The main purpose of the study was to report a comparative experience with primary and secondary esophagocoloplasty for caustic injuries. Secondary esophagocoloplasty is the main rescue option after ...graft loss, but data in the literature are scarce.
The operative characteristics, postoperative course, and functional outcomes of 21 secondary and of 246 primary esophagocoloplasty operations performed for caustic injuries between 1987 and 2006 were compared. Intraoperative events requiring significant changes in the planned operative strategy, such as graft ischemia or necrosis, were recorded. Statistical tests were performed in both cohorts to identify factors predictive of postoperative graft necrosis. Univariate analysis was performed to identify factors predictive of functional failure after secondary esophagocoloplasty.
Operative mortality (5% vs 4%, p=0.56), morbidity (62% vs 59%, p=0.96), postoperative graft necrosis (14% vs 7%, p=0.16), and functional success (68% vs 70%, p=0.79) rates of the secondary and primary esophagocoloplasty operations were similar. Intraoperative graft ischemia at the time of secondary esophagocoloplasty was significantly associated with the risk of postoperative graft necrosis (p=0.015) and functional failure (p=0.046). At the time of primary esophagocoloplasty, intraoperative necrosis of the colon was the only independent predictive factor of postoperative graft necrosis (p<0.0001).
Secondary esophagocoloplasty is a safe and reliable salvage option after primary graft loss in patients with caustic injuries. Delayed esophagocoloplasty should be considered if intraoperative colon necrosis occurs at the time of primary reconstruction.
Abstract Purpose To describe gastrointestinal emergencies in cancer patients. Methods All cancer patients admitted to the medical ICU of Saint-Louis Hospital for an acute abdominal syndrome during ...the study period (1997–2011) were included. Results A total of 164 patients were included. The most common diagnoses were: neutropenic enterocolitis (NE) ( n = 54, 33%), infectious colitis and peritonitis ( n = 51, 31%), bowel infiltration by malignancy ( n = 14, 9%), and mucosal toxicity of chemotherapy ( n = 12, 7%). Microbiologically documented infections were reported in 82 patients (50%), including 12 fungal infections. Twenty-seven patients (16%) underwent urgent surgery. The hospital mortality rate was 35%. Five factors were independently associated with hospital mortality: the Simplified Acute Physiology Score II (SAPS II) score on day 1 (OR 1.03/SAPS II point, 95% CI 1.01 to 1.05), microbiological documentation (OR 0.27, 95% CI 0.11 to 0.64), neutropenia (OR 0.42, 95% CI 0.19 to 0.95), allogenic hematopoietic stem-cell transplantation (HSCT) (OR 5.13, 95% CI 1.71 to 15.4), and mechanical ventilation (OR 3.42, 95% CI 1.37 to 8.51). Conclusions Gastrointestinal emergencies in cancer patients are associated with significant mortality. Mortality correlated both with the severity of organ failure upon ICU admission and the underlying diagnosis. Interestingly, patients admitted to the ICU with neutropenia had better survival.
In this letter we report the first scientific result based on antineutrinos emitted from the BR2 reactor at SCK CEN. The SoLid experiment uses a novel type of highly granular detector whose basic ...detection unit combines two scintillators, PVT and 6LiF:ZnS(Ag), to measure antineutrinos via their inverse-beta-decay products. An advantage of PVT is its highly linear response as a function of deposited particle energy. The full-scale detector comprises 12800 voxels and operates over a very short 6.3--8.9 m baseline from the reactor core. The detector segmentation and its 3D imaging capabilities facilitate the extraction of the positron energy from the rest of the visible energy, allowing the latter to be utilised for signal-background discrimination. We present a result based on 280 reactor-on days (55 MW mean power) and 172 reactor-off days, respectively, of live data-taking. A total of 29479 \(\pm\) 603 (stat.) antineutrino candidates have been selected, corresponding to an average rate of 105 events per day and a signal-to-background ratio of 0.27. A search for disappearance of antineutrinos to a sterile state has been conducted using complementary model-dependent frequentist and Bayesian fits, providing constraints on the allowed region of the Reactor Antineutrino Anomaly.
Background The aim of this study was to identify the specific preoperative characteristics of patients with parathyroid microadenoma and to report their outcomes after surgical treatment. Study ...Design Parathyroid microadenomas (weight < 100 mg) were identified in 62 (6%) of the 1,012 patients operated on for a parathyroid adenoma between 1995 and 2004. Presentation and outcomes after surgery were compared with those of 124 patients operated on consecutively for parathyroid adenoma (>100 mg) during the last year of the study. All patients underwent bilateral surgical exploration of the neck. Success was defined as resection of a pathologic gland combined with normocalcemia at 6 months after operation. Logistic regression was used to test the relationship between groups and potential predictive factors of microadenoma. Results There were 57 women (92%) and the median age was 57 years (range 29 to 77 years). Median preoperative calcemia and parathyroid hormone (PTH) serum levels were 2.64 mmol/L (range 2.31 to 3 mmol/L) and 79 pg/mL (range 30 to 189 pg/mL), respectively. There was no difference in the clinical presentation between patients with microadenoma and adenoma. Preoperative calcium (p < 0.001) and PTH serum levels (p = 0.014) were significantly higher in patients with adenoma. Calcium and PTH serum levels lower than 2.6 mmol/L and 60 pg/mL, respectively, predicted the presence of microadenoma with respective specificities of 0.89 and 0.87. Success rates were similar in the microadenoma and adenoma groups (92% vs 98%; p = 0.11). Conclusions Mild preoperative elevations of calcium or PTH serum levels should warn about the risk of microadenoma. In this setting, intraoperative difficulties should be expected in identifying the pathologic gland, and bilateral neck exploration should be the preferred surgical approach.
The NEMO-3 results for the double-$\beta$ decay of $^{150}$Nd to the 0$^+_1$
and 2$^+_1$ excited states of $^{150}$Sm are reported. The data recorded during
5.25 yr with 36.6 g of the isotope ...$^{150}$Nd are used in the analysis. For the
first time, the signal of the $2\nu\beta\beta$ transition to the 0$^+_1$
excited state is detected with a statistical significance exceeding 5$\sigma$.
The half-life is measured to be $T_{1/2}^{2\nu\beta\beta}(0^+_1) = \left 1.11
^{+0.19}_{-0.14} \,\left(\mbox{stat}\right) ^{+0.17}_{-0.15}\,
\left(\mbox{syst}\right) \right \times10^{20}\,\mbox{yr}$. The limits are set
on the $2\nu\beta\beta$ decay to the 2$^+_1$ level and on the $0\nu\beta\beta$
decay to the 0$^+_1$ and 2$^+_1$ levels of $^{150}$Sm.
In 1956 Reines & Cowan discovered the neutrino using a liquid scintillator detector. The neutrinos interacted with the scintillator, producing light that propagated across transparent volumes to ...surrounding photo-sensors. This approach has remained one of the most widespread and successful neutrino detection technologies used since. This article introduces a concept that breaks with the conventional paradigm of transparency by confining and collecting light near its creation point with an opaque scintillator and a dense array of optical fibres. This technique, called LiquidO, can provide high-resolution imaging to enable efficient identification of individual particles event-by-event. A natural affinity for adding dopants at high concentrations is provided by the use of an opaque medium. With these and other capabilities, the potential of our detector concept to unlock opportunities in neutrino physics is presented here, alongside the results of the first experimental validation.
The SoLid experiment, short for Search for Oscillations with a Lithium-6 detector, is a new generation neutrino experiment which tries to address the key challenges for high precision reactor ...neutrino measurements at very short distances from a reactor core and with little or no overburden. The primary goal of the SoLid experiment is to perform a precise measurement of the electron antineutrino energy spectrum and flux and to search for very short distance neutrino oscillations as a probe of eV-scale sterile neutrinos. This paper describes the SoLid detection principle, the mechanical design and the construction of the detector. It then reports on the installation and commissioning on site near the BR2 reactor, Belgium, and finally highlights its performance in terms of detector response and calibration.
The SuperNEMO experiment will search for neutrinoless double-beta decay (\(0\nu\beta\beta\)), and study the Standard-Model double-beta decay process (\(2\nu\beta\beta\)). The SuperNEMO technology can ...measure the energy of each of the electrons produced in a double-beta (\(\beta\beta\)) decay, and can reconstruct the topology of their individual tracks. The study of the double-beta decay spectrum requires very accurate energy calibration to be carried out periodically. The SuperNEMO Demonstrator Module will be calibrated using 42 calibration sources, each consisting of a droplet of \(^{207}\)Bi within a frame assembly. The quality of these sources, which depends upon the entire \(^{207}\)Bi droplet being contained within the frame, is key for correctly calibrating SuperNEMO's energy response. In this paper, we present a novel method for precisely measuring the exact geometry of the deposition of \(^{207}\)Bi droplets within the frames, using Timepix pixel detectors. We studied 49 different sources and selected 42 high-quality sources with the most central source positioning.
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