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1.
Phys Rev Lett ; 129(20): 201801, 2022 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-36461983

RESUMO

This Letter presents the results from the MiniBooNE experiment within a full "3+1" scenario where one sterile neutrino is introduced to the three-active-neutrino picture. In addition to electron-neutrino appearance at short baselines, this scenario also allows for disappearance of the muon-neutrino and electron-neutrino fluxes in the Booster Neutrino Beam, which is shared by the MicroBooNE experiment. We present the 3+1 fit to the MiniBooNE electron-(anti)neutrino and muon-(anti)neutrino data alone and in combination with MicroBooNE electron-neutrino data. The best-fit parameters of the combined fit with the exclusive charged-current quasielastic analysis (inclusive analysis) are Δm^{2}=0.209 eV^{2}(0.033 eV^{2}), |U_{e4}|^{2}=0.016(0.500), |U_{µ4}|^{2}=0.500(0.500), and sin^{2}(2θ_{µe})=0.0316(1.0). Comparing the no-oscillation scenario to the 3+1 model, the data prefer the 3+1 model with a Δχ^{2}/d.o.f.=24.7/3(17.3/3), a 4.3σ(3.4σ) preference assuming the asymptotic approximation given by Wilks's theorem.

2.
J Clin Monit Comput ; 35(6): 1349-1356, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-33094826

RESUMO

Postoperative hypotension is common (occurring in one third of patients) and is associated with worse clinical outcomes. The LiDCO CNAP (continuous non-invasive arterial pressure) device measures haemodynamics but has not been widely adopted in ward environments. Improved early detection of hypotension by CNAP might guide interventions to improve clinical outcomes. We aimed to find the proportion of patients who tolerated LiDCO CNAP for 12 h postoperatively, to unmask episodes of hypotension detected by continuous monitoring and to characterise the haemodynamic profile at the time of hypotension. In this feasibility study, patients undergoing major elective surgery were continuously postoperatively monitored using CNAP. Haemodynamic data gathered from CNAP, including nSVRI (nominal systemic vascular resistance index), nSVI (nominal stroke volume index), SVV (stroke volume variation) and blood pressure, were analysed using Microsoft Excel and GraphPad Prism 8. 104 patients (age (mean ± sd): 68 ± 14, male (56%)) had CNAP sited postoperatively. 39% tolerated the CNAP device for at least 12 h. Within the 104 patients a mean of 81.2 min of hypotension detected by CNAP was not detected by usual care. The proportion of low/normal/high nSVI was 71%, 27% and 2%, nSVRI was 43%, 17% and 40%, respectively. CNAP monitoring was not tolerated for 12 h in the majority of patients. There were many episodes of hypotension unmasked through continuous monitoring. Based on the advanced haemodynamic data provided it is possible that the underlying cause of a third of postoperative hypotensive episodes is vasodilation rather than hypovolaemia.Trial registry number: NCT04010058 (ClinicalTrials.gov) Date of registration: 08/07/2019.


Assuntos
Determinação da Pressão Arterial , Monitores de Pressão Arterial , Idoso , Idoso de 80 Anos ou mais , Pressão Sanguínea , Débito Cardíaco , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Volume Sistólico
3.
Phys Rev Lett ; 121(22): 221801, 2018 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-30547637

RESUMO

The MiniBooNE experiment at Fermilab reports results from an analysis of ν_{e} appearance data from 12.84×10^{20} protons on target in neutrino mode, an increase of approximately a factor of 2 over previously reported results. A ν_{e} charged-current quasielastic event excess of 381.2±85.2 events (4.5σ) is observed in the energy range 200

4.
Phys Rev Lett ; 120(14): 141802, 2018 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-29694148

RESUMO

We report the first measurement of monoenergetic muon neutrino charged current interactions. MiniBooNE has isolated 236 MeV muon neutrino events originating from charged kaon decay at rest (K^{+}→µ^{+}ν_{µ}) at the NuMI beamline absorber. These signal ν_{µ}-carbon events are distinguished from primarily pion decay in flight ν_{µ} and ν[over ¯]_{µ} backgrounds produced at the target station and decay pipe using their arrival time and reconstructed muon energy. The significance of the signal observation is at the 3.9σ level. The muon kinetic energy, neutrino-nucleus energy transfer (ω=E_{ν}-E_{µ}), and total cross section for these events are extracted. This result is the first known-energy, weak-interaction-only probe of the nucleus to yield a measurement of ω using neutrinos, a quantity thus far only accessible through electron scattering.

5.
Phys Rev Lett ; 118(22): 221803, 2017 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-28621993

RESUMO

The MiniBooNE-DM Collaboration searched for vector-boson mediated production of dark matter using the Fermilab 8-GeV Booster proton beam in a dedicated run with 1.86×10^{20} protons delivered to a steel beam dump. The MiniBooNE detector, 490 m downstream, is sensitive to dark matter via elastic scattering with nucleons in the detector mineral oil. Analysis methods developed for previous MiniBooNE scattering results were employed, and several constraining data sets were simultaneously analyzed to minimize systematic errors from neutrino flux and interaction rates. No excess of events over background was observed, leading to a 90% confidence limit on the dark matter cross section parameter, Y=ε^{2}α_{D}(m_{χ}/m_{V})^{4}≲10^{-8}, for α_{D}=0.5 and for dark matter masses of 0.01

6.
Phys Rev Lett ; 110(16): 161801, 2013 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-23679593

RESUMO

The MiniBooNE experiment at Fermilab reports results from an analysis of ν[over ¯](e) appearance data from 11.27×10(20) protons on target in the antineutrino mode, an increase of approximately a factor of 2 over the previously reported results. An event excess of 78.4±28.5 events (2.8σ) is observed in the energy range 200

7.
Phys Rev Lett ; 105(18): 181801, 2010 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-21231096

RESUMO

The MiniBooNE experiment at Fermilab reports results from a search for ¯ν_{µ}→¯ν_{e} oscillations, using a data sample corresponding to 5.66×10²° protons on target. An excess of 20.9±14.0 events is observed in the energy range 475

8.
Br J Dermatol ; 163(4): 859-62, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20716225

RESUMO

BACKGROUND: There are few reports of the practical use of adalimumab outside of a clinical trial setting and, to our knowledge, none from the U.K. OBJECTIVES: We assessed the efficacy and safety of adalimumab in a cohort of patients with severe psoriasis attending a tertiary dermatology referral centre in the U.K. METHODS: A retrospective case-note review was used to identify all patients initiated on adalimumab for psoriasis. RESI;TS: Baseline Psoriasis Area and Severity Index (PASI) was 24+/-11 (range 9-54; n=46). After 4 months' treatment with adalimumab 64% (29/45), of patients had achieved PASI 75 (75% decrease from baseline) whilst 80% (36/45) of patients met NICE criteria for continuation of treatment. Therapy was well-tolerated. Importantly, 68% (21/31) of patients who had previously received another tumour necrosis factor alpha inhibitor met NICE criteria for continuation of treatment at 16 weeks. CONCLUSIONS: In a cohort of U.K. patients with severe psoriasis, adalimumab has proved to be a significant addition to the expanding armamentarium of biologics for psoriasis. Pharmacovigilance, in the form of registries, is essential to assess the long-term safety of such drugs.


Assuntos
Anti-Inflamatórios/uso terapêutico , Anticorpos Monoclonais/uso terapêutico , Psoríase/tratamento farmacológico , Adalimumab , Adulto , Idoso , Anti-Inflamatórios/administração & dosagem , Anticorpos Monoclonais/administração & dosagem , Anticorpos Monoclonais Humanizados , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Estudos Retrospectivos , Terapia de Salvação , Resultado do Tratamento
9.
Clin Exp Dermatol ; 35(7): 688-91; quiz 692, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20545953

RESUMO

This review summarizes the clinical importance of 18 systematic reviews and guidelines on psoriasis published or indexed between November 2008 and October 2009. The topics covered include guidance on the use of topical, systemic and biological therapies for the treatment of psoriasis; comorbidities associated with psoriasis; and complementary therapies for psoriasis. A similar and more detailed review to this appeared in the 2009 Annual Evidence Update on Psoriasis from NHS Evidence - Skin Disorders in November 2009.


Assuntos
Guias de Prática Clínica como Assunto , Psoríase/tratamento farmacológico , Literatura de Revisão como Assunto , Fármacos Dermatológicos/uso terapêutico , Humanos , Fatores Imunológicos/uso terapêutico
10.
Br J Dermatol ; 160(1): 162-9, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18808412

RESUMO

BACKGROUND: Large-scale clinical trials provide clear evidence of the efficacy and short-term toxicity of biologic therapies for psoriasis. However, to date, there are few reports of the practical use of these therapies outside of the trial setting and, to our knowledge, none from a U.K. cohort of patients with psoriasis. OBJECTIVES: (i) To assess efficacy and safety of efalizumab, etanercept and infliximab in a U.K. cohort of patients with psoriasis, with mean Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index 21.8 and 21.7, respectively, outside of the clinical trial setting. (ii) To examine our approach to the processes involved in the initiation of biologic therapies in the era of National Institute for Health and Clinical Excellence guidance. METHODS: A retrospective case-note review to identify all patients initiated on biologic therapies for psoriasis in a U.K. tertiary referral centre. RESULTS: At 3 months of treatment the efficacy of efalizumab (n = 28), etanercept (n = 70) and infliximab (n = 20), as assessed by PASI 75 (75% decrease from baseline score), was 24%, 35% and 85%, respectively. All three biologics used were well tolerated. Combination therapy with traditional systemic agents was required either at transition to, or to counter relapse while established on, a biologic therapy in 30% of cases. Streamlined approaches to screening and funding significantly (P

Assuntos
Anti-Inflamatórios/uso terapêutico , Anticorpos Monoclonais/uso terapêutico , Imunoglobulina G/uso terapêutico , Psoríase/terapia , Receptores do Fator de Necrose Tumoral/uso terapêutico , Adolescente , Adulto , Idoso , Anti-Inflamatórios/efeitos adversos , Anti-Inflamatórios/economia , Anticorpos Monoclonais/efeitos adversos , Anticorpos Monoclonais/economia , Anticorpos Monoclonais Humanizados , Análise Custo-Benefício/economia , Relação Dose-Resposta a Droga , Etanercepte , Feminino , Humanos , Imunoglobulina G/efeitos adversos , Imunoglobulina G/economia , Infliximab , Masculino , Pessoa de Meia-Idade , Psoríase/economia , Estudos Retrospectivos , Terapia de Salvação/métodos , Índice de Gravidade de Doença , Resultado do Tratamento , Reino Unido , Adulto Jovem
11.
Clin Exp Dermatol ; 34(6): 664-7, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19572945

RESUMO

This review summarizes the clinical importance of six systematic reviews on psoriasis published between January 2007 and October 2008. A meta-analysis demonstrated that several traditional nonbiological systemic therapies have equal or superior efficacy to some biological therapies used in the treatment of psoriasis. Two further meta-analyses comparing biological therapies for psoriasis (excluding adalimumab) have established a hierarchy of efficacy for short-term treatment (10-16 weeks): infliximab > etanercept 50 mg twice weekly > etanercept 25 mg twice weekly > efalizumab > alefacept. Excluding adalimumab, rates of adverse events are significantly higher for biological therapies than for placebo, except for etanercept at both 25 and 50 mg twice weekly. Further, head to head trials of biological therapies for psoriasis and longer-term safety data on their use are required. Psoriasis can be induced by and/or exacerbated during antitumour necrosis factor (TNF) therapy. It is recommended to initially switch anti-TNF agent in this situation and only discontinue therapy if psoriasis is extensive and/or intolerable, allowing the primary disease to remain under control. Most screening and monitoring tests carried out during treatment of psoriasis with biological therapies are neither supported nor refuted by current evidence and the clinician must assess each case individually. Studies designed specifically to assess appropriate use of these tests are required. Further research is needed to evaluate the effectiveness of existing psychological interventions in psoriasis. The effectiveness of support groups has not been adequately proven, although there are limited data supporting the use of cognitive behavioural therapy.


Assuntos
Psoríase/terapia , Anticorpos Monoclonais/efeitos adversos , Anticorpos Monoclonais/uso terapêutico , Terapia Cognitivo-Comportamental , Humanos , Psoríase/induzido quimicamente , Ensaios Clínicos Controlados Aleatórios como Assunto , Grupos de Autoajuda , Resultado do Tratamento
12.
Thorax ; 63(10): 933-4, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-18820120

RESUMO

Pulmonary veno-occlusive disease (PVOD) is a disorder which causes progressive pulmonary hypertension, usually presenting with worsening dyspnoea and right heart failure. Pulmonary oedema induced by pulmonary vasodilator therapy to reduce pulmonary arterial pressure has been well described in PVOD, but here we describe a case of PVOD presenting with recurrent episodes of acute non-cardiogenic pulmonary oedema, in the absence of significant pulmonary hypertension. Concern over the risk of precipitating pulmonary oedema led us to use inhaled nitric oxide to predict the safety and efficacy of sildenafil.


Assuntos
Broncodilatadores/uso terapêutico , Óxido Nítrico/uso terapêutico , Piperazinas/uso terapêutico , Edema Pulmonar/etiologia , Pneumopatia Veno-Oclusiva/tratamento farmacológico , Sulfonas/uso terapêutico , Vasodilatadores/uso terapêutico , Adulto , Dispneia/etiologia , Humanos , Masculino , Pneumopatia Veno-Oclusiva/complicações , Purinas/uso terapêutico , Recidiva , Citrato de Sildenafila , Tomografia Computadorizada por Raios X
14.
Am J Surg ; 171(5): 460-3, 1996 May.
Artigo em Inglês | MEDLINE | ID: mdl-8651384

RESUMO

PURPOSE: Subcutaneous emphysema following laparoscopy could result in postoperative respiratory acidosis from prolonged CO2 absorption. We studied the magnitude and duration of alterations in PaCO2 coincident with direct CO2 insufflation into the subcutaneous fat of the anterior abdominal wall of 5 anesthetized juvenile pigs. METHODS: First, each pig was insufflated with 6 L of CO2 to produce moderate emphysema over the trunk. Following return to baseline PaCO2, each pig was re-insufflated with 12 L of CO2 to produce severe emphysema over lower limbs, neck, head, and trunk. Measurements of arterial blood gases were performed every 5 or 10 min. Minute ventilation was held constant to represent the worst case scenario. RESULTS: From baseline PaCO2 of 41.8 +/- 2.3 mm Hg, PaCO2 peaked at 68.3 +/- 8.6 (P < 0.02) and 92.9 +/- 10.7 (P < 0.01) mm Hg for the 6- and 12-L volumes, respectively, 20 to 25 minutes following insufflation. From baseline arterial pH of 7.40 +/- 0.02, respective nadirs of pH were 7.21 +/- 0.06 (P < 0.02) and 7.08 +/- 0.05 (P < 0.01). PaCO2 and arterial pH took approximately 100 minutes to return to baseline after insufflation with both 6 and 12 L volumes. CONCLUSIONS: When minute ventilation is fixed, subcutaneous CO2 insufflation causes increased PaCO2 and decreased pH that may persist for a prolonged period of time. Therefore, patients with subcutaneous emphysema after laparoscopy should be observed in postanesthetic recovery until PaCO2 and pH approach baseline.


Assuntos
Dióxido de Carbono/sangue , Enfisema Subcutâneo/sangue , Músculos Abdominais , Acidose Respiratória , Animais , Débito Cardíaco , Concentração de Íons de Hidrogênio , Hipercapnia , Laparoscopia , Suínos
15.
Am Surg ; 56(6): 364-8, 1990 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-2161631

RESUMO

Malignant fibrous histiocytoma (MFH) is a well-recognized soft-tissue sarcoma; however, its presentation as a primary neoplasm of the pancreas is unusual. We report a rare case of primary MFH of the pancreas treated with wide local excision and postoperative chemotherapy. Three cases of MFH of the pancreas have previously been reported in the world literature. The natural history of MFH of the pancreas cannot be summarized due to the rarity of the tumor. It appears, however, that the behavior of this tumor parallels the behavior of retroperitoneal MFH in terms of aggressiveness and poor prognosis.


Assuntos
Histiocitoma Fibroso Benigno , Neoplasias Pancreáticas , Terapia Combinada , Histiocitoma Fibroso Benigno/patologia , Histiocitoma Fibroso Benigno/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Pâncreas/patologia , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/terapia , Prognóstico
16.
Am Surg ; 53(9): 505-9, 1987 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-2820286

RESUMO

Apudomas are neoplasms known to produce many biologically active amines. Some of these tumors have been known for 70 years, but over the last 15 years a wealth of new knowledge has been obtained. This study reports experience with apudomas over an 8-year period (1975-1983) at The Piedmont Hospital. There were 159 tumors with the potential for producing various ectopic hormones as well as biologically active amines, including 112 oat cell carcinomas, 37 carcinoid tumors, 4 paragangliomas, 2 pancreatic islet cell tumors, 2 medullary thyroid carcinomas, 1 pituitary adenoma, and 1 pinealocytoma. Of the 112 oat cell carcinomas, only 2 per cent had hormone-related symptoms. Of the carcinoid tumors, 12 were found in the appendix, 9 in the small intestine, 9 in the lungs, 4 in the colon and 2 in the rectum. Nineteen of the 37 carcinoids had hormone-related symptoms but none had a classic carcinoid syndrome. A third group of apudomas included several of relative rarity, the paragangliomas, the medullary thyroid carcinomas, the pancreatic islet cell tumors, pituitary adenomas, and pinealocytomas. Of this latter group, only the pancreatic islet cell tumors had symptomatology that could be related to ectopic hormone production.


Assuntos
Apudoma/epidemiologia , Adenoma de Células das Ilhotas Pancreáticas/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Encefálicas/epidemiologia , Tumor Carcinoide/epidemiologia , Carcinoma/epidemiologia , Carcinoma de Células Pequenas/epidemiologia , Humanos , Neoplasias Pulmonares/epidemiologia , Pessoa de Meia-Idade , Neoplasias Pancreáticas/epidemiologia , Paraganglioma/epidemiologia , Pinealoma/epidemiologia , Neoplasias Hipofisárias/epidemiologia , Sistema de Registros , Estudos Retrospectivos , South Carolina , Neoplasias da Glândula Tireoide/epidemiologia
17.
Talanta ; 28(6): 365-8, 1981 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18962940

RESUMO

Lead is determined in aqueous solution in the concentration range 0.002-10 mug/ml by its catalytic effect on the oxidation of Pyrogallol Red at pH 8.5. The method has been applied to the determination of lead in mosses by means of a wet ashing procedure using nitric and perchloric acids and separation from interfering ions by extraction as the dithizone complex into chloroform, and back-extraction.

19.
J Med Assoc Ga ; 80(8): 435-8, 1991 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-1940696

RESUMO

Primary neoplasms of the heart are rare and difficult to diagnose prior to surgery, even with modern imaging techniques. Often, the tumors are diagnosed only at autopsy. Angiosarcoma is the most common malignant neoplasm. This disease is most commonly found in middle-aged men, and the tumor is most often located in the right atrium. It commonly causes blood flow abnormalities, extensively infiltrates cardiac structures, and may extend through the heart wall to involve adjacent structures. Metastatic spread at the time of diagnosis is common, and surgical mortality is high. We present a case of primary angiosarcoma involving the right ventricle of the heart. This tumor developed 6 months after the patient had undergone coronary artery bypass surgery. The patient was initially thought to have a massive thrombus within the right ventricle but at surgery was found to have a malignant neoplasm invading the myocardium. Subsequently, he was found to have pulmonary metastases. A debulking procedure was performed, and the patient was started on chemotherapy. Rather prompt improvement occurred after the debulking procedure, but subsequent studies have indicated progression of the pulmonary metastases despite ongoing chemotherapy.


Assuntos
Neoplasias Cardíacas , Hemangiossarcoma , Adulto , Neoplasias Cardíacas/diagnóstico , Neoplasias Cardíacas/terapia , Hemangiossarcoma/diagnóstico , Hemangiossarcoma/secundário , Hemangiossarcoma/terapia , Humanos , Masculino
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