The role of open abdomen in non-trauma patient : WSES Consensus Paper

The open abdomen (OA) is defined as intentional decision to leave the fascial edges of the abdomen un-approximated after laparotomy (laparostomy). The abdominal contents are potentially exposed and therefore must be protected with a temporary coverage, which is referred to as temporal abdominal closure (TAC). OA use remains widely debated with many specific details deserving detailed assessment and clarification. To date, in patients with intra-abdominal emergencies, the OA has not been formally endorsed for routine utilization; although, utilization is seemingly increasing. Therefore, the World Society of Emergency Surgery (WSES), Abdominal Compartment Society (WSACS) and the Donegal Research Academy united a worldwide group of experts in an international consensus conference to review and thereafter propose the basis for evidence-directed utilization of OA management in non-trauma emergency surgery and critically ill patients. In addition to utilization recommendations, questions with insufficient evidence urgently requiring future study were identified.Peer reviewe

Quantum dynamics of a single, mobile spin impurity

Quantum magnetism describes the properties of many materials such as transition metal oxides and cuprate superconductors. One of its elementary processes is the propagation of spin excitations. Here we study the quantum dynamics of a deterministically created spin-impurity atom, as it propagates in a one-dimensional lattice system. We probe the full spatial probability distribution of the impurity at different times using single-site-resolved imaging of bosonic atoms in an optical lattice. In the Mott-insulating regime, a post-selection of the data allows to reduce the effect of temperature, giving access to a space- and time-resolved measurement of the quantum-coherent propagation of a magnetic excitation in the Heisenberg model. Extending the study to the bath's superfluid regime, we determine quantitatively how the bath strongly affects the motion of the impurity. The experimental data shows a remarkable agreement with theoretical predictions allowing us to determine the effect of temperature on the coherence and velocity of impurity motion. Our results pave the way for a new approach to study quantum magnetism, mobile impurities in quantum fluids, and polarons in lattice systems

Hypogammaglobulinemia: Incidence, risk factors, and outcomes following pediatric lung transplantation

WOS: 000268793800015PubMed ID: 19067916Infection is the leading cause of morbidity and mortality in the first year following lung transplantation. HG after adult lung transplantation has been associated with increased infections and hospitalization as well as decreased survival. The purpose of this study is to define the incidence, risk factors, and outcomes of HG in the first year following pediatric lung transplantation. A retrospective review of all lung transplant recipients at a single pediatric center over a four-yr period was performed. All serum Ig levels drawn within one yr of transplantation were recorded. An association between HG during the first year after transplantation and age, race, gender, diagnosis leading to transplantation and clinical outcomes including hospitalization, infections requiring hospitalization, viremia, fungal recovery from BAL lavage, and mortality was sought. HG was defined using age-based norms. Fifty-one charts were reviewed. Mean (+/- s.d.) post-transplantation levels for IgG, IgA, and IgM were 439.9 +/- 201.3, 82.3 +/- 50.2, and 75.2 +/- 41.4 mg/dL, respectively. HG was present in 48.8%, 12.2%, and 17.1% of patients for IgG, IgA, and IgM, respectively. Patients with HG for IgG were older (14.3 +/- 3.8 vs. 9.2 +/- 5.4 yr; p < 0.01). IgA and IgM HG were associated with invasive aspergillosis (p < 0.01 and p = 0.05, respectively). IgG and IgM levels inversely correlated with bacterial infections and hospital days, respectively (p < 0.01, p < 0.05). HG is a frequent complication following pediatric lung transplantation. Low Ig levels are associated with increased infections and hospital stay