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Search Results: 1 - 10 of 297485 matches for " J. Ruppen "
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Infection rates associated with epidural indwelling catheters for seven days or longer: systematic review and meta-analysis
Wilhelm Ruppen, Sheena Derry, Henry J McQuay, R Andrew Moore
BMC Palliative Care , 2007, DOI: 10.1186/1472-684x-6-3
Abstract: Systematic review and pooled analysis of observational studies.Twelve studies with 4,628 patients (median 197 patients) provided information, of which nine (4,334 patients) were published after 1990. Eight studies (3,893 patients) were retrospective, and four studies (735 patients) prospective. Electronic searches identified three studies and searching reference lists nine.There were 257 catheter-related infections in total, of which 211 were superficial and 57 deep, giving rates of 6.1%, 4.6% and 1.2% respectively. Ten of the 12 studies had deep infection rates of 2% or less. The incidence of deep infection was 1 per 2391 days of treatment, or 0.4 per 1000 catheter treatment days. In nine studies (1503 patients), predominantly in cancer, and with average catheter duration of 74 days, the deep infection rate was 2.8%. The proportion of patients with infection of any type was higher in cancer patients with longer catheter duration. Limited numbers of events meant that no reliable estimate of the impact of prospective and retrospective design could be made. There appeared to be a relationship between catheter duration and infection rate from this and other recent estimates. Four of 57 (7%) patients with deep infection died.The best estimate is that one person in 35 with an epidural catheter in place for 74 days for relief of cancer pain can be expected to have a deep epidural infection, and that about 1 in 500 may die of infection-related causes. This is a most uncertain estimate given the limited nature of the evidence.Managing very severe pain is important and not always easy. Not all patients receiving appropriate conventional analgesics for nociceptive pain experience adequate pain relief, and some suffer from intolerable adverse effects. Changing delivery route from oral to epidural for opioids is one strategy in this situation [1,2]. Epidural drug delivery may also be used to manage severe neuropathic or movement-related pain.A potential risk of epidural cathete
Incidence of epidural haematoma and neurological injury in cardiovascular patients with epidural analgesia/anaesthesia: systematic review and meta-analysis
Wilhelm Ruppen, Sheena Derry, Henry J McQuay, R Andrew Moore
BMC Anesthesiology , 2006, DOI: 10.1186/1471-2253-6-10
Abstract: We performed an extensive systematic review to find published cohorts of use of epidural catheters during vascular, cardiac, and thoracic surgery, using electronic searching, hand searching, and reference lists of retrieved articles.Twelve studies included 14,105 patients, of whom 5,026 (36%) had vascular surgery, 4,971 (35%) cardiac surgery, and 4,108 (29%) thoracic surgery. There were no cases of epidural haematoma, giving maximum risks following epidural anaesthesia in cardiac, thoracic, and vascular surgery of 1 in 1,700, 1 in 1,400 and 1 in 1,700 respectively. In all these surgery types combined the maximum expected rate would be 1 in 4,700. In all these patients combined there were eight cases of transient neurological injury, a rate of 1 in 1,700 (95% confidence interval 1 in 3,300 to 1 in 850). There were no cases of persistent neurological injury (maximum expected rate 1 in 4,600).These estimates for cardiothoracic epidural anaesthesia should be the worst case. Limitations are inadequate denominators for different types of surgery in anticoagulated cardiothoracic or vascular patients more at risk of bleeding.Epidural anaesthesia and analgesia are widely and successfully used to alleviate perioperative pain. The technique claims to offer many advantages, such as improved cardio-pulmonary function, less intraoperative anaesthetic, improved postoperative gut function, early tracheal extubation, and better mobilisation. There is concern, however, about its use in patients with perioperative anticoagulation, because of the risk of bleeding, which could cause serious adverse events like epidural haematoma and neurological injury.While potential benefits of epidural anaesthesia and analgesia may be immediate and well reported, information about rare adverse events is more difficult to come by. Because serious harm is uncommon, even large cohorts may report no events. When catheters are used for a short time, as in obstetrics, risks have been calculated [1]: epidur
Optical spectroscopy and the nature of the insulating state of rare-earth nickelates
J. Ruppen,J. Teyssier,O. E. Peil,S. Catalano,M. Gibert,J. Mravlje,J. -M. Triscone,A. Georges,D. van der Marel
Physics , 2015,
Abstract: Using a combination of spectroscopic ellipsometry and DC transport measurements, we determine the temperature dependence of the optical conductivity of NdNiO$_3$ and SmNiO$_{3}$ films. The optical spectra show the appearance of a characteristic two-peak structure in the near-infrared when the material passes from the metal to the insulator phase. Dynamical mean-field theory calculations confirm this two-peak structure, and allow to identify these spectral changes and the associated changes in the electronic structure. We demonstrate that the insulating phase in these compounds and the associated characteristic two-peak structure are due to the combined effect of bond-disproportionation and Mott physics associated with half of the disproportionated sites. We also provide insights into the structure of excited states above the gap.
New components of the mercury’s perihelion precession  [PDF]
J. J. Smulsky
Natural Science (NS) , 2011, DOI: 10.4236/ns.2011.34034
Abstract: The velocity of perihelion rotation of Mercury's orbit relatively motionless space is computed. It is prove that it coincides with that calculated by the Newtonian interaction of the planets and of the compound model of the Sun’s rotation.
Simple General Purpose Ion Beam Deceleration System Using a Single Electrode Lens  [PDF]
J. Lopes, J. Rocha
World Journal of Engineering and Technology (WJET) , 2015, DOI: 10.4236/wjet.2015.33014
Abstract: Ion beam deceleration properties of a newly developed low-energy ion beam implantation system were studied. The objective of this system was to produce general purpose low-energy (5 to 15 keV) implantations with high current beam of hundreds of μA level, providing the most wide implantation area possible and allowing continuously magnetic scanning of the beam over the sample(s). This paper describes the developed system installed in the high-current ion implanter at the Laboratory of Accelerators and Radiation Technologies of the Nuclear and Technological Cam-pus, Sacavém, Portugal (CTN).
Constraints on velocity anisotropy of spherical systems with separable augmented densities
J. An
Physics , 2011, DOI: 10.1088/0004-637X/736/2/151
Abstract: If the augmented density of a spherical anisotropic system is assumed to be multiplicatively separable to functions of the potential and the radius, the radial function, which can be completely specified by the behavior of the anisotropy parameter alone, also fixes the anisotropic ratios of every higher-order velocity moment. It is inferred from this that the non-negativity of the distribution function necessarily limits the allowed behaviors of the radial function. This restriction is translated into the constraints on the behavior of the anisotropy parameter. We find that not all radial variations of the anisotropy parameter satisfy these constraints and thus that there exist anisotropy profiles that cannot be consistent with any separable augmented density.
On the augmented density of a spherical anisotropic dynamic system
J. An
Physics , 2010, DOI: 10.1111/j.1365-2966.2011.18324.x
Abstract: This paper presents a set of new conditions on the augmented density of a spherical anisotropic system that is necessary for the underlying two-integral phase-space distribution function to be non-negative. In particular, it is shown that the partial derivatives of the Abel transformations of the augmented density must be non-negative. Applied for the separable augmented densities, this recovers the result of van Hese et al. (2011).
Fractional calculus, completely monotonic functions, a generalized Mittag-Leffler function and phase-space consistency of separable augmented densities
J. An
Physics , 2012,
Abstract: Under the separability assumption on the augmented density, a distribution function can be always constructed for a spherical population with the specified density and anisotropy profile. Then, a question arises, under what conditions the distribution constructed as such is non-negative everywhere in the entire accessible subvolume of the phase-space. We rediscover necessary conditions on the augmented density expressed with fractional calculus. The condition on the radius part R(r^2) -- whose logarithmic derivative is the anisotropy parameter -- is equivalent to R(1/w)/w being a completely monotonic function whereas the condition on the potential part is stated as its derivative up to the order not greater than 3/2-b being non-negative (where b is the central limiting value for the anisotropy parameter). We also derive the set of sufficient conditions on the separable augmented density for the non-negativity of the distribution, which generalizes the condition derived for the generalized Cuddeford system by Ciotti & Morganti to arbitrary separable systems. This is applied for the case when the anisotropy is parameterized by a monotonic function of the radius of Baes & Van Hese. The resulting criteria are found based on the complete monotonicity of generalized Mittag-Leffler functions.
When is an axisymmetric potential separable?
J. An
Physics , 2013, DOI: 10.1093/mnras/stt1498
Abstract: An axially symmetric potential psi(R,z)=psi(r,theta) is completely separable if the ratio s:k is constant. Here r*s=d^2(r^2*psi)/dr/d(theta) and k=d^2(psi)/dR/dz. If beta=s/k, then the potential admits an integral of the form of I=(L^2+beta*v_z^2)/2+xi where xi is some function of positions determined by the potential psi. More generally, an axially symmetric potential respects the third axisymmetric integral of motion -- in addition to the classical integrals of the Hamiltonian and the axial component of the angular momentum -- if there exist three real constants a,b,c (not all simultaneously zero, a^2+b^2+c^2>0) such that a*s+b*h+c*k=0 where r*h=d^2(r*psi)/d(sigma)/d(tau) and (sigma,tau) is the parabolic coordinate in the meridional plane such that sigma^2=r+z and tau^2=r-z.
Flaws, Fallacies and Facts: Reviewing the Early History of the Lipid and Diet/Heart Hypotheses  [PDF]
J. Elliott
Food and Nutrition Sciences (FNS) , 2014, DOI: 10.4236/fns.2014.519201
Abstract: The lipid hypothesis of coronary heart disease proposes that a high total cholesterol level has a causative role in coronary heart disease (CHD), specifically in the development of atherosclerosis. It forms the basis for formulating target levels of serum cholesterol and hence the widespread use of statins for lowering cholesterol. An extension of the lipid hypothesis is the diet/heart hypothesis of coronary heart disease. This theory combines two ideas—that saturated fat raises cholesterol levels, and that a reduced saturated fat intake will lower cholesterol levels, thereby inhibiting the development of atherosclerosis and manifestations of CHD. Those who make diet recommendations or prescribe medication to reduce cholesterol may be unaware of the underpinning science. The original research behind these recommendations has given us “healthy heart” guidelines and preventive measures we assume to be true. While the lipid and diet/heart hypotheses are often presented as fact, they remain inadequately proven theories that have little agreement from experts. Historical perspectives can help us understand the basis of current-day beliefs. In the lipid hypothesis case, research from the 1950s and 60s was instrumental in its formation. This early work should not be considered irrelevant, outdated or obsolete because current recommendations from national heart associations in many countries continue to be shaped by these studies. This paper examines evidence used to formulate the lipid hypothesis and, subsequently, the diet/ heart hypothesis. By critically evaluating steps in the formation of the theory, inconsistencies, mistakes and alternate explanations become apparent and cast doubt on its validity.
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