We present results for B-meson decay modes involving a charm meson, protons, and pions using 455 x 10{sup 6} B{bar B} pairs recorded by the BABAR detector at the SLAC PEP-II asymmetric-energy e{sup ...+}e{sup -} collider. The branching fractions are measured for the following ten decays: {bar B}{sup 0} {yields} D{sup 0}p{bar p}, {bar B}{sup 0} {yields} D*{sup 0}p{bar p}, {bar B}{sup 0} {yields} D{sup +}p{bar p}{pi}{sup -}, {bar B}{sup 0} {yields} D*{sup +}p{bar p}{pi}{sup -}, B{sup -} {yields} D{sup 0}p{bar p}{pi}{sup -}, B{sup -} {yields} D*{sup 0}pp{pi}{sup -}, {bar B}{sup 0} {yields} D{sup 0}p{bar p}{pi}{sup -}{pi}{sup +}, {bar B}{sup 0} {yields} D*{sup 0}p{bar p}{pi}{sup -}{pi}{sup +}, B{sup -} {yields} D{sup +}p{bar p}{pi}{sup -}{pi}{sup -}, and B{sup -} {yields} D*{sup +}p{bar p}{pi}{sup -}{pi}{sup -}. The four B{sup -} and the two five-body B{sup 0} modes are observed for the first time. The four-body modes are enhanced compared to the three- and the five-body modes. In the three-body modes, the M(p{bar p}) and M(D{sup (*)0}p) invariant mass distributions show enhancements near threshold values. In the four-body mode {bar B}{sup 0} {yields} D{sup +}p{bar p}{pi}{sup -}, the M(p{pi}{sup -}) distribution shows a narrow structure of unknown origin near 1.5GeV/c{sup 2}. The distributions for the five-body modes, in contrast to the others, are similar to the expectations from uniform phase-space predictions.
Evidence for the decay X(3872)→J/ψω Garra Ticó, Jordi; Graugés Pous, Eugeni; BABAR Collaboration
Physical review. D, Particles, fields, gravitation, and cosmology,
07/2010
Journal Article
Odprti dostop
We present a study of the decays B 0 , + → J / ψ π + π − π 0 K 0 , + , using 467 × 10 6 B ¯¯¯ B pairs recorded with the BABAR detector. We present evidence for the decay mode X ( 3872 ) → J / ψ ω , ...with product branching fractions B ( B + → X ( 3872 ) K + ) × B ( X ( 3872 ) → J / ψ ω ) = 0.6 ± 0.2 ( stat ) ± 0.1 ( syst ) × 10 − 5 , and B ( B 0 → X ( 3872 ) K 0 ) × B ( X ( 3872 ) → J / ψ ω ) = 0.6 ± 0.3 ( stat ) ± 0.1 ( syst ) × 10 − 5 . A detailed study of the π + π − π 0 mass distribution from X ( 3872 ) decay favors a negative-parity assignment.
Search for the decay B0→γγ Garra Ticó, Jordi; Graugés Pous, Eugeni; BABAR Collaboration
Physical review. D, Particles, fields, gravitation, and cosmology,
02/2011
Journal Article
Odprti dostop
We report the result of a search for the rare decay B 0 → γ γ in 426 fb − 1 of data, corresponding to 226 × 10 6 B 0 ¯¯¯ B 0 pairs, collected on the Υ ( 4 S ) resonance at the PEP-II ...asymmetric-energy e + e − collider using the BABAR detector. We use a maximum likelihood fit to extract the signal yield and observe 21 + 13 − 12 signal events with a statistical significance of 1.8 σ . This corresponds to a branching fraction B ( B 0 → γ γ ) = ( 1.7 ± 1.1 ( stat . ) ± 0.2 ( syst . ) ) × 10 − 7 . Based on this result, we set a 90% confidence level upper limit of B ( B 0 → γ γ ) < 3.2 × 10 − 7 .
Age alone is not a robust predictor of mortality in critically ill elderly patients. Chronic health status and functional status before admission could be better predictors. This study aimed to ...determine whether functional status, assessed using the Functional Independence Measure (FIM), could be an independent predictor of mortality in a geriatric population admitted to an intermediate care unit (IMCU).
A monocentric, retrospective, observational study of all patients aged ≥75 years old admitted to Geneva University Hospitals' geriatric IMCU between 01.01.2012 and 31.05.2016. The study's primary outcome metrics were one-year mortality's associations with a pre-admission FIM score and other relevant prospectively recorded prognostic variables.
A total of 345 patients were included (56% female, mean age 85 +/- 6.5 years). Mean FIM score was 66 +/- 26. One-year mortality was 57%. Dichotomized low (≤ 63) and high FIM (> 63) scores were associated with one-year mortalities of 68 and 44%, respectively. Logistic regression calculations found an association between pre-admission FIM score and one-year mortality (p < 0.0001), including variables usually associated with mortality (e.g., age, sex, comorbidities, mini-mental health state score, renal function). Multivariate survival analysis showed a significant difference between groups, with a hazard ratio of 0.29 (95% CI: 0.13-0.65) for patients with high FIM scores.
In the present study, higher functional status, assessed using the FIM tool before admission to an IMCU, was significantly and independently associated with lower one-year mortality. This opens up perspectives on the potential value of FIM for establishing a finer prognosis and better triage of critically ill older patients.
The aim was to create and validate a community-acquired pneumonia (CAP) diagnostic algorithm to facilitate diagnosis and guide chest computed tomography (CT) scan indication in patients with CAP ...suspicion in Emergency Departments (ED).
We performed an analysis of CAP suspected patients enrolled in the ESCAPED study who had undergone chest CT scan and detection of respiratory pathogens through nasopharyngeal PCRs. An adjudication committee assigned the final CAP probability (reference standard). Variables associated with confirmed CAP were used to create weighted CAP diagnostic scores. We estimated the score values for which CT scans helped correctly identify CAP, therefore creating a CAP diagnosis algorithm. Algorithms were externally validated in an independent cohort of 200 patients consecutively admitted in a Swiss hospital for CAP suspicion.
Among the 319 patients included, 51% (163/319) were classified as confirmed CAP and 49% (156/319) as excluded CAP. Cough (weight = 1), chest pain (1), fever (1), positive PCR (except for rhinovirus) (1), C-reactive protein ≥50 mg/L (2) and chest X-ray parenchymal infiltrate (2) were associated with CAP. Patients with a score below 3 had a low probability of CAP (17%, 14/84), whereas those above 5 had a high probability (88%, 51/58). The algorithm (score calculation + CT scan in patients with score between 3 and 5) showed sensitivity 73% (95% CI 66–80), specificity 89% (95% CI 83–94), positive predictive value (PPV) 88% (95% CI 81–93), negative predictive value (NPV) 76% (95% CI 69–82) and area under the curve (AUC) 0.81 (95% CI 0.77–0.85). The algorithm displayed similar performance in the validation cohort (sensitivity 88% (95% CI 81–92), specificity 72% (95% CI 60–81), PPV 86% (95% CI 79–91), NPV 75% (95% CI 63–84) and AUC 0.80 (95% CI 0.73–0.87).
Our CAP diagnostic algorithm may help reduce CAP misdiagnosis and optimize the use of chest CT scan.
The diagnosis of pneumonia based on semiology and chest X-rays is frequently inaccurate, particularly in elderly patients. Older (C-reactive protein (CRP); procalcitonin (PCT)) or newer (Serum ...amyloid A (SAA); neopterin (NP)) biomarkers may increase the accuracy of pneumonia diagnosis, but data are scarce and conflicting. We assessed the accuracy of CRP, PCT, SAA, NP and the ratios CRP/NP and SAA/NP in a prospective observational cohort of elderly patients with suspected pneumonia. We included consecutive patients more than 65 years old, with at least one respiratory symptom and one symptom or laboratory finding suggestive of infection, and a working diagnosis of pneumonia. Low-dose CT scan and comprehensive microbiological testing were done in all patients. The index tests, CRP, PCT, SAA and NP, were obtained within 24 hours. The reference diagnosis was assessed a posteriori by a panel of experts considering all available data, including patients' outcome. We used area under the curve (AUROC) and Youden index to assess the accuracy and obtain optimal cut-off of the index tests. 200 patients (median age 84 years) were included; 133 (67%) had pneumonia. AUROCs for the diagnosis of pneumonia was 0.64 (95% CI: 0.56-0.72) for CRP; 0.59 (95% CI: 0.51-0.68) for PCT; 0.60 (95% CI: 0.52-0.69) for SAA; 0.41 (95% CI: 0.32-0.49) for NP; 0.63 (95% CI: 0.55-0.71) for CRP/NP; and 0.61 (95% CI: 0.53-0.70) for SAA/NP. No cut-off resulted in satisfactory sensitivity or specificity. Accuracy of traditional (CRP, PCT) and newly proposed biomarkers (SAA, NP) and ratios of CRP/NP and SAA/NP was too low to help diagnosing pneumonia in the elderly. CRP had the highest AUROC.
We aimed to assess the accuracy of PCR detection of viruses and bacteria on nasopharyngeal and oropharyngeal swabs (NPS) for the diagnosis of pneumonia in elderly individuals.
We included consecutive ...hospitalized elderly individuals suspected of having pneumonia. At inclusion, NPS were collected from all participants and tested by PCR for the presence of viral and bacterial respiratory pathogens (index test, defined as comprehensive molecular testing). Routine diagnostic tests (blood and sputum culture, urine antigen detection) were also performed. The reference standard was the presence of pneumonia on a low-dose CT scan as assessed by two independent expert radiologists.
The diagnosis of pneumonia was confirmed in 127 of 199 (64%) included patients (mean age 83 years, community-acquired pneumonia in 105 (83%)). A pathogen was identified by comprehensive molecular testing in 114 patients (57%) and by routine methods in 22 (11%). Comprehensive molecular testing was positive for viruses in 62 patients (31%) and for bacteria in 73 (37%). The sensitivity and specificity were 61% (95% CI 53%–69%) and 50% (95% CI 39%–61%) for comprehensive molecular testing, and 14% (95% CI 82%–21%) and 94% (95% CI 86%–98%) for routine testing, respectively. Positive likelihood ratio was 2.55 for routine methods and 1.23 for comprehensive molecular testing.
Comprehensive molecular testing of NPS increases the number of pathogens detected compared with routine methods, but results are poorly predictive of the presence of pneumonia. Hence, comprehensive molecular testing is unlikely to impact clinical decision-making (NCT02467192).
NCT02467192.
Highlights • Antimicrobial suppression appears to be effective for prosthetic joint infection (PJI). • Antimicrobial suppression appears safe for PJI. • Antimicrobial suppression is an adequate ...option for elderly patients with PJI.
During prosthetic joint infection (PJI), optimal surgical management with exchange of the device is sometimes impossible, especially in the elderly population. Thus, prolonged suppressive antibiotic ...therapy (PSAT) is the only option to prevent acute sepsis, but little is known about this strategy. We aimed to describe the characteristics, outcome and tolerance of PSAT in elderly patients with PJI. We performed a national cross-sectional cohort study of patients >75 years old and treated with PSAT for PJI. We evaluated the occurrence of events, which were defined as: (i) local or systemic progression of the infection (failure), (ii) death and (iii) discontinuation or switch of PSAT. A total of 136 patients were included, with a median age of 83 years interquartile range (IQR) 81–88. The predominant pathogen involved was
Staphylococcus
(62.1%) (
Staphylococcus aureus
in 41.7%). A single antimicrobial drug was prescribed in 96 cases (70.6%). There were 46 (33.8%) patients with an event: 25 (18%) with an adverse drug reaction leading to definitive discontinuation or switch of PSAT, 8 (5.9%) with progression of sepsis and 13 died (9.6%). Among patients under follow-up, the survival rate without an event at 2 years was 61% 95% confidence interval (CI): 51;74. In the multivariate Cox analysis, patients with higher World Health Organization (WHO) score had an increased risk of an event hazard ratio (HR) = 1.5,
p
= 0.014, whereas patients treated with beta-lactams are associated with less risk of events occurring (HR = 0.5,
p
= 0.048). In our cohort, PSAT could be an effective and safe option for PJI in the elderly.
Digestive tract sarcoidosis (DTS) is rare and case-series are lacking. In this retrospective case-control study, we aimed to compare the characteristics, outcome, and treatment of patients with DTS, ...nondigestive tract sarcoidosis (NDTS), and Crohn disease.We included cases of confirmed sarcoidosis, symptomatic digestive tract involvement, and noncaseating granuloma in any digestive tract. Each case was compared with 2 controls with sarcoidoisis without digestive tract involvement and 4 with Crohn disease.We compared 25 cases of DTS to 50 controls with NDTS and 100 controls with Crohn disease. The major digestive clinical features were abdominal pain (56%), weight loss (52%), nausea/vomiting (48%), diarrhea (32%), and digestive bleeding (28%). On endoscopy of DTS, macroscopic lesions were observed in the esophagus (9%), stomach (78%), duodenum (9%), colon, (25%) and rectum (19%). As compared with NDTS, DTS was associated with weight loss (odds ratio OR 5.8; 95% confidence interval CI 1.44-23.3) and the absence of thoracic adenopathy (OR 5.0; 95% CI 1.03-25). As compared with Crohn disease, DTS was associated with Afro-Caribbean origin (OR 27; 95% CI 3.6-204) and the absence of ileum or colon macroscopic lesions (OR 62.5; 95% CI 10.3-500). On the last follow-up, patients with DTS showed no need for surgery (versus 31% for patients with Crohn disease; P = 0.0013), and clinical digestive remission was frequent (76% vs. 35% for patients with Crohn disease; P = 0.0002).The differential diagnosis with Crohn disease could be an issue with DTS. Nevertheless, the 2 diseases often have different clinical presentation and outcome.
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