2,539 research outputs found
A strategy for the design of skyrmion racetrack memories
Magnetic storage based on racetrack memory is very promising for the design
of ultra-dense, low-cost and low-power storage technology. Information can be
coded in a magnetic region between two domain walls or, as predicted recently,
in topological magnetic objects known as skyrmions. Here, we show the
technological advantages and limitations of using Bloch and Neel skyrmions
manipulated by spin current generated within the ferromagnet or via the
spin-Hall effect arising from a non-magnetic heavy metal underlayer. We found
that the Neel skyrmion moved by the spin-Hall effect is a very promising
strategy for technological implementation of the next generation of skyrmion
racetrack memories (zero field, high thermal stability, and ultra-dense
storage). We employed micromagnetics reinforced with an analytical formulation
of skyrmion dynamics that we developed from the Thiele equation. We identified
that the excitation, at high currents, of a breathing mode of the skyrmion
limits the maximal velocity of the memory
Anterior cervical discectomy and fusion with ROI-C peek cage: cervical alignment and patient outcomes
OBJECTIVE:
The intersomatic cage ROI-C one is a new promising system in anterior cervical discectomy with subsequent fusion.
METHODS:
Patients were studied prospectively. ROI-C cages were used in consecutive 32 patients. Intraoperative parameters, clinical features and dysphagia scores were recorded. Radiographs evaluated the height of intervertebral space, the cervical Cobb angle and implant positioning. Data were collected on the last day of hospital stay, at 6 weeks, at 3, 6, 12 and 24 months.
RESULTS:
A total of 32 cages were implanted. One patient had transient dysphagia. The intervertebral height and the cervical Cobb angle were significantly improved at 24 months follow-up (P < 0.05). Compared to pre-operatively, visual analog scale pain score and neck pain and disability scale were reduced at 1-month follow-up without change during subsequent follow-up.
CONCLUSIONS:
This is the first prospective study on ROI-C cages. Although this is a preliminary assessment, the ROI-C cage may represent an excellent alternative to other devices or simple bone graft
CORRELATION BETWEEN IBD, INTESTINAL DYSBIOSIS, DIET AND MOOD TONE DISEASE: ANALYSIS OF LITERATURE
This essay's main goal the present review is to highlight the connections between intestinal dysbiosis and the ensuing activation of the mucosal lymphatic system. One of the study's goals is to investigate the impact on mood caused by a serotonergic deficit driven by mucosal inflammation. It assesses the relationship between food consumption and the onset of psychological and mental illness as a secondary end aim. Patients with inflammatory bowel diseases and psychological and psychiatric mood disorders appear to benefit therapeutically from the sort of diet they consume
2016 WHO GLOBAL GUIDELINES FOR THE PREVENTION OF SURGICAL SITE INFECTION: A NEW STEP TO IMPROVE PATIENT'S SAFETY BEFORE, DURING AND AFTER SURGERY
Surgical site infection (SSI) are among the most preventable health-care-associated infections and are a substantial burden to health-care systems and service payers worldwide in terms of patient morbidity, mortality, and additional costs. SSI prevention is complex and requires the integration of a range of measures before, during and after surgery. No international guidelines are available and incosistencies in the interpretations of evidence and recommendations of national guidelines have been identified. Given the burden of SSI worldwide, the numerous gaps in evidence-based guidance, and the need for standardisation and a global approach, WHO decided to prioritise the development of evidence-based recommendations for thew prevention of SSI. The guidelines take into account the balance between benefits and harms, the evidence quality, costs and resource use implications, and patgients values andf preferences. on the basis of systematic literature reviews and expert consensus, we present 23 recommendations on preoperative, intraoperative and postoperative preventive measures. The WHO recommendations were developed with a global perspective and they take into account the balance between benefitgs and harms, the evidence quality level, cost and resource use implications, and patient values and preferences
HEAT SHOCK PROTEINS AND ULCERATIVE COLITIS: THE START OF A NEW ERA?
We read with great interest the article written by Abou El Azm
and coworkers, published in the last issue of the Arab Journal of
Gastroenterology [1]. In this article, the authors investigated the
molecular expression of heat shock proteins (HSP) 70 and 90 in
relation to the grades of inflammation and dysplasia in patients
with ulcerative colitis (UC) before and after treatment.
In this study, in agreement with other published studies [2–4],
the authors not only found a potential role for HSP 70 and HSP 90
for assessment of the activity and prognosis of UC, but also such
markers predicted the presence of dysplasia and differentiated it
from reactive atypia [1].
HSP had been found not only a marker of active disease, thus
considering UC as a ‘‘chaperonopathy by mistake’’, but also show
a key role in the psychosocial setting in which inflammatory bowel
diseases manifest themselves [5]. Furthermore, they could represent
a new diagnostic tool to differentiate the different phenotypes
of UC, thus allowing to tailor a targeted approach to better manage
UC patients [6].
However, some unresolved issues still remain about the potential
roles of HSP in both the acute and the longstanding disease. First, it
should be interesting to assess the role of HSP in the infections
associated to UC flares, like Clostridium difficile and Cytomegalovirus
(CMV) infections. In fact, HSP could be investigated as a further
marker of inflammation in case of severe and steroid-refractory
disease; with regard to CMV infection, mucosal levels of HSP could
differentiate when CMV plays a role of direct pathogen or when it
represents merely a ‘‘silent bystander’’. Second, in longstanding
UC, an integrated approach of colorectal cancer surveillance, by
using the advanced endoscopic imaging together with mucosal
markers, like HSP, could result in being markedly helpful, both to
clinicians and pathologist. In fact, current guidelines recommend
that image-enhanced endoscopy (IEE) may increase the yield of
detection of dysplasia, thus representing a reasonable alternative
to the random sampling of colon using standard white light [7].
The use of both IEE and new biomarkers, like HSP, predicting future
occurrence of colonic neoplasia, could lead to a more centralised
approach of UC patients, in which a ‘‘biomarker-based surveillance’’
might play a pivotal rol
Association between time to reperfusion and outcome is primarily driven by the time from imaging to reperfusion
Background and Purpose A progressive decline in the odds of favorable outcome as time to reperfusion increases is well known. However, the impact of specific workflow intervals is not clear.; Methods We studied the mechanical thrombectomy group (n=103) of the prospective, randomized REVASCAT (Randomized Trial of Revascularization With Solitaire FR Device Versus Best Medical Therapy in the Treatment of Acute Stroke due to Anterior Circulation Large Vessel Occlusion Presenting Within Eight Hours of Symptom Onset) trial. We defined 3 workflow metrics: time from symptom onset to reperfusion (OTR), time from symptom onset to computed tomography, and time from computed tomography (CT) to reperfusion. Clinical characteristics, core laboratory-evaluated Alberta Stroke Program Early CT Scores (ASPECTS) and 90-day outcome data were analyzed. The effect of time on favorable outcome (modified Rankin scale, 0-2) was described via adjusted odds ratios (ORs) for every 30-minute delay.; Results Median admission National Institutes of Health Stroke Scale was 17.0 (14.0-20.0), reperfusion rate was 66%, and rate of favorable outcome was 43.7%. Mean (SD) workflow times were as follows: OTR: 342 (107) minute, onset to CT: 204 (93) minute, and CT to reperfusion: 138 (56) minute. Longer OTR time was associated with a reduced likelihood of good outcome (OR for 30-minute delay, 0.74; 95% confidence interval [CI], 0.59-0.93). The onset to CT time did not show a significant association with clinical outcome (OR, 0.87; 95% CI, 0.67-1.12), whereas the CT to reperfusion interval showed a negative association with favorable outcome (OR, 0.72; 95% CI, 0.54-0.95). A similar subgroup analysis according to admission ASPECTS showed this relationship for OTR time in ASPECTS<8 patients (OR, 0.56; 95% CI, 0.35-0.9) but not in ASPECTS8 (OR, 0.99; 95% CI, 0.68-1.44).; Conclusions Time to reperfusion is negatively associated with favorable outcome, being CT to reperfusion, as opposed to onset to CT, the main determinant of this association. In addition, OTR was strongly associated to outcome in patients with low ASPECTS scores but not in patients with high ASPECTS scores.; Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT01692379.Peer ReviewedPostprint (author's final draft
SURGICAL TREATMENT OF SACROCOCCYGEAL PILONIDAL SINUS WITH THE LIMBERG FLAP: REVIEW OF 81 CASES
Pilonidal sinus disease is a complex condition that causes both discomfort and embarassment to suffers. Direct cost through absence from work is high. Controversy still exists regarding the best surgical technique for its treatment in terms of minimizing disease recurrence and patient discomfort. Thus, we conducted this study to evaluate the results of rhomboid excision and Limberg flap reconstruction in the surgical treatment of pilonidal sinus disease. This prospective study included 81 patients who had pilonidal sinus and were treated by the rhomboid excision and Limberg flap. The mean follow-up was 18 months and all patients were satisfied with the procedure. There were lower complication rates, minimal discomfort, patients disharged in 2-3 days and only two recurrences. The Authors recommend the Limberg flap procedure for pilonidal sinus disease. It is effective, with short hospitalization, low recurrence rate and shorter time off work
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