RESUMO
AIMS: To determine whether alcohol-dependent patients in a hospital setting benefit from extended brief interventions (EBI) delivered by an Alcohol Specialist Nurse. METHODS: Alcohol-dependent patients recruited via screening at the emergency department (ED) (n = 267), whether or not admitted to hospital, were randomized to EBI (up to six counselling sessions offered) or control. At 6 months, 84.2% of patients were assessed by a researcher blinded to the intervention. The primary outcome was a fall in Severity of Alcohol Dependence Questionnaire. RESULTS: There was no difference between groups in the primary outcome [odds ratio (OR) 1.02; 95% confidence interval (CI): 0.38, 2.75, P = 0.97]. Secondary outcomes including alcohol consumption and readiness to change did not show a significant difference between groups. However, all secondary outcome measures improved, on average, in both arms. CONCLUSIONS: Although EBI can be delivered in an ED or inpatient setting, it was not shown to be an advantage over screening and usual management (which included advice on alternative services), with patients in both groups showing an average improvement. TRIAL REGISTRATION: ISRCTN78062794.
Assuntos
Alcoolismo/terapia , Psicoterapia Breve/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Aconselhamento/métodos , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Enfermagem Psiquiátrica/métodos , Resultado do Tratamento , Adulto JovemRESUMO
A fit and well young man presented to our emergency department in the UK. On examination, he had an isolated left-sided ptosis; he had a 3-day history of frontal headache which was worse on head movement. He lacked any clinical signs of cranial, orbital, or preseptal infection, and his eye movements were normal. Ten days before presentation, he tested positive for SARS-CoV-2. Inflammatory markers were moderately raised, and CT of the head did not reveal any vascular abnormality or intracranial lesion. Imaging revealed opacification, predominantly in the left facial sinuses, keeping with sinusitis. He was discharged the same evening with oral antibiotics and made a full recovery over the next few days. He remained well at 6-month follow-up. The authors convey their findings to raise awareness of a rare complication of sinusitis and to demonstrate the utility of CT imaging for diagnosing sinusitis and ruling out severe pathology.
Assuntos
Blefaroptose , COVID-19 , Sinusite , Masculino , Humanos , COVID-19/complicações , SARS-CoV-2 , Sinusite/diagnóstico , Sinusite/diagnóstico por imagem , Blefaroptose/etiologia , Blefaroptose/diagnóstico , Cefaleia/etiologiaRESUMO
As part of a comprehensive study of X-ray emission from planetary surfaces and in particular the planet Mercury, we have measured fluorescent radiation from a number of planetary analog rock samples using monochromatized synchrotron radiation provided by the BESSY II electron storage ring. The experiments were carried out using a purpose built X-ray fluorescence (XRF) spectrometer chamber developed by the Physikalisch-Technische Bundesanstalt, Germany's national metrology institute. The XRF instrumentation is absolutely calibrated and allows for reference-free quantitation of rock sample composition, taking into account secondary photon- and electron-induced enhancement effects. The fluorescence data, in turn, have been used to validate a planetary fluorescence simulation tool based on the GEANT4 transport code. This simulation can be used as a mission analysis tool to predict the time-dependent orbital XRF spectral distributions from planetary surfaces throughout the mapping phase.
RESUMO
While Si and Ge have become detection standards for X-ray and gamma-ray spectroscopy in the laboratory, their use for an increasing range of applications is becoming marginalized by one or more of their physical limitations; namely the need for ancillary cooling systems or bulky cryogenics, their modest stopping powers and radiation intolerance. Wide band-gap compounds offer the ability to operate in a range of chemical, thermal and radiation environments while still maintaining sub-keV spectral resolution at X-ray wavelengths. In addition, these materials encompass such a wide range of physical properties that it is technically feasible to engineer materials to specific applications. However, while compound materials are used routinely in the optical and infrared wave bands, their development at hard X- and gamma-ray wavelengths has been plagued by material and fabrication problems. In this paper an overview of suitable materials is presented and the current progress in producing X- and gamma-ray radiation detectors is reviewed.