ABSTRACT
In this paper, we present a newly developed crossed beam experimental setup that utilizes the velocity map imaging (VMI) technique to simultaneously measure both the kinetic energy and emission angle of electrons emitted from atoms or molecules upon ion collision. The projectile ion beam with keV to MeV kinetic energy orthogonally crosses the neutral target beam produced by an effusion cell. The emitted electrons are extracted and analyzed by a multi-electrode VMI spectrometer. By monitoring the target density, the projectile ion beam intensity, and the beams' overlap, we are able to measure absolute differential cross sections for collision-induced electron emission from molecules. The characterization of the setup and the methodology will be presented as well as first results for electron emission from uracil upon 0.98 MeV/u 12C4+ collision.
Subject(s)
ElectronsABSTRACT
OBJECTIVES: Professional practice evaluation of anaesthesiologist for high cardiac-risk patient cares in non-cardiac surgery, and assess disparities between results and recommendations. MATERIALS AND METHODS: Since June to September 2011, a self-questionnaire was sent to 5000 anesthesiologist. They were considered to be representative of national anesthesiology practitioner. Different items investigated concerned: demography, preoperative cardiac-risk assessment, modalities of specialized cardiologic advice, per- and postoperative care, and finally knowledge of current recommendations. RESULTS: We collected 1255 questionnaire, that is to say 25% of answers. Men were 73%, 38% were employed by public hospital; 70% worked in a shared operating theatre with a general activity. With regards to preoperative assessment, 85% of anaesthetists referred high cardiac-risk patient to a cardiologist. In only 16% of answer, Lee's score appeared in anaesthesia file to assess perioperative cardiac-risk. Only 61% considered the six necessary items to optimal estimate of cardiac-risk. On the other hand, 91% measured routinely the exercise capacities by interrogation. The most frequently doing exam (49% of anaesthetist) was an electrocardiogram in elderly patient. In 96% of case, beta-blockers were given in premedication if they were usually thought. Clopidogrel was stopped by 62% of anesthetist before surgery. In this case, 38% used another medication to take over from this one. Only 7% considered revascularization in coronary patient who were effectively treated. POISE study was know by 40% of practitioner, and 18% estimated that they have changed their practice. Preoperatively, 21% organized multidisciplinary approach for high-risk patient. During surgery, 63% monitored the ST-segment. In postoperative period for cardiac-risk patient, only 11% prescribed systematically an ECG, a troponin dosage, a postoperative monitoring of ST-segment, a cardiologic advice. In case of moderate troponin elevation, they were 70% to realize at least an ECG and/or an echocardiography. CONCLUSION: This study highlights some difference between current recommendation concerning assessment of cardiac-risk patient in non-cardiac surgery and daily practice of anesthetist, justifying regular update of this one.
Subject(s)
Preoperative Care/statistics & numerical data , Risk Assessment , Surgical Procedures, Operative/statistics & numerical data , Adult , Anesthesiology , Exercise Test , Female , France , Health Care Surveys , Heart Diseases/diagnosis , Humans , Male , Middle Aged , Physicians , Postoperative Care , Pregnancy , Professional Practice , Referral and Consultation , Surveys and QuestionnairesABSTRACT
Thermal injury induce a two-phase inflammatory response: first, a pro-inflammatory status, resulting in a systemic inflammatory response syndrome, then an anti-inflammatory phase characterized by a profound defect in cellular-mediated immunity. This inflammatory reaction proceeds from complex phenomenons in whom many cellular elements are involved (macrophage is the central one) and very complex molecular products interact (especially cytokines). These phenomenons promote significant physiopathologic consequences, especially on cardiovascular homeostasis and endothelial permeability, that lower the prognosis. The inflammatory reaction can be modified, enhanced or maintained by adverse events (i.e. infection) resulting in degradation of clinical situation. Despite a better comprehension of the phenomenons underlying this inflammatory process, diagnosis or therapeutic applications are at that time disappointing.
