2,839 research outputs found

    Preliminary results of an aging test of RPC chambers for the LHCb Muon System

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    The preliminary results of an aging test performed at the CERN Gamma Irradiation Facility on a single--gap RPC prototype developed for the LHCb Muon System are presented. The results are based on an accumulated charge density of 0.42 C/cm^2, corresponding to about 4 years of LHCb running at the highest background rate. We observe a rise in the dark current and noise measured with source off. The current drawn with source on steadily decreased, possibly indicating an increase of resistivity of the chamber plates. The performance of the chamber, studied with a muon beam under several photon flux values, is found to still fulfill the LHCb operation requirements.Comment: 4 pages, 6 figures, presented at RPC2001, VIth Workshop on Resistive Plate Chambers and Related Detectors, November 26-27 2001, Coimbra, Portuga

    The use of fentanyl buccal tablets for breakthrough pain by using doses proportional to opioid basal regimen in a home care setting.

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    Abstract The dose of rapid onset opioids to be given for breakthrough cancer pain (BTcP) is controversial. Dose proportional to the basal opioid regimen seem to be safe and effective in hospital units. However, data in other less protected settings, like home care, are lacking. The aim of this open-label study was to assess the efficacy and safety in a group of patients with BTcP followed at home, after giving a dose of fentanyl buccal tablets (FBT) proportional to the opioid basal regimen, skipping the steps for dose titration. Consecutive patients admitted to a home care program presenting BTcP episodes and receiving stable doses of opioids for background pain were selected. Data from four consecutive episodes of BTcP were collected. For each episode, patients were instructed to routinely collect changes in pain intensity and severe adverse effects when pain got severe (T0) and to reassess the same items 15 min after FBT, given as a rescue medication in doses proportional to the daily opioid doses used for background pain (T15). One hundred twenty episodes of BTcP were recorded in 30 patients. One hundred eight episodes were defined as successfully treated, while 12 episodes required a further administration of opioids. Pain intensity significantly decreased at T15 (p < 0.001). In 95.5 and 90.8 % of episodes treated, there was a reduction in pain intensity of more than 33 and 50 %, respectively. No relevant adverse effects were recorded, even in older patients. This study suggests that FBT given in doses proportional to the basal opioid regimen for the management of BTcP is very effective and safe in clinical practice in the home care setting

    Opioid switching in patients with advanced cancer followed at home. A retrospective analysis

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    Abstract CONTEXT: Opioid switching has been found to improve opioid responsiveness in different conditions. However, data on opioid switching performed at home are almost nonexistent, despite the fact that most patients are followed at home. OBJECTIVES: The aim of this retrospective survey was to determine frequency, indications, usefulness, and safety of opioid switching when treating advanced cancer-related pain in patients followed at home. METHODS: A retrospective review of data from patients with advanced cancer followed at home by three home care teams for a period of two years was performed. Patients who had their opioids switched were selected. Reasons for switching opioid doses and routes of administration and outcomes were collected. RESULTS: Two hundred one (17%) of 1141 patients receiving "strong" opioids were switched. The mean Karnofsky Performance Status score was 35.6, and the median survival was 30 days. The most frequent reason to switch was for convenience, and the most frequent switch was to parenteral morphine. In most patients, a better analgesic response was observed. Patients who were switched to parenteral morphine had a shorter survival in comparison with other opioid sequences (P<0.0005). After switching, opioid doses were increased by 23% and 41%, after a week and at time of death, respectively. CONCLUSION: Opioid switching was useful for most patients in the home environment, at least in less complex circumstances, when done by experienced home care teams. Prospective studies are needed to provide information about the decision to admit to hospital for this purpose and the predictive factors that may relatively contraindicate transportation to a facility in severely ill patients

    Assembly and Certification of ATLAS Muon Stations for the Middle and Outer Barrel at CERN

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    Roughly 400 of the approximately 700 muon stations of the ATLAS barrel belong to the middle and outer layer. Barrel Middle and Barrel Outer stations consist of both an MDT chamber and one or two RPC planes delivering the level-1 trigger information. While MDT chambers and individual RPC units are constructed at their home institutes, the assembly of the RPCs into planes, including the final cabling and the mounting of the trigger electronics, as well as the integration of MDTs and RPCs into muon stations takes place at CERN. MDT chambers, RPC planes and the completed stations have to pass a series of tests before being declared 'ready-for-installation'. Final certification criteria is the passing of a one-day cosmic ray test, for which a special setup has been built in building 899 (BB5). This note gives an overview over the work carried out in BB5, with emphasis on the cosmic ray test. Examples of abnormal chamber behavior will be discussed and a summary of common mistakes in station assembly or chamber cabling will be given. A second focus of the note is on the statistical analysis of the certification results

    Emergencies in patients with advanced cancer followed at home.

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    Abstract CONTEXT: Patients with advanced cancer stay at home for most of their time, and acute problems may occur during home care. Caregivers may call medical services for an emergency, which can result in patients being admitted to the hospital. No data exist on emergencies in patients followed by a home care team. OBJECTIVES: The aim of this multicenter prospective study was to assess the frequency, reasons for, and subsequent course of emergency calls for patients followed at home by a palliative care team. METHODS: A consecutive sample of patients admitted to home care programs was surveyed for a period of seven months. Epidemiological data, and characteristics of emergency calls and outcomes, as well as environmental situations were recorded. RESULTS: Six hundred eighty-nine patients were surveyed; 118 patients (17.1% of the total number of patients surveyed) made one emergency call, 23 made two calls, and four made three calls for a total number of 176 emergency calls. The mean age was 71 years (standard deviation [SD] 13), and the mean Karnofsky status the day before the emergency call was 38 (SD 14). The mean time from admission to the first emergency call was 38.4 days (SD 67), and the mean time from the first emergency call to death was 17.5 days (SD 41.5). No differences were found for age, diagnosis, gender, duration of assistance, and survival between patients making emergency calls and those who did not make a call during an emergency. Twenty-three patients were managed by phone, and 122 were visited at home for the emergency. Calls were prevalently recorded on weekdays and were primarily made by relatives. The most frequent reasons for calling were dyspnea, pain, delirium, and loss of consciousness. Calls were considered justified by home care physicians in most cases. The mean number of relatives present during the emergency home visit was 2.2 (SD 1.5). The intervention was mainly pharmacological and considered satisfactory in the majority of cases. CONCLUSION: Emergency calls are relatively frequent in patients followed at home by a palliative care team. Phone consultation or intervention at home may avoid inappropriate hospital admission
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