PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Synthesis and Characterization of Sol-Gel Derived PZT Nano Powder

Single phase nanocrystalline lead zirconate titanate (PZT) powder of composition Pb(Zr0.52Ti0.48)O3 has been prepared by sol-gel process by using lead acetate trihydrate, zirconium propoxide and titanium propoxide as lead, zirconium and titanium precursor materials respectively. XRD, FTIR and TGA/DTA techniques are used to characterize structural, vibrational and thermal changes involved during the formation of PZT nanocrystalline powder with tetragonal phase. XRD pattern exhibits the polycrystalline nature of the powder heat treated at 800 °C with preferential orientation of (110) plane. Simultaneous TGA/DTA studies of the gel powder show endothermic and exothermic peaks corresponding to weight loss at different temperatures and increase in weight between 750 °C and 800 °C which confirms the improvement in crystallization. IR transmittance spectra of the powders heat treated at 650 °C and 750 °C show the coexistence of rhombohedral and teragonal phases and above this temperature only teragonal phase exist

Sol-Gel Derived Nanocrystalline Lanthanum Doped Lead Zirconate Titanate Thin Films Studied for Solitary Waves Propagation

Nanocrystalline PLZT thin films of composition Pb1-xLaxZr0.52Ti0.48 (x = 0, 2, 5%) were deposited on silicon substrates by sol-gel process using lead acetate trihydrate, lanthanum nitrate hydrate, zirconium propoxide and titanium propoxide as lead, lanthanum, zirconium and titanium precursor materials. Experimental studies have been made on solitary waves in 2 mol% lanthanum doped sol-gel derived lead zirconate titanate thin films. The solitary waves are generated under the influence of external alternating electric field, which has the same frequency as the external field. These solitary waves propagate through the thin film upto its boundary and then reflect back. The magnitude of the solitary waves attenuates as they move away from the electrodes and their phase reverses on reflection. For certain frequencies of the external electric field, solitary waves exhibit resonance effect. Distortion in hysteresis loops has been demonstrated on the basis of solitary waves propagation in the film having different electrode area

Clinical Utility of Stepwise Bronchoalveolar Lavage Fluid Analysis in Diagnosing and Managing Lung Infiltrates in Leukemia/Lymphoma Patients With Febrile Neutropenia

PURPOSEFebrile neutropenia (FN) is a serious complication in hematologic malignancies, and lung infiltrates (LIs) remain a significant concern. An accurate microbiological diagnosis is crucial but difficult to establish. To address this, we analyzed the utility of a standardized method for performing bronchoalveolar lavage (BAL) along with a two-step strategy for the analysis of BAL fluid.PATIENTS AND METHODSThis prospective observational study was conducted at a tertiary cancer center from November 2018 to June 2020. Patients age 15 years and older with confirmed leukemia or lymphomas undergoing chemotherapy, with presence of FN, and LIs observed on imaging were enrolled.RESULTSAmong the 122 enrolled patients, successful BAL was performed in 83.6% of cases. The study used a two-step analysis of BAL fluid, resulting in a diagnostic yield of 74.5%. Furthermore, antimicrobial therapy was modified in 63.9% of patients on the basis of BAL reports, and this population demonstrated a higher response rate (63% v 45%; P = .063).CONCLUSIONOur study demonstrates that a two-step BAL fluid analysis is safe and clinically beneficial to establish an accurate microbiological diagnosis. Given the crucial impact of diagnostic delays on mortality in hematologic malignancy patients with FN, early BAL studies should be performed to enable prompt and specific diagnosis, allowing for appropriate treatment modifications