Der Ileus - ein Findling in der modernen Medizin?

Zusammenfassung: Kaum einem Krankheitsbild liegt ein so breites differenzialdiagnostisches Spektrum zugrunde wie dem Ileus. Insbesondere die hochgradige Obstruktion und der komplette Ileus können über eine bakterielle Translokation und Mikroperfusionsstörungen des dilatierten Darmes zu intestinalen Perforationen und einer Kreislaufinstabilität führen. Klare Algorithmen zur schnellen Kategorisierung des Ileus sind deshalb unabdingbar. Dabei sind insbesondere die Lokalisation des Kalibersprungs beim mechanischen Ileus als auch der Grad der Obstruktion wichtige Kriterien. Die Anamnese, klinische Untersuchung und das konventionelle Röntgenbild des Abdomens sind elementare Bestandteile der Basisdiagnostik. Als Goldstandard der erweiterten bildgebenden Diagnostik hat sich die Computertomographie etabliert. Während für die meisten hochgradigen mechanischen Obstruktionen des Dünndarms, die in drei Vierteln der Fälle durch Adhäsionen und Briden bedingt sind, eine explorative Laparotomie indiziert ist, stehen beim obstruierenden Dickdarmileus auch endoskopische Optionen zur Verfügung. Das Stenting von malignen kolorektalen Tumoren aboral der linken Flexur als überbrückende oder palliative Intervention hat sich ebenso wie die koloskopische Detorquierung des Volvulus etablier

Calibration of surface contamination monitors for the detection of iodine incorporation in the thyroid gland

In Switzerland, individuals exposed to the risk of activity intake are required to perform regular monitoring. Monitoring consists in a screening measurement and is meant to be performed using commonly available laboratory instruments. More particularly, iodine intake is measured using a surface contamination monitor. The goal of the present paper is to report the calibration method developed for thyroid screening instruments. It consists of measuring the instrument response to a known activity located in the thyroid gland of a standard neck phantom. One issue of this procedure remains that the iodine radioisotopes have a short half-life. Therefore, the adequacy and limitations to simulate the short-lived radionuclides with so-called mock radionuclides of longer half-life were also evaluated. In light of the results, it has been decided to use only the appropriate iodine sources to perform the calibratio

Environmental changes and violent conflict

This letter reviews the scientific literature on whether and how environmental changes affect the risk of violent conflict. The available evidence from qualitative case studies indicates that environmental stress can contribute to violent conflict in some specific cases. Results from quantitative large-N studies, however, strongly suggest that we should be careful in drawing general conclusions. Those large-N studies that we regard as the most sophisticated ones obtain results that are not robust to alternative model specifications and, thus, have been debated. This suggests that environmental changes may, under specific circumstances, increase the risk of violent conflict, but not necessarily in a systematic way and unconditionally. Hence there is, to date, no scientific consensus on the impact of environmental changes on violent conflict. This letter also highlights the most important challenges for further research on the subject. One of the key issues is that the effects of environmental changes on violent conflict are likely to be contingent on a set of economic and political conditions that determine adaptation capacity. In the authors' view, the most important indirect effects are likely to lead from environmental changes via economic performance and migration to violent conflict. © 2012 IOP Publishing Ltd

EnergyWeb Screening Criteria Report

This report describes a framework for evaluating candidate participants in the Bonneville Power Administration's (BPA) EnergyWeb program. The framework includes definition of system goals, relevant material that characterizes a distributed energy resource (DER) participant, rules for evaluating candidate participants, and a process that utilizes this information to produce a list of the most attractive candidates

Integration of external and internal dosimetry in Switzerland

Individual monitoring regulations in Switzerland are based on the ICRP60 recommendations. The annual limit of 20 mSv for the effective dose applies to the sum of external and internal radiation. External radiation is monitored monthly or quarterly with TLD, DIS or CR-39 dosemeters by 10 approved external dosimetry services and reported as Hp(10) and Hp(0.07). Internal monitoring is done in two steps. At the workplace, simple screening measurements are done frequently in order to recognise a possible incorporation. If a nuclide dependent activity threshold is exceeded then one of the seven approved dosimetry services for internal radiation does an incorporation measurement to assess the committed effective dose E50. The dosimetry services report all the measured or assessed dose values to the employer and to the National Dose Registry. The employer records the annually accumulated dose values into the individual dose certificate of the occupationally exposed person, both the external dose Hp(10) and the internal dose E50 as well as the total effective dose E = Hp(10)+E50. Based on the national dose registry an annual report on the dosimetry in Switzerland is published which contains the statistics for the total effective dose, as well as separate statistics for external and internal exposur

High-Performance Home Technologies: Solar Thermal & Photovoltaic Systems

This document is the sixth volume of the Building America Best Practices Series. It presents information that is useful throughout the United States for enhancing the energy efficiency practices in the specific climate zones that are presented in the first five Best Practices volumes. It provides an introduction to current photovoltaic and solar thermal building practices. Information about window selection and shading is included

Probing the boundaries of the Hadronic Phase through a Strangeness including Statistical Bootstrap Model (S-SBM)

A recently constructed strangeness-including Statistical Bootstrap Model (S-SBM), which defines the limits of the hadronic phase and provides for a phase beyond, is further extended so as to include a factor that describes strangeness suppression. The model is then used to analyse the multiplicity data from collision experiments in which the colliding entities form isospin symmetric systems, the primary focus being on S+S interactions (NA35 collaboration). An optimal set of thermodynamical variables is extracted through a fit to both the inclusive full phase space and midrapidity data. The assumption that the measured particles originate from a thermally and partial-chemically equilibrated source described by the S-SBM is satisfactorily established. The proximity of the thermodynamical variables extracted from the S+S data to the limits of the hadronic phase is systematically investigated. Finally, experimental data from proton-antiproton collisions (UA5 collaboration) are similarly analysed.Comment: 39 pages, 17 figures, all the figures joined in one file. Submitted in Phys. Rev.

(210)Po poisoning as possible cause of death: forensic investigations and toxicological analysis of the remains of Yasser Arafat.

The late president of the Palestinian Authority, Yasser Arafat, died in November 2004 in Percy Hospital, one month after having experienced a sudden onset of symptoms that included severe nausea, vomiting, diarrhoea and abdominal pain and which were followed by multiple organ failure. In spite of numerous investigations performed in France, the pathophysiological mechanisms at the origin of the symptoms could not be identified. In 2011, we found abnormal levels of polonium-210 ((210)Po) in some of Arafat's belongings that were worn during his final hospital stay and which were stained with biological fluids. This finding led to the exhumation of Arafat's remains in 2012. Significantly higher (up to 20 times) activities of (210)Po and lead-210 ((210)Pb) were found in the ribs, iliac crest and sternum specimens compared to reference samples from the literature (p-value <1%). In all specimens from the tomb, (210)Po activity was supported by a similar activity of (210)Pb. Biokinetic calculations demonstrated that a (210)Pb impurity, as identified in a commercial source of 3MBq of (210)Po, may be responsible for the activities measured in Arafat's belongings and remains 8 years after his death. The absence of myelosuppression and hair loss in Mr Arafat's case compared to Mr Litvinenko's, the only known case of malicious poisoning with (210)Po, could be explained by differences in the time delivery-scheme of intake. In conclusion, statistical Bayesian analysis combining all the evidence gathered in our forensic expert report moderately supports the proposition that Mr Arafat was poisoned by (210)Po

J/Psi Suppression in Heavy Ion Collisions at the CERN SPS

We reexamine the production of J/Psi and other charmonium states for a variety of target-projectile choices at the SPS. For this study we use a newly constructed cascade code LUCIFER II, which yields acceptable descriptions of both hard and soft processes, specifically Drell-Yan and hidden charm production, and soft energy loss and meson production, at the SPS. Glauber calculations of other authors are redone, and compared directly to the cascade results. The modeling of the charmonium states differs from that of earlier workers in its unified treatment of the hidden charm meson spectrum, which is introduced from the outset as a set of coupled states. The result is a description of the NA38 and NA50 data in terms of a conventional hadronic picture. The apparently anomalous suppression found in the most massive Pb+Pb system arises from three sources: destruction in the initial nucleon-nucleon cascade, use of coupled channels to exploit the larger breakup in the less bound Chi and Psi' states, and comover interaction in the final low energy phase.Comment: 36 pages (15 figures

Inclusive Particle Spectra at RHIC

A simulation is performed of the recently reported data from PHOBOS at energies of 56 and 130 A GeV using the relativistic heavy ion cascade LUCIFER which had previously given a good description of the NA49 inclusive spectra at E=17.2 A GeV. The results compare well with these early measurements at RHIC.Comment: 4 pages, 2 figure