119 research outputs found
Dielectric spectroscopy studies of 4-cyano-3-fluorophenyl 4-butylbenzoate liquid crystal at high pressure
For 4-cyano-3- uorophenyl 4-butylbenzoate, nematic glassformer at ambient pressure, dielectric relaxation
studies were performed under elevated pressure. In the isobaric experiment, on cooling the nematic phase two
superarrhenius -relaxations, ascribed to the reorientations of molecules around short axes and precession of long molecular axes were found and the Arrhenius -relaxation related to intramolecular motions. Complexity of dynamics at elevated and ambient pressure is similar. Shift towards lower frequencies was found for both-relaxations
Global Compartmental Analysis of the Excited-State Reaction between Fluorescein and (±)- N
Calibration and operation of SiPM-based cameras for gamma-ray astronomy in presence of high night-sky light
The SST-1M project for the Cherenkov Telescope Array
The SST-1M project, run by a Consortium of institutes from Czech Republic, Poland and Switzerland, has been proposed as a solution for implementing the small-size telescope array of the southern site of the Cherenkov Telescope Array. The technology is a pathfinder for efficient production of cost-effective imaging air Cherenkov telescopes. We report on the main system features and recent upgrades, the performances validation and the operation campaign carried out in 2018
Satisfaction and discontent of Polish patients with biological therapy of rheumatic diseases : results of a multi-center questionnaire study
Objectives: Biologics are medications widely applied in the management of inflammatory rheumatic
diseases. The drugs were found to be effective but their application is associated with some
disadvantages. Medication with biologics is relatively expensive, and in Poland, it is carried out in
specialized centers. The study was designed to evaluate various aspects of satisfaction and dissatisfaction
of Polish patients treated with biologics.
Material and methods: An anonymous questionnaire was distributed in 23 Polish rheumatological
centers involved in the treatment; 1212 returned questionnaires were used for analysis. Responses
were received from 606 patients with rheumatoid arthritis, 427 with ankylosing spondylitis,
117 psoriatic arthritis, and 62 adult patients with juvenile idiopathic arthritis (in whom administration
of the drugs had been introduced before they were 18 years old). The investigated group
constituted about one-fifth of all rheumatic patients on biologics in Poland.
Results: A beneficial or very beneficial influence of the medication on the state of physical health
was found mostly in patients with rheumatoid arthritis (51.3 and 30.5%) and ankylosing spondylitis
(51.0 and 36.8%). Family life was improved by the treatment especially in patients with ankylosing
spondylitis (40.7 and 35.6% beneficial and very beneficial, respectively), sleep quality and sexual
life mostly in those with ankylosing spondylitis (beneficial/very beneficial influence 41.5/38.4, and
38.7/23.9, respectively). There was a rather small influence of biological treatment on the financial
situation of the patients. In general, satisfaction with the treatment was evaluated as positive or
very positive in 88% of all investigated patients.
In a significant part of the patients, transportation to the medical center was considered as a disadvantage
of the treatment. About one-third of the patients considered laboratory and imaging tests
to be done before initiation of the medication as a difficulty, and for about 40% waiting time for
qualification for the medication was a significant disadvantage. The route of drug administration
was without importance for 4/5 of the patients.
Conclusions: Summing up, the results were similar in the patients suffering from various diseases
although those with psoriatic arthritis felt the highest satisfaction (possibly due to the positive
aesthetic effect), and those with ankylosing spondylitis had significant improvement in sexual life
(probably due to younger age). Relatively low satisfaction was found in patients with juvenile idiopathic
arthritis. There was a small influence of medication on financial status of the patients. Application
of biologics has few disadvantages and most of them are associated with the organization of
health services (waiting time for the tests, transportation to the medical centers)
Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.
PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks
Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study
PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks
Surgical site infections after emergency hernia repair: substudy from the Management of Acutely Symptomatic Hernia (MASH) study
Introduction
Acutely symptomatic abdominal wall and groin hernias (ASH) are a common acute surgical presentation. There are limited data to guide decisions related to surgical repair technique and use of antibiotics, which can be driven by increased risk of surgical site infection (SSI) in this group. This study aims to report rates of SSI following ASH repair and explore the use of patient-reported outcome measure reporting in this setting.
Methods
An 18-week, UK-based, multicentre prospective cohort study (NCT04197271) recruited adults with ASH. This study reports operatively managed patients. Data on patient characteristics, inpatient management, quality of life, complications, and wound healing (Bluebelle score) were collected. Descriptive analyses were performed to estimate event rates of SSI and regression analysis explored the relationship between Bluebelle scores and SSI. The 30 and 90-day follow-up visits assessed complications and quality of life.
Results
The MASH study recruited 273 patients, of whom 218 were eligible for this study, 87.2 per cent who underwent open repair. Mesh was used in 123 patients (50.8 per cent). Pre- and postoperative antibiotics were given in 163 (67.4 per cent) and 28 (11.5 per cent) patients respectively. There were 26 reported SSIs (11.9 per cent). Increased BMI, incisional, femoral, and umbilical hernia were associated with higher rates of SSI (P = 0.006). In 238 patients, there was a difference in healthy utility values at 90 days between patients with and without SSI (P = 0.025). Also, when analysing 191 patients with Bluebelle scores, those who developed an SSI had higher Bluebelle values (P < 0.001).
Conclusion
SSI is frequent in repair of acutely symptomatic hernia and correlates with BMI and site of hernia
PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK
Abstract
Background
Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment.
Methods
All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals.
Results
A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death.
Conclusion
Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions.
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