We report the result of a blinded search for Weakly Interacting Massive Particles (WIMPs) using the full SuperCDMS Soudan dataset. With an exposure of 1690 kg days, a single event was observed after ...unblinding, consistent with expected backgrounds. This analysis (combined with previous Ge results) sets an upper limit on the spin-independent WIMP-nucleon cross section of 1.4x10^-44 (1.0x10^-44) cm^2 at 46 GeV/c^2 . These results set the strongest limits for WIMP-germanium-nucleus interactions for masses >12 GeV/c^2.
Future direct searches for low-mass dark matter particles with germanium detectors, such as SuperCDMS SNOLAB, are expected to be limited by backgrounds from radioactive isotopes activated by ...cosmogenic radiation inside the germanium. There are limited experimental data available to constrain production rates and a large spread of theoretical predictions. We examine the calculation of expected production rates, and analyze data from the second run of the CDMS low ionization threshold experiment (CDMSlite) to estimate the rates for several isotopes. We model the measured CDMSlite spectrum and fit for contributions from tritium and other isotopes. Using the knowledge of the detector history, these results are converted to cosmogenic production rates at sea level. The production rates in atoms/(kg·day) are 74±9 for 3H, 1.5±0.7 for 55Fe, 17±5 for 65Zn, and 30±18 for 68Ge.
Future direct searches for low-mass dark matter particles with germanium detectors, such as SuperCDMS SNOLAB, are expected to be limited by backgrounds from radioactive isotopes activated by ...cosmogenic radiation inside the germanium. There are limited experimental data available to constrain production rates and a large spread of theoretical predictions. We examine the calculation of expected production rates, and analyze data from the second run of the CDMS low ionization threshold experiment (CDMSlite) to estimate the rates for several isotopes. We model the measured CDMSlite spectrum and fit for contributions from tritium and other isotopes. Using the knowledge of the detector history, these results are converted to cosmogenic production rates at sea level. The production rates in atoms/(kg$\cdot$day) are 74$\pm$9 for $^3$H, 1.5$\pm$0.7 for $^{55}$Fe, 17$\pm$5 for $^{65}$Zn, and 30$\pm$18 for $^{68}$Ge.
Abstract The direct anterior (DA) approach for total hip arthroplasty (THA) has demonstrated successful short term outcomes in several studies. However, there is no consensus about which patients are ...appropriate candidates for DA total hip arthroplasty. It is also unclear if short term outcomes in obese patients undergoing THA through a DA approach are elevated in comparison to non-obese patients. The purpose of this study was to evaluate complication rates and short term outcomes of obese, pre-obese, and normal body mass index (BMI) patients undergoing THA with a DA approach in a consecutive group of patients. This study was a retrospective review of 210 consecutive patients who underwent unilateral THA through a DA approach for osteoarthritis or avascular necrosis during the early peri-operative period. The study included 61 patients with normal BMI, 70 pre-obese patients, and 79 obese patients according to World Health Organization (WHO) classification (49 class I obese, 22 class II obese, and 8 class III obese patients). Patient charts were reviewed to determine differences in surgical time, length of stay, disposition, major complications, wound complications, and short term outcome measures. When comparing normal and pre-obese patients (BMI < 30) to a combined group of WHO class I, II, and III obese patients (BMI > 30), the obese group demonstrated increased surgical times by 12.7 minutes ( P < 0.0001), as well as increased length of stay ( P = 0.0303), narcotic use ( P = 0.0037), and assistive device use at two weeks ( P < 0.0030). In addition, major complications and wound complications were both significantly increased in the obese group (odds ratio OR, 8.8; P = 0.0493 and OR, 3.6; P = 0.0431, respectively). There was also a trend toward increased use of rehabilitation facilities in the obese group at disposition, 15.4% vs 7.6% ( P = 0.0774). This study demonstrates that obese patients undergoing a DA approach have a 8.8 and 3.6 times increase in major and wound complications, respectively, compared to patients with a BMI < 30. Obese patients also demonstrated significant increases in operative time, use of narcotics, use of assistive devices, and length of stay. There was a trend toward higher use of rehabilitation placement. While significant, these findings are similar to complication rates in the literature for other THA operative approaches. This study further defines the risks associated with performing THA on obese patients regardless of approach.
Trouble with tramadol Kaye, Karen
Australian prescriber,
04/2004, Letnik:
27, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Since tramadol was marketed in Australia in late 1998 its use has increased dramatically.1 While there is a large amount of information supporting tramadol’s effectiveness for pain, there is an ...increasingly large body of evidence from post-marketing surveillance showing there are problems. Tramadol is also metabolised by CYP3A4 so its activity is reduced by drugs which induce CYP3A4.3 The analgesic effects of tramadol are not completely reversed by the opioid antagonist naloxone and some patients who do not respond to codeine do respond to tramadol. A severe serotonin syndrome may occur when tramadol is combined with other drugs which also increase serotonin activity.6 Such drugs include SSRIs, moclobemide and other monoamine oxidase inhibitors, tricyclic antidepressants, sibutramine, St John’s wort, lithium and pethidine.1,7 ADRAC has received 35 reports of serotonin syndrome in association with tramadol, usually in combination with other serotonergic drugs.
Abstract Sakzewski L, Ziviani J, Abbott DF, Macdonell RA, Jackson GD, Boyd RN. Participation outcomes in a randomized trial of 2 models of upper-limb rehabilitation for children with congenital ...hemiplegia. Objective To determine if constraint-induced movement therapy (CIMT) is more effective than bimanual training to improve occupational performance and participation in children with congenital hemiplegia. Design Single-blind randomized comparison trial with evaluations at baseline, 3, and 26 weeks. Setting Community facilities in 2 Australian states. Participants Referred sample of children (N=64; mean age ± SD, 10.2±2.7y, 52% boys) were matched for age, sex, side of hemiplegia, and upper-limb function and were randomized to CIMT or bimanual training. After random allocation, 100% of CIMT and 94% of the bimanual training group completed the intervention. Interventions Each intervention was delivered in day camps (total 60h over 10d) using a circus theme with goal-directed training. Children receiving CIMT wore a tailor-made glove during the camp. Main Outcome Measures The primary outcome was the Canadian Occupational Performance Measure (COPM). Secondary measures included the Assessment of Life Habits (LIFE-H), Children's Assessment of Participation and Enjoyment, and School Function Assessment. Results There were no between-group differences at baseline. Both groups made significant changes for COPM performance at 3 weeks (estimated mean difference =2.9; 95% confidence interval CI, 2.3–3.6; P <.001 for CIMT; estimated mean difference=2.8; 95% CI, 2.2–3.4; P <.001 for bimanual training) that were maintained at 26 weeks. Significant gains were made in the personal care LIFE-H domain following CIMT (estimated mean difference=0.5; 95% CI, 0.1–0.9; P =.01) and bimanual training (estimated mean difference=0.6; 95% CI, 0.2–1.1; P =.006). Conclusions There were minimal differences between the 2 training approaches. Goal-directed, activity-based, upper-limb training, addressed through either CIMT or bimanual training achieved gains in occupational performance. Changes in participation on specific domains of participation assessments appear to correspond with identified goals.
We compared total and cause-specific mortality for workers at the Pantex nuclear weapons assembly facility employed between 1951 and 31 December 1978 with expected mortality based on U.S. death ...rates. We observed significantly fewer deaths than expected from all causes of death, all cancers, digestive cancers, lung cancer, arteriosclerotic heart disease, and digestive diseases. There were no causes of death which occurred significantly more frequently than expected. Analyses of worker mortality by duration of employment, time since first employment, and radiation exposure greater than 1.00 rem produced similar results. We found no evidence that mortality from any cause of death was increased as a result of employment at Pantex.
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