8 research outputs found
Transient grating spectroscopy on a DyCo thin film with femtosecond extreme ultraviolet pulses
Surface acoustic waves (SAWs) are excited by femtosecond extreme ultraviolet
(EUV) transient gratings (TGs) in a room-temperature ferrimagnetic DyCo
alloy. TGs are generated by crossing a pair of EUV pulses from a free electron
laser (FEL) with the wavelength of 20.8\,nm matching the Co -edge, resulting
in a SAW wavelength of \,nm. Using the pump-probe transient grating
scheme in a reflection geometry the excited SAWs could be followed in the time
range of -10 to 100\,ps in the thin film. Coherent generation of TGs by
ultrafast EUV pulses allows to excite SAW in any material and to investigate
their couplings to other dynamics such as spin waves and orbital dynamics
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Postoperative pain management in non-traumatic emergency general surgery: WSES-GAIS-SIAARTI-AAST guidelines.
BACKGROUND: Non-traumatic emergency general surgery involves a heterogeneous population that may present with several underlying diseases. Timeous emergency surgical treatment should be supplemented with high-quality perioperative care, ideally performed by multidisciplinary teams trained to identify and handle complex postoperative courses. Uncontrolled or poorly controlled acute postoperative pain may result in significant complications. While pain management after elective surgery has been standardized in perioperative pathways, the traditional perioperative treatment of patients undergoing emergency surgery is often a haphazard practice. The present recommended pain management guidelines are for pain management after non-traumatic emergency surgical intervention. It is meant to provide clinicians a list of indications to prescribe the optimal analgesics even in the absence of a multidisciplinary pain team. MATERIAL AND METHODS: An international expert panel discussed the different issues in subsequent rounds. Four international recognized scientific societies: World Society of Emergency Surgery (WSES), Global Alliance for Infection in Surgery (GAIS), Italian Society of Anesthesia, Analgesia Intensive Care (SIAARTI), and American Association for the Surgery of Trauma (AAST), endorsed the project and approved the final manuscript. CONCLUSION: Dealing with acute postoperative pain in the emergency abdominal surgery setting is complex, requires special attention, and should be multidisciplinary. Several tools are available, and their combination is mandatory whenever is possible. Analgesic approach to the various situations and conditions should be patient based and tailored according to procedure, pathology, age, response, and available expertise. A better understanding of the patho-mechanisms of postoperative pain for short- and long-term outcomes is necessary to improve prophylactic and treatment strategies
Acute abdomen in the immunocompromised patient: WSES, SIS-E, WSIS, AAST, and GAIS guidelines
Immunocompromised patients are a heterogeneous and diffuse category frequently presenting to the emergency department with acute surgical diseases. Diagnosis and treatment in immunocompromised patients are often complex and must be multidisciplinary. Misdiagnosis of an acute surgical disease may be followed by increased morbidity and mortality. Delayed diagnosis and treatment of surgical disease occur; these patients may seek medical assistance late because their symptoms are often ambiguous. Also, they develop unique surgical problems that do not affect the general population. Management of this population must be multidisciplinary. This paper presents the World Society of Emergency Surgery (WSES), Surgical Infection Society Europe (SIS-E), World Surgical Infection Society (WSIS), American Association for the Surgery of Trauma (AAST), and Global Alliance for Infection in Surgery (GAIS) joined guidelines about the management of acute abdomen in immunocompromised patients
Acute abdomen in the immunocompromised patient: WSES, SIS-E, WSIS, AAST, and GAIS guidelines
Immunocompromised patients are a heterogeneous and diffuse category
frequently presenting to the emergency department with acute surgical
diseases. Diagnosis and treatment in immunocompromised patients are
often complex and must be multidisciplinary. Misdiagnosis of an acute
surgical disease may be followed by increased morbidity and mortality.
Delayed diagnosis and treatment of surgical disease occur; these
patients may seek medical assistance late because their symptoms are
often ambiguous. Also, they develop unique surgical problems that do not
affect the general population. Management of this population must be
multidisciplinary. This paper presents the World Society of Emergency
Surgery (WSES), Surgical Infection Society Europe (SIS-E), World
Surgical Infection Society (WSIS), American Association for the Surgery
of Trauma (AAST), and Global Alliance for Infection in Surgery (GAIS)
joined guidelines about the management of acute abdomen in
immunocompromised patients
Rates and predictors of seizure freedom in resective epilepsy surgery: an update
Epilepsy is a debilitating neurological disorder affecting approximately 1 % of the world’s population. Drug-resistant focal epilepsies are potentially surgically remediable. Although epilepsy surgery is dramatically underutilized among medically refractory patients, there is an expanding collection of evidence supporting its efficacy which may soon compel a paradigm shift. Of note is that a recent randomized controlled trial demonstrated that early resection leads to considerably better seizure outcomes than continued medical therapy in patients with pharmacoresistant temporal lobe epilepsy. In the present review, we provide a timely update of seizure freedom rates and predictors in resective epilepsy surgery, organized by the distinct pathological entities most commonly observed. Class I evidence, meta-analyses, and individual observational case series are considered, including the experiences of both our institution and others. Overall, resective epilepsy surgery leads to seizure freedom in approximately two thirds of patients with intractable temporal lobe epilepsy and about one half of individuals with focal neocortical epilepsy, although only the former observation is supported by class I evidence. Two common modifiable predictors of postoperative seizure freedom are early operative intervention and, in the case of a discrete lesion, gross total resection. Evidence-based practice guidelines recommend that epilepsy patients who continue to have seizures after trialing two or more medication regimens should be referred to a comprehensive epilepsy center for multidisciplinary evaluation, including surgical consideration