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At least 19 recordsLinked to original sources
PubMed2002

Exploring self-image during hot flushes using a semantic differential scale: associations between poor self-image, depression, flush frequency and flush distress.

OBJECTIVES: This study developed a semantic differential scale for assessing self-image during hot flushes, based on a previously published scale (Nursing Res. 35 (1986) 81). The objectives were to explore the sensitivity and validity of this scale, and to examine whether poor self-image during hot flushes is linked to flush distress, perceived control, flush frequency, flush chronicity, self-esteem and depression. METHOD: Two community samples of women with current experience of hot flushes completed a postal questionnaire. RESULTS: The semantic differential scale was sensitive to individual differences in self-image, and was validated through its association with measured self-esteem using a standardised scale. Defining the self in negative ways during flushes was highly predictive of flush distress. Poor self-image was also closely associated with depression. Correlations with perceived control, and flush frequency were weaker and did not reach significance in the second, smaller sample. CONCLUSION: The study extends previous findings that women low in self-esteem have more difficulty coping with menopausal changes, by showing that negative self-appraisal during flushes (e.g. defining self as unattractive or dirty) are highly demoralising and associated with distress. The findings suggest that cognitive behavioural strategies of challenging and re-interpreting thoughts about self could be helpful in moderating the discomfort and stressfulness of hot flushes for women not taking HRT. However, the findings are based on relatively small, volunteer samples and require further replication.

Adaptation, Psychological↗
PubMed2001

Always flush the sampling port before flushing the arterial cannula in pediatric patients.

BACKGROUND: Blood sampling from arterial lines is a frequent event in anesthesia and critical care. To avoid clot formation, both the stopcock outlet and the cannula must be flushed after sampling. We investigated in a bench experiment whether fluid flow through the cannula is affected by the sequence of flushing procedures. METHODS: Continuity of fluid delivery from a vascular cannula was gravimetrically determined using two different flushing techniques with either a syringe pump flush system or a bag flush system. The procedures comprised first flushing the stopcock towards the cannula and then towards the stopcock sampling outlet or the reverse order. Experiments were repeated in triplicate and two sets for each flushing system at hydrostatic pressures of 37 mm Hg and 74 mm Hg. RESULTS: The main finding of the study was that flushing the stopcock towards the outlet after flushing the cannula resulted in considerable retrograde aspiration volumes and zero flow times, in particular in combination with syringe pump flush systems. At a hydrostatic pressure of 74 mm Hg, the observed zero flow time at the cannula tip amounted to (mean+/-SD) 0.1+/-0.01 min with the bag flush system and 7.7+/-0.5 min with the syringe pump flush system. The related retrograde aspiration volumes were 2.2+/-0.7 microl with the bag system and 30.0+/-2.0 microl with the syringe pump system. No backflow was recorded when the stopcock was first flushed to ambient pressure and then afterwards towards the cannula. CONCLUSION: Opening a flush system to ambient pressure affects the continuity of fluid delivery, particularly when using syringe pump flush systems. After blood sampling, the stopcock outlet should be flushed first followed by cannula flushing.

Blood Specimen Collection↗
PubMed2006

Switching from heparinized saline flush to normal saline flush for maintaining peripheral venous catheter patency.

BACKGROUND: The practice of using heparinized saline as a flush fluid for maintaining peripheral venous catheter patency of hospitalized patients in Siriraj Hospital in Bangkok, Thailand is not evidence-based. OBJECTIVE: To switch from heparinized saline flush to normal saline flush for maintaining peripheral venous catheter patency in the patients hospitalized to medical wards. METHODS: Study sites were 10 medical wards containing 240 beds. The interventions included (i) disseminating evidence-based clinical practice policy on using flush fluid for maintaining peripheral venous catheter patency to responsible personnel, (ii) reminding the prescribers on using normal saline flush instead of heparinized saline flush, (iii) providing technical advice on using normal saline flush to nurses who encountered peripheral venous catheter clot while using normal saline flush, (iv) confirming a necessity of heparinized saline flush order with the prescriber, and (v) setting up a regulation on marking a special symbol on heparinized saline flush prescription if one really needed heparinized saline flush. The information on using flush fluids was collected from the physicians' order sheets in the medical records at baseline, every 2-4 weeks during the intervention periods, and at 6 months after launching intervention. RESULTS: All hospitalized patients in medical wards who had peripheral venous catheter locks received heparinized saline flush in February 2005. The practice was totally switched to normal saline flush in June and November 2005. CONCLUSION: The key features critical to success of this implementation are dissemination of evidence-based clinical practice policy and a regulation of having prescriber mark a specific sign right after the heparinized saline flush order.

Catheterization, Peripheral↗
PubMed1996

Investigator-observed alcohol-induced flushing but not self-report of flushing is a valid predictor of ALDH2 genotype.

OBJECTIVE: This article presents data on the validity of using self-report of alcohol-induced flushing and actual investigator-observed flushing following alcohol challenge to predict ALDH2 genotype in Asian-American men. METHOD: Men between the ages of 21 and 25 years who were of Chinese, Japanese or Korean descent completed questionnaires about their drinking history and their alcohol-induced flushing history and associated symptoms. Fifty men selected for participation in the study were genotyped for alleles of ALDH2 and individually tested on two separate occasions following oral administration of placebo and 0.75 ml/kg (0.56 g/kg) alcohol. Facial flushing was assessed at baseline and at intervals over a 150-minute period after drinking using observational ratings. RESULTS: By comparing the results of ALDH2 genotype with investigator-observed flushing and with previous self-report of facial flushing, it was found that investigator-observed flushing is both a sensitive (100%) and specific (96%) predictor of ALDH2 genotype, whereas self-report of facial flushing is a sensitive (100%) but not a specific (68%) predictor of ALDH2 genotype. CONCLUSIONS: The results suggest that investigator-observed flushing provides a valid estimate of ALDH2 genotype, but that self-report of facial flushing is biased, giving a substantial overestimate. Due to an increase in error variance, studies that rely solely on self-report of flushing will more often lead to the conclusion that no association exists. This study supports the importance of using ALDH2 genotype, rather than self-report of flushing or ALDH2 phenotype, when examining factors associated with differences in drinking behavior, response to alcohol and risk for alcoholism or alcohol-related disease among Asians.

Adult↗
PubMed2003

Arterial fast bolus flush systems used routinely in neonates and infants cause retrograde embolization of flush solution into the central arterial and cerebral circulation.

PURPOSE: To evaluate the risk of retrograde embolization of flush solution in neonates and infants with routinely used electronic syringe pumps and infusion bag pump flush systems. METHODS: With hospital Ethical Committee approval we studied intubated neonates and infants with a 24-GA radial arterial cannula. Fast flush boluses were delivered from the infusion bag pump flush system by opening the flow regulating device for two seconds at bag pump manometre pressures of 100, 200 and 300 mmHg. In the syringe pump flush system, fast flush bolus volumes of 0.5, 1.0, 1.5 and 2.0 mL were programmed on the electronic syringe pump and released by opening the flow regulating device for two seconds. A 12-MHz ultrasonic probe placed in the jugular fossa was used to detect white bubbles indicating retrograde embolization of flush solution into the ipsilateral subclavian and common carotid artery. RESULTS: Sixteen patients, aged from 1-105 days (median 22 days) were studied. In all patients retrograde embolization into the subclavian artery was detected at syringe pump bolus volumes of 0.5-1.5 mL and at 100-200 mmHg bag pump pressure. In nine of the 16 patients a positive signal was detected in the common carotid artery with 1.5-2.0 mL syringe pump bolus volumes and at 200-300 mmHg bag pump pressure. CONCLUSIONS: In neonates and infants, the standard practice of arterial fast bolus flushing using syringe pump and bag pump flush systems causes retrograde embolization of flush solution into the central arterial and even into the cerebral circulation. The mandatory limitation of fast flush bolus volumes and manometre pressures is urgent in order to reduce retrograde embolization of flush solution and the associated risks in these small patients.

Catheters, Indwelling↗
PubMed2002

Flush volumes delivered from pressurized bag pump flush systems in neonates and small children.

BACKGROUND: The aim of this study was to measure the volumes of fluid delivered with a fast flush bolus from a flow regulating device. METHODS: In-vitro fast flush bolus volumes, the volumes delivered from a bag pump flush system while opening the flow regulating device for 1, 2 or 5 s, were gravimetrically measured through a 22-G and a 24-G cannula. In-vivo 1- and 2-s fast flush bolus volumes and the volume required to purge the tubing between stopcock and arterial cannula from visible blood after blood sampling were recorded in 12 anaesthetized neonates and infants (mean age 2.17 +/- 1.97 months, range 0.26-5.37 months) with a 24-G radial arterial cannula by continuously weighing the bag pump flush system at manometer pressures of 100, 200 and 300 mmHg. RESULTS: In-vitro fast flush bolus volumes ranged from 0.23 +/- 0.04 ml (1-s, 100 mmHg, 24-G cannula) to 2.95 +/- 0.38 ml (5-s, 300 mmHg, 22-G cannula). Volumes were larger using a 22-G cannula than a 24-G cannula (P < 0.01) and increased with longer flushing periods (P < 0.0001) and higher manometer pressures (P < 0.0001). In-vivo 1- and 2-s fast flush bolus volumes correlated well with driving pressures (infusion pressure minus mean arterial pressure) (r2 = 0.81/0.72). 1-s fast flush bolus volumes delivered (ml) were 0.0025 x mmHg driving pressure and 2-s fast flush bolus volumes delivered (ml) were 0.0043 x mmHg driving pressure. The mean volume delivered to purge blood from the arterial pressure tubing was 0.94 +/- 0.18 ml (range 0.61-1.34 ml). CONCLUSIONS: Fast bolus flushing from pressurized infusion bag systems, using the flow regulating device tested, can be applied during neonatal and paediatric anaesthesia without delivering uncontrolled amounts of fluid.

Analysis of Variance↗
PubMed1990

Impact of stress on objectively recorded menopausal hot flushes and on flush report bias.

The hot flush (or flash) is the most widely reported menopausal symptom. Anecdotal reports suggest that women experience more hot flushes when stressed. Although stress may actually trigger hot flushes, another possibility is that women under stress may be more aware of the physiological changes associated with flushes and, therefore, more likely to report them. The goal of this study was to test these hypotheses by investigating the association between stress and both objective (i.e., physiologically recorded) and subjective hot flushes. Twenty-one postmenopausal women who reported having frequent hot flushes each underwent psychophysiological monitoring during stressful and nonstressful laboratory sessions. Significantly more objective flushes were recorded during the stress session than during the nonstress session. The stress manipulation, however, did not affect subjects' propensity to report flushes. These results suggest that the observed association between reported hot flushes and stress is not due to changes in report bias. The physiological mechanisms through which stress may stimulate hot flushes are discussed.

Adult↗
PubMed1995

Serotonin, catecholamines, and spontaneous midgut carcinoid flush: plasma studies from flushing and nonflushing sites.

BACKGROUND/AIMS: Serotonin is the diagnostic hallmark of midgut carcinoids, but the pathophysiology of spontaneous flushing is unknown. The aim of this study was to assess to what extent serotonin and catecholamine blood levels are related in time with spontaneous midgut carcinoid flush. METHODS: Using specific radioenzymatic assays, we measured prospectively before, during, and after spontaneous flushing platelet-poor plasma and whole blood serotonin and plasma catecholamines and their metabolites in 10 patients with primary midgut carcinoids. Blood was drawn simultaneously from a forearm vein and an external jugular vein draining the flushing area. RESULTS: During flushing, plasma serotonin and norepinephrine levels increased (P < 0.001) over preflush levels at both sampling sites. Intraflush serotonin and norepinephrine were twice as high (P < 0.01) in external jugular (9.57 +/- 1.40 ng/mL and 857 +/- 33 pg/mL, respectively) than in antecubital plasma (4.59 +/- 0.73 ng/mL and 471 +/- 26 pg/mL). Preflush and postflush levels were similar at both venous sites. CONCLUSIONS: Vein plasma serotonin and norepinephrine levels do increase during midgut carcinoid flush, especially in the flushing area. This may reflect a local release secondary to flush but also suggests a role for these bioamines in the pathogenesis of flushing.

Adult↗
PubMed1987

[Flushes, blushing or hot flushes].

Apart from physiological flushes represented by emotional or prudish blushing, post-prandial flushes and menopausal hot flushes, various pathologic flushes exist of various etiologies: endocrine, dysmetabolic, histaminic and iatrogenic. Their pathogenicity is based mainly on local metabolites secretion provoking vasodilatation of the intermediary microcirculation rather than of the terminal microcirculation. Treatment is a function of etiology and therefore of the patient's history and results of clinical examination, functional exploration and standard biologic tests.

Blood Vessels↗
PubMed2004

The FLUSH trial--flushing with lipiodol for unexplained (and endometriosis-related) subfertility by hysterosalpingography: a randomized trial.

BACKGROUND: To assess the effectiveness of flushing with the oil-soluble contrast medium lipiodol in women with unexplained infertility. METHODS: An open randomized controlled trial design in a single centre secondary and tertiary level infertility service setting. A total of 158 women with unexplained infertility were stratified into two populations: 96 women without confirmed endometriosis and 62 women with endometriosis who had normal Fallopian tubes and ovaries. Randomization was computer-generated, with allocation concealment by opaque sequentially numbered envelopes. Lipiodol flushing was tested versus no intervention. The main outcome measures were clinical pregnancy (assessed at 6 months following randomization) and live birth. RESULTS: Lipiodol flushing resulted in a significant increase in pregnancy [48.0 versus 10.8%, relative risk (RR) 4.44, 95% confidence interval (CI) 1.61-12.21] and live birth (40.0 versus 10.8%, RR 3.70, 95% CI 1.30-10.50) rates versus no intervention for women with endometriosis, although there was no significant difference in pregnancy (33.3 versus 20.8%, RR 1.60, 95% CI 0.81-3.16) or live birth (27.1 versus 14.6%, RR 1.86, 95% CI 0.81-4.25) rates for women with unexplained infertility without confirmed endometriosis. CONCLUSIONS: Lipiodol flushing is an effective treatment for couples with unexplained infertility (based on meta-analysis data), but is particularly effective for women with endometriosis who have normal Fallopian tubes and ovaries.

Adult↗
PubMed2006

After the FLUSH trial: a prospective observational study of lipiodol flushing as an innovative treatment for unexplained and endometriosis-related infertility.

OBJECTIVES: To assess the demographics, efficacy and safety of lipiodol flushing fertility treatment. DESIGN: Prospective observational study. SETTING: Secondary level care infertility clinic and radiology centre based in Auckland, New Zealand. POPULATION: The first cohort of 100 New Zealand women with infertility to undergo lipiodol flushing as an innovative fertility treatment. METHODS: Women received lipiodol flushing performed by a hysterosalpingogram technique and were followed up at 6 months. MAIN OUTCOME MEASURES: Clinical pregnancy at 6 months post-treatment; and live birth or ongoing pregnancy. RESULTS: The overall pregnancy rate was 30% and the live birth or ongoing pregnancy rate 27%. For women under 40 years old, a 32% pregnancy rate and a 25% live birth or ongoing pregnancy rate were seen in women with unexplained infertility, and a 50% pregnancy rate and a 47% live birth or ongoing pregnancy rate were seen in women with endometriosis. Of women aged 40 years and older, the pregnancy rate was 13% and the live birth or ongoing pregnancy rate was 13%. The pregnancy rates included those occurring after additional interventions, such as intrauterine insemination and in vitro fertilisation, accounting for 12 of the 30 pregnancies. There were no treatment complications. CONCLUSION: This study provides further evidence of the efficacy and safety of lipiodol flushing fertility treatment.

Adult↗
PubMed2006

Experimental analysis of the hydrass flushing gate and laboratory validation of flush propagation modelling.

Periodical cleansing operations prove necessary inside sewer systems in order to reduce hydraulic and environmental problems owing to the accumulation of deposits on the bottom of channels. For this objective, new effective hydraulic devices based on the scouring effects of flushing waves have been recently set up and adopted in many sewer systems. In this paper, the results of an experimental and numerical investigation on the hydraulic operation of the Hydrass flushing gate are reported. The experimental analysis has been carried out using a laboratory channel and a reduced scale model of the gate, in order to characterise the flushing waves generated by the device. The numerical analysis has been performed using a mathematical model specifically developed for the simulation of flushing waves inside sewer channels. The comparison of numerical results and experimental data has allowed evaluation of the applicability under unsteady flow conditions of the outflow relations determined for the Hydrass gate in a previous investigation under steady flow conditions.

Drainage, Sanitary↗
PubMed2005

Forced exercise-induced flushing of tail skin in ovariectomized mice, as a new experimental model of menopausal hot flushes.

Hot flushes are the most common complaint of menopausal women. In the present study, a new animal model of hot flushes was established. Tail skin temperature was measured with a thermo tracer after mice were subjected to a forced exercise task using a motor driven treadmill. In ovariectomized mice, forced exercise for 10 min was most effective in increasing tail skin temperature over that of sham-operated mice. This elevation was blocked by estradiol replacement (1 mg/kg per week for 3 weeks), suggesting that our model simulates menopausal hot flushes.

Animals↗
PubMed2005

Experimental analysis of the hydrass flushing gate and field validation of flush propagation modelling.

As well known, a periodical cleansing of sewers results necessary in order to avoid or reduce many unpleasant consequences due to the presence of sediments, such as the solid re-suspension during rain events and the reduction of the channel flow capacity. For this purpose, different systems based on flushing techniques have been adopted in sewers. In the present paper, the results of an analysis of the hydraulics of a flushing device, the Hydrass gate, is presented. In particular, an experimental investigation on a scale model under steady conditions was carried out in order to determine the behaviour of the device during the flushing phase. Outflow relations were derived for the different outflow conditions. A numerical model was finally set up for testing the relations under unsteady conditions, using for validation the experimental data of a previous measurement campaign carried out in a sewer reach of the city of Lyon, France.

Models, Theoretical↗
PubMedDate not supplied

A meta-analysis of effects of heparin flush and saline flush: quality and cost implications.

The purpose of this meta-analysis was to estimate the effects of heparin flush and saline flush solutions on maintaining patency, preventing phlebitis, and increasing duration in peripheral heparin locks. The average effect size (d value) across 15 studies with a total sample size of 3,490 was .0573 for patency (clotting). The 95% credibility interval ranged from -.2267 to .3413. The average effect size across 13 studies with a total sample size of 2,356 was -.0757 for phlebitis. The 95% credibility interval ranged from -.2497 to .0983. The average effect size for duration across six samples with a total sample size of 1,960 was -.0550. The 95% credibility interval ranged from -.2424 to .1324. It can be concluded that saline is as effective as heparin in maintaining patency, preventing phlebitis, and increasing duration in peripheral intravenous locks. Quality of care can be enhanced by using saline as the flush solution, thereby eliminating problems associated with anticoagulant effects and drug incompatibilities. In addition, an estimated yearly savings of $109,100,000 to $218,200,000 U.S. health care dollars could be attained.

Catheterization, Peripheral↗
PubMed1983

Effect of subdepressor clonidine on flushing reactions in rosacea. Change in malar thermal circulation index during provoked flushing reactions.

The effects of clonidine hydrochloride, an agent effective in suppressing other types of flushing reactions, were investigated in patients with erythematotelangiectatic rosacea. Clonidine hydrochloride, 0.05 mg, was given orally twice daily for two weeks. Mean arterial BP was not altered during clonidine treatment. Flushing reactions provoked with water at 60 degrees C, red wine, and chocolate were not suppressed during clonidine treatment. Clonidine did lead to malar hypothermia. It may be that any treatment benefit obtained from the reduction in vascular reactivity by clonidine in rosacea is offset by the malar hypothermia.

Clonidine↗