Very Prolonged Treatment with Albendazole of a Case of Disseminated Abdominal Cystic Echinococcosis

Cystic echinococcosis is a zoonosis caused by the ingestion of food or water contaminated by Echinococcus eggs. E. granulosus is the most common causative agent of cystic echinococcosis that still has a relevant incidence in Italy, especially on the islands of Sicily and Sardinia. We report the case of a 64-year-old man with disseminated abdominal cystic echinococcosis (liver, spleen, peritoneum). The patient was asymptomatic and non-eligible for surgical treatment. Treatment with albendazole 400 mg/twice daily was started in 2012 for 15 cycles (each cycle consisted of three 28-day treatments at 14-day intervals) over 10 years for a total of 1260 days of treatment. Serum anti-Echinococcus antibody titers and imaging (echography, TC) were evaluated to monitor the evolution of the disease. Imaging techniques documented the regression of all cyst lesions, but it was less evident for the peritoneal localizations that still are in follow-up. In this case, the prolonged treatment with albendazole was effective, safe and free of side effects. Until today, the patient displays a good clinical condition

Perioperative and anesthetic deaths: toxicological and medico legal aspects

Background: Anesthesia has become safer during decades, though there is still a preventable mortality; the complexity of medical and surgical interventions, increasingly older and sicker patients, has created a host of new hazards in anesthesiology. In this paper, some of these perioperative (PO) fatal adverse events are investigated in terms of health responsibility. Selective literature research in several data bases, concerning perioperative and anesthetic deaths and medical responsibility, was performed. Main text: A generally accepted definition of the anesthesia and perioperatory-related death still remains one of the major concerns in forensic pathology, and the terms “operative deaths” and “anesthetic deaths” are usually applied inaccurately within the medico-legal literature. Such events involve comprehensively PO fatalities and allow for subtle separation of natural and unnatural death, at least from the prospective of forensic pathology. Iatrogenic deaths in this field can be separated into some major categories, as attributable to previous patient’s unfavorable conditions or depending from surgical procedure per se (such as PO cardiac and cerebrovascular events). In this review, the authors carried out syntheses of specific research areas regarding epidemiology, complications of general and spinal anesthetic, failure in airway management and patient’s circulatory homeostasis, and adverse drugs reactions; analysis considering the challenge of anesthetic-related mortality, epidemiology and classifications, by indicating causal chain of death, in respect of both contributing and associated anesthetic and surgery facts. Conclusions: Perioperative quality control programs and its relevance for medico-legal evaluation are emphasized as, although mortality rates have decreased worldwide over the last decades, however, preventable drug-related deaths still happen. Such fatal events have to be considered within the field of forensic pathology experts, with regard of malpractice claims, to implement a strategy for preventing potentially fatal complications

Optimal Time-Reversal of Multi-phase Equatorial States

Even though the time-reversal is unphysical (it corresponds to the complex conjugation of the density matrix), for some restricted set of states it can be achieved unitarily, typically when there is a common de-phasing in a n-level system. However, in the presence of multiple phases (i. e. a different de-phasing for each element of an orthogonal basis occurs) the time reversal is no longer physically possible. In this paper we derive the channel which optimally approaches in fidelity the time-reversal of multi-phase equatorial states in arbitrary (finite) dimension. We show that, in contrast to the customary case of the Universal-NOT on qubits (or the universal conjugation in arbitrary dimension), the optimal phase covariant time-reversal for equatorial states is a nonclassical channel, which cannot be achieved via a measurement/preparation procedure. Unitary realizations of the optimal time-reversal channel are given with minimal ancillary dimension, exploiting the simplex structure of the optimal maps.Comment: 7 pages, minor change

Contracts for Abstract Processes in Service Composition

Contracts are a well-established approach for describing and analyzing behavioral aspects of web service compositions. The theory of contracts comes equipped with a notion of compatibility between clients and servers that ensures that every possible interaction between compatible clients and servers will complete successfully. It is generally agreed that real applications often require the ability of exposing just partial descriptions of their behaviors, which are usually known as abstract processes. We propose a formal characterization of abstraction as an extension of the usual symbolic bisimulation and we recover the notion of abstraction in the context of contracts.Comment: In Proceedings FIT 2010, arXiv:1101.426

Physical realizations of quantum operations

Quantum operations (QO) describe any state change allowed in quantum mechanics, such as the evolution of an open system or the state change due to a measurement. We address the problem of which unitary transformations and which observables can be used to achieve a QO with generally different input and output Hilbert spaces. We classify all unitary extensions of a QO, and give explicit realizations in terms of free-evolution direct-sum dilations and interacting tensor-product dilations. In terms of Hilbert space dimensionality the free-evolution dilations minimize the physical resources needed to realize the QO, and for this case we provide bounds for the dimension of the ancilla space versus the rank of the QO. The interacting dilations, on the other hand, correspond to the customary ancilla-system interaction realization, and for these we derive a majorization relation which selects the allowed unitary interactions between system and ancilla.Comment: 8 pages, no figures. Accepted for publication on Phys. Rev.

Late postpancreatectomy hemorrhage after pancreaticoduodenectomy: is it possible to recognize risk factors?

CONTEXT: Post-pancreatectomy hemorrhage is one of the most common complications after pancreaticoduodenectomy. OBJECTIVE: To evaluate the late post-pancreatectomy hemorrhage rate according to the International Study Group of Pancreatic Surgery criteria and to recognize factors related to its onset. METHODS: A prospective study of 113 patients who underwent pancreaticoduodenectomy was conducted. Late post-pancreatectomy hemorrhage was defined according to the criteria of the International Study Group of Pancreatic Surgery. Demographic, clinical, surgical and pathological data were considered and related to late post-pancreatectomy hemorrhage. RESULTS: Thirty-one (27.4%) patients had a post-pancreatectomy hemorrhage. Twenty-five (22.1%) patients developed late post-pancreatectomy hemorrhage: 19 (16.8%) grade B, 6 (5.3%) grade C. Surgical re-operation was performed in 2 out of the 25 cases with late post-pancreatectomy hemorrhage (8.0%) grade C associated with postoperative pancreatic fistula. At univariate analysis, the only factor significantly related to late post-pancreatectomy hemorrhage was postoperative pancreatic fistula (P<0.001). Multivariate analysis underlined that the severity of postoperative pancreatic fistula (P<0.001) and pancreatic anastomosis (P=0.049) independently increased the risk of late hemorrhage. CONCLUSION: In patients undergoing pancreaticoduodenectomy, the criteria introduced by International Study Group of Pancreatic Surgery to define late postpancreatectomy hemorrhage are related to a higher incidence of hemorrhage than previously detected because they considered also mild hemorrhage

Private quantum decoupling and secure disposal of information

Given a bipartite system, correlations between its subsystems can be understood as information that each one carries about the other. In order to give a model-independent description of secure information disposal, we propose the paradigm of private quantum decoupling, corresponding to locally reducing correlations in a given bipartite quantum state without transferring them to the environment. In this framework, the concept of private local randomness naturally arises as a resource, and total correlations get divided into eliminable and ineliminable ones. We prove upper and lower bounds on the amount of ineliminable correlations present in an arbitrary bipartite state, and show that, in tripartite pure states, ineliminable correlations satisfy a monogamy constraint, making apparent their quantum nature. A relation with entanglement theory is provided by showing that ineliminable correlations constitute an entanglement parameter. In the limit of infinitely many copies of the initial state provided, we compute the regularized ineliminable correlations to be measured by the coherent information, which is thus equipped with a new operational interpretation. In particular, our results imply that two subsystems can be privately decoupled if their joint state is separable.Comment: Child of 0807.3594 v2: minor changes v3: presentation improved, one figure added v4: extended version with a lot of discussions and examples v5: published versio

Global information balance in quantum measurements

We perform an information-theoretical analysis of quantum measurement processes and obtain the global information balance in quantum measurements, in the form of a closed chain equation for quantum mutual entropies. Our balance provides a tight and general entropic information-disturbance trade-off, and explains the physical mechanism underlying it. Finally, the single-outcome case, that is, the case of measurements with post-selection, is briefly discussed.Comment: Final version to appear on Physical Review Letter