Momentum-resolved charge excitations in high-Tc cuprates studied by resonant inelastic x-ray scattering

We report a Cu K-edge resonant inelastic x-ray scattering (RIXS) study of high-Tc cuprates. Momentum-resolved charge excitations in the CuO2 plane are examined from parent Mott insulators to carrier-doped superconductors. The Mott gap excitation in undoped insulators is found to commonly show a larger dispersion along the [pi,pi] direction than the [pi,0] direction. On the other hand, the resonance condition displays material dependence. Upon hole doping, the dispersion of the Mott gap excitation becomes weaker and an intraband excitation appears as a continuum intensity below the gap at the same time. In the case of electron doping, the Mott gap excitation is prominent at the zone center and a dispersive intraband excitation is observed at finite momentum transfer

Prise en Charge des Appendicites Compliquées de l’Adulte à l’Hôpital National de Niamey

            Objectif : rapporter les résultats de la prise en charge des appendicites compliquées chez l’adulte à l’Hôpital National de Niamey (HNN).   Résultats : Pendant  la période de l’étude 8127 urgences abdominales avaient été enregistrées dont 1837 d’origine appendiculaire, parmi lesquelles  512 étaient des appendicites compliquées, soit 6,3 % des urgences abdominales et 27,9 % de toutes les pathologies appendiculaires. Il s’agissait de 337 (65,8 %) hommes et 175 (34,2 %) femmes ; soit un sex ratio de 1,9. L’âge médian des patients était de 30 ans, avec 75% de patients d’âge inférieur ou égal à 40 ans (3è quartile=40 ans) ainsi que des extrêmes allant de 16 ans et de 90 ans. Le délai d’admission  médian était   de 5 jours (Q1=3, Q3=7) avec un taux de 49,6 %(n=254) de patients  admis après 48 heures. Les appendicites compliquées retrouvées étaient la péritonite appendiculaire dans 74 % des cas (n=379) suivie de l’abcès appendiculaire dans 21,5 % des cas (n=110) et du plastron appendiculaire dans 4,5%(n=23) des cas. La chirurgie était pratiquée dans  95,5% des cas (n = 489). La voie d’abord utilisée était la laparotomie médiane sus et sous ombilicale dans 81 % des cas (n=415) et l’incision de Mac Burney dans 14,5%(n=74). L’appendice était gangréné dans 95,7 % des cas (n=490) à l’exploration. Le geste  réalisé était l’appendicectomie dans 89,9 % des cas (n= 460).  L’étude rapporte que 93,3%(n=478) des patients avaient un séjour total (pré et postopératoire)  ≤ 10 jours avec des extrêmes allant d’un jour et de 76 jours d’hospitalisation. La morbimortalité globale était de 11,5 %(n= 59). La suppuration pariétale était retrouvée dans 10 % des cas (n= 51). La  mortalité  était de 1,5 % (n = 8) tous enregistrés parmi les cas de péritonite appendiculaire. Le séjour hospitalier total (initial et post-appendicectomie) variait de un(1) jour à 76 jours ; 93,36%(n=478) avaient un séjour ≤ 10 jours. La médiane de séjour hospitalier était de 14,5 jours ; 75% des patients passaient moins de 28 jours en hospitalisation (3è quartile=28 jours).  Conclusion : Les appendicites compliquées sont fréquentes à l’HNN avec une morbimortalité importante. Le retard de la prise en charge constitue un facteur influencant la survenue des complications.                 Objective : To report the results of the management of complicated appendicitis in adults at the National Hospital of Niamey (HNN). Patients and method: This was a 10-year retrospective, descriptive, and analytical study including all patients over 15 years of age who had been managed for complicated appendicitis at HNN. Results: During the study period, 8127 abdominal emergencies were recorded, of which 1837 were of appendicular origin, of which 512 were complicated appendicitis, i.e. 6.3% of abdominal emergencies and 27.9% of all appendicular pathologies. These were 337 (65.8%) men and 175 (34.2%) women; i.e. a sex ratio of 1.9. The median age of patients was 30 years, with 75% of patients less than or equal to 40 years of age (3rd quartile=40 years) as well as extremes ranging from 16 years to 90 years. The median time to admission was 5 days (Q1=3, Q3=7) with a rate of 49.6% (n=254) of patients admitted after 48 hours. Complicated appendicitis was appendicular peritonitis in 74% of cases (n=379) followed by appendicular abscess in 21.5% of cases (n=110) and appendicular plastron in 4.5% (n=23) of cases. Surgery was performed in 95.5% of cases (n = 489). The approach used was median laparotomy above and subumbilical laparotomy in 81% of cases (n=415) and Mac Burney incision in 14.5% (n=74). The appendix was gangrenous in 95.7% of cases (n=490) on exploration. Appendectomy was performed in 89.9% of cases (n=460).  The study reports that 93.3% (n=478) of patients had a total stay (pre and postoperative) ≤ 10 days with extremes ranging from one day and 76 days of hospitalization. Overall morbidity mortality was 11.5% (n=59). Parietal suppuration was found in 10% of cases (n=51). Mortality was 1.5% (n=8), all recorded among cases of appendicular peritonitis. Conclusion: Complicated appendicitis is common at NNH with significant morbidity mortality. Delayed treatment is a factor influencing the occurrence of complications.&nbsp

Prise en Charge des Appendicites Compliquées de l’Adulte à l’Hôpital National de Niamey

Objectif : rapporter les résultats de la prise en charge des appendicites compliquées chez l’adulte à l’Hôpital National de Niamey (HNN). Patients et méthode : Il s’agissait d’une étude rétrospective, descriptive et analytique sur 10 ans incluant tous les patients âgés de plus de 15 ans qui avaient été pris en charge pour appendicites compliquées à l’HNN. Résultats : durant la période de l’étude 8127 urgences abdominales avaient été enregistrées dont 1837 d’origine appendiculaire, parmi elles 512 étaient des appendicites compliquées (AC), soit 6, 30% des urgences abdominales et 27, 87% des appendicites. Il s’agissait de 337 (65, 82%) hommes et 175 (34, 18 %) femmes ; soit un sex ratio de 1, 92. L’âge moyen des patients était de 32, 83 [±14, 50] ans avec des extrêmes de 16 ans et de 90 ans. Le délai moyen d’admission était de 6 [±3, 82] jours avec des extrêmes de 1 et de 14 jours. Les AC retrouvées étaient la péritonite appendiculaire dans 74, 02% des cas (n =379) suivie de l’abcès appendiculaire dans 21, 48% des cas (n=110) et du plastron appendiculaire dans 4, 5%(n=23) des cas. Le traitement avait été opératoire dans 95, 5% des cas (n = 489). La voie d’abord utilisée était la laparotomie médiane dans 81, 05% des cas (n=415) et l’appendice était gangréné dans 95, 70% des cas (n=490) à l’exploration. Le geste le plus réalisé était l’appendicectomie dans 89, 84% des cas (n= 460). La durée moyenne d’hospitalisation était de 9 [±10, 61] jours avec des extrêmes d’un et de 76 jours. La morbimortalité globale était de 11, 52% avec 9, 96% de suppuration pariétale (n=51) et une mortalité de 1, 56% (n = 8) tous enregistrés parmi les cas de péritonite appendiculaire. Il existe une corrélation significative entre le type de complications et le délai d’admission (P=0, 00001).  Conclusion : Les appendicites compliquées sont fréquentes à l’HNN avec une morbimortalité importante. Le retard de la prise en charge constitue un facteur influencant la survenue des complications.   Objective: to report the results of the management of complicated appendicitis in adults at the National Hospital of Niamey (NHN). Patients and method: This was a retrospective, descriptive and analytical study over 10 years including all patients over the age of 15 who had been treated for complicated appendicitis at NHN. Results: during the study period, 8127 abdominal emergencies were recorded, of which 1837 were of appendicular origin, among them 512 were complicated appendicitis, i.e. 6.30% of abdominal emergencies and 27.87% of appendicitis. These were 337 (65.82%) men and 175 (34.18%) women; i.e. a sex ratio of 1.92. The mean age of the patients was 32.83 [±14.50] years with extremes of 16 and 90 years. The average admission time was 6 [±3.82] days with extremes of 1 and 14 days. Complicated appendicitis found was appendicular peritonitis in 74.02% of cases (n=379) followed by appendicular abscess in 21.48% of cases (n=110) and appendicular plastron in 4.5% (n= 23) cases. The treatment was operative in 95.5% of cases (n = 489). The approach used was the midline laparotomy in 81.05% of cases (n=415) and the appendix was gangrenous in 95.70% of cases (n=490) on exploration. The most performed procedure was appendectomy in 89.84% of cases (n = 460). The average duration of hospitalization was 9 [±10.61] days with extremes of one and 76 days. The overall morbidity and mortality was 11.52% with 9.96% parietal suppuration (n=51) and a mortality of 1.56% (n=8) all recorded among the cases of appendicular peritonitis. There is a significant correlation between the type of complications and the admission time (P=0.00001). Conclusion: Complicated appendicitis is common in NHN with significant morbidity and mortality. Delay in treatment is a factor influencing the occurrence of complications

Prise en Charge des Appendicites Compliquées de l’Adulte à l’Hôpital National de Niamey

Objectif : rapporter les résultats de la prise en charge des appendicites compliquées chez l’adulte à l’Hôpital National de Niamey (HNN). Patients et méthode : Il s’agissait d’une étude rétrospective, descriptive et analytique sur 10 ans incluant tous les patients âgés de plus de 15 ans qui avaient été pris en charge pour appendicites compliquées à l’HNN. Résultats : durant la période de l’étude 8127 urgences abdominales avaient été enregistrées dont 1837 d’origine appendiculaire, parmi elles 512 étaient des appendicites compliquées (AC), soit 6, 30% des urgences abdominales et 27, 87% des appendicites. Il s’agissait de 337 (65, 82%) hommes et 175 (34, 18 %) femmes ; soit un sex ratio de 1, 92. L’âge moyen des patients était de 32, 83 [±14, 50] ans avec des extrêmes de 16 ans et de 90 ans. Le délai moyen d’admission était de 6 [±3, 82] jours avec des extrêmes de 1 et de 14 jours. Les AC retrouvées étaient la péritonite appendiculaire dans 74, 02% des cas (n =379) suivie de l’abcès appendiculaire dans 21, 48% des cas (n=110) et du plastron appendiculaire dans 4, 5%(n=23) des cas. Le traitement avait été opératoire dans 95, 5% des cas (n = 489). La voie d’abord utilisée était la laparotomie médiane dans 81, 05% des cas (n=415) et l’appendice était gangréné dans 95, 70% des cas (n=490) à l’exploration. Le geste le plus réalisé était l’appendicectomie dans 89, 84% des cas (n= 460). La durée moyenne d’hospitalisation était de 9 [±10, 61] jours avec des extrêmes d’un et de 76 jours. La morbimortalité globale était de 11, 52% avec 9, 96% de suppuration pariétale (n=51) et une mortalité de 1, 56% (n = 8) tous enregistrés parmi les cas de péritonite appendiculaire. Il existe une corrélation significative entre le type de complications et le délai d’admission (P=0, 00001).  Conclusion : Les appendicites compliquées sont fréquentes à l’HNN avec une morbimortalité importante. Le retard de la prise en charge constitue un facteur influencant la survenue des complications.   Objective: to report the results of the management of complicated appendicitis in adults at the National Hospital of Niamey (NHN). Patients and method: This was a retrospective, descriptive and analytical study over 10 years including all patients over the age of 15 who had been treated for complicated appendicitis at NHN. Results: during the study period, 8127 abdominal emergencies were recorded, of which 1837 were of appendicular origin, among them 512 were complicated appendicitis, i.e. 6.30% of abdominal emergencies and 27.87% of appendicitis. These were 337 (65.82%) men and 175 (34.18%) women; i.e. a sex ratio of 1.92. The mean age of the patients was 32.83 [±14.50] years with extremes of 16 and 90 years. The average admission time was 6 [±3.82] days with extremes of 1 and 14 days. Complicated appendicitis found was appendicular peritonitis in 74.02% of cases (n=379) followed by appendicular abscess in 21.48% of cases (n=110) and appendicular plastron in 4.5% (n= 23) cases. The treatment was operative in 95.5% of cases (n = 489). The approach used was the midline laparotomy in 81.05% of cases (n=415) and the appendix was gangrenous in 95.70% of cases (n=490) on exploration. The most performed procedure was appendectomy in 89.84% of cases (n = 460). The average duration of hospitalization was 9 [±10.61] days with extremes of one and 76 days. The overall morbidity and mortality was 11.52% with 9.96% parietal suppuration (n=51) and a mortality of 1.56% (n=8) all recorded among the cases of appendicular peritonitis. There is a significant correlation between the type of complications and the admission time (P=0.00001). Conclusion: Complicated appendicitis is common in NHN with significant morbidity and mortality. Delay in treatment is a factor influencing the occurrence of complications

Les Occlusions Intestinales Par Nœud Ileo-Sigmoïdien : Aspects Diagnostiques, Thérapeutiques Et Pronostiques

Introduction: Ileosigmoid knot (ISK), also known as compound volvulus or double volvulus, is a rare disease and affects mostly male subjects in their fourth decade. Delayed diagnosis often leads to complications with a high incidence of digestive necrosis. Materials and methods: This was a 10-year retrospective, descriptive and analytical study from 1 January 2007 to 31 December 2016, which covered all patients operated emergently for ISK in the surgical and surgical specialty departments at the Niamey National Hospital (NNH). Results: The series involved 8 cases of ISK, representing 0.82% of intestinal obstructions. There were 7 men and 1 woman. The average age of patients was 44.33 years with extremes ranging from 25 to 60 years. The main clinical signs were: abdominal pain (100%), inability to pass gas and stool (100%), vomiting (87.5%) and abdominal meteorism (87.5%). Four patients (50%) had a clear obstructive syndrome and the other 4 patients (50%) had associated signs of peritoneal irritation. Paraclinical diagnosis was difficult because of atypical clinico-radiological signs, but in all cases an abdominal x-ray was performed and showed a double loop of dilated sigmoid shadow in 87.5% of the cases. Laparotomy was the first approach used in all patients and led to a 50% necrosis rate. Hartmann’s colectomy and ideal colectomy were used in identical proportions, with 50% each. Ideal colectomy was characterized by a morbidity rate of 50% and a mortality rate of 25% compared to 0% for Hartmann’s procedure. The overall morbidity was 25% and the overall mortality was 12.5%. The average hospital stay was 65.87 days (range 17 to 128 days). The average time before reestablishment of digestive continuity was 50.37 days (range 31-128 days). Conclusion: Ileosigmoid knot is a rare condition at Niamey national hospital where the diagnostic approach is similar to that of occlusions in general, but remains difficult due to its uncommonness and atypical clinico-radiological signs. Necrosis rates and postoperative complications remain high

Cholécystectomies Laparoscopiques Pour Cholécystite Aigue Lithiasique Versus Lithiase Vésiculaire Symptomatique

Introduction: The aim of this work was to highlight the therapeutic and prognostic difficulties between a laparoscopic cholecystectomy for acute gallstone cholecystitis (CAL) and uncomplicated symptomatic vesicular lithiasis (LVS) as well as the reasons for conversion to laparotomy. Patients and Methods: This was a prospective comparative and analytic study over 18 months. Patients admitted and operated for CAL or LVS in the A Surgery Department of the National Hospital of Niamey (HNN) were included. Results: The study involved 61 patients divided into two groups. Group 1 (30 patients) corresponding to patients operated for CAL, group 2 (31 patients) corresponding to patients operated for LVS. Laparoscopic cholecystectomy accounted for 61% of all cholecystectomies performed and 1.45% of surgical activity during the same period. The average age in group 1 was 43.7 years with extremes of 14 and 61 years. In group 2, the average age was 38.9 years with extremes ranging from 12 to 55 years. Women were predominantly represented with 63.3% and 96.7% respectively for groups 1 and 2. Patients were overweight in 9 cases for group 1 (30% of cases) and 12 cases in group 2 (38%), 7% of cases). Hepatic colic was the main sign of appeal in all patients in both groups. In group 1; 26 out of 30 cases or 86.7% of cases had leukocytosis, whereas in group 2, leukocytosis was normal in 30 cases, ie 96.8% of cases. Accessibility of the vesicle was difficult in 73.3% of cases in group 1 against 22.6% of cases in group 2. The vesicle was distended and necrotic in groups 1 in 76.7% and 10 respectively. % of cases. On the other hand, in 25.8% of cases, the vesicle was distended and without any necrosis in group 2. The rate of conversion to laparotomy was 6.55% (4 cases) and exclusively concerned group 1. Operative follow-up immediate outcomes were simple in 98.34% of cases. The complications involved 2 patients in group 1 (1.66% of the total), including parietal suppuration and biliary leakage. Mean operative time was 68.7 min in group 1 versus 41.6 min in group 2. Mean duration of hospitalization was 4.3 days with extremes between 2 and 10 days in group 1 versus1,7 days with extremes ranging from 1 to 7 days in group 2. Mortality was zero. Conclusion: In recent years, laparoscopic surgery has made remarkable progress in Niger. Laparoscopic cholecystectomy seems to be more difficult to perform with significant morbidity in the case of CAL than LVS. The risk of per and postoperative complications can be estimated from the clinical data (acute cholecystitis or symptomatic vesicular lithiasis) and the surgeon's experience. In a cholecystectomy that lasts more than 2 hours, the cumulative risk of complications is highe