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Impact of COVID-19 on presentation,management,and outcomes of acute care surgery for gallbladder disease and acute appendicitis

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World Journal of Gastrointestinal Surgery 2021年第8期13卷 859-870页

作者： Orly Nadell Farber Giselle I Gomez Ashley L Titan Andrea T Fisher Christopher J Puntasecca veronica toro arana Arielle Kempinsky Clare E Wise Kovi E Bessoff Mary T Hawn James R Korndorffer Jr Joseph D Forrester Micaela M Esquivel Department of Surgery Stanford University School of MedicinePalo AltoCA 94305United States

BACKGROUND The ongoing coronavirus disease 2019(COVID-19)pandemic has significantly disrupted both elective and acute medical *** from the early months suggest that acute care patient populations deferred presenting to the emergency department(ED),portending more severe disease at the time of ***,care for this patient population trended towards initial non-operative *** To examine the presentation,management,and outcomes of patients who developed gallbladder disease or appendicitis during the *** A retrospective chart review of patients diagnosed with acute cholecystitis,symptomatic cholelithiasis,or appendicitis in two EDs affiliated with a single tertiary academic medical center in Northern California between March and June,2020 and in the same months of *** were selected through a research repository using international classification of diseases(ICD)-9 and ICD-10 *** both years,313 patients were identified with either type of gallbladder disease,while 361 patients were identified with acute *** primary outcome was overall incidence of *** outcomes included presentation,management,complications,and 30-d re-presentation *** between different variables were explored using Pearson’s r correlation *** were compared using the Welch’s t-Test,Chi-squared tests,and Fisher’s exact test as *** Patients with gallbladder disease and appendicitis both had more severe presentations in *** respect to gallbladder disease,more patients in the COVID-19 cohort presented with acute cholecystitis compared to the control cohort[50%(80)vs 35%(53);P=0.01].Patients also presented with more severe cholecystitis in 2020 as indicated by higher mean Tokyo Criteria Scores[mean(SD)1.39(0.56)vs 1.16(0.44);P=0.02].With respect to appendicitis,more patients were diagnosed with a perforated appendix at presentation in 2020[20%(36)vs 16%(29);P=0.0

关键词： COVID-19 Cholecystitis Biliary colic Appendicitis Acute care surgery

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Generation of high energy laser-driven electron and proton sources with the 200 TW system VEGA 2 at the Centro de Laseres Pulsados

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High Power Laser Science and Engineering 2019年第2期7卷 34-39页

作者： L.Volpe R.Fedosejevs G.Gatti J.A.Pérez-Hernández C.Méndez J.Apinaniz X.Vaisseau C.Salgado M.Huault S.Malko G.Zeraouli V.Ospina A.Longman D.De Luis K.Li O.Varela E.García I.Hernandez J.D.Pisonero J.Garcia Ajates J.M.Alvarez C.García M.Rico D.arana J.Hernandez-toro L.Roso Centro de Laseres Pulsados(CLPU) Edicio M5.Parque Cientco.C/Adaja&37185VillamayorSalamancaSpain Laser-Plasma Chair at the University of Salamanca SalamancaSpain Department of Electrical and Computer Engineering University of AlbertaEdmontonAlberta T6G2V4Canada University of Salamanca SalamancaSpain

The Centro de Laseres Pulsados in Salamanca,Spain has recently started operation phase and the first user access period on the 6 J 30 fs 200 TW system(VEGA 2)already started at the beginning of *** this paper we report on two commissioning experiments recently performed on the VEGA 2 system in preparation for the user *** 2 system has been tested in different configurations depending on the focusing optics and targets *** configuration(long focal length F=130 cm)is for underdense laser-matter interaction where VEGA 2 is focused onto a low density gas-jet generating electron beams(via laser wake field acceleration mechanism)with maximum energy up to 500 MeV and an X-ray betatron source with a 10 keV critical energy.A second configuration(short focal length F= 40 cm)is for overdense laser-matter interaction where VEGA 2 is focused onto a 5 μm thick Al target generating a proton beam with a maximum energy of 10 MeV and temperature of 2.5 *** this paper we present preliminary experimental results.

关键词： high power laser laser-plasma particle acceleration

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