Esophageal atresia in newborns: a wide spectrum from the isolated forms to a full VACTERL phenotype?

Background: VATER association was first described in 1972 by Quan and Smith as an acronym which identifies a non-random co-occurrence of Vertebral anomalies, Anal atresia, Tracheoesophageal fistula and/or Esophageal atresia, Radial dysplasia. It is even possible to find out Cardiovascular, Renal and Limb anomalies and the acronym VACTERL was adopted, also, embodying Vascular, as single umbilical artery, and external genitalia anomalies. Methods: Data on patients with esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) admitted in the Neonatal Intensive Care Unit (NICU) between January 2003 and January 2013 were evaluated for the contingent occurrence of typical VACTERL anomalies (VACTERL-type) and non tipical VACTERL anomalies (non-VACTERL-type). The inclusion criterion was the presence of EA with or without TEF plus two or more of the following additional malformations: vertebral defects, anal atresia, cardiovascular defects, renal anomalies and lower limb deformities, like radial dysplasia. Results: Among 52 patients with EA/TEF, 20 (38,4%) had isolated EA and 7 (21,8%) had a recognized etiology such a syndrome and therefore were excluded. Among 32 infants with EA and associated malformations, 15 (46,8%) had VACTERL association. The most common anomalies were congenital heart defects (73,3%), followed by vertebral anomalies (66,6%). Many patients also had additional non-VACTERL-type defects. Single umbilical artery was the most common one followed by nervous system abnormalities and anomalies of toes. Between the groups of infants with VACTERL type and non-VACTERL-type anomalies, there are several overlapping data regarding both the tipically described spectrum and the most frequently reported non-VACTERL-type malformations. Thus, it is possible to differentiate infants with a full phenotype (VACTERL full phenotype) and patients that do not meet all the criteria mentioned above, but with some homologies with the first group (VACTERL partial phenotype). Conclusion: The high frequency of non-VACTERL-type anomalies encountered in full and partial phenotype patients would suggest the need for an extension of the clinical criteria for the diagnosis of VACTERL association and also for pre- and post-operative management and follow-up in the short and long term

Successful control of an outbreak of colonization by Klebsiella pneumoniae carbapenemase-producing K.\ua0pneumoniae sequence type 258 in a neonatal intensive care unit, Italy

This article reports an outbreak of colonization by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) sequence type (ST) 258 in a neonatal intensive care unit (NICU) in Palermo, Italy. KPC-Kp ST258 was detected by an active surveillance culture programme. Between 18th September and 14th November 2012, KPC-Kp was isolated from 10 out of 54 neonates admitted in the outbreak period. No cases of infection were recorded. Male sex was associated with colonization, whereas administration of ampicilline-sulbactam plus gentamicin was protective. Infection control interventions interrupted the spread of KPC-Kp without the need to close the NICU to new admissions. (C) 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved

Population of high-spin isomeric states following fragmentation of 238 U

Isomeric ratios have been determined for 23 metastable states identified in A?200 nuclei from Pt to Rn near the valley of stability following fragmentation of 238U. This includes high-spin states with angular momenta ranging from (39/2) to 25. The experimental results are discussed together with those of similar experiments performed in this mass region. Isomeric ratios are compared with theoretical predictions where the angular momentum of the fragment arises purely due to the angular momentum of nucleons removed from the projectile. The theoretical yield of low-spin states is generally overestimated. In these cases the assumption of 100% feeding of the isomer may require modification. However, the yield of high-spin isomeric states [Im ? (39/2)] is significantly underestimated and highlights the requirement for a more complete theoretical framework in relation to the generation of fragment angular momentum. The enhanced population of high-spin states reported here is advantageous to future studies involving isomeric beams at fragmentation facilities such as the Rikagaku Kenkyusho RI Beam Factory (Japan) and next-generation facilities at the Facility for Antiproton and Ion Research (Germany) and Facility for Rare Isotope Beams (USA). � 2013 American Physical Society

Time Scales in Spectator Fragmentation

Proton-proton correlations and correlations of p-alpha, d-alpha, and t-alpha from spectator decays following Au + Au collisions at 1000 AMeV have been measured with an highly efficient detector hodoscope. The constructed correlation functions indicate a moderate expansion and low breakup densities similar to assumptions made in statistical multifragmentation models. In agreement with a volume breakup rather short time scales were deduced employing directional cuts in proton-proton correlations. PACS numbers: 25.70.Pq, 21.65.+f, 25.70.MnComment: 8 pages, with 5 included figures; To appear in the proceedings of the CRIS 2000 conference; Also available from http://www-kp3.gsi.de/www/kp3/aladin_publications.htm

Present and Future Experiments with Stored Exotic Nuclei at Relativistic Energies

Recent progress is presented from experiments on masses and lifetimes of bare and few-electron exotic nuclei at GSI.Comment: Proceedings of International Conference on "Frontiers in Nuclear Structure, Astrophysics and Reactions", Kos, Greece, September 12-17, 200

Schottky mass measurements of heavy neutron-rich nuclides in the element range 70\leZ \le79 at the ESR

Storage-ring mass spectrometry was applied to neutron-rich $^{197}$Au projectile fragments. Masses of $^{181,183}$Lu, $^{185,186}$Hf, $^{187,188}$Ta, $^{191}$W, and $^{192,193}$Re nuclei were measured for the first time. The uncertainty of previously known masses of $^{189,190}$W and $^{195}$Os nuclei was improved. Observed irregularities on the smooth two-neutron separation energies for Hf and W isotopes are linked to the collectivity phenomena in the corresponding nuclei.Comment: 10 pages, 9 figures, 2 table

High-resolution measurement of the time-modulated orbital electron capture and of the β+\beta^+ decay of hydrogen-like 142^{142}Pm60+^{60+} ions

The periodic time modulations, found recently in the two-body orbital electron-capture (EC) decay of both, hydrogen-like $^{140}$Pr$^{58+}$ and $^{142}$Pm$^{60+}$ ions, with periods near to 7s and amplitudes of about 20%, were re-investigated for the case of $^{142}$Pm$^{60+}$ by using a 245 MHz resonator cavity with a much improved sensitivity and time resolution. We observed that the exponential EC decay is modulated with a period $T = 7.11(11)$s, in accordance with a modulation period $T = 7.12(11)$ s as obtained from simultaneous observations with a capacitive pick-up, employed also in the previous experiments. The modulation amplitudes amount to $a_R = 0.107(24)$ and $a_P = 0.134(27)$ for the 245 MHz resonator and the capacitive pick-up, respectively. These new results corroborate for both detectors {\it exactly} our previous findings of modulation periods near to 7s, though with {\it distinctly smaller} amplitudes. Also the three-body $\beta^+$ decays have been analyzed. For a supposed modulation period near to 7s we found an amplitude $a = 0.027(27)$, compatible with $a = 0$ and in agreement with the preliminary result $a = 0.030(30)$ of our previous experiment. These observations could point at weak interaction as origin of the observed 7s-modulation of the EC decay. Furthermore, the data suggest that interference terms occur in the two-body EC decay, although the neutrinos are not directly observed.Comment: In memoriam of Prof. Paul Kienle, 9 pages, 1 table, 5 figures Phys. Lett. B (2013) onlin

Thermal and Chemical Freeze-out in Spectator Fragmentation

Isotope temperatures from double ratios of hydrogen, helium, lithium, beryllium, and carbon isotopic yields, and excited-state temperatures from yield ratios of particle-unstable resonances in 4He, 5Li, and 8Be, were determined for spectator fragmentation, following collisions of 197Au with targets ranging from C to Au at incident energies of 600 and 1000 MeV per nucleon. A deviation of the isotopic from the excited-state temperatures is observed which coincides with the transition from residue formation to multi-fragment production, suggesting a chemical freeze-out prior to thermal freeze-out in bulk disintegrations.Comment: 14 pages, 10 figures, submitted to Phys. Rev. C, small changes as suggested by the editors and referee