EANM guideline for ventilation/perfusion single-photon emission computed tomography (SPECT) for diagnosis of pulmonary embolism and beyond

These guidelines update the previous EANM 2009 guidelines on the diagnosis of pulmonary embolism (PE). Relevant new aspects are related to (a) quantification of PE and other ventilation/perfusion defects; (b) follow-up of patients with PE; (c) chronic PE; and (d) description of additional pulmonary physiological changes leading to diagnoses of left ventricular heart failure (HF), chronic obstructive pulmonary disease (COPD) and pneumonia. The diagnosis of PE should be reported when a mismatch of one segment or two subsegments is found. For ventilation, Technegas or krypton gas is preferred over diethylene triamine pentaacetic acid (DTPA) in patients with COPD. Tomographic imaging with V/P-SPECT has higher sensitivity and specificity for PE compared with planar imaging. Absence of contraindications makes V/P-SPECT an essential method for the diagnosis of PE. When V/P-SPECT is combined with a low-dose CT, the specificity of the test can be further improved, especially in patients with other lung diseases. Pitfalls in V/P-SPECT interpretation are discussed. In conclusion, V/P-SPECT is strongly recommended as it accurately establishes the diagnosis of PE even in the presence of diseases like COPD, HF and pneumonia and has no contraindications.Peer reviewe

ISOLDE Workshop and Users meeting 2014 "50th Anniversary Edition"

On December 17, 1964 the CERN DG, Victor Weisskopf, sent a letter to the ISOLDE Collaboration giving green light to perform experiments at CERN. An underground hall was built close to the SC, which accelerated protons to 600MeV energy. The first experiment at ISOLDE was preformed on September 17, 1967. In my talk I shall cover the first years of experiments at ISOLDE at CERN, the SC Improvement Programme and the building of ISOLDE 2

Nucleus: a trip into the heart of the matter

At the core of the atom, enshrouded by electrons, lies the nucleus. The discovery of the nucleus transformed the past century and will revolutionize this one. Nuclear physics is an exciting, cutting-edge science that has helped to save lives through innovative medical technologies, such as the MRI. In nuclear astrophysics, state-of-the-art theoretical and computer models help to explain the powerful stellar explosions known as supernovas, to account for how stars shine, and to describe how the chemical elements in the universe were formed. This illustrated volume describes the evolution of our understanding of this phenomenon. The authors, who include expert nuclear physicists and acclaimed science journalists, tell the story of the nucleus from the early experimental work of the quiet New Zealander Lord Rutherford to the huge atom-smashing machines of today and beyond. They discuss the protons and neutrons which make up the nucleus, why some nuclei crumble and are radioactive, and how scientists came up with the "standard model", which shows the nucleus composed of quarks held together by gluons. The work also tells the tale of the people behind the struggle to understand this fascinating subject more fully, and of how a vibrant research community uses the power of the nucleus to probe unanswered scientific questions while others seek to harness the nucleus as a tool of 21st-century medicine

Effect of inspired oxygen fraction on alveolar derecruitment in acute respiratory distress syndrome

Objective: High fractions of inspired oxygen (FIO2) used in acute lung injury (ALI) may promote resorption atelectasis. The impact of derecruitment related to high FIO2 in ALI is debated. We evaluated derecruitment with 100% vs. 60% FIO2 at two levels of positive end-expiratory pressure (PEEP). Patients: Fourteen consecutive patients with ALI were studied. Interventions: Recruited volume at two PEEP levels was computed from two pressure-volume curves, recorded from PEEP and from zero end-expiratory pressure, using the sinusoidal flow modulation method. PEEP-induced recruitment was measured during prolonged expiration as the difference between the two curves at a given pressure. PaO2/FIO2 was also measured. PEEP was 5 +/- 1 or 14 +/- 3 cmH(2)O and FIO2 was 60% or 100%, yielding four combinations. We looked for differences between the beginning and end of a 30-min period with each combination. Measurement and results: With low PEEP and 100% FIO2, recruited volume decreased significantly from 68 +/- 53 to 39 +/- 43 ml and PaO2/FIO2 from 196 +/- 104 to 153 +/- 83 mmHg. With the three other combinations (low PEEP and 60% FIO2 or high PEEP and 60% or 100% FIO2) none of the parameters decreased significantly. Conclusion: In mechanically ventilated patients with ALI the breathing of pure oxygen leads to derecruitment, which is prevented by high PEEP

Elastic scattering of p-halo 8B beam close to the Coulomb barrier

CERN Europe/Zurich, 5-6 diciembre 2019Peer reviewe