Measurements of the νμ\nu_{\mu} and νˉμ\bar{\nu}_{\mu}-induced Coherent Charged Pion Production Cross Sections on 12C^{12}C by the T2K experiment

We report an updated measurement of the $\nu_{\mu}$-induced, and the first measurement of the $\bar{\nu}_{\mu}$-induced coherent charged pion production cross section on $^{12}C$ nuclei in the T2K experiment. This is measured in a restricted region of the final-state phase space for which $p_{\mu,\pi} > 0.2$ GeV, $\cos(\theta_{\mu}) > 0.8$ and $\cos(\theta_{\pi}) > 0.6$, and at a mean (anti)neutrino energy of 0.85 GeV using the T2K near detector. The measured $\nu_{\mu}$ CC coherent pion production flux-averaged cross section on $^{12}C$ is $(2.98 \pm 0.37 (stat.) \pm 0.31 (syst.) \substack{ +0.49 \\ -0.00 } \mathrm{ (Q^2\,model)}) \times 10^{-40}~\mathrm{cm}^{2}$. The new measurement of the $\bar{\nu}_{\mu}$-induced cross section on $^{12}{C}$ is $(3.05 \pm 0.71 (stat.) \pm 0.39 (syst.) \substack{ +0.74 \\ -0.00 } \mathrm{(Q^2\,model)}) \times 10^{-40}~\mathrm{cm}^{2}$. The results are compatible with both the NEUT 5.4.0 Berger-Sehgal (2009) and GENIE 2.8.0 Rein-Sehgal (2007) model predictions

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage 653 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage 653 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage 653 CKD (eGFR < 60 mL/min/1.73 m2) or eGFR reduction > 30% from baseline was evaluated. Results: The mean estimated GFR was 98 \ub1 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR < 90 ml/min/m2 were independent risk factors for stage 653 CKD and renal function worsening. When compared to patients with eGFR > 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage 653 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening

Measurements of the νμ and ν¯μ -induced coherent charged pion production cross sections on C12 by the T2K experiment

We report an updated measurement of the ν μ -induced, and the first measurement of the ¯ ν μ -induced coherent charged pion production cross section on 12 C nuclei in the Tokai-to-Kamioka experiment. This is measured in a restricted region of the final-state phase space for which p μ , π > 0.2     GeV , cos ( θ μ ) > 0.8 and cos ( θ π ) > 0.6 , and at a mean (anti)neutrino energy of 0.85 GeV using the T2K near detector. The measured ν μ charged current coherent pion production flux-averaged cross section on 12 C is ( 2.98 ± 0.37 ( stat ) ± 0.31 ( syst ) + 0.49 − 0.00 ( Q 2   model ) ) × 10 − 40     cm 2 . The new measurement of the ¯ ν μ -induced cross section on 12 C is ( 3.05 ± 0.71 ( stat ) ± 0.39 ( syst ) + 0.74 − 0.00 ( Q 2   model ) ) × 10 − 40     cm 2 . The results are compatible with both the NEUT 5.4.0 Berger-Sehgal (2009) and GENIE 2.8.0 Rein-Sehgal (2007) model predictions

Scintillator ageing of the T2K near detectors from 2010 to 2021

The T2K experiment widely uses plastic scintillator as a target for neutrino interactions and an active medium for the measurement of charged particles produced in neutrino interactions at its near detector complex. Over 10 years of operation the measured light yield recorded by the scintillator based subsystems has been observed to degrade by 0.9–2.2% per year. Extrapolation of the degradation rate through to 2040 indicates the recorded light yield should remain above the lower threshold used by the current reconstruction algorithms for all subsystems. This will allow the near detectors to continue contributing to important physics measurements during the T2K-II and Hyper-Kamiokande eras. Additionally, work to disentangle the degradation of the plastic scintillator and wavelength shifting fibres shows that the reduction in light yield can be attributed to the ageing of the plastic scintillator. The long component of the attenuation length of the wavelength shifting fibres was observed to degrade by 1.3–5.4% per year, while the short component of the attenuation length did not show any conclusive degradation

Il diaframma mucoso.Una singolare complicanza della tecnica di Knight-Griffen associata a stomia protettiva

L'incidenza di diaframmi occlusivi su anastomosi meccaniche per resezioni anteriori del retto non è nota e la gestione di questa complicanza non è ben definita.Un uomo di 74 anni è stato sottoposto a resezione curativa di un adenocarcinoma del retto e a resezione segmentaria digiunale di un tumore stromale scoperto incidentalmente. L'anastomosi colorettale termino-terminale meccanica, secondo la tecnica di Knight-Griffen, e l'anastomosi digiuno-digiunale termino-terminale manuale sono state protette da un'ileostomia temporanea.Alcuni elementi rendono il caso del tutto singolare: il diaframma occlusivo anastomotico, sotteso a livello dell'anastomosi meccanica, non era costituito da tessuto di granulazione ma da un lembo di mucosa.Vari fattori hanno contribuito alla genesi e al mancato riconoscimento di questa complicanza.Vanificato l'approccio endoscopico, il trattamento è avvenuto nel corso di un intervento per perforazione intestinale

Angiomixoma aggressivo della pelvi e del perineo. Presentazione di un caso clinico e revisione della letteratura

L'angiomixoma aggressivo è un raro tumore mesenchimale che origina dal tessuto connettivo della pelvi e del perineo. Si caratterizza per una sintomatologia aspecifica, per la tendenza ad infiltrare i tessuti circostanti e per la facilità con cui recidiva anche a notevole distanza di tempo. Viene presentato il caso di una paziente di sesso femminile di 57 anni che giunge alla nostra osservazione per la comparsa di una voluminosa tumefazione del perineo e già sottoposta più volte ad asportazione di neoformazioni della regione pelviperineale. Si descrive l'iter diagnostico che ha consentito il riconoscimento della neoplasia già in fase preoperatoria e l'iter terapeutico. L'intervento chirurgico di asportazione è stato condotto con un duplice accesso laparotomico e perineale a doppia equipe ed è stato reso particolarmente difficoltoso dall'imponente sclerosi retroperitoneale coinvolgente le basse vie urinarie, il moncone vaginale ed il mesoretto. L'asportazione radicale della neoplasia ha permesso la ricostituzione della normale anatomia pelvica, la regressione della sintomatologia preoperatoria e la ripresa della usuale attività lavorativa. Il trattamento di scelta dell'angiomixoma aggressivo è chirurgico. Questa neoplasia pur essendo benigna assume il comportamento di una malattia maligna per il coinvolgimento degli organi pelvici. Data l'aggressività locale tende a recidivare con un'elevata frequenza potendosi ripresentare anche dopo decenni dal primo intervento. Fondamentale risulta pertanto un follow up a lungo termine

Usefulness of lateral internal sphincterotomy combined with hemorrhoidectomy by the Milligan-Morgan's technique: results of a prospective randomized trial

Pain is invariably experienced after haemorrhoidectomy. Internal anal spasm is considered to be a major factor in the genesis of such pain. This prospective randomized study was designed to compare the effectiveness of two manoeuvres (surgical sphincterotomy and chemical sphincterotomy) in reducing post-haemorrhoidectomy pain. Sixty patients (38 males, 22 females) with grade III and IV haemorrhoids were included in this study. In all cases resting anal pressure was reported in the range of 50-100 mm Hg. Group A patients underwent Milligan-Morgan haemorrhoidectomy plus chemical sphincterotomy; group B patients underwent Milligan-Morgan haemorrhoidectomy plus internal left lateral sphincterotomy (0.8-1 cm in length) and group C patients underwent Milligan-Morgan haemorrhoidectomy alone. The postoperative course was carefully evaluated and was found to be better in group B. None of the patients treated by surgical sphincterotomy developed incontinence. Two patients in group C developed anal strictures. When indicated, internal left lateral sphincterotomy (0.8-1 cm) is a safe procedure and reduces post-haemorrhoidectomy pain and stenosis

Erratum: Variant of Rett syndrome and CDKL5 gene: Clinical and autonomic description of 10 cases (Neuropediatrics (2013) 44 (237-238))

No abstract availabl