Correlated two-pion exchange and large-N(C) behavior of nuclear forces

The effect of correlated scalar-isoscalar two-pion exchange (CrTPE) modes is considered in connection with central and spin-orbit parts of the NN force. The two-pion correlation function is coupled directly to the scalar form factor of the nucleon which we calculate in the large-N(C) limit where the nucleon can be described as a soliton of an effective chiral theory. The results for the central NN force show a strong repulsive core at short internucleon distances supplemented by a moderate attraction beyond 1 fm. The long-range tail of the central NN potential is driven by the the pion-nucleon sigma term and consistent with the effective $\sigma$ meson exchange. The spin-orbit part of the NN potential is repulsive. The large-N(C) scaling behavior of the scalar-isoscalar NN interaction is addressed. We show that the spin-orbit part is O(1/N^2(C)) in strength relative to the central force resulting in the ratio $\simeq 1/9$ suggested by the 1/N(C) expansion for N(C)=3. The latter is in agreement with our numerical analysis and with the Kaplan-Manohar large-N(C) power counting. Unitarization of the $\pi \pi$ scattering amplitude plays here an important role and improves the tree level results. Analytical representations of the CrTPE NN potential in terms of elementary functions are derived and their chiral content is discussed.Comment: 29 pages, 7 figure

Post-contrast acute kidney injury \u2013 Part 1: Definition, clinical features, incidence, role of contrast medium and risk factors: Recommendations for updated ESUR Contrast Medium Safety Committee guidelines

Purpose: The Contrast Media Safety Committee (CMSC) of the European Society of Urogenital Radiology (ESUR) has updated its 2011 guidelines on the prevention of post-contrast acute kidney injury (PC-AKI). The results of the literature review and the recommendations based on it, which were used to prepare the new guidelines, are presented in two papers. Areas covered in part 1: Topics reviewed include the terminology used, the best way to measure eGFR, the definition of PC-AKI, and the risk factors for PC-AKI, including whether the risk with intravenous and intra-arterial contrast medium differs. Key Points: \u2022 PC-AKI is the preferred term for renal function deterioration after contrast medium. \u2022 PC-AKI has many possible causes. \u2022 The risk of AKI caused by intravascular contrast medium has been overstated. \u2022 Important patient risk factors for PC-AKI are CKD and dehydration

Post-contrast acute kidney injury. Part 2: risk stratification, role of hydration and other prophylactic measures, patients taking metformin and chronic dialysis patients: Recommendations for updated ESUR Contrast Medium Safety Committee guidelines

Objectives: The Contrast Media Safety Committee (CMSC) of the European Society of Urogenital Radiology (ESUR) has updated its 2011 guidelines on the prevention of post-contrast acute kidney injury (PC-AKI). The results of the literature review and the recommendations based on it, which were used to prepare the new guidelines, are presented in two papers. Areas covered in part 2: Topics reviewed include stratification of PC-AKI risk, the need to withdraw nephrotoxic medication, PC-AKI prophylaxis with hydration or drugs, the use of metformin in diabetic patients receiving contrast medium and the need to alter dialysis schedules in patients receiving contrast medium. Key points: \u2022 In CKD, hydration reduces the PC-AKI risk \u2022 Intravenous normal saline and intravenous sodium bicarbonate provide equally effective prophylaxis \u2022 No drugs have been consistently shown to reduce the risk of PC-AKI \u2022 Stop metformin from the time of contrast medium administration if eGFR < 30 ml/min/1.73 m2 \u2022 Dialysis schedules need not change when intravascular contrast medium is given

Waiting times between examinations with intravascularly administered contrast media: a review of contrast media pharmacokinetics and updated ESUR Contrast Media Safety Committee guidelines

The pharmacokinetics of contrast media (CM) will determine how long safe waiting intervals between successive CT or MRI examinations should be. The Contrast Media Safety Committee has reviewed the data on pharmacokinetics of contrast media to suggest safe waiting intervals between successive contrast-enhanced imaging studies in relation to the renal function of the patient

Analytical interference of intravascular contrast agents with clinical laboratory tests: a joint guideline by the ESUR Contrast Media Safety Committee and the Preanalytical Phase Working Group of the EFLM Science Committee

The Contrast Media Safety Committee of the European Society of Urogenital Radiology has, together with the Preanalytical Phase Working Group of the EFLM Science Committee, reviewed the literature and updated its recommendations to increase awareness and provide insight into these interferences

Electrical-hydraulic relationships observed for unconsolidated sediments in the presence of a cobble framework

Mechanistic models now exist to predict hydraulic conductivity (K) from the spectral induced polarization (SIP) response of granular media. We examined the predictions of such a model on unconsolidated coarse fluvial sediments and compared them to those obtained with a modified Kozeny Carman (KC) model. Samples were retrieved from the Boise Hydrogeophysical Research Site (BHRS), located on a gravel bar adjacent to the Boise River, Idaho. A sample holder (0.102 m diameter and 0.12 m in length) was designed to include the cobble framework in reconstituted samples representing the primary stratigraphic units defined based on porosity variation at this site. SIP (0.001-1000 Hz) and K (from Darcy tests) measurements were recorded for twelve samples, with SIP measurements made as a function of pore fluid conductivity (3-300 mS/m); grain, grain size distribution (GSD) and total porosity. K prediction with the KC model was improved after discounting of the cobble framework and multiplying by the tortuosity resulting from matrix “capillaries” around the cobbles, resulting in estimates within 0.5 orders of magnitude of the measurements. K prediction with a mechanistic SIP model based on Stern layer polarization (SLP model) that requires an estimate of the GSD alsoalso required discounting for the cobble framework to obtain estimates within 0.5 orders of magnitude of the measurements. Similarly, the SLP model over predicts the measured imaginary conductivity (σ") unless the cobble framework is discounted, which then results in estimates of σ” within 0.1 orders of magnitude of the measurements. This can be explained by the fact that the cobbles polarize at frequencies well below the minimum measurement frequency (0.001 Hz). The SLP model for K prediction parameterized in terms of the formation factor and imaginary conductivity performed well for the ten samples with a cobble framework without modification as the imaginary conductivity directly senses the matrix grain size characteristics, whereas the formation factor captures the porosity reduction and tortuosity resulting from the presence of the cobble framework (capillary tortuosity). Our findings suggest that the estimation of contrasts in hydraulic conductivityK in coarse sediments may be achievable through measurements of electrical properties after appropriate consideration of the cobble fractio

Iodine-based contrast media, multiple myeloma and monoclonal gammopathies: literature review and ESUR Contrast Media Safety Committee guidelines

Imaging- and therapeutic targets in neoplastic and musculoskeletal inflammatory diseas

Iodine-based contrast media, multiple myeloma and monoclonal gammopathies: literature review and ESUR Contrast Media Safety Committee guidelines

Objectives Many radiologists and clinicians still consider multiple myeloma (MM) and monoclonal gammopathies (MG) a contraindication for using iodine-based contrast media. The ESUR Contrast Media Safety Committee performed a systematic review of the incidence of post-contrast acute kidney injury (PC-AKI) in these patients. Methods A systematic search in Medline and Scopus databases was performed for renal function deterioration studies in patients with MM or MG following administration of iodine-based contrast media. Data collection and analysis were performed according to the PRISMA statement 2009. Eligibility criteria and methods of analysis were specified in advance. Cohort and case-control studies reporting changes in renal function were included. Results Thirteen studies were selected that reported 824 iodine-based contrast medium administrations in 642 patients withMMorMG, in which 12 unconfounded cases of PC-AKIwere found (1.6 %). The majority of patients had intravenous urography with high osmolality ionic contrast media after preparatory dehydration and purgation. Conclusions MM and MG alone are not risk factors for PCAKI. However, the risk of PC-AKI may become significant in dehydrated patients with impaired renal function. Hypercalcaemia may increase the risk of kidney damage, and should be corrected before contrast medium administration. Assessment for Bence-Jones proteinuria is not necessary. Key Points \u2022 Monoclonal gammopathies including multiple myeloma are a large spectrum of disorders. \u2022 In monoclonal gammopathy with normal renal function, PCAKI risk is not increased. \u2022 Renal function is often reduced in myeloma, increasing the risk of PC-AKI. \u2022 Correction of hypercalcaemia is necessary in myeloma before iodine-based contrast medium administration. \u2022 Bence-Jones proteinuria assessment in myeloma is unnecessary before iodine-based contrast medium administration