Hospital mortality in diffuse liver diseases, complicated by portal hypertension

Departamentul de chirurgie N3, Universitatea Naţională de Medicină “A.Bogomoletz”, Kiev, Ucraina, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Introducere: Recurența hemoragiei variceale (RHV) în maladiile hepatice difuze (MHD), ca complicație a hipertensiunii portale (HTP) agravează prognosticul și este considerată un factor de risc independent de deces. Scopul lucrării: De a studia cauzele mortalității intra-spitalicești în cazul MHD cu HTP și episoade de RHV. Materiale și metode: Am analizat datele clinice și cele ale autopsiei a 525 pacienți cu MHD și HTP cu hemoragie variceală în Centrul de Hemoragii Gastrointestinale (HGI) din Kiev pe perioada anilor 2007-2014. Toate cazurile au fost divizate în 2 grupe: A). 388 pacienți (73,9%) care au decedat în timpul hemoragiei continue sau recurente; B). 137 pacienți (26,1%) care au decedat după stoparea hemoragiei. Rezultate: La toți pacienții din momentul internării au fost efectuate măsuri adecvate de diagnosticare, terapie intensivă cu hemostază endoscopică și resuscitare. În grupul A, după internare au decedat: în primele 24h - 186 (35,4%) pacienți, în 24-48h - 113 (21,5%) pacienți și în 48-72h - 89 (17%) pacienți, în timpul hemoragiei variceale continue (61,1%) sau recurente (38,9%). Rezultatele autopsiei au relevat varice esofagiene și gastrice de un grad sever cu mai multe leziuni (41,0%), combinații de eroziuni esofagiene și gastrice (31,2%), ulcer acut esofagian și gastric (15,2%), ulcere peptice (7,2%), sindrom Mallory-Weiss (5,4%). Principalele cauze ale deceselor ne-asociate cu continuarea sau recurența hemoragiei (grupul B) au fost: insuficiența renală progresivă și poliorganică (70,9%), edemul cerebral (12,4%), insuficiența cardiacă acută cu edem pulmonar (10,9%), sepsisul (5,8%). Concluzii: Pacienții cu MHD și HTP necesită o abordare multidisciplinară, folosind metode endovasculare de reducere a fluxului de sînge portal cu scop de prevenire a RHV secundare.Introduction: Recurrence of varicose bleeding (RVB) in diffuse liver diseases (DLD), complicated portal hypertension (PH) worsen prognosis and is considered as an independent risk factor for death. The aim: To study the causes of hospital mortality in DLD with PH and episodes of RVB. Material and methods: We analyzed clinical data with the data of the autopsies of deceased 525 patients (pts) with DLD and PH with varicose bleeding in Kiev center of GIB from 2007 to 2014 yrs. All cases were divided in 2 groups: A) 388 (73.9%) pts died amid continued or recurrent bleeding B) 137 (26.1%) pts died after stopping bleeding later. Results: All the patients from the time of hospitalization were conducted adequate diagnostic complex, intensive therapy with endoscopic hemostasis, resuscitation. In group A after admission 186 (35.4%) died during first 24 hours, next 24-48 hours – 113 (21.5%) and 48-72 hours – 89 (17%) pts from continued varix bleeding (61.1%) or recurrent bleeding (38.9%). Autopsy showed sever grade esophageal and upper part of stomach varix with multiple veins ruptures (41.0%), combinations with multiple esophageal and stomach erosions (31.2%), acute esophageal and stomach ulcer (15.2%), peptic ulcers (7.2%), MVS (5.4%). The main causes of deaths not associated with continued or recurrent bleeding (group B) were progressive renal and multiple organ failure (70.9%), edema and swelling of the brain (12.4%), acute heart failure with pulmonary edema (10.9%), sepsis (5.8%). Conclusions: Patients with DLD and PH need multidisciplinary approach using endovascular portal blood flow reduction methods for secondary prevention RVB

Electric dipole moment enhancement factor of thallium

The goal of this work is to resolve the present controversy in the value of the EDM enhancement factor of Tl. We have carried out several calculations by different high-precision methods, studied previously omitted corrections, as well as tested our methodology on other parity conserving quantities. We find the EDM enhancement factor of Tl to be equal to -573(20). This value is 20% larger than the recently published result of Nataraj et al. [Phys. Rev. Lett. 106, 200403 (2011)], but agrees very well with several earlier results.Comment: 5 pages; v2: link to supplemental material adde

Effect of Plasma Irradiation on CdI2Cd I_2 films

The effect of plasma irradiation is studied systematically on a 4H polytype (002) oriented ${\rm CdI_2}$ stoichiometric film having compressive residual stress. Plasma irradiation was found to change the orientation to (110) of the film at certain moderate irradiation distances. A linear decrease in grain size and residual stress was observed with decreasing irradiation distance (or increasing ion energy) consistent with both structural and morphological observations. The direct optical energy gap ${\rm E_g}$ was found to increase linearly at the rate ${\rm 15\mu eV/atm}$ with the compressive stress. The combined data of present compressive stress and from earlier reported tensile stress show a consistent trend of ${\rm E_g}$ change with stress. The iodine-iodine distance in the unit cell could be responsible for the observed change in ${\rm E_g}$ with stress.Comment: 13 pages and 10 fi

Enhancement of the electric dipole moment of the electron in PbO

The a(1) state of PbO can be used to measure the electric dipole moment of the electron d_e. We discuss a semiempirical model for this state, which yields an estimate of the effective electric field on the valence electrons in PbO. Our final result is an upper limit on the measurable energy shift, which is significantly larger than was anticipated earlier: $2|W_d|d_e \ge 2.4\times 10^{25} \textrm{Hz} [ \frac{d_e}{e \textrm{cm}} ]$.Comment: 4 pages, revtex4, no figures, submitted to PR

Study of the correlation effects in Yb^+ and implications for parity violation

Calculation of the energies, magnetic dipole hyperfine structure constants, E1 transition amplitudes between the low-lying states, and nuclear spin-dependent parity-nonconserving amplitudes for the ^2S_{1/2} - ^2D_{3/2,5/2} transitions in ^{171}Yb^+ ion is performed using two different approaches. First, we carried out many-body perturbation theory calculation considering Yb^+ as a monovalent system. Additional all-order calculations are carried out for selected properties. Second, we carried out configuration interaction calculation considering Yb as a 15-electron system and compared the results obtained by two methods. The accuracy of different methods is evaluated. We find that the monovalent description is inadequate for evaluation of some atomic properties due to significant mixing of the one-particle and the hole-two-particle configurations. Performing the calculation by such different approaches allowed us to establish the importance of various correlation effects for Yb^+ atomic properties for future improvement of theoretical precision in this complicated system.Comment: 11 pages;v2: minor changes and one reference adde

Highly charged ions: optical clocks and applications in fundamental physics

Recent developments in frequency metrology and optical clocks have been based on electronic transitions in atoms and singly charged ions as references. These systems have enabled relative frequency uncertainties at a level of a few parts in $10^{-18}$. This accomplishment not only allows for extremely accurate time and frequency measurements, but also to probe our understanding of fundamental physics, such as variation of fundamental constants, violation of the local Lorentz invariance, and forces beyond the Standard Model of Physics. In addition, novel clocks are driving the development of sophisticated technical applications. Crucial for applications of clocks in fundamental physics are a high sensitivity to effects beyond the Standard Model and Einstein's Theory of Relativity and a small frequency uncertainty of the clock. Highly charged ions offer both. They have been proposed as highly accurate clocks, since they possess optical transitions which can be extremely narrow and less sensitive to external perturbations compared to current atomic clock species. The selection of highly charged ions in different charge states offers narrow transitions that are among the most sensitive ones for a change in the fine-structure constant and the electron-to-proton mass ratio, as well as other new physics effects. Recent advances in trapping and sympathetic cooling of highly charged ions will in the future enable high accuracy optical spectroscopy. Progress in calculating the properties of selected highly charged ions has allowed the evaluation of systematic shifts and the prediction of the sensitivity to the "new physics" effects. This article reviews the current status of theory and experiment in the field.Comment: 53 pages, 16 figures, submitted to RM

Calculation of nuclear spin-dependent parity-nonconserving amplitude for (7s,F=4) --> (7s,F=5) transition in Fr

Many-body calculation of nuclear spin-dependent parity-nonconserving amplitude for (7s,F=4) --> (7s,F=5) transition between hyperfine sublevels of the ground state of $^{211}$Fr is carried out. The final result is <7s,F=5 ||d_PNC|| 7s,F=4> = -0.49 10^{-10} i kappa a.u., where kappa is the dimensionless coupling constant. This is approximately an order of magnitude larger than similar amplitude in Cs. The dominant contribution to kappa is associated with the anapole moment of the nucleus.Comment: 4 pages, submitted to Phys.Rev.