RESUMO
State-of-the-art 19th century spectroscopy led to the discovery of quantum mechanics, and 20th century spectroscopy led to the confirmation of quantum electrodynamics. State-of-the-art 21st century astrophysical spectrographs, especially ANDES at ESO's ELT, have another opportunity to play a key role in the search for, and characterization of, the new physics which is known to be out there, waiting to be discovered. We rely on detailed simulations and forecast techniques to discuss four important examples of this point: big bang nucleosynthesis, the evolution of the cosmic microwave background temperature, tests of the universality of physical laws, and a real-time model-independent mapping of the expansion history of the universe (also known as the redshift drift). The last two are among the flagship science drivers for the ELT. We also highlight what is required for the ESO community to be able to play a meaningful role in 2030s fundamental cosmology and show that, even if ANDES only provides null results, such 'minimum guaranteed science' will be in the form of constraints on key cosmological paradigms: these are independent from, and can be competitive with, those obtained from traditional cosmological probes.
RESUMO
This study represents our experience with 1461 patients who were seen in the Emergency Room of the University Hospital in Ghent with multiple traumatic lesions, between 1978 and 1982. In 43% of these polytraumata, we did an explorative peritoneal lavage in order to obtain a quick evaluation of intrabdominal haemorrhage. In 65% of the patients, the lavage was negative; 221 positive lavages (35%) underwent abdominal exploration; in 85% of these there were evident positive findings. The remaining 15% showed either no lesions, or minor lesions not involving risk of life. The overall accuracy-rate of the technique described above is at least 93%.
Assuntos
Traumatismos Abdominais/diagnóstico , Hematoma/etiologia , Hemoperitônio/diagnóstico , Lavagem Peritoneal , Adulto , Reações Falso-Negativas , Reações Falso-Positivas , Feminino , Humanos , Masculino , Cavidade Peritoneal , Estudos Retrospectivos , Sensibilidade e EspecificidadeRESUMO
The use of a perisplenic prosthesis in Polyglactin (Vicryl) is a recent technique for spleen conservation after trauma. We present our experience in eight severely traumatised patients with hemoperitoneum on the basis of a ruptured spleen. In all cases we were able to save the spleen. No complications occurred and the splenic function was intact after the operation. An overview of the techniques for conservation of the spleen after trauma is given.
Assuntos
Poliglactina 910/uso terapêutico , Polímeros/uso terapêutico , Próteses e Implantes , Baço/cirurgia , Ruptura Esplênica/cirurgia , Adolescente , Adulto , Feminino , Humanos , Masculino , Métodos , Pessoa de Meia-Idade , Baço/lesõesRESUMO
Kaunitz-procedure for gastro-oesophageal reflux. Between May '74 and May '86 we performed 121 Kaunitz-procedures for gastro-oesophageal reflux, mostly with oesofagitis. Follow-up was obtained in 120 of these 121 patients. The mean follow-up is 55 months and the mean age 49.5 years at the time of operation. Of these patients 103 were completely free of reflux-symptoms after the operation while 6 patients had apparent amelioration of their symptoms. In 7 patients we obtained no subjective improvement but in 4 of them the oesofagitis, which they had preoperatively, has disappeared. 4 patients were reoperated because of anatomical recurrence. The results can be considered as good or excellent in 94% of the patients. The Kaunitz procedure is a simple and efficient operative technique in patients with hiatus hernia and reflux.
Assuntos
Refluxo Gastroesofágico/cirurgia , Hérnia Diafragmática/cirurgia , Hérnia Hiatal/cirurgia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Seguimentos , Refluxo Gastroesofágico/etiologia , Hérnia Hiatal/complicações , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , ReoperaçãoRESUMO
A case of fusiform aneurysm of the abdominal aorta discovered during a septic procedure is presented. The aneurysm showed signs of impending rupture. The aorta was strengthened by external grafting using resorbable material. The patient died two months later of his underlying disease. The histology of the aorta and surrounding tissue is described. The repair proved to be satisfactory.