Thermodynamics Inducing Massive Particles' Tunneling and Cosmic Censorship

By calculating the change of entropy, we prove that the first law of black hole thermodynamics leads to the tunneling probability of massive particles through the horizon, including the tunneling probability of massive charged particles from the Reissner-Nordstr\"om black hole and the Kerr-Newman black hole. Novelly, we find the trajectories of massive particles are close to that of massless particles near the horizon, although the trajectories of massive charged particles may be affected by electromagnetic forces. We show that Hawking radiation as massive particles tunneling does not lead to violation of the weak cosmic-censorship conjecture

Irbesartan in Marfan syndrome (AIMS): a double-blind, placebo-controlled randomised trial

BACKGROUND: Irbesartan, a long acting selective angiotensin-1 receptor inhibitor, in Marfan syndrome might reduce aortic dilatation, which is associated with dissection and rupture. We aimed to determine the effects of irbesartan on the rate of aortic dilatation in children and adults with Marfan syndrome. METHODS: We did a placebo-controlled, double-blind randomised trial at 22 centres in the UK. Individuals aged 6-40 years with clinically confirmed Marfan syndrome were eligible for inclusion. Study participants were all given 75 mg open label irbesartan once daily, then randomly assigned to 150 mg of irbesartan (increased to 300 mg as tolerated) or matching placebo. Aortic diameter was measured by echocardiography at baseline and then annually. All images were analysed by a core laboratory blinded to treatment allocation. The primary endpoint was the rate of aortic root dilatation. This trial is registered with ISRCTN, number ISRCTN90011794. FINDINGS: Between March 14, 2012, and May 1, 2015, 192 participants were recruited and randomly assigned to irbesartan (n=104) or placebo (n=88), and all were followed for up to 5 years. Median age at recruitment was 18 years (IQR 12-28), 99 (52%) were female, mean blood pressure was 110/65 mm Hg (SDs 16 and 12), and 108 (56%) were taking β blockers. Mean baseline aortic root diameter was 34·4 mm in the irbesartan group (SD 5·8) and placebo group (5·5). The mean rate of aortic root dilatation was 0·53 mm per year (95% CI 0·39 to 0·67) in the irbesartan group compared with 0·74 mm per year (0·60 to 0·89) in the placebo group, with a difference in means of -0·22 mm per year (-0·41 to -0·02, p=0·030). The rate of change in aortic Z score was also reduced by irbesartan (difference in means -0·10 per year, 95% CI -0·19 to -0·01, p=0·035). Irbesartan was well tolerated with no observed differences in rates of serious adverse events. INTERPRETATION: Irbesartan is associated with a reduction in the rate of aortic dilatation in children and young adults with Marfan syndrome and could reduce the incidence of aortic complications

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

The thymidylate synthase inhibitor ZD 1694 (TOMUDEX) Pharmacological studies in mouse and man

SIGLEAvailable from British Library Document Supply Centre-DSC:DXN025794 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

A large size complicated epidermal cyst of perineum and gluteal region, with a long fistulous tract to the coccygeal area. A rare entity, challenging in diagnosis and surgical treatment

Epidermal cysts of perineum are rare entities of obscure etio-pathogenesis, rarely found as cases reports in literature. a 36-year-old female, with a perineal epidermal cyst of the left ischiorectal space, long fistulous tract, and external opening in posterior retro-coccygeal area, is described. The past history, symptoms, imaging data, surgical intervention and results are registered. 1.5 years before admission, she was treated elsewhere for intermittent low-moderate fever up to 38.5Ϲ and draining an abscess of the retro-coccygeal area, due to inflamed cyst according to CT scan. The pathology report of the abscess wall revealed an epidermal cyst. Next year, in the surgical site of the drain, intermittent exit of a mucous content was observed. Before final surgery, an MRI of pelvis and ano-rectal canal, with fistula protocol was performed; showing a multi-loculated perineal cyst, at 6,4x3cm, and a long fistulous tract of 9 cm. Fistulectomy and circumferential excision of the cyst was performed. Cultures from cyst content showed enterococcus feacalis. Epidermal cysts of perineum are rare entities, even more inflamed cysts with fistula formation, rarely are mentioned in literature. Complicated cysts rise severe difficulties in surgery that is the only treatment in order to avoid severe perineal sepsis. Surgery of inflamed perineal epidermal cysts is quiet difficult. A meticulous analysis and study of imaging data and the changes in anatomy of perineum is compulsory and determine the success or fail of the surgical treatment. © 2018 Edizioni Minerva Medic