Background
Defining severe postoperative ileus in terms of consequences could help physicians standardize the management of this condition. The recently described classification based on consequences ...requires further investigation. The aim of this study was to obtain a snapshot of postoperative ileus in patients undergoing colorectal surgery within enhanced recovery programs and to identify factors associated with non-severe and severe postoperative ileus.
Methods
This prospective registry data analysis was conducted in 40 centers in five different countries. A total of 786 patients scheduled for colorectal surgery within enhanced recovery programs were included. The primary endpoint was the incidence rate of postoperative ileus as defined by Vather et al.
Results
A total of 121 patients experienced postoperative ileus (15.4%). Non-severe POI occurred in 48 patients (6.1%), and severe postoperative ileus occurred in 73 patients (9.3%). In multivariate analysis, the male gender and intra-abdominal complications were associated with severe postoperative ileus: odd ratio (OR) = 2.03 95% confidence interval (CI) 1.14–3.59,
p
= 0.01 and OR = 3.60 95% CI 1.75–7.40,
p
< 0.0001, respectively. Conversely, open laparotomy and urinary retention were associated with non-severe POI: OR = 3.03 95% CI 1.37–6.72,
p
= 0.006 and OR = 2.70 95% CI 0.89–8.23,
p
= 0.08, respectively.
Conclusions
Postoperative ileus occurred in 15% of patients after colorectal surgery within enhanced recovery programs. For 60% of patients, this was considered severe. The physiopathology of these two entities could be different, severe POI being linked to intraabdominal complication, while non-severe POI being linked with risk factors for “primary” POI. The physician should pay attention to male patients having POI after colorectal surgery and look for features evocating intraabdominal complications.
The MEMPHYS project Borne, J.L.; Busto, J.; Campagne, J.-E. ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
05/2011, Letnik:
639, Številka:
1
Journal Article
Recenzirano
MEMPHYS is a proposed 0.5
Mton scale Water Cherenkov experiment to be performed deep underground. Possible sites are under study in the European FP7 design study LAGUNA. It is dedicated to nucleon ...decay, neutrinos from supernovæ, solar and atmospheric neutrinos, as well as neutrinos from a future Super-Beam or
β-Beam to measure the mixing angle
θ
13, the CP violating phase
δ and the mass hierarchy. A small-scale prototype, Memphyno, has been constructed with the purpose of serving as a test bench for new photodetection and data acquisition solutions, such as grouped readout system.
Nous rapportons le cas d’une césarienne sous rachianesthésie-péridurale séquentielle (RPS) chez une femme de 32 ans atteinte d’une cardiomyopathie hypertrophique obstructive. Chez ces patientes, les ...variations des conditions de charge ventriculaire peuvent entraîner une inefficacité myocardique. Dans ce contexte, l’hémorragie du post-partum est une complication redoutée, dont la prévention repose sur l’utilisation d’ocytocine. Or son injection peut s’accompagner d’une instabilité hémodynamique délétère, même à faible dose, et n’écarte pas le risque d’une hémorragie du post-partum. La ligature artérielle selon le procédé de Tsirulnikov, est une alternative que nous rapportons. Cette technique est dotée d’un bon pronostic obstétrical.
We report the case of a caesarean section under combined spinal and epidural anaesthesia in a pregnant 32-year-old woman with an hypertrophic obstructive cardiomyopathy. In these patients, variations of the ventricular load conditions may induce a cardiac inefficacy. In this context, the post-partum haemorrhage is a feared complication, prevent in part by oxytocine intravenously. However, its injection can be associated with haemodynamic instability, even at a low dose, and it does not spread post-partum haemorrhage. The arterial ligation according to the technique of Tsirulnikov is an alternative that we reported. This technique is followed by a good obstetrical prognosis.
Status report on high-pressure TPC Salin, P.; Gorodetzky, P.; Dolbeau, J. ...
Nuclear Instruments and Methods in Physics Research Section A: Accelerators, Spectrometers, Detectors and Associated Equipment,
2004, Letnik:
535, Številka:
1
Journal Article, Conference Proceeding
Recenzirano
HELLAZ experiment intends to measure with high precision the low-energy solar neutrino (p–p and
7Be) spectrum. The method uses the neutrino elastic scattering over the 2×10
30 electrons contained in ...a 2000
m
3 TPC filled with helium (for its high radio isotopic purity, its low transverse diffusion and its low drift velocity), at a pressure of 20
bar at 300
K.
Reconstructing the neutrino energy requires a precise measurement over the angle and energy (between 100
keV and 1
MeV) of the scattered electron. 1% electron energy accuracy is easy to get through an integral charge measurement. An angular accuracy ≈±2° yields a neutrino energy resolution better than 10%, not only enough to separate the p-p and
7Be spectrum, but which also possibly allows to show the shape variation of p–p spectrum in certain cases of neutrino oscillations. In a TPC the only way to obtain an angular resolution better than 5° is to detect every single ionization electrons of the diffused electron cloud. Hence, we need a very fast detector (collection time ⩽10
ns) and a gain of around 10
6 with a signal over noise ratio near 2 for the single electron detection. The only gas detector that meets the criterion is the MICROMEGAS detector which has a very good separation between electron and ion signal. These conditions are easy to obtain with a gas mixture like He and isoC
4H
10 at atmospheric pressure. But in the real condition at 20
bar, where we currently use CH
4 as a quencher, we are limited to a gain ⩽4–5×10
4. We have studied the dependence of the gain with the gas mixture. Several improvements have been done with a new mixing gas He, isoC
4H
10 and CH
4. After a simulation with IMONTE45 we did obtain the right mixing gas and high gain up to 5×10
5 with near 50% efficiency for the single electron detection. Recently, a new improvement has been done with a double stage MICROMEGAS. With this set-up we obtained 1.6×10
6 and an efficiency greater than 90% for the single electron detection.
The nitrogen fluorescence induced in air is used to detect ultra-high-energy cosmic rays (UHECR) and to measure their energy. The precise knowledge of the absolute fluorescence yield is the key ...quantity to improve the accuracy on the cosmic ray energy. The total yield has been measured in dry air using a
90Sr source and a 300–430
nm filter. The fluorescence yield in air is 4.23±0.21
photons/m when normalized to 760
mmHg, 15
°C and with an electron energy of 0.85
MeV. This result is consistent with previous experiments made at various energies, but with an accuracy improved by a factor of about 3. For the first time, the absolute continuous spectrum of nitrogen excited by
90Sr electrons has also been measured with a spectrometer. Details of this experiment are given in one of the author's Ph. D. thesis G. Lefeuvre, Ph. D. Thesis, Paris 7 University, 2006 (Ref: APC-26-06)
33..
The new concept of the spherical TPC aims at relatively large target masses with low threshold and background, keeping an extremely simple and robust operation. Such a device would open the way to ...detect the neutrino-nucleus interaction, which, although a standard process, remains undetected due to the low energy of the neutrino-induced nuclear recoils. The progress in the development of the first 1 m3 prototype at Saclay is presented. Other physics goals of such a device could include supernova detection, low energy neutrino oscillations and study of non-standard properties of the neutrino, among others.
The photo-detector for the EUSO experiment Ameri, M; Catalano, O; Cadoux, F ...
Nuclear Instruments and Methods in Physics Research Section A: Accelerators, Spectrometers, Detectors and Associated Equipment,
05/2003, Letnik:
504, Številka:
1-3
Journal Article, Conference Proceeding
Recenzirano
Odprti dostop
The EUSO experiment is currently under study by ESA for a possible installation on the International Space Station. The experiment is designed to study, by means of a space-based observational ...apparatus, the Extensive Air Showers produced in the atmosphere by Extreme High-Energy Cosmic Rays. The design of a fast, single-photon sensitive photo-detector in the near UV, covering a large area with a few hundreds thousands pixels, and suitable for 3 years of operation in space is a challenging task. The basic aspects of the current EUSO photo-detector design, based on the presently known requirements and constraints, and the results of the preliminary studies carried on so far will be described.
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