The nature of the neutrino is one of the major open questions in experimental nuclear and particle physics. The most sensitive known method to establish the Majorana nature of the neutrino is ...detection of the ultra-rare process of neutrinoless double beta decay. However, identification of one or a handful of decay events within a large mass of candidate isotope, without obfuscation by backgrounds is a formidable experimental challenge. One hypothetical method for achieving ultra- low-background neutrinoless double beta decay sensitivity is the detection of single
Ba ions produced in the decay of
Xe ("barium tagging"). To implement such a method, a single-ion-sensitive barium detector must be developed and demonstrated in bulk liquid or dry gaseous xenon. This paper reports on the development of two families of dry-phase barium chemosensor molecules for use in high pressure xenon gas detectors, synthesized specifically for this purpose. One particularly promising candidate, an anthracene substituted aza-18-crown-6 ether, is shown to respond in the dry phase with almost no intrinsic background from the unchelated state, and to be amenable to barium sensing through fluorescence microscopy. This interdisciplinary advance, paired with earlier work demonstrating sensitivity to single barium ions in solution, opens a new path toward single ion detection in high pressure xenon gas.
Evidence Basis for Hysterectomy Byrnes, Jenifer N; Trabuco, Emanuel C
Obstetrics and gynecology clinics of North America,
09/2016, Letnik:
43, Številka:
3
Journal Article
Recenzirano
Although vaginal hysterectomy has long been championed by the American College of Obstetricians and Gynecologists as the preferred mode of uterine removal, nationwide vaginal hysterectomy utilization ...has steadily declined. This article reviews the evidence comparing vaginal with other modes of hysterectomy and highlights areas of ongoing controversy regarding contraindications to vaginal surgery, risk of subsequent prolapse development, and impacts of changing hysterectomy trends on resident education.
MRI review of female pelvic fistulizing disease Hyde, Brenda J.; Byrnes, Jenifer N.; Occhino, John A. ...
Journal of magnetic resonance imaging,
November 2018, 2018-11-00, 20181101, Letnik:
48, Številka:
5
Journal Article
Recenzirano
A wide variety of fistulae occur in the female pelvis, most of which cause significant morbidity. Diagnosis, characterization, and treatment planning may be difficult using traditional imaging ...modalities such as fluoroscopy and computed tomography. To date, there is no comprehensive literature review of the radiologic findings associated with various types of female pelvic fistulae, and furthermore, none dedicated to magnetic resonance imaging (MRI). In this article, we seek to provide a broad overview of the MRI characteristics of female pelvic fistulizing disease in combination with epidemiologic and clinical characteristics. MRI is often considered the imaging modality of choice for evaluation of fistulae owing to its superior soft‐tissue contrast and ability to provide surgeons with the highest quality information derived from just one study, including anatomic location of fistulae and associated pelvic pathology. In other instances, MRI can be complementary to the more traditional imaging techniques. This review will describe the etiology, anatomy, MRI findings, and treatment pearls for several of the more common pelvic fistulae found in female patients, including anovaginal, rectovaginal, colovaginal, vesicovaginal, colovesical, and other complex fistulae.
Level of Evidence: 5
Technical Efficacy: Stage 3
J. Magn. Reson. Imaging 2018;47:1172–1184
As minimally invasive technology continues to be developed and refined, surgeons must be discerning in choosing the safest, cost-effective surgical approach associated with the best outcomes for each ...individual patient. Vaginal hysterectomy can be successfully accomplished even in challenging situations, such as previous pelvic surgery, nulliparity, uterine enlargement, or obesity. Vaginal hysterectomy should be considered the primary route for treatment of benign disease.
Voluntary and forced exercise decrease morbidity and mortality in laboratory animals. Caloric restriction has similar effects on health and unique benefits on life span. Nonetheless, in most ...experiments, animals do not have access to physical activity and are fed ad libitum (AL). We hypothesized that with regular access to either unlimited running wheel exercise (EX) or limited physical activity (PA), key biomarkers of health would be enhanced enough to counter some consequences of a sedentary AL lifestyle. This 16-month study compared body weight, tumor number and size, tissue lesions, oxidative stress, and reactive stress in (1) sedentary animals with no access to physical activity (SED); (2) animals with access to hour-long, twice weekly activity in a large box (PA); and (3) animals with access every other day to a running wheel (EX). At the end of the study, EX body weight was 8–9% lower than PA and SED. In addition, EX had no kidney lesions versus 50% in PA and SED, and had smaller tumor size (10±2 vs. 14±4 and 30±4 mm). Exhaustive exercise lowered glutathione/oxidized glutathione ratio in EX and PA, but in SED, the ratio was depressed even in resting animals. In all treatments, prolactin (PRL) levels were lower in resting animals than in acutely exercised animals. In conclusion, EX had the most favorable health biomarkers while SED had the least. PA did not confer gross health benefits different than the SED group, but was biochemically more similar to EX animals.
Introduction and hypothesis
Women with hereditary disorders of connective tissue (HDCT) are at increased risk of pelvic organ prolapse (POP) and stress urinary incontinence (SUI). We hypothesized ...that patients would have increased incidence and severity of perioperative complications up to 6 weeks after surgeries for POP/SUI. Secondary objectives were to compare pre- and post-operative pelvic floor symptoms and anatomical support as well as pelvic floor disorder recurrence.
Methods
In this multi-center retrospective cohort study, we identified patients with HDCTs by patient history and ICD-9 codes over an 11-year period. Controls without HDCTs were matched 2:1 to the primary POP or SUI procedure and surgeon. Demographic characteristics, perioperative pelvic floor information and complications were collected. A sample size of 65 HDCT patients and 130 controls was calculated to detect a 20% difference in complications with 80% power and alpha of 0.05.
Results
We identified 59 HDCT patients and 118 controls. Of the women with HDCTs, 49% had Ehlers–Danlos, 22% joint hypermobility syndrome, 15% Marfan syndrome, and 14% had others. Compared with controls, HDCT patients had more total perioperative complications (46% vs 22%,
p =
0.002); an age-adjusted relative risk of complications was 1.4 (CI 0.7–2.6). HDCT patients had more Clavien–Dindo grades I and II complications (
p =
0.02, 0.03) and more hospital readmissions (14% vs 3%,
p =
0.01) than controls. There was no difference in the incidence of specific complications nor was there a difference in recurrence of POP (10%) or SUI (11%) between groups.
Conclusions
Patients with HDCTs had more Clavien–Dindo grade I and II complications following pelvic floor reconstructive surgery and more readmissions.
The interaction between genes and environment can influence cardiovascular disease (CVD). This 16 month study investigated if genes associated with cardiovascular (CV) regulation were expressed ...differently in animals having: 1) no access to physical activity or exercise (SED), 2) access to hour-long, twice weekly activity (PA), and 3) access every-other-day to a running wheel (EX). Out of 31,000 genes, a CV subset comprising 44 genes was investigated. Ten genes from this subset were expressed differently in EX compared with SED, and 34 genes were expressed differently in PA compared with SED (
p
<
0.05). Total cholesterol (70
±
8 vs. 101
±
9 mg dl
−
1
), triglycerides (104
±
8 vs. 127
±
4 mg dl
−
1
), resting systolic blood pressure (130
±
3 vs. 141
±
3 mmHg), mean arterial pressure (110
±
2 vs. 120
±
2 mmHg) and heart rate (380
±
6 vs. 405
±
9 beats min
−
1
) were lower in EX compared with SED (
p
<
0.05), but intracellular adhesion molecule levels did not differ among groups. Mean gene expressions for
Gja1, Fdft1, Edn1, Cd36, and
Hmgb2 differed in animals according to access to physical activity. These genes play roles in heart rate, cholesterol biosynthesis, blood pressure, cell adhesion, and transcription and neurogenesis regulation, respectively. In conclusion, a total of 44 CV genes were expressed differently in SED compared to PA and EX; and SED showed more physiological evidence of CVD.
Outcomes of Rectovaginal Fistula Repair Byrnes, Jenifer N; Schmitt, Jennifer J; Faustich, Benjamin M ...
Female pelvic medicine & reconstructive surgery,
2017 Mar/Apr, Letnik:
23, Številka:
2
Journal Article
Recenzirano
Rectovaginal fistulae (RVF) often represent surgical challenges, and treatment must be individualized. We describe outcomes after primary surgical repair stratified by fistula etiology and surgical ...approach.
This retrospective cohort study included women who underwent surgical management of RVF at a tertiary care center between July 1, 2001 and December 31, 2013. Cases were stratified according to the following etiology: cancer (RVF-C), inflammatory bowel disease or infectious (RVF-I), and other (RVF-O). Patients with prior surgical treatment of RVF were excluded. Surgical approaches included local (seton, plug), transvaginal or endorectal, abdominal, diversion alone, or definitive (completion proctocolectomy with permanent colostomy or pelvic exenteration). Recurrence-free survival was estimated using the Kaplan-Meier method, and comparisons between subgroups were evaluated based on fitting Cox proportional hazards models. Censoring occurred at last relevant clinical follow-up. Factors contributing to recurrence-free survival were evaluated including age, body mass index, smoking status, fistula etiology, ileostomy, and surgical approach.
During the study period, 107 women underwent surgical repair of RVF. The most common fistula etiology was RVF-I (54.2%), followed by RVF-O (23.4%), and RVF-C (22.4%). Ninety-four women underwent fistula repair by the local (29.9%), transvaginal/endorectal (25.2%), abdominal approach (19.6%), or diversion alone (13.1%), whereas 13 underwent definitive surgery (12.2%). Recurrence-free survival was significantly different depending on surgical approach (P < 0.001), but not etiology (P = 0.71). Recurrence-free survival (95% confidence interval) at 1 year after surgery was 35.2% (21.8%-56.9%) for the local approach, 55.6% (37.0%-83.3%) for the transvaginal or endorectal approach, 95% (85.9%-100%) for the abdominal approach, and 33.3% (15%-74.2%) for those with diversion only.
Recurrence rates after RVF repair are high and did not differ by fistula etiology. Abdominal repair of RVF had significantly fewer recurrences.
PDF
