192 research outputs found
Emergency Severity Index: Deutsche Übersetzung eines validen Triageinstruments
Zusammenfassung: Der Emergency Severity Index (ESI) ist ein von amerikanischen Notfallmedizinern und -pflegenden entwickeltes fünfstufiges Triageinstrument, das die Gütekriterien der Validität und Reliabilität erfüllt. Beim ESI handelt es sich um einen Algorithmus mit vier Entscheidungspunkten. Neben der Akutheit des Leitsymptoms wird bei Patienten, die keine sofortige oder zeitnahe Behandlung benötigen, der vermutliche Ressourcenbedarf abgeschätzt, um zu einer Triageentscheidung zu kommen. Das Instrument wurde nun mit einer standardisierten Methode übersetzt. Pflegenden und Ärzten auf Notfallstationen, die Triageentscheidungen fällen, liegt nun erstmals eine akkurate und autorisierte deutsche Version des ESI vo
Molecular and clinical determinants of drug-induced long QT syndrome: an iatrogenic channelopathy.
More than 70 drugs present on the Swiss market can cause drug-induced long QT syndrome (LQTS), which is associated with torsades de pointes (TdP) arrhythmias, potentially leading to sudden cardiac death. Basic and clinical investigations performed during the last decade have helped a better understanding of the mechanisms and risk factors of this serious public health problem. In their vast majority, QT interval prolonging drugs block the human ERG (hERG) channel involved in the repolarisation phase of the cardiac action potential, and thus lengthen the QT interval. Beside the well-known QT interval prolonging action of class IA, IC and III anti-arrhythmic drugs, many antibiotics, neurotropic, antifungal, and antimalarial drugs are also able to cause drug-induced LQTS. Reviewing the literature indicates that the risk of QT interval prolongation and TdP is increased in females, in patients with organic heart diseases and hypokalaemia. Furthermore in a few cases, genetic factors have also been reported. However thus far, no genetic test is available to detect at-risk patients, and in consequence, drug prescribers are still relying only on the clinical history and findings to perform an evaluation of the risk. Treatment of drug-induced LQTS and TdP includes identifying and withdrawing the culprit drug(s), infusing magnesium and, in resistant cases acceleration of the heart rate. In this review article we provide a list of QT interval prolonging drugs adapted to the pharmaceuticals found on the Swiss market that can be used as a check-list for drug prescribers and at-risk patients
Brugada syndrome and fever: genetic and molecular characterization of patients carrying SCN5A mutations.
OBJECTIVE: Brugada syndrome (BrS) is characterized by ventricular tachyarrhythmias leading to sudden cardiac death and is caused, in part, by mutations in the SCN5A gene encoding the sodium channel Na(v)1.5. Fever can trigger or exacerbate the clinical manifestations of BrS. The aim of this work was to characterize the genetic and molecular determinants of fever-dependent BrS. METHODS: Four male patients with typical BrS ST-segment elevation in V1-V3 or ventricular arrhythmias during fever were screened for mutations in the SCN5A gene. Wild-type (WT) and mutant Na(v)1.5 channels were expressed in HEK293 cells. The sodium currents (I(Na)) were analysed using the whole-cell patch clamp technique at various temperatures. Protein expression of WT and mutant channels was studied by Western blot experiments. RESULTS: Two mutations in SCN5A, L325R and R535X, were identified. Expression of the two mutant Na(v)1.5 channels in HEK293 cells revealed in each case a severe loss-of-function. Upon the increase of temperature up to 42 degrees C, we observed a pronounced acceleration of Na(v)1.5 activation and fast inactivation kinetics. Cardiac action potential modelling experiments suggest that in patients with reduced I(Na), fever could prematurely shorten the action potential by virtue of its effect on WT channels. Further experiments revealed that L325R channels are likely misfolded, since their function could be partially rescued by mexiletine or curcumin. In co-expression experiments, L325R channels interfered with the proper function of WT channels, suggesting that a dominant negative phenomenon may underlie BrS triggered by fever. CONCLUSIONS: The genetic background of BrS patients sensitive to fever is heterogeneous. Our experimental data suggest that the clinical manifestations of fever-exacerbated BrS may not be mutation specific
NMR and NQR Fluctuation Effects in Layered Superconductors
We study the effect of thermal fluctuations of the s-wave order parameter of
a quasi two dimensional superconductor on the nuclear spin relaxation rate near
the transition temperature Tc. We consider both the effects of the amplitude
fluctuations and the Berezinskii-Kosterlitz-Thouless (BKT) phase fluctuations
in weakly coupled layered superconductors. In the treatment of the amplitude
fluctuations we employ the Gaussian approximation and evaluate the longitudinal
relaxation rate 1/T1 for a clean s-wave superconductor, with and without pair
breaking effects, using the static pair fluctuation propagator D. The increase
in 1/T1 due to pair breaking in D is overcompensated by the decrease arising
from the single particle Green's functions. The result is a strong effect on
1/T1 for even a small amount of pair breaking. The phase fluctuations are
described in terms of dynamical BKT excitations in the form of pancake
vortex-antivortex (VA) pairs. We calculate the effect of the magnetic field
fluctuations caused by the translational motion of VA excitations on 1/T1 and
on the transverse relaxation rate 1/T2 on both sides of the BKT transitation
temperature T(BKT)<Tc. The results for the NQR relaxation rates depend strongly
on the diffusion constant that governs the motion of free and bound vortices as
well as the annihilation of VA pairs. We discuss the relaxation rates for real
multilayer systems where the diffusion constant can be small and thus increase
the lifetime of a VA pair, leading to an enhancement of the rates. We also
discuss in some detail the experimental feasibility of observing the effects of
amplitude fluctuations in layered s-wave superconductors such as the
dichalcogenides and the effects of phase fluctuations in s- or d-wave
superconductors such as the layered cuprates.Comment: 38 pages, 12 figure
Differential cross section and recoil polarization measurements for the gamma p to K+ Lambda reaction using CLAS at Jefferson Lab
We present measurements of the differential cross section and Lambda recoil
polarization for the gamma p to K+ Lambda reaction made using the CLAS detector
at Jefferson Lab. These measurements cover the center-of-mass energy range from
1.62 to 2.84 GeV and a wide range of center-of-mass K+ production angles.
Independent analyses were performed using the K+ p pi- and K+ p (missing pi -)
final-state topologies; results from these analyses were found to exhibit good
agreement. These differential cross section measurements show excellent
agreement with previous CLAS and LEPS results and offer increased precision and
a 300 MeV increase in energy coverage. The recoil polarization data agree well
with previous results and offer a large increase in precision and a 500 MeV
extension in energy range. The increased center-of-mass energy range that these
data represent will allow for independent study of non-resonant K+ Lambda
photoproduction mechanisms at all production angles.Comment: 22 pages, 16 figure
Measurement of the nuclear multiplicity ratio for hadronization at CLAS
The influence of cold nuclear matter on lepto-production of hadrons in
semi-inclusive deep inelastic scattering is measured using the CLAS detector in
Hall B at Jefferson Lab and a 5.014 GeV electron beam. We report the
multiplicity ratios for targets of C, Fe, and Pb relative to deuterium as a
function of the fractional virtual photon energy transferred to the
and the transverse momentum squared of the . We find that the
multiplicity ratios for are reduced in the nuclear medium at high
and low , with a trend for the transverse momentum to be
broadened in the nucleus for large .Comment: Submitted to Phys. Lett.
Demonstration of a novel technique to measure two-photon exchange effects in elastic scattering
The discrepancy between proton electromagnetic form factors extracted using
unpolarized and polarized scattering data is believed to be a consequence of
two-photon exchange (TPE) effects. However, the calculations of TPE corrections
have significant model dependence, and there is limited direct experimental
evidence for such corrections. We present the results of a new experimental
technique for making direct comparisons, which has the potential to
make precise measurements over a broad range in and scattering angles. We
use the Jefferson Lab electron beam and the Hall B photon tagger to generate a
clean but untagged photon beam. The photon beam impinges on a converter foil to
generate a mixed beam of electrons, positrons, and photons. A chicane is used
to separate and recombine the electron and positron beams while the photon beam
is stopped by a photon blocker. This provides a combined electron and positron
beam, with energies from 0.5 to 3.2 GeV, which impinges on a liquid hydrogen
target. The large acceptance CLAS detector is used to identify and reconstruct
elastic scattering events, determining both the initial lepton energy and the
sign of the scattered lepton. The data were collected in two days with a
primary electron beam energy of only 3.3 GeV, limiting the data from this run
to smaller values of and scattering angle. Nonetheless, this measurement
yields a data sample for with statistics comparable to those of the
best previous measurements. We have shown that we can cleanly identify elastic
scattering events and correct for the difference in acceptance for electron and
positron scattering. The final ratio of positron to electron scattering:
for GeV and
Precise Measurements of Beam Spin Asymmetries in Semi-Inclusive production
We present studies of single-spin asymmetries for neutral pion
electroproduction in semi-inclusive deep-inelastic scattering of 5.776 GeV
polarized electrons from an unpolarized hydrogen target, using the CEBAF Large
Acceptance Spectrometer (CLAS) at the Thomas Jefferson National Accelerator
Facility. A substantial amplitude has been measured in the
distribution of the cross section asymmetry as a function of the azimuthal
angle of the produced neutral pion. The dependence of this amplitude
on Bjorken and on the pion transverse momentum is extracted with
significantly higher precision than previous data and is compared to model
calculations.Comment: to be submitted PL
Advances in ab-initio theory of Multiferroics. Materials and mechanisms: modelling and understanding
Within the broad class of multiferroics (compounds showing a coexistence of
magnetism and ferroelectricity), we focus on the subclass of "improper
electronic ferroelectrics", i.e. correlated materials where electronic degrees
of freedom (such as spin, charge or orbital) drive ferroelectricity. In
particular, in spin-induced ferroelectrics, there is not only a {\em
coexistence} of the two intriguing magnetic and dipolar orders; rather, there
is such an intimate link that one drives the other, suggesting a giant
magnetoelectric coupling. Via first-principles approaches based on density
functional theory, we review the microscopic mechanisms at the basis of
multiferroicity in several compounds, ranging from transition metal oxides to
organic multiferroics (MFs) to organic-inorganic hybrids (i.e. metal-organic
frameworks, MOFs)Comment: 22 pages, 9 figure
First measurement of direct photoproduction on the proton
We report on the results of the first measurement of exclusive
meson photoproduction on protons for GeV and GeV. Data were collected with the CLAS detector at the Thomas
Jefferson National Accelerator Facility. The resonance was detected via its
decay in the channel by performing a partial wave analysis of the
reaction . Clear evidence of the meson
was found in the interference between and waves at GeV. The -wave differential cross section integrated in the mass range of
the was found to be a factor of 50 smaller than the cross section
for the meson. This is the first time the meson has been
measured in a photoproduction experiment
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