599 research outputs found
Relationship Between Lung Function and Skeletal Muscle Morphology in Predicting Risk of Cachexia
poste
Pregnant with metastatic neuroendocrine tumour of the ovary: what now?
Neuroendocrine tumours (NET) are a heterogeneous group of neoplasms commonly occurring in the gastrointestinal tract or lungs but can occur in other regions. Primary ovarian NET account for 5% of all NET and 0.1% of all ovarian malignancies. In metastatic disease, the therapeutic goal is to extend survival and to improve quality of life. As these tumours express somatostatin receptors, somatostatin analogues are frequently used to control symptoms. Here we present a case of a pregnant woman with an ovarian NET with liver metastases and carcinoid syndrome who was treated with the somatostatin analogue, Octreotide LAR. We also summarize reported data of the use of somatostatin analogues during pregnancy
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n-3 Fatty Acid Supplementation for the Treatment of Dry Eye Disease.
BackgroundDry eye disease is a common chronic condition that is characterized by ocular discomfort and visual disturbances that decrease quality of life. Many clinicians recommend the use of supplements of n-3 fatty acids (often called omega-3 fatty acids) to relieve symptoms.MethodsIn a multicenter, double-blind clinical trial, we randomly assigned patients with moderate-to-severe dry eye disease to receive a daily oral dose of 3000 mg of fish-derived n-3 eicosapentaenoic and docosahexaenoic acids (active supplement group) or an olive oil placebo (placebo group). The primary outcome was the mean change from baseline in the score on the Ocular Surface Disease Index (OSDI; scores range from 0 to 100, with higher scores indicating greater symptom severity), which was based on the mean of scores obtained at 6 and 12 months. Secondary outcomes included mean changes per eye in the conjunctival staining score (ranging from 0 to 6) and the corneal staining score (ranging from 0 to 15), with higher scores indicating more severe damage to the ocular surface, as well as mean changes in the tear break-up time (seconds between a blink and gaps in the tear film) and the result on Schirmer's test (length of wetting of paper strips placed on the lower eyelid), with lower values indicating more severe signs.ResultsA total of 349 patients were assigned to the active supplement group and 186 to the placebo group; the primary analysis included 329 and 170 patients, respectively. The mean change in the OSDI score was not significantly different between the active supplement group and the placebo group (-13.9 points and -12.5 points, respectively; mean difference in change after imputation of missing data, -1.9 points; 95% confidence interval [CI], -5.0 to 1.1; P=0.21). This result was consistent across prespecified subgroups. There were no significant differences between the active supplement group and the placebo group in mean changes from baseline in the conjunctival staining score (mean difference in change, 0.0 points; 95% CI, -0.2 to 0.1), corneal staining score (0.1 point; 95% CI, -0.2 to 0.4), tear break-up time (0.2 seconds; 95% CI, -0.1 to 0.5), and result on Schirmer's test (0.0 mm; 95% CI, -0.8 to 0.9). At 12 months, the rate of adherence to treatment in the active supplement group was 85.2%, according to the level of n-3 fatty acids in red cells. Rates of adverse events were similar in the two trial groups.ConclusionsAmong patients with dry eye disease, those who were randomly assigned to receive supplements containing 3000 mg of n-3 fatty acids for 12 months did not have significantly better outcomes than those who were assigned to receive placebo. (Funded by the National Eye Institute, National Institutes of Health; DREAM ClinicalTrials.gov number, NCT02128763 .)
4.5 years multi-wavelength observations of Mrk 421 during the ARGO-YBJ and Fermi common operation time
We report on the extensive multi-wavelength observations of the blazar
Markarian 421 (Mrk 421) covering radio to gamma-rays, during the 4.5 year
period of ARGO-YBJ and Fermi common operation time, from August 2008 to
February 2013. In particular, thanks to the ARGO-YBJ and Fermi data, the whole
energy range from 100 MeV to 10 TeV is covered without any gap. In the
observation period, Mrk 421 showed both low and high activity states at all
wavebands. The correlations among flux variations in different wavebands were
analyzed. Seven large flares, including five X-ray flares and two GeV gamma-ray
flares with variable durations (3-58 days), and one X-ray outburst phase were
identified and used to investigate the variation of the spectral energy
distribution with respect to a relative quiescent phase. During the outburst
phase and the seven flaring episodes, the peak energy in X-rays is observed to
increase from sub-keV to few keV. The TeV gamma-ray flux increases up to
0.9-7.2 times the flux of the Crab Nebula. The behavior of GeV gamma-rays is
found to vary depending on the flare, a feature that leads us to classify
flares into three groups according to the GeV flux variation. Finally, the
one-zone synchrotron self-Compton model was adopted to describe the emission
spectra. Two out of three groups can be satisfactorily described using injected
electrons with a power-law spectral index around 2.2, as expected from
relativistic diffuse shock acceleration, whereas the remaining group requires a
harder injected spectrum. The underlying physical mechanisms responsible for
different groups may be related to the acceleration process or to the
environment properties.Comment: 17 pages, 9 figures, 5 tables, Accepted for publication in ApJ
The cosmic ray proton plus helium energy spectrum measured by the ARGO-YBJ experiment in the energy range 3-300 TeV
The ARGO-YBJ experiment is a full-coverage air shower detector located at the
Yangbajing Cosmic Ray Observatory (Tibet, People's Republic of China, 4300 m
a.s.l.). The high altitude, combined with the full-coverage technique, allows
the detection of extensive air showers in a wide energy range and offer the
possibility of measuring the cosmic ray proton plus helium spectrum down to the
TeV region, where direct balloon/space-borne measurements are available. The
detector has been in stable data taking in its full configuration from November
2007 to February 2013. In this paper the measurement of the cosmic ray proton
plus helium energy spectrum is presented in the region 3-300 TeV by analyzing
the full collected data sample. The resulting spectral index is . These results demonstrate the possibility of performing an accurate
measurement of the spectrum of light elements with a ground based air shower
detector.Comment: 18 pages, 8 figures, preprint submitted to Phys. Rev.
Observation of TeV gamma rays from the Cygnus region with the ARGO-YBJ experiment
We report the observation of TeV gamma-rays from the Cygnus region using the
ARGO-YBJ data collected from 2007 November to 2011 August. Several TeV sources
are located in this region including the two bright extended MGRO J2019+37 and
MGRO J2031+41. According to the Milagro data set, at 20 TeV MGRO J2019+37 is
the most significant source apart from the Crab Nebula. No signal from MGRO
J2019+37 is detected by the ARGO-YBJ experiment, and the derived flux upper
limits at 90% confidence level for all the events above 600 GeV with medium
energy of 3 TeV are lower than the Milagro flux, implying that the source might
be variable and hard to be identified as a pulsar wind nebula. The only
statistically significant (6.4 standard deviations) gamma-ray signal is found
from MGRO J2031+41, with a flux consistent with the measurement by Milagro.Comment: 14 pages, 4 figure
The Knee of the Cosmic Hydrogen and Helium Spectrum below 1 PeV Measured by ARGO-YBJ and a Cherenkov Telescope of LHAASO
The measurement of cosmic ray energy spectra, in particular for individual
species, is an essential approach in finding their origin. Locating the "knees"
of the spectra is an important part of the approach and has yet to be achieved.
Here we report a measurement of the mixed Hydrogen and Helium spectrum using
the combination of the ARGO-YBJ experiment and of a prototype Cherenkov
telescope for the LHAASO experiment. A knee feature at 640+/-87 TeV, with a
clear steepening of the spectrum, is observed. This gives fundamental inputs to
galactic cosmic ray acceleration models
Observation of TeV gamma-rays from the unidentified source HESS J1841-055 with the ARGO-YBJ experiment
We report the observation of a very high energy \gamma-ray source, whose
position is coincident with HESS J1841-055. This source has been observed for
4.5 years by the ARGO-YBJ experiment from November 2007 to July 2012. Its
emission is detected with a statistical significance of 5.3 standard
deviations. Parameterizing the source shape with a two-dimensional Gaussian
function we estimate an extension \sigma=(0.40(+0.32,-0.22}) degree, consistent
with the HESS measurement. The observed energy spectrum is dN/dE =(9.0-+1.6) x
10^{-13}(E/5 TeV)^{-2.32-+0.23} photons cm^{-2} s^{-1} TeV^{-1}, in the energy
range 0.9-50 TeV. The integral \gamma-ray flux above 1 TeV is 1.3-+0.4 Crab
units, which is 3.2-+1.0 times the flux derived by HESS. The differences in the
flux determination between HESS and ARGO-YBJ, and possible counterparts at
other wavelengths are discussed.Comment: 17 pages, 4 figures, have been accepted for publication in Ap
The ARGO-YBJ Experiment Progresses and Future Extension
Gamma ray source detection above 30TeV is an encouraging approach for finding
galactic cosmic ray origins. All sky survey for gamma ray sources using wide
field of view detector is essential for population accumulation for various
types of sources above 100GeV. To target the goals, the ARGO-YBJ experiment has
been established. Significant progresses have been made in the experiment. A
large air shower detector array in an area of 1km2 is proposed to boost the
sensitivity. Hybrid detection with multi-techniques will allow a good
discrimination between different types of primary particles, including photons
and protons, thus enable an energy spectrum measurement for individual specie.
Fluorescence light detector array will extend the spectrum measurement above
100PeV where the second knee is located. An energy scale determined by balloon
experiments at 10TeV will be propagated to ultra high energy cosmic ray
experiments
EAS age determination from the study of the lateral distribution of charged particles near the shower axis with the ARGO-YBJ experiment
The ARGO-YBJ experiment, a full coverage extensive air shower (EAS) detector
located at high altitude (4300 m a.s.l.) in Tibet, China, has smoothly taken
data, with very high stability, since November 2007 to the beginning of 2013.
The array consisted of a carpet of about 7000 m Resistive Plate Chambers
(RPCs) operated in streamer mode and equipped with both digital and analog
readout, providing the measurement of particle densities up to few particles
per cm. The unique detector features (full coverage, readout granularity,
wide dynamic range, etc) and location (very high altitude) allowed a detailed
study of the lateral density profile of charged particles at ground very close
to the shower axis and its description by a proper lateral distribution
function (LDF). In particular, the information collected in the first 10 m from
the shower axis have been shown to provide a very effective tool for the
determination of the shower development stage ("age") in the energy range 50
TeV - 10 PeV. The sensitivity of the age parameter to the mass composition of
primary Cosmic Rays is also discussed
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