259 research outputs found
Interaction of (3-Aminopropyl)triethoxysilane with Pulsed Ar-O 2 Afterglow: Application to Nanoparticles Synthesis
International audienceThe interaction of (3-Aminopropyl)triethoxysilane (APTES) with pulsed late Ar-O 2 afterglow is characterized by the synthesis of OH, CO and CO 2 in the gas phase as main by-products. Other minor species like CH, CN and C 2 H are also produced. We suggest that OH radicals are produced in a first step by dehydrogenation of APTES after interaction with oxygen atoms. In a second step, the molecule is oxidized by any O 2 state, to form peroxides that transform into by-products, break thus the precursor CC bonds. If oxidation is limited, i.e. a low duty cycle, fragmentation of the precursor is limited and produced nanoparticles keep the backbone structure of the precursor, but contain amide groups produced from the amine groups initially available in APTES. At high duty cycle, silicon-containing fragments contain some carbon and react together and produce nanoparticles with a non-silica-like structure
Do antibiotic-impregnated shunts in hydrocephalus therapy reduce the risk of infection? An observational study in 258 patients
<p>Abstract</p> <p>Background</p> <p>Shunt infection in hydrocephalus patients is a severe, even life-threatening complication. Antibiotic-impregnated shunts (AIS) have been developed in an attempt to reduce rate of shunt infection. The study was performed to analyze if AIS can diminish the rate of shunt infection. The pathogenic nature of shunt infection in patients with AIS systems and those without antibiotic impregnated shunts (non-AIS) was compared.</p> <p>Methods</p> <p>Over a period of 24 months in the Department of Neurosurgery at University Hospital of Tübingen shunt surgery was performed in 258 patients. In 86 patients AIS systems were implanted. Shunt catheters were commercially impregnated with clindamycin and rifampicin. Analysis of the clinical data included sex, age, classification of hydrocephalus, shunt types and risk factors for shunt infection [age (< 1 year and > 80 years), prematurely born patients, external ventricular drainage, former shunt infection, former systemic infection, disturbance of consciousness, former radiation-/chemotherapy]. Infection rates and underlying bacterial pathogens of patients with AIS were compared to patients with implanted non-AIS systems (172 patients).</p> <p>Results</p> <p>AIS and non-AIS patients did not differ in sex, etiology of hydrocephalus and the shunt type. In the AIS group 72 out of 86 patients had at least one risk factor (83.7 %), compared to 126 patients in the non-AIS group (73.3 %). There was no significant difference between the two groups (p = 0.0629; Fisher's exact test). In patients with no risk factors, only one patient with non-AIS suffered from shunt infection. In patients with one or more risk factors the rate for shunt infection was 7.14 % in patients with non-AIS and 6.94 % in patients with AIS. Former shunt infection (p = 0.0124) was related to higher risk for shunt infection. The use of AIS had therefore no significant advantage (p = 0.8611; multiple logistic regression).</p> <p>Significantly related to a shunt infection was the number of shunt surgeries. 190 interventions in the AIS group (2.21 interventions per patient) and 408 in the non-AIS group (2.37 interventions per patient) had been performed (p = 0.3063; Wilcoxon). There was no shunt infection in the group of patients on whom only one shunt surgery was performed. In patients with at least two shunt surgeries the infection rate was 9%. The infection rate in AIS patients was 5/52 (9.6 %) and in the non-AIS 10/114 (8.77 %), (p = 1.0; Fisher's exact test). Staphylococcus epidermidis was the most frequent pathogen for shunt infection. Fourteen out of 15 infections occurred within the first 6 months of surgery. The most frequent pathogen for shunt infection was S. epidermidis. No toxic or allergic complications were seen using the AIS shunt systems. The presented data show a remarkably low infection rate of 5.8 % in the non-AIS group compared to other studies which demonstrated a significant decrease in the infection rate by AIS.</p> <p>Conclusion</p> <p>AIS did not significantly reduce shunt infection in hydrocephalus patients in the presented study. In the AIS group three patients suffered from shunt infections caused by skin ulceration or neurosurgical procedures with exposure of the cerebrospinal liquor after shunt implantation. AIS was not developed to prevent infection in such cases, therefore an advantage of AIS can not be excluded. In view of the presented data and the small number of reported studies a prospective randomized multicenter study is required.</p
Laparoscopic assisted ventriculoperitoneal shunt revisions as an option for pediatric patients with previous intraabdominal complications
Multiple shunt failure is a challenge in pediatric neurosurgery practice and one of the most feared complications of hydrocephalus. Objective: To demonstrate that laparoscopic procedures for distal ventriculoperitoneal shunt failure may be an effective option for patients who underwent multiple revisions due to repetitive manipulation of the peritoneal cavity, abdominal pseudocyst, peritonitis or other situations leading to a “non reliable” peritoneum. Method: From March 2012 to February 2013, the authors reviewed retrospectively the charts of six patients born and followed up at our institution, which presented with previous intra-peritoneal complications and underwent ventriculoperitoneal shunt revision assisted by video laparoscopy. Results: After a mean follow-up period of nine months, all patients are well and no further shunt failure was identified so far. Conclusion: Laparoscopy assisted shunt revision in children may be, in selected cases, an effective option for patients with multiple peritoneal complications due to ventriculo-peritoneal shunting
The flesh of painting: Caillebotte’s Modern Olympia
The language of putrefaction, often applied through a culinary analogy, appeared consistently in the critical reception of modern-life and Impressionist painting. For example, two critics used the term faisandé, referring to well-hung meat, to describe Manet’s nude figure of Olympia in 1865. The analogies that they posed between morgue bodies, female figures, meat, and fleshy paint material became central modes of denigrating Impressionist paintings of women in the ensuing decades. Gustave Caillebotte’s Veal in a Butcher’s Shop (c. 1882), depicting anthropomorphized, gendered, and sexualized animal flesh, can be considered in this context. In my reading, the painting enacts the critical responses to his colleagues’ figures, foregrounding the violent operations through which bodies might be reduced to meat, whether literal or metaphorical. In their comparisons to rotting flesh, nineteenth-century critics expressed a visceral reaction to works of art that Veal in a Butcher’s Shop demands
Comparative genomic hybridization and histological variation in primitive neuroectodermal tumours
Fratura com afundamento craniano em crianças com menos de dois anos de idade: estudo retrospectivo de 43 casos
Medulloblastoma: evaluation of proliferative index by monoclonal antibody Mib-1, its prognostic correlation and therapeutic implications
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