Blood ordering practices in the management of ectopic pregnancy at Groote Schuur hospital

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Blood ordering practices in the management of ectopic pregnancy at Groote Schuur hospital

The International Society for Burns Injuries (ISBI) has published guidelines for the management of multiple or mass burns casualties, and recommends that 'each country has or should have a disaster planning system that addresses its own particular needs.' The need for a national burns disaster plan integrated with national and provincial disaster planning was discussed at the South African Burns Society Congress in 2009, but there was no real involvement in the disaster planning prior to the 2010 World Cup; the country would have been poorly prepared had there been a burns disaster during the event. This article identifies some of the lessons learnt and strategies derived from major burns disasters and burns disaster planning from other regions. Members of the South African Burns Society are undertaking an audit of burns care in South Africa to investigate the feasibility of a national burns disaster plan. This audit (which is still under way) also aims to identify weaknesses of burns care in South Africa and implement improvements where necessary

Comparison of preserved bimatoprost 0.01% with preservative-free tafluprost: A randomised, investigator-masked, 3-month crossover, multicentre trial, SPORT II

IMPORTANCE: This study compares the efficacy and tolerability of a preservative-free prostaglandin analogue (tafluprost 15 mg/ml) to a prostaglandin analogue that uses 0.02% of benzalkonium chloride (bimatoprost 0.1 mg/ml). BACKGROUND: Different prostaglandin analogues have been commercially approved, with differences in tolerability. DESIGN: Prospective, randomised, investigator-masked, 3-month crossover, multicentre trial. PARTICIPANTS: Sixty-four patients with ocular hypertension or open-angle glaucoma were randomised to two groups, after a 4-week washout period from their current topical drop regimen. METHODS: Participants were randomised to tafluprost (Group 1; n = 33) or bimatoprost (Group 2; n = 31). At month 3, each group switched to the opposite treatment. IOP was evaluated at multiple timepoints. MAIN OUTCOME MEASURES: The primary outcome was difference in mean IOP between the two groups at the final visit. Secondary outcomes included change from baseline IOP at month 3 and month 6, difference in mean IOP at month 3 and difference in IOP at all timepoints. Safety outcomes included best-corrected visual acuity (BCVA), adverse events, ocular tolerability, optic nerve assessment and slit lamp biomicroscopy. RESULTS: Both medications significantly lowered IOP at month 6 compared to baseline: 5.4 mmHg (27%) for tafluprost and 6.8 mmHg (33%) for bimatoprost (p < 0.0001). No significant differences in any of the safety measures (including conjunctival hypearemia) were detected. CONCLUSIONS AND RELEVANCE: Bimatoprost produced a statistically significant greater IOP reduction compared to tafluprost with minimal to no difference in side effects. This should be borne in mind when weighing up the pros and cons of preserved versus preservative-free prostaglandin analogue therapy

Black hole mergers: the first light

The coalescence of supermassive black hole binaries occurs via the emission of gravitational waves, that can impart a substantial recoil to the merged black hole. We consider the energy dissipation, that results if the recoiling black hole is surrounded by a thin circumbinary disc. Our results differ significantly from those of previous investigations. We show analytically that the dominant source of energy is often potential energy, released as gas in the outer disc attempts to circularize at smaller radii. Thus, dimensional estimates, that include only the kinetic energy gained by the disc gas, underestimate the real energy loss. This underestimate can exceed an order of magnitude, if the recoil is directed close to the disc plane. We use three dimensional Smooth Particle Hydrodynamics (SPH) simulations and two dimensional finite difference simulations to verify our analytic estimates. We also compute the bolometric light curve, which is found to vary strongly depending upon the kick angle. A prompt emission signature due to this mechanism may be observable for low mass (10^6 Solar mass) black holes whose recoil velocities exceed about 1000 km/s. Emission at earlier times can mainly result from the response of the disc to the loss of mass, as the black holes merge. We derive analytically the condition for this to happen.Comment: 16 pages, accepted by MNRAS. Animations of the simulations are available at http://jilawww.colorado.edu/~pja/recoil.htm

Fermion scattering off electroweak phase transition kink walls with hypermagnetic fields

We study the scattering of fermions off a finite width kink wall during the electroweak phase transition in the presence of a background hypermagnetic field. We derive and solve the Dirac equation for such fermions and compute the reflection and transmission coefficients for the case when the fermions move from the symmetric to the broken symmetry phase. We show that the chiral nature of the fermion coupling with the background field in the symmetric phase generates an axial asymmetry in the scattering processes. We discuss possible implications of such axial charge segregation for baryon number generation.Comment: 9 pages, 3 Postscript figures, uses RevTeX4. Expanded discussion, published versio

Spatiotemporal structure of intracranial electric fields induced by transcranial electric stimulation in humans and nonhuman primates

Transcranial electric stimulation (TES) is an emerging technique, developed to non-invasively modulate brain function. However, the spatiotemporal distribution of the intracranial electric fields induced by TES remains poorly understood. In particular, it is unclear how much current actually reaches the brain, and how it distributes across the brain. Lack of this basic information precludes a firm mechanistic understanding of TES effects. In this study we directly measure the spatial and temporal characteristics of the electric field generated by TES using stereotactic EEG (s-EEG) electrode arrays implanted in cebus monkeys and surgical epilepsy patients. We found a small frequency dependent decrease (10%) in magnitudes of TES induced potentials and negligible phase shifts over space. Electric field strengths were strongest in superficial brain regions with maximum values of about 0.5 mV/mm. Our results provide crucial information of the underlying biophysics in TES applications in humans and the optimization and design of TES stimulation protocols. In addition, our findings have broad implications concerning electric field propagation in non-invasive recording techniques such as EEG/MEG

Method to estimate ISCO and ring-down frequencies in binary systems and consequences for gravitational wave data analysis

Recent advances in the description of compact binary systems have produced gravitational waveforms that include inspiral, merger and ring-down phases. Comparing results from numerical simulations with those of post-Newtonian (PN), and related, expansions has provided motivation for employing PN waveforms in near merger epochs when searching for gravitational waves and has encouraged the development of analytic fits to full numerical waveforms. The models and simulations do not yet cover the full binary coalescence parameter space. For these yet un-simulated regions, data analysts can still conduct separate inspiral, merger and ring-down searches. Improved knowledge about the end of the inspiral phase, the beginning of the merger, and the ring-down frequencies could increase the efficiency of both coherent inspiral-merger-ring-down (IMR) searches and searches over each phase separately. Insight can be gained for all three cases through a recently presented theoretical calculation, which, corroborated by the numerical results, provides an implicit formula for the final spin of the merged black holes, accurate to within 10% over a large parameter space. Knowledge of the final spin allows one to predict the end of the inspiral phase and the quasinormal mode ring-down frequencies, and in turn provides information about the bandwidth and duration of the merger. In this work we will discuss a few of the implications of this calculation for data analysis.Comment: Added references to section 3 14 pages 5 figures. Submitted to Classical and Quantum Gravit

Horizontal partial laryngectomy for supraglottic squamous cell carcinoma

Between 1981-1999, 75 patients treated for supraglottic SCC with horizontal supraglottic laryngectomy (HSL) at the Otolaryngology Head and Neck Surgery Department of Lausanne University Hospital were retrospectively studied. There were 16 patients with T1, 46 with T2 and 13 with T3 tumors. Among these, 16 patients (21%) had clinical neck disease corresponding to stage I, II, III and IV in 12, 39, 18 and 6 patients, respectively. All patients had HSL. Most patients had either elective or therapeutic bilateral level II-IV selective neck dissection. Six patients (8%) with advanced neck disease had ipsilateral radical and controlateral elective II-IV selective neck dissections. Adjuvant radiotherapy was given to 25 patients (30%) for either positive surgical margins (n=8), pathological nodal status (n=14) or both (n=3). Median follow-up was 48 months (range, 24-199). Five-year disease-specific survival and locoregional and local control were 92, 90 and 92.5%, respectively. Among five patients who were diagnosed with local recurrence, one had a total laryngectomy (1.4%); the others were treated by endoscopic laser surgery. Two patients had both a local and regional recurrence. They were salvaged with combined surgery and radiotherapy, but eventually died of their disease. Cartilage infiltration seems to influence both local control (P=0.03) and disease-specific survival (P=0.06). There was a trend for worse survival with pathological node involvement (P=0.15) and extralaryngeal extension of the cancer (P=0.1). All patients except one recovered a close to normal function after the treatment. Aspiration was present in 16 patients (26%) in the early postoperative period. A median of 16 days (7-9) was necessary to recover a close to normal diet. Decannulation took a median of 17 days (8-93). Seven patients kept a tracheotomy tube for up to 3 months because of persistent aspiration. There was no permanent tracheostomy or total laryngectomy for functional purposes. Horizontal supraglottic laryngectomy remains an adequate therapeutic alternative for supraglottic squamous cell carcinoma, offering an excellent oncological outcome. The postoperative functional morbidity is substantial, indicating the need for careful patient selection, but good laryngeal function recovery is the rule. The surgical alternative is endoscopic laser surgery, which may offer comparable oncological results with less functional morbidity. Nevertheless, these two different techniques need to be compared prospectively

First-order cosmological phase transitions in the radiation dominated era

We consider first-order phase transitions of the Universe in the radiation-dominated era. We argue that in general the velocity of interfaces is non-relativistic due to the interaction with the plasma and the release of latent heat. We study the general evolution of such slow phase transitions, which comprise essentially a short reheating stage and a longer phase equilibrium stage. We perform a completely analytical description of both stages. Some rough approximations are needed for the first stage, due to the non-trivial relations between the quantities that determine the variation of temperature with time. The second stage, instead, is considerably simplified by the fact that it develops at a constant temperature, close to the critical one. Indeed, in this case the equations can be solved exactly, including back-reaction on the expansion of the Universe. This treatment also applies to phase transitions mediated by impurities. We also investigate the relations between the different parameters that govern the characteristics of the phase transition and its cosmological consequences, and discuss the dependence of these parameters with the particle content of the theory.Comment: 38 pages, 3 figures; v2: Minor changes, references added; v3: several typos correcte

Elliptic and hyperelliptic magnetohydrodynamic equilibria

The present study is a continuation of a previous one on "hyperelliptic" axisymmetric equilibria started in [Tasso and Throumoulopoulos, Phys. Plasmas 5, 2378 (1998)]. Specifically, some equilibria with incompressible flow nonaligned with the magnetic field and restricted by appropriate side conditions like "isothermal" magnetic surfaces, "isodynamicity" or P + B^2/2 constant on magnetic surfaces are found to be reducible to elliptic integrals. The third class recovers recent equilibria found in [Schief, Phys. Plasmas 10, 2677 (2003)]. In contrast to field aligned flows, all solutions found here have nonzero toroidal magnetic field on and elliptic surfaces near the magnetic axis.Comment: 9 page