The absorption spectrum of deutereted cyanoacethylene between 180 and 370cm−1370 cm^{-1} has been recorded in W\"{u}ppertal with a resolution of 0.02cm−10.02 cm^{-1}.The following transitions and their associated hot bands have been observed: v7←G.S,v51←v71.v61←v71v_{7} \leftarrow G.S, v^{1}_{5}\leftarrow v^{1}_{7}.v^{1}_{6}\leftarrow v^{1}_{7} and v4←v61v_{4} \leftarrow v^{1}_{6}. From these spectra we have obtained with an accuracy in the range of 0.01cm−10.01 cm^{-1} the vibrational energies of most states of DCCCN below 1100cm−11100 cm^{-1}. These results combined with the Stark transitions Δv5=2(1)\Delta v_{5} =2^{(1)} and the microwave analysis[2]analysis^{[2]} yields the determination of any xijx_{ij} and gijg_{ij} anharmonicity parameters with ij=4ij = 4 to 7. The observation of the crossing of v4v_{4} with 4v724v^{2}_{7} at J=47J=47 and with 4v704v^{0}_{7} at J=57J = 57 confirms the anharmonic interactions scheme of Plummer etal.[2]et al.^{[2]}

Author Institution: Universite Catholique de Louvain, Molecular Spectroscopy Laboratory 2 chemin du cyclotron; FB9 Anorgan. Chemic, Bergische Univ. - Gesamthochschule W\""{u}ppertal$^{[1]}$ B. Coveliers. W.K. Ahmed, A. Fayt and A.G. Maki, submitted to the J. Mol. Spectrosc. $^{[2]}$ G.M. Plummer. D. Mauer, and K.M.T. Yamada, J. Mol. Spectrosc. 130, 407-418 (1988)

Thoracic sympathectomy for digital ischemia:A summary of evidence

BackgroundThoracic sympathectomy is used in the management of a variety of upper limb disorders. We have analyzed the evidence for thoracic sympathectomy in the management of digital ischemia.MethodsWe reviewed the English literature between 1980 and 2010. Our analysis included reports with the clinical end points of relief, recurrence of symptoms or healing of ulcers, or both. Primary Raynaud disease (PRD) and secondary Raynaud phenomenon (SRP) were analyzed separately.ResultsAn initial postoperative positive effect was reported in 92% of PRD patients and in 89% of SRP patients. Long-term beneficial effect was 58% for PRD and 89% for SRP. Ulcer healing or improvement was achieved in 95%.ConclusionsThe available evidence suggests that thoracic sympathectomy has a role in the treatment of severe PRD and SRP, albeit with better results in SRP patients than in PRD patients. In case of digital ulceration, thoracic sympathectomy may maximize tissue preservation or prevent amputation

Value of risk scores in the decision to palliate patients with ruptured abdominal aortic aneurysm

Background: The aim of this study was to develop a 48-h mortality risk score, which included morphology data, for patients with ruptured abdominal aortic aneurysm presenting to an emergency department, and to assess its predictive accuracy and clinical effectiveness in triaging patients to immediate aneurysm repair, transfer or palliative care. Methods: Data from patients in the IMPROVE (Immediate Management of the Patient With Ruptured Aneurysm: Open Versus Endovascular Repair) randomized trial were used to develop the risk score. Variables considered included age, sex, haemodynamic markers and aortic morphology. Backwards selection was used to identify relevant predictors. Predictive performance was assessed using calibration plots and the C-statistic. Validation of the newly developed and other previously published scores was conducted in four external populations. The net benefit of treating patients based on a risk threshold compared with treating none was quantified. Results: Data from 536 patients in the IMPROVE trial were included. The final variables retained were age, sex, haemoglobin level, serum creatinine level, systolic BP, aortic neck length and angle, and acute myocardial ischaemia. The discrimination of the score for 48-h mortality in the IMPROVE data was reasonable (C-statistic 0·710, 95 per cent c.i. 0·659 to 0·760), but varied in external populations (from 0·652 to 0·761). The new score outperformed other published risk scores in some, but not all, populations. An 8 (95 per cent c.i. 5 to 11) per cent improvement in the C-statistic was estimated compared with using age alone. Conclusion: The assessed risk scores did not have sufficient accuracy to enable potentially life-saving decisions to be made regarding intervention. Focus should therefore shift to offering repair to more patients and reducing non-intervention rates, while respecting the wishes of the patient and family