4,819 research outputs found

    Critical points in a relativistic bosonic gas induced by the quantum structure of spacetime

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    It is well known that phase transitions arise if the interaction among particles embodies an attractive as well as a repulsive contribution. In this work it will be shown that the breakdown of Lorentz symmetry, characterized through a deformation in the relation dispersion, plus the bosonic statistics predict the emergence of critical points. In other words, in some quantum gravity models the structure of spacetime implies the emergence of critical points even when no interaction among the particle has been considered.Comment: 5 pages, no figure

    Pelvic inflammatory disease by actinomyces: report of 1 case and review of the literature

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    Actinomycosis is a chronic disease that is characterized by the formation of abscesses, fistulas and dense fibrous tissue at the site of involvement. Its distribution is worldwide. However, pelvic actinomycosis has increased in frequency and has been associated with abdominal surgery, intestinal perforation or trauma, due to the destruction of the muscular barrier. The clinical elements of suspicion are the latency of months and even years of symptoms and the history of being a carrier of an intrauterine device. Actinomyces israelli is a rare etiological agent of pelvic inflammatory disease, so it is difficult to reach the diagnosis. A case report is made of a 48-year-old patient with an intrauterine device older than 5 years, who entered the emergency department with abdominal pain syndrome and 7-day evolutionary fever accompanied by dyspareunia. She was hospitalized for antibiotic treatment, presenting an unsatisfactory evolution, with increased leukocytosis and persistent abdominal pain. An exploratory laparotomy with abdominal hysterectomy was performed. The histopathological diagnosis was pelvic inflammatory disease due to actinomyces. We must always suspect in the presence of a pelvic inflammatory disease in any of its clinical forms, the presence of actinomyces as one of the possible causative germs, especially in patients with intrauterine device for more than 5 years

    Primary Angioplasty in a Catastrophic Presentation: Acute Left Main Coronary Total Occlusion—The ATOLMA Registry

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    Objectives. To determine the outcome predictors of in-hospital mortality in acute total occlusion of the left main coronary artery (ATOLMA) patients referred to emergent angioplasty and to describe the clinical presentation and the long-term outcome of these patients.Background. ATOLMA is an uncommon angiographic finding that usually leads to a catastrophic presentation. Limited and inconsistent data have been previously reported regarding true ATOLMA, yet comprehensive knowledge remains scarce.Methods. This is a multicenter retrospective cohort that includes patients presenting with myocardial infarction due to a confirmed ATOLMA who underwent emergency percutaneous coronary intervention (PCI).Results. In the period of the study, 7930 emergent PCI were performed in the five participating centers, and 46 of them had a true ATOLMA (0.58%). At admission, cardiogenic shock was present in 89% of patients, and cardiopulmonary resuscitation was required in 67.4%. All the patients had right dominance. Angiographic success was achieved in 80.4% of the procedures, 13 patients (28.2%) died during the catheterization, and the in-hospital mortality rate was 58.6% (27/46). At one-year and at the final follow-up, 18 patients (39%) were alive, including four cases successfully transplanted. Multivariate analysis showed that postprocedural TIMI flow was the only independent predictor of in-hospital mortality (OR 0.23, (95% CI 0.1-0.36),p<0.001).Conclusions. Our study confirms that the clinical presentation of ATOLMA is catastrophic, presenting a high in-hospital mortality rate; nevertheless, primary angioplasty in this setting is feasible. Postprocedural TIMI flow resulted as the only independent predictor of in-hospital mortality. In-hospital survivors presented an encouraging outcome. ATOLMA and left dominance could be incompatible with life

    Randomized clinical trial to evaluate the effect of fecal microbiota transplant for initial Clostridium difficile infection in intestinal microbiome

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    Objective The aim of this study was to evaluate the impact of fecal donor-unrelated donor mix (FMT-FURM) transplantation as first-line therapy for C. difficile infection (CDI) in intestinal microbiome. Methods We designed an open, two-arm pilot study with oral vancomycin (250mg every 6 h for 10–14 days) or FMT-FURM as treatments for the first CDI episode in hospitalized adult patients in Hospital Universitario “Dr. Jose Eleuterio Gonzalez”. Patients were randomized by a closed envelope method in a 1: 1 ratio to either oral vancomycin or FMT-FURM. CDI resolution was considered when there was a reduction on the Bristol scale of at least 2 points, a reduction of at least 50% in the number of bowel movements, absence of fever, and resolution of abdominal pain (at least two criteria). From each patient, a fecal sample was obtained at days 0, 3, and 7 after treatment. Specimens were cultured to isolate C. difficile, and isolates were characterized by PCR. Susceptibility testing of isolates was performed using the agar dilution method. Fecal samples and FMT-FURM were analyzed by 16S rRNA sequencing. Results We included 19 patients; 10 in the vancomycin arm and 9 in the FMT-FURM arm. However, one of the patients in the vancomycin arm and two patients in the FMT-FURM arm were eliminated. Symptoms resolved in 8/9 patients (88.9%) in the vancomycin group, while symptoms resolved in 4/7 patients (57.1%) after the first FMT-FURM dose (P = 0.26) and in 5/7 patients (71.4%) after the second dose (P = 0.55). During the study, no adverse effects attributable to FMT-FURM were observed in patients. Twelve isolates were recovered, most isolates carried tcdB, tcdA, cdtA, and cdtB, with an 18-bp deletion in tcdC. All isolates were resistant to ciprofloxacin and moxifloxacin but susceptible to metronidazole, linezolid, fidaxomicin, and tetracycline. In the FMT-FURM group, the bacterial composition was dominated by Firmicutes, Bacteroidetes, and Proteobacteria at all-time points and the microbiota were remarkably stable over time. The vancomycin group showed a very different pattern of the microbial composition when comparing to the FMT-FURM group over time. Conclusion The results of this preliminary study showed that FMT-FURM for initial CDI is associated with specific bacterial communities that do not resemble the donors’ sample.Peer reviewedFinal Published versio

    10 Years of Experience in Ultrasound-Guided Thrombin Injection, a Safe and Effective Technique in Femoral Pseudoaneurysm Treatment

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    Introdução: O elevado número de procedimentos vasculares percutâneos resulta num aumento das complicações relacionadas com o acesso vascular. A mais frequente é o falso aneurisma (FA), cuja intervenção de primeira linha é atualmente a injeção eco-guiada de trombina humana (IETH). Métodos: Estudo observacional retrospetivo realizado através da consulta de processos clínicos dos doentes submetidos a IETH por FA femoral num hospital terciário no período de 2008 a 2018. O end-point primário foi o sucesso desta modalidade terapêutica (trombose primária e à reavaliação ecográfica). Os end-points secundários foram complicações relacionadas com o procedimento, reintervenções, duração de internamento e sobrevida. Resultados: A amostra incluiu 102 doentes. 97% dos FA tinham etiologia iatrogénica confirmada. 4% foram diagnosticados após intervenção pela Cirurgia Vascular e 85% após intervenção pela Cardiologia, dos quais 80% após cateterismo coronário e 13% após TAVI (transcatheter aortic valve implantation). 58% dos doentes estavam antiagregados e 50% anticoagulados. 80% dos FA ocorreram à direita. 65% afetavam a AFC e 35% a AFS ou AFP. O diâmetro médio dos FA tratados por IETH foi de 36,8mm. 29% apresentavam-se lobulados (FA complexos). Quanto às características do colo do FA, 58% tinham colo longo (≥3mm de comprimento) e 58% tinham colo estreito (<3mm de calibre). O tempo mediano até à IETH após intervenção causal foi de 6 dias. 89% apresentaram trombose primária após IETH, decrescendo para 73% à reavaliação posterior por Eco Doppler. 16% repetiram IETH, 5% mais que uma vez. Não foram documentadas complicações relacionadas com o procedimento. Os falsos aneurismas complexos associaram-se a taxas inferiores de trombose completa à reavaliação ecográfica (p=0,012). O segmento arterial afetado, realização de antitrombóticos, diâmetro do FA e características do colo não apresentaram associação com a taxa de trombose do FA. 6% dos doentes submetidos a IETH foram submetidos a tratamento cirúrgico de FA femoral (a maioria após mais de 2 IETH), num dos casos por via endovascular. O tempo mediano de internamento após 1ª IETH foi de 3 dias, superior nos doentes com etiologia iatrogénica após TAVI comparativamente a após cateterismo coronário (p=0,006). A sobrevida dos doentes submetidos a IETH foi de 97±2% a 1 mês, 86±4% a 1 ano e 60±7% a 5 anos, sem diferença significativa de acordo com etiologia do FA femoral. Conclusão: A IETH é uma alternativa segura e com elevada eficácia para o tratamento de FA pós cateterização vascular. É expectável que 1/6 dos doentes necessite de mais do que uma injeção para obter o sucesso desejado, sendo esse risco mais elevado no caso de FA complexos. Apesar dos bons resultados, alguns doentes continuarão a necessitar de correção cirúrgica.info:eu-repo/semantics/publishedVersio

    Measurement of Leptonic Asymmetries and Top Quark Polarization in ttbar Production

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    We present measurements of lepton (l) angular distributions in ttbar -> W+ b W- b -> l+ nu b l- nubar bbar decays produced in ppbar collisions at a center-of-mass energy of sqrt(s)=1.96TeV, where l is an electron or muon. Using data corresponding to an integrated luminosity of 5.4fb^-1, collected with the D0 detector at the Fermilab Collider, we find that the angular distributions of l- relative to anti-protons and l+ relative to protons are in agreement with each other. Combining the two distributions and correcting for detector acceptance we obtain the forward-backward asymmetry A^l_FB = (5.8 +- 5.1(stat) +- 1.3(syst))%, compared to the standard model prediction of A^l_FB (predicted) = (4.7 +- 0.1)%. This result is further combined with the measurement based on the analysis of the l+jets final state to obtain A^l_FB = (11.8 +- 3.2)%. Furthermore, we present a first study of the top-quark polarization.Comment: submitted versio

    Search for B0→π0π0B^{0}\to \pi^{0}\pi^{0} Decay

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    We have searched for the charmless hadronic decay of B0 mesons into two neutral pions. Using 9.13fb^-1 taken at the Upsilon(4S) with the CLEO detector, we obtain an improved upper limit for the branching fraction BR(B0-->pi0pi0) < 5.7*10^-6 at the 90% confidence level.Comment: pages postscript, also available through http://w4.lns.cornell.edu/public/CLN

    Search for Zgamma events with large missing transverse energy in ppbar collisions at sqrt(s)=1.96 TeV

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    We present the first search for supersymmetry (SUSY) in Zgamma final states with large missing transverse energy using data corresponding to an integrated luminosity of 6.2 fb-1 collected with the D0 experiment in ppbar collisions at sqrt(s)=1.96 TeV. This signature is predicted in gauge-mediated SUSY-breaking models, where the lightest neutralino is the next-to-lightest supersymmetric particle (NLSP) and is produced in pairs, possibly through decay from heavier supersymmetric particles. The NLSP can decay either to a Z boson or a photon and an associated gravitino that escapes detection. We exclude this model at the 95% C.L. for SUSY breaking scales of Lambda < 87 TeV, corresponding to neutralino masses of < 151 GeV.Comment: submitted to Phys. Rev. Let
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