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1.
Eur Phys J A Hadron Nucl ; 59(10): 232, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37860634

RESUMO

The target asymmetry T, recoil asymmetry P, and beam-target double polarization observable H were determined in exclusive π0 and η photoproduction off quasi-free protons and, for the first time, off quasi-free neutrons. The experiment was performed at the electron stretcher accelerator ELSA in Bonn, Germany, with the Crystal Barrel/TAPS detector setup, using a linearly polarized photon beam and a transversely polarized deuterated butanol target. Effects from the Fermi motion of the nucleons within deuterium were removed by a full kinematic reconstruction of the final state invariant mass. A comparison of the data obtained on the proton and on the neutron provides new insight into the isospin structure of the electromagnetic excitation of the nucleon. Earlier measurements of polarization observables in the γp→π0p and γp→ηp reactions are confirmed. The data obtained on the neutron are of particular relevance for clarifying the origin of the narrow structure in the ηn system at W=1.68GeV. A comparison with recent partial wave analyses favors the interpretation of this structure as arising from interference of the S11(1535) and S11(1650) resonances within the S11-partial wave.

2.
J Clin Virol ; 165: 105518, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37354690

RESUMO

BACKGROUND: Commercially available ELISA-based antibody tests are used to approximate vaccination success against SARS-CoV-2 in at-risk patients, but it is unclear whether they correlate with neutralization of the Omicron variant. METHODS: 269 serum samples of a cohort of 44 non-immunosuppressed participants and 65 MTX-treated rheumatic patients taken before and after COVID-19 booster vaccinations were measured using COVID-19 antibody testing systems with wild-type and Omicron BA.1 antigens developed by three different manufacturers (surrogate virus neutralization test cPass, and binding antibody tests QuantiVac and SeraSpot), as well as with a pseudovirus neutralization test (pVNT). The pVNT was considered the gold standard for determining the presence and level of anti-SARS-CoV-2 antibodies. RESULTS: All three wild-type ELISAs showed excellent test performance compared with wild-type neutralization in pVNT. However, out of 56 samples without Omicron BA.1 neutralization in pVNT, 71.4% showed positive results in at least one and 28.6% in all three wild-type ELISAs at the manufacturer-defined cut-offs. Omicron ELISAs showed either decreased specificity (57.1% and 55.4% for binding ELISAs) or sensitivity (51.2% in cPass) compared to Omicron neutralization in pVNT. The proportion of any false positive results among all samples decreased from 26.5% before to 3.2% after booster vaccination, however binding antibody test specificities remained below 70%. CONCLUSIONS: We found a poorer test performance of new Omicron antibody test systems compared to wild-type tests in detecting neutralizing antibodies against the corresponding SARS-CoV-2 variants. Decisions for booster vaccination or passive immunization of at-risk patients should not be based solely on antibody test results.


Assuntos
COVID-19 , Vírus de RNA , Humanos , Testes de Neutralização , Teste para COVID-19 , COVID-19/diagnóstico , SARS-CoV-2 , Anticorpos Neutralizantes , Anticorpos Antivirais
3.
Nanotechnology ; 34(33)2023 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-37164000

RESUMO

We report on transport measurements in monolayer MoS2devices, close to the bottom of the conduction band edge. These devices were annealedin situbefore electrical measurements. This allows us to obtain good ohmic contacts at low temperatures, and to measure precisely the conductivity and mobility via four-probe measurements. The measured effective mobility up toµeff= 180 cm2V-1s-1is among the largest obtained in CVD-grown MoS2monolayer devices. These measurements show that electronic transport is of the insulating type forσ≤ 1.4e2/handn≤ 1.7 × 1012cm-2, and a crossover to a metallic regime is observed above those values. In the insulating regime, thermally activated transport dominates at high temperature (T> 120 K). At lower temperatures, conductivity is driven by Efros-Schklovkii variable range hopping in all measured devices, with a universal and constant hopping prefactor, that is a clear indication that hopping is not phonon-mediated. At higher carrier density, and high temperature, the conductivity is well modeled by the Boltzmann equation for a non-interacting Fermi gas, taking into account both phonon and impurity scatterings. Finally, even if this apparent metal-insulator transition can be explained by phonon-related phenomena at high temperature, the possibility of a genuine 2D MIT cannot be ruled out, as we can observe a clear power-law diverging localization length close to the transition, and a one-parameter scaling can be realized.

4.
J Ment Health ; 32(3): 560-566, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36102162

RESUMO

BACKGROUND: Service user satisfaction in inpatient psychiatric care is often measured with instruments that have been designed by professionals, without involving the perspective of service users. Views on Inpatient Care (VOICE), developed in England, is among the first service-user-generated outcome measures which included service users' perspectives in the process. AIMS: In this study, we aimed to validate a German version of VOICE. METHODS: The original questionnaire was translated into German and validated using data collected from 163 inpatients undergoing treatment in a psychiatric hospital. The instrument was tested for its psychometric properties, focusing on measurements of reliability and construct validity. Also, we assessed the impact of demographic variables. Finally, factorial analyses were carried out to compare the underlying factorial structure to the English version. RESULTS: The analyses revealed a high internal consistency (α = 0.90). No significant impact of demographic variables was observed. Factorial analyses indicated a one-factor structure which accounted for 40.39% of variance. CONCLUSIONS: Psychometrical evaluation of VOICE-DE indicated the questionnaire to be a suitable tool to assess service users' personal experience with treatment and satisfaction in German.


Assuntos
Pacientes Internados , Serviços de Saúde Mental , Humanos , Reprodutibilidade dos Testes , Satisfação do Paciente , Avaliação de Resultados em Cuidados de Saúde
5.
Eur Phys J A Hadron Nucl ; 57(1): 40, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33551676

RESUMO

A measurement of the double-polarization observable E for the reaction γ p → π 0 p is reported. The data were taken with the CBELSA/TAPS experiment at the ELSA facility in Bonn using the Bonn frozen-spin butanol (C 4 H 9 OH) target, which provided longitudinally-polarized protons. Circularly-polarized photons were produced via bremsstrahlung of longitudinally-polarized electrons. The data cover the photon energy range from E γ = 600 to 2310 MeV and nearly the complete angular range. The results are compared to and have been included in recent partial wave analyses.

6.
HIV Med ; 22(5): 397-408, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33421299

RESUMO

OBJECTIVES: Despite its importance as an HIV anatomic sanctuary, little is known about the characteristics of the HIV reservoir in the terminal ileum (TI). In blood, the immune checkpoint inhibitor programmed-death-1 (PD-1) has been linked to the HIV reservoir and T-cell immune dysfunction. We thus evaluated PD-1 expression and cell-associated HIV DNA in memory CD4 T-cell subsets from TI, peripheral blood (PB) and rectum (RE) of untreated and treated HIV-positive patients to identify associations between PD-1 and HIV reservoir in other sites. METHODS: Using mononuclear cells from PB, TI and RE of untreated HIV-positive (N = 6), treated (n = 18) HIV-positive and uninfected individuals (n = 16), we identified and sorted distinct memory CD4 T-cell subsets by flow cytometry, quantified their cell-associated HIV DNA using quantitative PCR and assessed PD-1 expression levels using geometric mean fluorescence intensity. Combined HIV-1 RNA in situ hybridization and immunohistochemistry was performed on ileal biopsy sections. RESULTS: Combined antiretroviral therapy (cART)-treated patients with undetectable HIV RNA and significantly lower levels of HIV DNA in PB showed particularly high PD-1 expression in PB and TI, and high HIV DNA levels in TI, irrespective of clinical characteristics. By contrast, in treatment-naïve patients HIV DNA levels in memory CD4 T-cell subsets were high in PB and TI. CONCLUSION: Elevated PD-1 expression on memory CD4 T-cells in PB and TI despite treatment points to continuous immune dysfunction and underlines the importance of evaluating immunotherapy in reversing HIV latency and T-cell reconstitution. As HIV DNA particularly persists in TI despite cART, investigating samples from TI is crucial in understanding HIV immunopathogenesis.


Assuntos
Infecções por HIV , HIV-1 , Linfócitos T CD4-Positivos , DNA , HIV-1/genética , Humanos , Íleo/metabolismo , Receptor de Morte Celular Programada 1 , Subpopulações de Linfócitos T/metabolismo
7.
Monatsschr Kinderheilkd ; 169(1): 46-51, 2021.
Artigo em Alemão | MEDLINE | ID: mdl-33235395

RESUMO

BACKGROUND: As of 18 June 2020 a total of 187,764 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections were reported in Germany and of these 6.9% were under the age of 19 years. There were initial indications that children are often asymptomatic and show a milder clinical course. OBJECTIVE: The aim of this study was to gain information on the prevalence of SARS-CoV­2 infections in a pediatric cohort. MATERIAL AND METHODS: Between 13 March and 18 June 2020 all children from whom a smear for SARS-CoV­2 was taken either to rule out an infection or as a suspected case were included. Data were collected on standardized patient record sheets. The analysis of data was anonymized and retrospective. RESULTS: During the given period 2192 children were investigated and 37 patients tested positive (1.7%) for SARS-CoV­2. Of these 36/37 were suspected cases and 28/37 were symptomatic. The leading symptoms were dry cough, runny nose and fever and three children had to be hospitalized. None showed a difficult course of the disease. Among those tested 505 were patients at risk due to an underlying chronic disease, 3 of whom (0.6%) were tested positive with an asymptomatic or mild course. CONCLUSION: We can confirm the first data showing that children and adolescents often have an asymptomatic or mild clinical course of infection or disease. We found no evidence of a high grey area of SARS-CoV­2 infections in this regional pediatric cohort.

8.
Rev Sci Instrum ; 91(10): 103102, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33138582

RESUMO

We present a novel locking scheme for active length-stabilization and frequency detuning of a cavity optomechanical device based on the optical spring effect. The error signal is generated by utilizing the position measurement of a thermally driven intra-cavity nanomechanical device and employing its detuning-dependent frequency shift caused by the dispersive coupling to the cavity field. The scheme neither requires external modulation of the laser or the cavity nor does it demand for additional error signal readout, rendering its technical implementation rather simple for a large variety of existing optomechanical devices. Specifically, for large-linewidth microcavities or in situations where other locking schemes appear unfavorable conceptually or are hard to realize technically, the optical spring lock represents a potential alternative for stabilizing the cavity length. We explain the functional principle of the lock and characterize its performance in terms of bandwidth and gain profile.

9.
Phys Rev Lett ; 125(15): 152002, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33095637

RESUMO

Data on the beam asymmetry Σ in the photoproduction of η mesons off protons are reported for tagged photon energies from 1130 to 1790 MeV (mass range from W=1748 MeV to W=2045 MeV). The data cover the full solid angle that allows for a precise moment analysis. For the first time, a strong cusp effect in a polarization observable has been observed that is an effect of a branch-point singularity at the pη^{'} threshold [E_{γ}=1447 MeV (W=1896 MeV)]. The latest BnGa partial wave analysis includes the new beam asymmetry data and yields a strong indication for the N(1895)1/2^{-} nucleon resonance, demonstrating the importance of including all singularities for a correct determination of partial waves and resonance parameters.

10.
Science ; 368(6490): 506-509, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32355026

RESUMO

The explicit breaking of the axial symmetry by quantum fluctuations gives rise to the so-called axial anomaly. This phenomenon is solely responsible for the decay of the neutral pion π0 into two photons (γγ), leading to its unusually short lifetime. We precisely measured the decay width Γ of the [Formula: see text] process. The differential cross sections for π0 photoproduction at forward angles were measured on two targets, carbon-12 and silicon-28, yielding [Formula: see text], where stat. denotes the statistical uncertainty and syst. the systematic uncertainty. We combined the results of this and an earlier experiment to generate a weighted average of [Formula: see text] Our final result has a total uncertainty of 1.50% and confirms the prediction based on the chiral anomaly in quantum chromodynamics.

11.
HPB Surg ; 2018: 2943879, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30364084

RESUMO

BACKGROUND: Since local tumor infiltration to the mesenteric-portal axis might represent a challenging assignment for curative intended resectability during pancreatic surgery, appropriate techniques for venous reconstruction are essential. In this study, we acknowledge the falciform ligament as a feasible and convenient substitute for mesenteric and portal vein reconstruction with high reliability and patency for local advanced pancreatic tumor. METHODS: A retrospective single-center analysis. Between June 2017 and January 2018, a total of eleven consecutive patients underwent pancreatic resections with venous reconstruction using falciform ligament. Among them, venous resection was performed in nine cases by wedge and in two cases by full segment. Patency rates and perioperative details were reviewed. RESULTS: Mean clamping time of the mesenteric-portal blood flow was 34 min, while perioperative mortality rate was 0%. By means of Duplex ultrasonography, nine patients were shown to be patent on the day of discharge, while two cases revealed an entire occlusion of the mesenteric-portal axis. Orthograde flow demonstrated a mean value of 34 cm/s. All patent grafts on discharge revealed persistent patency within various follow-up assessments. CONCLUSION: The falciform ligament appears to be a feasible and reliable autologous tissue for venous blood flow reconstruction with high postoperative patency. Especially the possibility of customizing graft dimensions to the individual needs based on local findings allows an optimal size matching of the conduit. The risk of stenosis and/or segmental occlusion may thus be further reduced.

12.
Hautarzt ; 69(12): 1014-1020, 2018 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-29881891

RESUMO

BACKGROUND: In addition to a broad and clinically diverse spectrum of known primary cutaneous lymphomas, for which an incidence of 1-3:100,000 is postulated, each year further entities are specified and defined. The goal is the presentation of a case series from daily clinical routine. METHODS: Over a period of 6 years and 2 months, patients consulting the Department of Dermatology, Medical Center University of Freiburg, were registered. Subsequently, collectives of mycosis fungoides (MF), Sezary syndrome (SS), CD30+ lymphoproliferative diseases, single cases with rare primary cutaneous lymphomas, and subcollectives of B­cell lymphomas were examined. The high number of MF cases allowed the additional quantitative analyses of the types of therapies used in this group. RESULTS: Yearly 16-25 new diagnoses of primary cutaneous lymphoma are made. The evaluation of 163 primary cutaneous lymphoma revealed 111 cases with MF (68.1%), including 9 particular variants, 15 primary cutaneous CD30+ lymphoproliferative diseases (9.2%) dominated by 10 lymphomatoid papulosis (LyP), in addition to 5 primary cutaneous anaplastic large cell lymphoma (PCALCL), 6 SS (3.68%), and 24 cutaneous B­cell lymphomas (14-72%). Three cases with rare primary cutaneous T/NK cell lymphomas are addressed in detail. In all, 82% of MF cases were stage IA and IB. The descending use of therapies for stage I-III included steroids and diverse UV therapies followed by bexarotene, interferon-α, methotrexate, and extracorporal photophoresis. CONCLUSIONS: Diagnoses of cutaneous lymphomas belong to a vast spectrum of differential diagnoses. This registry describes frequent findings and shows rare variants. You can only diagnose what you know; accordingly, a collection of case reports, which we wish to encourage, can help in processing and specification of entities.


Assuntos
Linfoma Cutâneo de Células T/classificação , Linfoma Cutâneo de Células T/epidemiologia , Papulose Linfomatoide/epidemiologia , Micose Fungoide/epidemiologia , Neoplasias Cutâneas/classificação , Neoplasias Cutâneas/epidemiologia , Alemanha/epidemiologia , Humanos , Antígeno Ki-1 , Papulose Linfomatoide/patologia , Micose Fungoide/patologia
13.
J Visc Surg ; 155(6): 439-443, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29482979

RESUMO

OBJECTIVE: Reducing the time required for diagnosis is one of the major challenges to improving and accelerating the management of patients. The aim of this work is to describe an organizational innovation in the management of patients with hepatobiliary or pancreatic diseases, and to report the initial results. MATERIALS AND METHODS: A multidisciplinary and multi-professional working group designed and instituted a patient-centered organizational system that optimizes the investigation of liver and pancreatic diseases, in order to achieve diagnosis in one day. From January 2017 to June 2017, all patients referred for consultation for hepatobiliary or pancreatic pathology were included in this new management pathway. Data were collected prospectively in a standardized form. RESULTS: Fifty-six patients with hepatobiliary or pancreatic disease were evaluated in the program during dedicated slots over a total of 20 days. Of these, four patients underwent evaluation in the program twice. The average number of patient slots in the program was three per day (range: 1-5). An additional computed tomography (CT) and/or magnetic resonance imaging (MRI) was required in 23 (41.7%) of the visits. These imaging studies were performed the same day, including nine patients who required both types of imaging (16.7% of cases). "One-day diagnosis" established an accurate diagnosis by the end of the day in 49 patient encounters (81.7%). Overall assessment of this organization was considered excellent by 46 (83%) of patients. CONCLUSION: An organizational innovation has made it possible to effectively diagnose hepatobiliary or pancreatic pathology within one day in the majority of cases, with good patient satisfaction. It is now necessary to evaluate the medico-economic aspect of this organization, and more generally to develop a methodology for multidimensional evaluation of organizational innovations.


Assuntos
Doenças Biliares/diagnóstico por imagem , Procedimentos Clínicos/organização & administração , Inovação Organizacional , Pancreatopatias/diagnóstico por imagem , Assistência Centrada no Paciente/organização & administração , Idoso , Anestesiologia , Doenças Biliares/cirurgia , Diagnóstico Precoce , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pancreatopatias/cirurgia , Satisfação do Paciente , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos , Encaminhamento e Consulta , Fatores de Tempo , Tomografia Computadorizada por Raios X
14.
Phys Rev Lett ; 118(24): 242002, 2017 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-28665642

RESUMO

We report the first beam-target double-polarization asymmetries in the γ+n(p)→π^{-}+p(p) reaction spanning the nucleon resonance region from invariant mass W=1500 to 2300 MeV. Circularly polarized photons and longitudinally polarized deuterons in solid hydrogen deuteride (HD) have been used with the CEBAF Large Acceptance Spectrometer (CLAS) at Jefferson Lab. The exclusive final state has been extracted using three very different analyses that show excellent agreement, and these have been used to deduce the E polarization observable for an effective neutron target. These results have been incorporated into new partial wave analyses and have led to significant revisions for several γnN^{*} resonance photocouplings.

15.
Transbound Emerg Dis ; 64(2): 354-363, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25958882

RESUMO

The Schmallenberg virus (SBV) has recently emerged in Europe, causing losses to the domestic livestock. A retrospective analysis of serodata was conducted in France for estimating seroprevalence of SBV among six wildlife species from 2011-2012 to 2013-2014, that is during the three vector seasons after the emergence of the SBV in France. Our objective was to quantify the exposure of wildlife to SBV and the potential protective effect of elevation such as previously observed for bluetongue. We also compared the spatiotemporal trends between domestic and wild animals at the level of the departments. We tested 2050 sera using competitive ELISA tests. Individual and population risk factors were further tested using general linear models among 1934 individuals. All populations but one exhibited positive results, seroprevalence up to 30% being observed for all species. The average seroprevalence did not differ between species but ranged from 0 to 90% according to the area and period, due to the dynamic pattern of infection. Seroprevalence was on average higher in the lowlands compared to areas located up to 800 m. Nevertheless, seroprevalence above 50% occurred in areas located up to 1500 m. Thus, contrary to what had been observed for bluetongue during the late 2000s in the same areas, SBV could spread to high altitudes and infect all the studied species. The spatial spread of SBV in wildlife did not fully match with SBV outbreaks reported in the domestic livestock. The mismatch was most obvious in mountainous areas where outbreaks in wildlife occurred on average one year after the peak of congenital cases in livestock. These results suggest a much larger spread and vector capacity for SBV than for bluetongue virus in natural areas. Potential consequences for wildlife dynamics are discussed.


Assuntos
Animais Selvagens/virologia , Infecções por Bunyaviridae/epidemiologia , Orthobunyavirus/isolamento & purificação , Animais , Bluetongue/epidemiologia , Surtos de Doenças , Ensaio de Imunoadsorção Enzimática , França/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Estações do Ano , Estudos Soroepidemiológicos
16.
Poult Sci ; 96(1): 160-168, 2017 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-27433015

RESUMO

The purpose of the study that is presented herein was to develop near-infrared reflectance spectroscopy (NIRS) calibrations to predict total phosphorus (P), phytate-P, and protein concentrations of feed ingredients commonly used in monogastric feed formulation. Samples representing 14 vegetable ingredients (cereals, cereal by-products, and oilseed meals) were collected worldwide throughout 2013. The samples were assayed by standard wet chemical techniques for total P, phytate-P, and protein content. There was substantial variability in protein, phytate-P, and total P within and between ingredients used in the calibration set. Protein content varied from 76 to 487 g/kg. Total P ranged from 2.09 and 22.5 g/kg and phytate-P ranged from 0.99 and 13.8 g/kg. Within these broad ranges, NIRS values were highly correlated for determination of protein, total P, and phytate-P with a standard error of prediction equal to 9.06 g/kg, 0.80 g/kg, and 0.66 g/kg, respectively. The wide diversity and heterogeneity of the mix of feed ingredients allowed the development of NIRS calibrations of sufficient accuracy to help nutritionists control the nutritional composition of their feed.


Assuntos
Ração Animal/análise , Proteínas Alimentares/análise , Fósforo na Dieta/análise , Ácido Fítico/análise , Espectroscopia de Luz Próxima ao Infravermelho/veterinária , Animais , Aves Domésticas
17.
Transplant Proc ; 48(2): 457-62, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27109978

RESUMO

BACKGROUND: Intestinal failure (IF) patients received parenteral nutrition (PN) as the only available therapy until intestinal transplantation (ITx) evolved as an accepted treatment. The aim of this article is to report the long-term outcomes of a series of ITx performed in pediatric and adult patients at a single center 9 years after its creation. PATIENTS AND METHODS: This is a retrospective analysis of the ITx performed between May 2006 and January 2015. Diagnoses, pre-ITx mean time on PN, indications for ITx, time on the waiting list for types of ITx, mean total ischemia time, and warm ischemia time, time until PN discontinuation, incidence of acute and chronic rejection, and 5-year actuarial patient survival are reported. RESULTS: A total of 42 patients received ITx; 80% had short gut syndrome (SG); the mean time on PN was 1620 days. The main indication for ITx was lack of central venous access followed by intestinal failure-associated liver disease (IFALD) and catheter-related infectious complications. The mean time on the waiting list was 188 days (standard deviation, ±183 days). ITx were performed in 26 children and 14 adults. In all, 32 procedures were isolated ITx (IITX); 10 were multiorgan Tx (MOT; 3 combined, 7 multivisceral Tx (MVTx), 1 modified MVTx and 2 with kidney); 2 (4.7 %) were retransplantations: 1 IITx, 1 MVTx, and 5 including the right colon. Thirteen patients (31%) received abdominal rectus fascia. All procedures were performed by the same surgical team. Total ischemia time was 7:53 ± 2:04 hours, and warm ischemia time was 40.2 ± 10.5 minutes. The mean length of implanted intestine was 325 ± 63 cm. Bishop-Koop ileostomy was performed in 67% of cases. In all, 16 of 42 Tx required early reoperations. The overall mean follow-up time was 41 ± 35.6 months. The mean time to PN discontinuation after Tx was 68 days (P = .001). The total number of acute cellular rejection (ACR) episodes until the last follow-up was 83; the total number of grafts lost due to ACR was 4; and the total graft lost due to chronic rejection was 3. At the time of writing, the overall 5-year patient survival is 55% (65% for IITx vs 22% for MOT; P = .0001); 60% for pediatric recipients vs 47% for adults (P = NS); 64% when the indication for ITx was SG vs 25% for non-SG (P = .002). CONCLUSIONS: At this center, candidates with SG, in the absence of IFALD requiring IITx, showed the best long-term outcomes, independent of recipient age. A multidisciplinary approach is mandatory for the care of intestinal failure patients, to sustain a rehabilitation and transplantation program over time.


Assuntos
Rejeição de Enxerto/epidemiologia , Intestinos/transplante , Falência Renal Crônica/cirurgia , Falência Hepática/cirurgia , Transplante de Fígado , Nutrição Parenteral Total/estatística & dados numéricos , Complicações Pós-Operatórias/epidemiologia , Síndrome do Intestino Curto/cirurgia , Adulto , Argentina , Criança , Feminino , Humanos , Enteropatias/complicações , Enteropatias/cirurgia , Falência Renal Crônica/complicações , Falência Hepática/etiologia , Masculino , Nutrição Parenteral Total/efeitos adversos , Reoperação , Estudos Retrospectivos , Síndrome do Intestino Curto/complicações , Listas de Espera , Isquemia Quente
19.
Ann Surg ; 263(3): 440-9, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26135690

RESUMO

OBJECTIVES: To assess pancreatic fistula rate and secondary endpoints after pancreatogastrostomy (PG) versus pancreatojejunostomy (PJ) for reconstruction in pancreatoduodenectomy in the setting of a multicenter randomized controlled trial. BACKGROUND: PJ and PG are established methods for reconstruction in pancreatoduodenectomy. Recent prospective trials suggest superiority of the PG regarding perioperative complications. METHODS: A multicenter prospective randomized controlled trial comparing PG with PJ was conducted involving 14 German high-volume academic centers for pancreatic surgery. The primary endpoint was clinically relevant postoperative pancreatic fistula. Secondary endpoints comprised perioperative outcome and pancreatic function and quality of life measured at 6 and 12 months of follow-up. RESULTS: From May 2011 to December 2012, 440 patients were randomized, and 320 were included in the intention-to-treat analysis. There was no significant difference in the rate of grade B/C fistula after PG versus PJ (20% vs 22%, P = 0.617). The overall incidence of grade B/C fistula was 21%, and the in-hospital mortality was 6%. Multivariate analysis of the primary endpoint disclosed soft pancreatic texture (odds ratio: 2.1, P = 0.016) as the only independent risk factor. Compared with PJ, PG was associated with an increased rate of grade A/B bleeding events, perioperative stroke, less enzyme supplementation at 6 months, and improved results in some quality of life parameters. CONCLUSIONS: The rate of grade B/C fistula after PG versus PJ was not different. There were more postoperative bleeding events with PG. Perioperative morbidity and mortality of pancreatoduodenectomy seem to be underestimated, even in the high-volume center setting.


Assuntos
Pancreatopatias/cirurgia , Pancreaticoduodenectomia , Pancreaticojejunostomia , Complicações Pós-Operatórias/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Alemanha/epidemiologia , Hemorragia/epidemiologia , Mortalidade Hospitalar , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Pancreatopatias/mortalidade , Fístula Pancreática/epidemiologia , Complicações Pós-Operatórias/mortalidade , Estudos Prospectivos , Qualidade de Vida , Fatores de Risco
20.
J Evol Biol ; 27(12): 2745-52, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25358546

RESUMO

Increasing evidence of senescence has been reported from long-term studies of wild populations. However, most studies have focused on life-history traits like survival, reproduction or body mass, generally from a single intensively monitored population. However, variation in the intensity of senescence across populations, and to a lesser extent between sexes, is still poorly understood. In addition, the pattern of age-specific changes in haematological parameters remains virtually unknown to date for any population of vertebrate living in the wild. Using repeated blood samples collected from known-aged (2-15 years of age) roe deer (Capreolus capreolus) from two populations facing highly different environmental conditions, we filled the gap. In particular, we investigated age-specific changes in haematocrit, albumin and creatinine. We reported clear evidence of senescence in all haematological parameters. Moreover, senescence patterns differed between sexes and populations. The rate of senescence was higher in males than in females for haematocrit with no site difference. On the other hand, the rate of senescence in creatinine was higher at Trois Fontaines than at Chizé with no sex difference. Our findings provide a first demonstration of age-specific declines in haematological parameters in wild populations of large herbivores and show that the process of senescence in vertebrates is not restricted to body mass or fitness components. We also demonstrate that the senescence pattern of haematological parameters is context dependent and varies both between sexes and according to environmental conditions.


Assuntos
Envelhecimento/fisiologia , Animais Selvagens/fisiologia , Cervos/fisiologia , Meio Ambiente , Fatores Etários , Envelhecimento/sangue , Animais , Animais Selvagens/sangue , Creatinina/sangue , Cervos/sangue , Feminino , França , Geografia , Hematócrito , Masculino , Modelos Biológicos , Fatores Sexuais
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