia; Climate Change; Environment; Food Supply; Green Chemistry Technology; Health Status; Humans; Water; Water Supply
PubMed: 19965339
DOI: No ID Found