1,044 research outputs found
Intraperitoneal aerosolization of bupivacaine is a safe and effective method in controlling postoperative pain in laparoscopic Roux-en-Y gastric bypass.
INTRODUCTION: Obesity is a worldwide problem and has grown in severity in the last few decades making bariatric surgery and, in particular, laparoscopic banding and Roux-en-Y gastric bypass efficacious and cost-effective procedures. The laparoscopic approach has been shown to offer significant healthcare benefits, of particular interests are reports of decreased postoperative pain resulting in a shorter hospital stay and an earlier return to normal activity. However, many patients still experience significant pain, including shoulder tip pain, that require strong analgesia including opiates during their early recovery period. The aims of this study were to establish the safe use of the aerosolization technique in bariatric surgery and to investigate the possible benefits in reducing postoperative pain. METHODS: In this study, fifty patients undergoing laparoscopic gastric bypass were recruited and divided into two groups; control (n = 25) and therapeutic (n = 25). The control group received intraperitoneal aerosolization of 10 mL of 0.9% normal saline while the therapeutic group received 10 mL of 0.5% bupivacaine. All the patients had standard preoperative, intraoperative, and postoperative care. Pain scores were carried out by the nursing staff in recovery and 6 h, 12 h and 24 h postoperatively using a standard 0-10 pain scoring scale. In addition, opiate consumption via patient-controlled analgesia (PCA) was recorded. RESULTS: Aerosolized bupivacaine reduced postoperative pain in comparison to normal saline (p < 0.05). However, PCA usage showed no statistically significant change from the control group. CONCLUSION: The aims of this study were achieved and we were able to establish the safe use of the aerosolization technique in bariatric surgery and its benefits in reducing postoperative pain
Modelling Oscillator synchronisation during vertebrate axis segmentation
he somitogenesis clock regulates the periodicity with which somites form in the posterior pre-somitic mesoderm. Whilst cell heterogeneity results in noisy oscillation rates amongst constituent cells, synchrony within the population is maintained as oscillators are entrained via juxtracine signalling mechanisms. Here we consider a population of phase-coupled oscillators and investigate how biologically motivated perturbations to the entrained state can perturb synchrony within the population. We find that the ratio of mitosis length to clock period can influence levels of desynchronisation. Moreover, we observe that random cell movement, and hence change of local neighbourhoods, increases synchronisation
Dark Matter, Muon g-2 and Other SUSY Constraints
Recent developments constraining the SUSY parameter space are reviewed within
the framework of SUGRA GUT models. The WMAP data is seen to reduce the error in
the density of cold dark matter by about a factor of four, implying that the
lightest stau is only 5 -10 GeV heavier than the lightest neutralino when m_0,
m_{1/2} < 1 TeV. The CMD-2 re-analysis of their data has reduced the
disagreement between the Standard Model prediction and the Brookhaven
measurement of the muon magnetic moment to 1.9 sigma, while using the tau decay
data plus CVC, the disagreement is 0.7 sigma. (However, the two sets of data
remain inconsistent at the 2.9 sigma level.) The recent Belle and BABAR
measurements of the B -> phi K CP violating parameters and branching ratios are
discussed. They are analyzed theoretically within the BBNS improved
factorization method. The CP parameters are in disagreement with the Standard
Model at the 2.7 sigma level, and the branching ratios are low by a factor of
two or more over most of the parameter space. It is shown that both anomalies
can naturally be accounted for by adding a non-universal cubic soft breaking
term at M_G mixing the second and third generations.Comment: 16 pages, 7 figures, plenary talk at Beyond The Desert '03, Castle
Ringberg, Germany, June 9, 2003. Typos correcte
Multidisciplinary team meetings and their impact on workflow in radiology and pathology departments
<p>Abstract</p> <p>Background</p> <p>The development of multidisciplinary team meetings (MDTMs) for radiology and pathology is a burgeoning area that increasingly impacts on work processes in both of these departments. The aim of this study was to examine work processes and quantify the time demands on radiologists and pathologists associated with MDTM practices at a large teaching hospital. The observations reported in this paper reflect a general trend affecting hospitals and our conclusions will have relevance for others implementing clinical practice guidelines.</p> <p>Methods</p> <p>For one month, all work related to clinical meetings between pathology and radiology with clinical staff was documented and later analysed.</p> <p>Results</p> <p>The number of meetings to which pathology and radiology contribute at a large university teaching hospital, ranges from two to eight per day, excluding grand rounds, and amounts to approximately 50 meetings per month for each department. For one month, over 300 h were spent by pathologists and radiologists on 81 meetings, where almost 1000 patients were discussed. For each meeting hour, there were, on average, 2.4 pathology hours and 2 radiology hours spent in preparation. Two to three meetings per week are conducted over a teleconferencing link. Average meeting time is 1 h. Preparation time per meeting ranges from 0.3 to 6 h for pathology, and 0.5 to 4 for radiology. The review process in preparation for meetings improves internal quality standards. Materials produced externally (for example imaging) can amount to almost 50% of the material to be reviewed on a single patient. The number of meetings per month has increased by 50% over the past two years. Further increase is expected in both the numbers and duration of meetings when scheduling issues are resolved. A changing trend in the management of referred patients with the development of MDTMs and the introduction of teleconferencing was noted.</p> <p>Conclusion</p> <p>Difficulties are being experienced by pathology and radiology departments participating fully in several multidisciplinary teams. Time spent at meetings, and in preparation for MDTMs is significant. Issues of timing and the coordination of materials to be reviewed are sometimes irreconcilable. The exchange of patient materials with outside institutions is a cause for concern when full data are not made available in a timely fashion. The process of preparation for meetings is having a positive influence on quality, but more resources are needed in pathology and radiology to realise the full benefits of multidisciplinary team working.</p
Topological semimetal in a fermionic optical lattice
Optical lattices play a versatile role in advancing our understanding of
correlated quantum matter. The recent implementation of orbital degrees of
freedom in chequerboard and hexagonal optical lattices opens up a new thrust
towards discovering novel quantum states of matter, which have no prior analogs
in solid state electronic materials. Here, we demonstrate that an exotic
topological semimetal emerges as a parity-protected gapless state in the
orbital bands of a two-dimensional fermionic optical lattice. The new quantum
state is characterized by a parabolic band-degeneracy point with Berry flux
, in sharp contrast to the flux of Dirac points as in graphene. We
prove that the appearance of this topological liquid is universal for all
lattices with D point group symmetry as long as orbitals with opposite
parities hybridize strongly with each other and the band degeneracy is
protected by odd parity. Turning on inter-particle repulsive interactions, the
system undergoes a phase transition to a topological insulator whose
experimental signature includes chiral gapless domain-wall modes, reminiscent
of quantum Hall edge states.Comment: 6 pages, 3 figures and Supplementary Informatio
Topological Surface States Protected From Backscattering by Chiral Spin Texture
Topological insulators are a new class of insulators in which a bulk gap for
electronic excitations is generated by strong spin orbit coupling. These novel
materials are distinguished from ordinary insulators by the presence of gapless
metallic boundary states, akin to the chiral edge modes in quantum Hall
systems, but with unconventional spin textures. Recently, experiments and
theoretical efforts have provided strong evidence for both two- and
three-dimensional topological insulators and their novel edge and surface
states in semiconductor quantum well structures and several Bi-based compounds.
A key characteristic of these spin-textured boundary states is their
insensitivity to spin-independent scattering, which protects them from
backscattering and localization. These chiral states are potentially useful for
spin-based electronics, in which long spin coherence is critical, and also for
quantum computing applications, where topological protection can enable
fault-tolerant information processing. Here we use a scanning tunneling
microscope (STM) to visualize the gapless surface states of the
three-dimensional topological insulator BiSb and to examine their scattering
behavior from disorder caused by random alloying in this compound. Combining
STM and angle-resolved photoemission spectroscopy, we show that despite strong
atomic scale disorder, backscattering between states of opposite momentum and
opposite spin is absent. Our observation of spin-selective scattering
demonstrates that the chiral nature of these states protects the spin of the
carriers; they therefore have the potential to be used for coherent spin
transport in spintronic devices.Comment: to be appear in Nature on August 9, 200
A review of reporting of participant recruitment and retention in RCTs in six major journals
<p>Abstract</p> <p>Background</p> <p>Poor recruitment and retention of participants in randomised controlled trials (RCTs) is problematic but common. Clear and detailed reporting of participant flow is essential to assess the generalisability and comparability of RCTs. Despite improved reporting since the implementation of the CONSORT statement, important problems remain. This paper aims: (i) to update and extend previous reviews evaluating reporting of participant recruitment and retention in RCTs; (ii) to quantify the level of participation throughout RCTs.</p> <p>Methods</p> <p>We reviewed all reports of RCTs of health care interventions and/or processes with individual randomisation, published July–December 2004 in six major journals. Short, secondary or interim reports, and Phase I/II trials were excluded. Data recorded were: general RCT details; inclusion of flow diagram; participant flow throughout trial; reasons for non-participation/withdrawal; target sample sizes.</p> <p>Results</p> <p>133 reports were reviewed. Overall, 79% included a flow diagram, but over a third were incomplete. The majority reported the flow of participants at each stage of the trial after randomisation. However, 40% failed to report the numbers assessed for eligibility. Percentages of participants retained at each stage were high: for example, 90% of eligible individuals were randomised, and 93% of those randomised were outcome assessed. On average, trials met their sample size targets. However, there were some substantial shortfalls: for example 21% of trials reporting a sample size calculation failed to achieve adequate numbers at randomisation, and 48% at outcome assessment. Reporting of losses to follow up was variable and difficult to interpret.</p> <p>Conclusion</p> <p>The majority of RCTs reported the flow of participants well after randomisation, although only two-thirds included a complete flow chart and there was great variability over the definition of "lost to follow up". Reporting of participant eligibility was poor, making assessments of recruitment practice and external validity difficult. Reporting of participant flow throughout RCTs could be improved by small changes to the CONSORT chart.</p
Enteric dysbiosis and fecal calprotectin expression in premature infants.
BackgroundPremature infants often develop enteric dysbiosis with a preponderance of Gammaproteobacteria, which has been related to adverse clinical outcomes. We investigated the relationship between increasing fecal Gammaproteobacteria and mucosal inflammation, measured by fecal calprotectin (FC).MethodsStool samples were collected from very-low-birth weight (VLBW) infants at ≤2, 3, and 4 weeks' postnatal age. Fecal microbiome was surveyed using polymerase chain reaction amplification of the V4 region of 16S ribosomal RNA, and FC was measured by enzyme immunoassay.ResultsWe enrolled 45 VLBW infants (gestation 27.9 ± 2.2 weeks, birth weight 1126 ± 208 g) and obtained stool samples at 9.9 ± 3, 20.7 ± 4.1, and 29.4 ± 4.9 days. FC was positively correlated with the genus Klebsiella (r = 0.207, p = 0.034) and its dominant amplicon sequence variant (r = 0.290, p = 0.003), but not with the relative abundance of total Gammaproteobacteria. Klebsiella colonized the gut in two distinct patterns: some infants started with low Klebsiella abundance and gained these bacteria over time, whereas others began with very high Klebsiella abundance.ConclusionIn premature infants, FC correlated with relative abundance of a specific pathobiont, Klebsiella, and not with that of the class Gammaproteobacteria. These findings indicate a need to define dysbiosis at genera or higher levels of resolution
A sonographic spectrum of psoriatic arthritis: “the five targets”
Ultrasound is a rapidly evolving technique that is gaining an increasing success in the assessment of psoriatic arthritis. Most of the studies have been aimed at investigating its ability in the assessment of joints, tendons, and entheses in psoriatic arthritis patients. Less attention has been paid to demonstrate the potential of ultrasound in the evaluation of skin and nail. The aim of this pictorial essay was to show the main high-frequency grayscale and power Doppler ultrasound findings in patients with psoriatic arthritis at joint, tendon, enthesis, skin, and nail level
SUSY, the Third Generation and the LHC
We develop a bottom-up approach to studying SUSY with light stops and
sbottoms, but with other squarks and sleptons heavy and beyond reach of the
LHC. We discuss the range of squark, gaugino and Higgsino masses for which the
electroweak scale is radiatively stable over the "little hierarchy" below ~ 10
TeV. We review and expand on indirect constraints on this scenario, in
particular from flavor and CP tests. We emphasize that in this context,
R-parity violation is very well motivated. The phenomenological differences
between Majorana and Dirac gauginos are also discussed. Finally, we focus on
the light subsystem of stops, sbottom and neutralino with R-parity, in order to
probe the current collider bounds. We find that 1/fb LHC bounds are mild and
large parts of the motivated parameter space remain open, while the 10/fb data
can be much more decisive.Comment: 42 pages, 8 figures, 1 table. V2: minor corrections, references adde
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