379 research outputs found

    A systematic review comparing the functional changes and complications of DIEP and TRAM flaps in patients receiving breast reconstruction

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    Aim: Treatment for breast cancer may involve unilateral or bilateral mastectomy, with subsequent breast reconstruction surgery. Using autologous tissue flaps during reconstructive surgery is increasingly popular. The aim of this systematic review was to determine if the DIEP flap is more effective than the TRAM flap for breast reconstruction in females after a mastectomy in terms of donor site morbidity, recipient site morbidity, and functional outcome. Methods: Studies were identified using the databases Medline and Embase and applying predefined search criteria. The limits applied were; peer-reviewed, published between January 1980 to May 2013, human trials, English language. Study inclusion followed a review of the title, abstract, and full text by two independent researchers. Results: Two trends were identified. 1) DIEP flap surgery reduces the risk of abdominal weakness without increasing the risk of flap complications if performed by a surgeon well trained in microsurgery; 2) TRAM flap surgery remains a good alternative due to its evolution towards muscle-sparing techniques. Conclusion: This appears to be the first systematic review in this area of research. The evidence demonstrates that DIEP flap reduces postoperative abdominal morbidity, with no increased flap complication compared to the TRAM flap if performed by a surgeon well trained in microsurgery

    Thermal correction to the Casimir force, radiative heat transfer, and an experiment

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    The low-temperature asymptotic expressions for the Casimir interaction between two real metals described by Leontovich surface impedance are obtained in the framework of thermal quantum field theory. It is shown that the Casimir entropy computed using the impedance of infrared optics vanishes in the limit of zero temperature. By contrast, the Casimir entropy computed using the impedance of the Drude model attains at zero temperature a positive value which depends on the parameters of a system, i.e., the Nernst heat theorem is violated. Thus, the impedance of infrared optics withstands the thermodynamic test, whereas the impedance of the Drude model does not. We also perform a phenomenological analysis of the thermal Casimir force and of the radiative heat transfer through a vacuum gap between real metal plates. The characterization of a metal by means of the Leontovich impedance of the Drude model is shown to be inconsistent with experiment at separations of a few hundred nanometers. A modification of the impedance of infrared optics is suggested taking into account relaxation processes. The power of radiative heat transfer predicted from this impedance is several times less than previous predictions due to different contributions from the transverse electric evanescent waves. The physical meaning of low frequencies in the Lifshitz formula is discussed. It is concluded that new measurements of radiative heat transfer are required to find out the adequate description of a metal in the theory of electromagnetic fluctuations.Comment: 19 pages, 4 figures. svjour.cls is used, to appear in Eur. Phys. J.

    Treatment Outcomes of Patients With Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis According to Drug Susceptibility Testing to First- and Second-line Drugs: An Individual Patient Data Meta-analysis

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    The clinical validity of drug susceptibility testing (DST) for pyrazinamide, ethambutol, and second-line antituberculosis drugs is uncertain. In an individual patient data meta-analysis of 8955 patients with confirmed multidrug-resistant tuberculosis, DST results for these drugs were associated with treatment outcome

    The Sudbury Neutrino Observatory

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    The Sudbury Neutrino Observatory is a second generation water Cherenkov detector designed to determine whether the currently observed solar neutrino deficit is a result of neutrino oscillations. The detector is unique in its use of D2O as a detection medium, permitting it to make a solar model-independent test of the neutrino oscillation hypothesis by comparison of the charged- and neutral-current interaction rates. In this paper the physical properties, construction, and preliminary operation of the Sudbury Neutrino Observatory are described. Data and predicted operating parameters are provided whenever possible.Comment: 58 pages, 12 figures, submitted to Nucl. Inst. Meth. Uses elsart and epsf style files. For additional information about SNO see http://www.sno.phy.queensu.ca . This version has some new reference
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